HSPA Endoscope Reprocessing 1 — Questions and Answers
Question 1: What is the first step that should be performed at the point of use after an endoscope procedure?
- Soak the endoscope in enzymatic detergent
- Wipe the insertion tube and flush all channels with manufacturer-recommended solution (Correct answer)
- Place the endoscope directly into an automated endoscope reprocessor
- Sterilize the endoscope using ethylene oxide
Correct answer: Wipe the insertion tube and flush all channels with manufacturer-recommended solution
Bedside pre-cleaning (wiping and flushing) prevents biofilm formation by removing gross soil before it dries. Manufacturer instructions typically require immediate wiping and channel flushing at the point of use. Delays allow organic material to harden, making subsequent cleaning far more difficult.
Question 2: Which type of endoscope poses the greatest reprocessing challenge due to its complex internal channel design?
- Colonoscope
- Duodenoscope (Correct answer)
- Gastroscope
- Bronchoscope
Correct answer: Duodenoscope
Duodenoscopes (ERCP scopes) have an elevator mechanism with a narrow channel that is extremely difficult to access and clean. FDA has issued multiple safety communications regarding duodenoscope reprocessing due to outbreaks linked to inadequate cleaning of the elevator channel.
Question 3: What is the minimum recommended contact time for high-level disinfection of a flexible endoscope using 2% glutaraldehyde at 25 degrees Celsius?
- 5 minutes
- 10 minutes
- 20 minutes (Correct answer)
- 45 minutes
Correct answer: 20 minutes
The standard minimum contact time for 2% glutaraldehyde at 25 degrees Celsius is 20 minutes for high-level disinfection. This time is necessary to kill all vegetative bacteria, mycobacteria, fungi, and viruses. The contact time may vary with different formulations and temperatures.
Question 4: What is the purpose of a leak test performed on a flexible endoscope?
- To verify the disinfectant concentration is adequate
- To confirm the scope channels are not blocked
- To detect damage to the outer sheath or internal channels that could allow fluid ingress (Correct answer)
- To measure the air flow rate through the suction channel
Correct answer: To detect damage to the outer sheath or internal channels that could allow fluid ingress
Leak testing detects perforations or damage in the endoscope's protective sheath and internal components. Fluid ingress through even a tiny breach can damage expensive internal optics and electronics. A failed leak test means the scope must be removed from service and sent for repair.
Question 5: Which organization publishes the multisociety guideline for endoscope reprocessing?
- CDC only
- SGNA, ASGE, and other GI societies jointly (Correct answer)
- OSHA exclusively
- The Joint Commission alone
Correct answer: SGNA, ASGE, and other GI societies jointly
The multisociety guideline for reprocessing flexible gastrointestinal endoscopes is published jointly by organizations including SGNA (Society of Gastroenterology Nurses and Associates), ASGE (American Society for Gastrointestinal Endoscopy), and other GI specialty societies. These guidelines represent the consensus standard of care.
Question 6: What should be used to manually clean the channels of a flexible endoscope?
- A lint-free cloth only
- Channel-specific brushes sized to manufacturer specifications (Correct answer)
- Standard pipe cleaners from a hardware store
- Compressed air without any brushing
Correct answer: Channel-specific brushes sized to manufacturer specifications
Manufacturer-specified channel brushes must be used because they are designed to match the diameter and length of each specific channel. Using incorrect brush sizes can fail to remove bioburden or damage the delicate channel lining. Each channel type may require a different brush size.
HSPA Endoscope Reprocessing 1
What is the first step that should be performed at the point of use after an endoscope procedure?