The Principles of Medical Device Decontamination

3. Manual cleaning This must take place in a dedicated decontamination area with clear segregation of clean and dirty equipment. Manual cleaning of the endoscope comprises of brushing, flushing, rinsing and air purging of all channels and lumens and washing and brushing of all detachable components, following manufacturers’ instructions using equipment that is fit for purpose. Brushes should be the correct size for the channel diameter and length. Avoid splash contamination to surrounding areas. Cleaning should take place in a sink that allows for complete immersion of the endoscope and is ergonomically designed to allow height adjustment and prevent occupational injury to staff. The temperature of the water and the quantity of the detergent should be regulated to prevent damage to the instrument and ensure thorough cleaning. There should be a separate sink to rinse the endoscope, both sinks and all surrounding surfaces must be of a medical grade and wipeable quality. Lining surfaces should be avoided but, where necessary, any covering should be lint free and sterile and changed after every instrument.

Dispose of all single use equipment including brushes safely. Ensure that irrigation devices or injection tube sets are also decontaminated as per manufacturers’ instructions. Transfer to the Endoscope Washer Disinfector (EWD)

4. Automated reprocessing EWDs are designed to ensure complete chemical disinfection of all surfaces and channels of the endoscopes. Ensure that disinfectants have a broad spectrum of microbiocidal activity, are compatible with the endoscope and EWD and are used in an effective concentration. All channels of the endoscope must be connected within the EWD using appropriate connectors, following manufacturers’ instructions. All detachable components must be safely reprocessed simultaneously with their corresponding endoscope.

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