HSPA Endoscope Reprocessing Flashcards

What is the maximum recommended reprocessing turnaround time from point of use to completion of high-level disinfection?

Answer: The time specified by the endoscope manufacturer's IFU

There is no single universal time limit; reprocessing must be completed within the timeframe specified in the endoscope manufacturer's instructions for use (IFU). However, pre-cleaning should begin immediately to prevent soil from drying. Delays increase the difficulty of cleaning and the risk of fixed bioburden.

What PPE is required when handling glutaraldehyde during endoscope reprocessing?

Answer: Gloves, fluid-resistant gown, face shield or goggles, and respiratory protection if not using a ventilated area

Glutaraldehyde is a known sensitizer and irritant requiring comprehensive PPE including chemical-resistant gloves, fluid-resistant gown, eye protection (face shield or goggles), and respiratory protection when adequate ventilation is not available. OSHA has established exposure limits for glutaraldehyde vapor.

What is the purpose of enzymatic detergent in endoscope reprocessing?

Answer: To break down organic material such as blood, tissue, and body fluids

Enzymatic detergents contain protease, lipase, and amylase enzymes that break down proteins, fats, and carbohydrates found in blood, tissue, and body fluids. This biochemical action is essential for removing organic soil that would otherwise protect microorganisms from subsequent disinfection.

How often should the disinfectant solution in an AER be tested for minimum effective concentration (MEC)?

Answer: At the beginning of each day of use and according to manufacturer recommendations

The minimum effective concentration must be verified at least at the beginning of each day the AER is used, and more frequently if recommended by the chemical manufacturer. Repeated use dilutes the disinfectant, and organic soil reduces its efficacy. Using sub-MEC solutions renders disinfection inadequate.

What microorganism has been most frequently linked to outbreaks associated with improperly reprocessed duodenoscopes?

Answer: Carbapenem-resistant Enterobacteriaceae (CRE)

Multiple outbreaks of carbapenem-resistant Enterobacteriaceae (CRE), including Klebsiella pneumoniae and E. coli strains, have been linked to improperly reprocessed duodenoscopes. CRE infections carry high mortality rates and limited treatment options, which prompted FDA action on duodenoscope reprocessing standards.

What is the correct sequence of steps in endoscope reprocessing?

Answer: Pre-clean, leak test, manual clean, rinse, HLD, rinse, dry

The correct sequence is: bedside pre-cleaning, leak testing, manual cleaning, rinsing, high-level disinfection, rinsing with quality water, and drying. Each step must occur in this order because later steps depend on the effectiveness of earlier ones. Skipping or reordering steps compromises the entire process.