Updated Guidance: Decontamination of Equipment for GI Endoscopy
Updated by: Dr Helen Griffiths (Nurse Consultant) - BSG Endoscopy Committee – November 2013
Flexible endoscopes are complex reusable instruments that require unique consideration with respect to decontamination. In addition to the external surface of endoscopes, their internal channels for air, water, aspiration and accessories are exposed to body fluids and other contaminants. In contrast to rigid endoscopes and most reusable accessories, flexible endoscopes are heat labile and cannot be autoclaved.
The Health Act was published in 2006 and updated in 2010. This stipulates the roles of decontamination leads and decontamination programmes. It emphasises the need for staff to be trained in decontamination processes and to hold appropriate competencies for their role. It decrees the need for monitoring systems to ensure that decontamination processes are fit for purpose and meet required standards. Finally it requires that there are systems in place for tracking reusable medical devices (such as endoscopes and reusable accessories) through decontamination processes, not only to assist with assuring their quality, but also to enable the identification of patients on whom the medical devices have been used.
The 6th Working Party met in 2006 to consider new developments and recommendations, including (a) the optimal modes for decontaminating water bottles and endoscope valves (pistons); (b) the latest recommendations for reducing the risks of endoscopic transmission of vCJD, including the tracking of equipment; and (c) updated recommendations on drying and storage of endoscopes, given the evolving range of purpose-built chambers designed for this purpose. The resulting guidelines below (February 2008) are in the process of being updated to take into account recent changes in decontamination practice and national and European policy changes and should be available on the website by the end of 2013.
Decontamination Alert - August 2013
Thursday, 22 August 2013 08:19
Choice Framework for local Policy and Procedures 01-06: Decontamination of flexible endoscopes details that manufacturer's instructions must be followed at all times when using an Endoscope Washer Disinfector (EWD), and selecting chemicals for use.
All units are asked to check that the chemicals (detergents and disinfectants) used in their EWDs are those tested by the machine manufacturer at the type-test stage with supporting evidence of efficacy. Under no circumstances should a chemical (i.e. disinfectant) be used that was not included in the type test data for that machine, this supports the need to follow manufacturer's instructions, as non-type tested chemicals may damage the internal mechanics of the EWD, therefore a possible risk to patients may occur.
If you are unsure which chemicals are recommended in your EWD please speak to your manufacturer requesting information specifically on 'type tested' chemicals.
Dr Helen Griffiths
Nurse Consultant Gastroenterology
Decontamination representative BSG Endoscopy Committee
On behalf of the Professional Expert Communications Forum: Decontamination of Medical Devices.
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Meeting the Demand for Endoscopy Services
Monday, 30 April 2012 11:12
Steve Hughes, BSG Vice-President Endoscopy & Roland Valori National Clinical Director for Endoscopy
There will be a 75% increase (on 2010/11 activity) in lower GI endoscopy demand in England in the next four years, on top of the 50% increase in activity achieved in the last four years. This extra demand arises from screening and symptomatic work. Most services have just been coping with increasing demand in recent years, but waiting lists initiatives remain common place and a few sites have perpetually long waits. Long waits is the most common reason sites struggle to maintain JAG accreditation. There is an urgent need to do things differently to respond to the increase in demand and to make 'just coping' a thing of the past. Learning from sites that maintain low waits indicates there are two key factors that determine how well a service keeps in control of its demand: effective planning and high productivity.
In anticipation of the increasing demand for endoscopy, and appreciation of the pressures endoscopy teams are under, the JAG, in collaboration with the Bowel Cancer Screening Programme, is delivering a series of ten workshops throughout England to help endoscopy teams plan better and be more productive. The principal objective of the workshops is to enable teams to present more effective business plans to their trust boards. They are aimed at the medical and nurse lead, and their manager, and a representative of their PCT. They will be delivered in the next six months and be led by Roland Valori, NCD for endoscopy. You are strongly encouraged to attend. For more details please visit the JAG website: www.thejag.org.uk
Administration of Drugs by Nurse Endoscopists
Monday, 29 November 2010 13:07
In response to the recent issues relating to the administration of drugs by nurse endoscopists, the National Prescribing Centre have issued a table of legal mechanisms for drug administration. This can be accessed at:
Shared examples of good practice can also be submitted on:
There is a breakfast meeting for nurse endoscopists at the BSG annual conference on Thursday March 17th where these issues will be discussed with Jane Brown Director of Policy and Implementation at the National Prescribing Centre.
Pauline Hutson, Chair BSG Nurses and Associates Section
Message to all Nurse Endoscopists
Monday, 19 July 2010 09:24
Message to all Nurse Endoscopists
The range of procedures being undertaken by nurse endoscopists is extending to include more therapeutic interventions particularly at bowel screening colonoscopy. It is timely therefore to review the issues relating to the administration of opiates by nurse endoscopists. A BSGE working party chaired by Dr Miles Allison Consultant Gastroenterologist convened in June to address these issues. The intention was also to review current practice involving other drugs including polyp lifting solutions used for endoscopic mucosal resection (EMR). In addition to representative nurse endoscopists from across the UK the meeting was also attended by Jane Brown, Director of Policy and Implementation from the National Prescribing Centre, David Cressey Consultant Anaesthetist representing the Royal College of Anaesthetists, Rick Forbes-Young representing the Royal College of Nursing and Pauline Hutson Representing the Endoscopy Associates Group.
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