CER Decontamination and Manual Cleaning 2 — Questions and Answers
Question 1: What is the primary purpose of pre-cleaning an endoscope immediately after a procedure?
- To achieve high-level disinfection
- To remove gross soil before transport to the reprocessing area (Correct answer)
- To sterilize external surfaces
- To neutralize enzymatic detergent residue
Correct answer: To remove gross soil before transport to the reprocessing area
Pre-cleaning removes gross soil and bioburden at the point of use, preventing soil from drying and making subsequent cleaning more effective.
Question 2: Which type of brush is recommended for cleaning the instrument channel of a flexible endoscope?
- A brush that is 10% larger than the channel diameter
- A brush sized exactly to the channel diameter per manufacturer instructions (Correct answer)
- Any stiff-bristle brush available in the department
- A brush that is 50% smaller than the channel diameter for flexibility
Correct answer: A brush sized exactly to the channel diameter per manufacturer instructions
Brushes must match the channel diameter as specified by the endoscope manufacturer to ensure effective contact with channel walls without causing damage.
Question 3: How many times should a channel brush be passed through an endoscope channel during manual cleaning?
- Once in each direction
- Until the brush emerges visibly clean (Correct answer)
- Exactly three times regardless of soil level
- Ten times minimum per SGNA guidelines
Correct answer: Until the brush emerges visibly clean
Brushing should continue until the brush emerges free of visible soil, ensuring thorough removal of debris from the channel.
Question 4: What should be done with single-use cleaning brushes after reprocessing an endoscope?
- Sterilize and reuse up to 10 times
- Discard after each use (Correct answer)
- Soak in enzymatic solution for 30 minutes then reuse
- Autoclave between uses
Correct answer: Discard after each use
Single-use cleaning brushes must be discarded after each use to prevent cross-contamination between patients.
Question 5: During manual cleaning, why should the endoscope be submerged in cleaning solution?
- To reduce splashing and minimize aerosolization of contaminants (Correct answer)
- To speed up enzymatic activity
- To allow the detergent to penetrate the outer casing
- To prevent damage to the insertion tube coating
Correct answer: To reduce splashing and minimize aerosolization of contaminants
Submerging the scope during cleaning reduces the risk of splashing and aerosolization of potentially infectious material, protecting the reprocessing technician.
Question 6: What is the correct dilution practice for enzymatic cleaners used in endoscope reprocessing?
- Double the recommended concentration for heavily soiled scopes
- Follow the manufacturer's recommended dilution exactly (Correct answer)
- Use the minimum concentration to extend product life
- Dilute at half the recommended rate to reduce residue
Correct answer: Follow the manufacturer's recommended dilution exactly
Enzymatic cleaners must be diluted exactly per manufacturer instructions to ensure efficacy without leaving harmful residues.
Question 7: Which water temperature is generally recommended for mixing enzymatic cleaning solutions for endoscopes?
- Cold water below 15°C to prevent protein coagulation
- Lukewarm water per manufacturer specifications, typically 20–35°C (Correct answer)
- Boiling water to activate enzymes faster
- Distilled water at exactly 40°C regardless of manufacturer guidance
Correct answer: Lukewarm water per manufacturer specifications, typically 20–35°C
Lukewarm water within the manufacturer's specified temperature range optimizes enzymatic activity without denaturing the enzymes.
CER Decontamination and Manual Cleaning 2
What is the primary purpose of pre-cleaning an endoscope immediately after a procedure?