Certification of reprocessing standardization: preventing endoscopy associated infections

Abstract

Background: Between 2012-2015, 25 outbreaks were linked to contaminated duodenoscopes worldwide due to human error or negligence during reprocessing. A standardized education and training reprocessing program is necessary to address nationally increasing Endoscopy Associated Infections (EAIs). Problem: A Montana endoscopy unit committed to adopting national standards. An unmet objective was the certification of endoscopy reprocessing (CER) requirement. This pilot project sted in developing a mandatory CER protocol to optimize infection control. Methods: A Plan-Do-Study-Act (PDSA) quality improvement method was employed, with pre- and post-intervention design to evaluate infection incidence and risk. This involved patient chart review and duodenoscope reprocessing log review. An aggregate comparison was made between a CER participant and eight non-CER technicians. To inform future program development, a survey was conducted to collect data on CER participant motivation, preparation, and perception of recommended educational materials. Intervention: A pilot study involving a single participant attempting to obtain nationally recognized CER was conducted. The facility manager shared the facility's intention of mandatory certification and via endoscope technician meeting, including incentives. Created certification-benefit video presentation and exam preparation materials were provided one month before the exam. Results: Zero infections occurred during pre- and post-intervention. Pre-intervention, the average infection risk scores per endoscope reprocessing were 12.2 relative light units (RLUs) for the unit and 11.1 RLUs for the CER participant. Post-intervention phase, these numbers were 15.7 RLUs by non-CER technicians and 2.8 RLUs by the CER participant. Conclusion: This study highlights the effectiveness of mandatory CER in reducing the risk of patient infections. Maintaining infection prevention and control in endoscopy procedures requires ongoing education, training, and motivation. Informing employees of the benefits of standardization may improve motivation.