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.