CER - Certified Endoscope Reprocessor Handling, Transport, and Storage Questions and Answers — Questions and Answers
Question 1: Immediately following a procedure, what is the required first step in handling a contaminated flexible endoscope before it is transported to the decontamination area?
- Place it in a puncture-resistant, sealed container.
- Detach all removable valves and place them in a separate bag.
- Perform point-of-use treatment by wiping the exterior and flushing channels with detergent. (Correct answer)
- Rinse the entire endoscope under running tap water.
Correct answer: Perform point-of-use treatment by wiping the exterior and flushing channels with detergent.
Point-of-use treatment (pre-cleaning) is the critical first step that must be performed immediately after the endoscope is removed from the patient. This process, which involves wiping the insertion tube and flushing channels with a detergent solution, helps prevent the drying of bioburden and the formation of biofilm, making subsequent manual cleaning more effective.
Question 2: According to SGNA and AAMI guidelines, which set of characteristics is required for a container used to transport a contaminated endoscope to the reprocessing area?
- Soft-sided, absorbent, and clearly labeled with the procedure time.
- Transparent, filled with saline, and ventilated.
- Puncture-resistant, leak-proof with a lid, and labeled as a biohazard. (Correct answer)
- Small enough to ensure the endoscope is coiled tightly to prevent movement.
Correct answer: Puncture-resistant, leak-proof with a lid, and labeled as a biohazard.
To ensure staff and environmental safety, standards require that contaminated endoscopes be transported in a container that is closed, puncture-resistant, leak-proof, and clearly labeled with a biohazard symbol to warn handlers of the contaminated contents. The container should also be large enough to prevent damage from tight coiling.
Question 3: A technician is storing a properly reprocessed and dried endoscope. Which of the following describes the ideal storage method according to AAMI ST91?
- Coiled horizontally in a closed, sterile peel-pack.
- Hung vertically in a dedicated cabinet that provides positive pressure with HEPA-filtered air. (Correct answer)
- Placed in its original carrying case on a shelf in a clean utility room.
- Submerged in 70% isopropyl alcohol in a covered basin.
Correct answer: Hung vertically in a dedicated cabinet that provides positive pressure with HEPA-filtered air.
AAMI ST91 recommends storing flexible endoscopes by hanging them vertically to facilitate continued drainage and drying. The storage cabinet should be designed to protect the scopes from contamination by providing continuous positive pressure with filtered air (HEPA or instrument grade), and it should be kept closed.
Question 4: A facility's policy, based on a risk assessment, states that a high-level disinfected endoscope cannot be used if it has been in storage for more than 14 days without being reprocessed. What is the primary infection control reason for this "hang time" policy?
- To allow time for any residual chemical disinfectant to evaporate completely.
- To mitigate the risk of microbial growth in any potential residual moisture. (Correct answer)
- To ensure the endoscope's internal electronic components are reset.
- To comply with the endoscope manufacturer's specified expiration date.
Correct answer: To mitigate the risk of microbial growth in any potential residual moisture.
The concept of a maximum storage time, or "hang time," is based on the risk that any microscopic residual moisture remaining after drying could support the proliferation of microorganisms over time. Although a consensus on a specific time limit is not universal, facilities establish policies based on risk assessments to prevent the use of a potentially contaminated endoscope.
Question 5: When removing a reprocessed endoscope from a clean storage cabinet to transport it to the procedure room, what is a critical step for the handler to perform to prevent contamination?
- Use sterile gloves and place the scope in a sterile transport tray.
- Wipe the endoscope down with a 70% alcohol solution.
- Perform hand hygiene and don a fresh pair of clean gloves. (Correct answer)
- Flush the channels with sterile water as a final rinse.
Correct answer: Perform hand hygiene and don a fresh pair of clean gloves.
Before handling a high-level disinfected endoscope, the handler must perform hand hygiene and put on fresh clean gloves. This prevents the transfer of microorganisms from the handler's hands or the environment to the clean endoscope, maintaining its disinfected state until it reaches the patient.
Question 6: A reprocessor is placing a clean and dried colonoscope into a storage cabinet. They hang the scope vertically but allow the distal tip to rest on the bottom surface of the cabinet. This practice is incorrect primarily because it:
- Prevents proper air circulation around the distal tip.
- Can cause damage to the delicate lens and other components at the distal end. (Correct answer)
- Violates the principle of keeping the scope's control body at the highest point.
- Makes it difficult to close the cabinet door securely.
Correct answer: Can cause damage to the delicate lens and other components at the distal end.
Endoscopes should hang freely without touching the bottom or sides of the cabinet. Allowing the distal tip to rest on a surface can cause physical stress and damage to sensitive components like the objective lens, light guide lenses, and nozzle.
CER - Certified Endoscope Reprocessor Handling, Transport, and Storage Questions and Answers
Immediately following a procedure, what is the required first step in handling a contaminated flexible endoscope before it is transported to the decontamination area?