The Principles of Medical Device Decontamination

Flow chart for decontamination of endoscopes

Drying and storage

Pre-clean

Manual cleaning

Automated Reprocessing EWDs must only be operated by

Leak testing

Outer surface Visually inspect Attach A/W adapter and flush all channels with low foaming neutral detergent until running clear Flush suction channel Expel excess water from channels Remove from processor Attach water resistant cap Discard biopsy port cap if breached Place in rigid container clearly marked as contaminated Transport to decontamination

Remove all detachable parts Immerse endoscope fully in water Complete leak test with complete manipulation of all angulation Deflate endoscope before

Temperature of water and volume of detergent as per manufacturer’s instructions Immerse endoscope fully in water/detergent Brush all accessible channels at least 3 times. Attach and use Irrigation devices/ injection tube sets as per manufacturers’ instructions Ensure all accessible channels come into contact with detergent Aspirate detergent from a separate container into sink Clean detachable parts, wash and brush their external surfaces Detach irrigation device Transfer to separate sink to rinse Use CE marked accessory holders

After decontamination the endoscope must be used within 3 hours unless placed in a validated endoscope drying cabinet or vacuum packed Drying cabinets should be located in a designated clean area Distal tips of endoscopes should not touch or trail on the floor of cabinets Print out parameters must be maintained for QA and tracking and traceability purposes.

appropriately trained staff Ensure all

channels are connected at the start and end of the cycle Reprocess all detachable components simultaneously with the corresponding endoscope Ensure periodic testing is carried out

commencing manual clean

as per EN standards and National guidance Ensure that machine

disinfection is carried out at the start of the day Print out parameters must be maintained

area Keep moist until

reprocessed. Best practice is within 3 hours from end of patient procedure

Manufacturers’ instructions must be followed at all times. Staff should wear full PPE in accordance with local policy

Table 7.1 Five step endoscope decontamination process