CER Decontamination and Manual Cleaning Questions and Answers 2 — Questions and Answers
Question 1: What is the minimum contact time recommended when using an enzymatic detergent during manual cleaning of a flexible endoscope?
- 30 seconds
- 1 minute
- The manufacturer-specified contact time (Correct answer)
- 5 minutes
Correct answer: The manufacturer-specified contact time
Always follow the manufacturer-specified contact time for enzymatic detergents, as contact times vary by product and soil load.
Enzymatic detergents require adequate contact time to break down organic matter such as blood, tissue, and biofilm. The IFU from both the detergent manufacturer and endoscope manufacturer must be followed. Arbitrary times (30 s, 1 min, 5 min) may be inadequate or unnecessary; only the validated, manufacturer-specified time ensures effective soil removal without damaging the scope.
Question 2: Which action must be taken immediately after a flexible endoscope is removed from a patient?
- Place directly in the AER
- Wipe the insertion tube and flush channels with detergent water at point of use (Correct answer)
- Soak in glutaraldehyde for 20 minutes
- Cap all channels and send to sterile processing
Correct answer: Wipe the insertion tube and flush channels with detergent water at point of use
Point-of-use pre-cleaning prevents soil from drying in channels, making subsequent cleaning more effective.
SGNA and IAHCSMM guidelines require immediate point-of-use treatment: wiping the exterior and flushing channels with detergent water before transport. Dried soil and biofilm are extremely difficult to remove and can harbor pathogens. Skipping this step compromises all downstream reprocessing steps.
Question 3: During manual cleaning, which channel of the endoscope requires the use of a channel-specific brush?
- Air/water channel only
- Biopsy/suction channel only
- All accessible channels (Correct answer)
- Only channels visibly contaminated
Correct answer: All accessible channels
All accessible channels must be brushed with appropriately sized brushes to remove soil from lumens.
SGNA guidelines state that all channels accessible to a brush must be brushed using the correct diameter and length brush specified by the endoscope manufacturer. This includes biopsy/suction, air/water, and auxiliary water channels. Brushing must continue until no visible debris appears on the brush.
Question 4: What water quality is required for the final rinse after manual cleaning of an endoscope?
- Tap water is acceptable
- Sterile water or filtered water per manufacturer IFU (Correct answer)
- Distilled water only
- Reverse osmosis water is never acceptable
Correct answer: Sterile water or filtered water per manufacturer IFU
The final rinse water quality must meet the standard specified in the endoscope manufacturer's IFU, typically sterile or filtered water.
Using poor-quality rinse water can introduce waterborne pathogens such as Pseudomonas aeruginosa or Mycobacterium species. Most manufacturers require sterile or filtered (0.2-micron) water for the final manual rinse. Using tap water may recontaminate a clean endoscope and lead to patient infections.
Question 5: How should reusable cleaning brushes be managed after each use during endoscope reprocessing?
- Rinse with tap water and reuse immediately
- Discard after each patient use or reprocess according to manufacturer IFU (Correct answer)
- Store dry and reuse until visibly soiled
- Soak in alcohol between uses
Correct answer: Discard after each patient use or reprocess according to manufacturer IFU
Reusable brushes must be thoroughly cleaned, disinfected, and inspected or discarded after each use to prevent cross-contamination.
Cleaning brushes are themselves a source of cross-contamination if not properly managed. Single-use brushes must be discarded after each patient. Reusable brushes must be cleaned, inspected for damaged bristles or fraying, and reprocessed according to their own manufacturer IFU before reuse. Damaged brushes must be discarded immediately.
Question 6: What is the primary purpose of the leak test during endoscope reprocessing?
- To verify chemical disinfectant concentration
- To detect any breach in the endoscope's protective sheath before immersion (Correct answer)
- To confirm channel patency after cleaning
- To measure water temperature in the basin
Correct answer: To detect any breach in the endoscope's protective sheath before immersion
The leak test identifies damage to the endoscope's external sheath before liquid immersion, preventing fluid ingress and scope damage.
The leak test is performed before immersing the endoscope in liquid. A leak testing device pressurizes the endoscope's interior; any escape of air indicates a breach. Immersing a leaking scope allows fluids to enter internal components, causing irreparable damage and potential patient harm from inadequately reprocessed internal surfaces.
CER Decontamination and Manual Cleaning Questions and Answers 2
What is the minimum contact time recommended when using an enzymatic detergent during manual cleaning of a flexible endoscope?