END !C PE "EP" CE!!IN# C MPE$ENCY C%ECK&I!

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Name: ______________________________ Dept.: ______________________________ Date: _________________________ Score: __________________________

Instructions: This document is to be completed by a designated endoscope trainer, signed off by the ASC manager, and retained in the employees personnel file. Performance Criteria
I. #. Demonstrates $no%ledge of all manufacturers manuals and recommendations applicable to the ASCs endoscope, endoscope accessories, re& processing methods, and re&processing e'uipment (. Demonstrates $no%ledge of all ASC policies related to endoscope reprocessing methods II. Chemical Management #. Chemical Documentation a. )aintains high&le*el disinfectant logboo$ %ith: Dates of acti*ation and e+piration,

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Know Your Equipment

Documents corresponding date %ith strip in log boo$ 0abels /C strip bottle %ith e+piration date !erforms /C, if re'uired by manufacturer, on test strips per guidelines %hen bottle is first opened and documents results b. Soa$ing bin is labeled %ith secondary container label %ith the follo%ing information filled in-chec$ed off: Date of acti*ation and e+piration,

Type and percentage of high&le*el disinfectant solution ,ach use high&le*el disinfectant strip chec$s results pass-fail" %ith appropriate follo%&up actions if test strip fails .alidates correct /C strip is being used

Type and percentage of high&le*el disinfectant solution The physical-health ha1ards that the chemical poses
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Performance Criteria
The re'uired personal protecti*e e'uipment c. 0ocates the )SDSs for each chemical utili1ed in endoscope re&processing (. Chemical :andling: :igh&le*el Disinfectant a. <ears re'uired !!, imper*ious go%n, nitrile glo*es, chemical goggles and face shield". b. Acti*ates and mi+es high&le*el disinfectant as needed follo%ing manufacturers recommendations" at the beginning of the day or before the endoscopic procedure c. Transfers high&le*el disinfectant into processing bin-A,6 d. Demonstrates $no%ledge of eye %ash station location and its correct use e. States as applicable" %hat departmental *entilation control measures are utili1ed and %hat the operational re'uirements are i.e.: $no%s ho% to operate hoods-fans etc." f. 0ists the symptoms of high&le*el disinfectant o*er&e+posure g. Spills: )anageable spills: demonstrates appropriate spill clean&up and chemical disposal =nmanageable spills any spill %hich causes eye and-or respiratory tract irritation or occurs on carpet": demonstrates ho% to initiate spill management response call Safety"and e*acuates the area h. Disposes of chemicals appropriately per departmental processes by pouring used disinfectant do%n the drain and flushing %ith large amounts of cold %ater 2 mins. continuous flo% or 4 gallons" 2. Chemical :andling: ,n1ymatic Cleaner a. <ears re'uired !!, imper*ious go%n, nitrile glo*es, chemical goggles and face shield". b. )i+es fresh en1ymatic cleaner for each endoscope per manufacturers recommendations III.

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En'oscope Cleaning

#. ,ndoscope !rocessing )ethods a. =nderstands the endoscopes clinical application sterile or clean" and chooses the correct re&processing method sterili1ation or high&le*el disinfection" based on the endoscopes clinical application and manufacturers recommendations b. =nderstands the physical design of the endoscope being cleaned and specific
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Performance Criteria
cleaning re'uirements rigid or fle+ible, channeled or non&channeled, immersible or non&immersible, etc." c. =nderstands processing for biopsy forceps reusable need sterili1ation and should be soa$ed in en1ymatic cleaner after procedure, dispose single use in sharps container" d. :as $no%ledge of appropriate >non& modified? connections specific to each departmental o%ned (. !recleaning <ears personal protecti*e e'uipment including go%ns, glo*es, and eye protection 2. 7mmediately follo%ing procedure %ipes the endoscope sheath in a circular motion %ith en1ymatic solution. @. Suctions the en1ymatic solution through the endoscope until the solution is *isibly clean. Alternates suctioning the solution and suctioning air. Ainishes %ith air. 4. Clears the air and %ater channels according to manufacturers recommendations B. 0ea$age Test as applicable" Attaches any necessary %ater&resistant caps to electrical connectors. C. .isually inspects the endoscope, uni*ersal cord, and bending section as applicable" for holes, tears, or other gross damage. D. Aills basin large enough to hold endoscope %ithout e+cessi*e coiling" %ith %ater for the lea$ test E. Attaches lea$ tester and pressuri1es endoscope according to manufacturers recommendations #3. 7nspects the bending rubber as applicable" to insure the endoscope is pressuri1ed&either *isually, or by touch. ##. Submerges the tip of the endoscope into the %ater and chec$s for bubbles. Angulates the bending section as applicable" loo$ing for lea$s. #(. Curls the light guide and endoscope and submerges the entire endoscope in %ater for t%o minutes. 0oo$s for lea$s during the entire time specifically chec$ing the follo%ing areas: a. Control $nob b. ,ndoscope sheath c. Fending section as applicable": fle+es it up and do%n, left and right d. All channels, including the distal tip, the *al*e ports, and the connectors Note: small holes may be represented by a single bubble perfectly timed #2. 7f the endoscope is lea$ing, calls the manufacturer for repair assistance. Aollo%s manufacturers recommended procedures for disinfecting the endoscope before sending out

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Performance Criteria
for repair. #@. )anual Cleaning %ith an ,n1ymatic Solution Detaches all remo*able parts as applicable", soa$s them and brushes them to remo*e debris. 6inses parts %ith %ater. #4. 7mmerses endoscope in en1ymatic solution and thoroughly cleans the e+terior of the endoscope #B. Cleans inside the suction *al*e, air %ater *al*e, biopsy port openings and all other channel openings as applicable", %ith a brush or lint free applicator. #C. Frushes the entire biopsy-suction and all other channel systems as applicable". a. Chooses correctly si1ed channel brush b. Frushes in the direction of the distal tip from the biopsy port. c. Frushes the channel bet%een the suction *al*es. d. Frushes the channels in the direction of the light guide connector. e. =ses short choppy stro$es %ith the brush f. Cleans the bristles of the brush each time it e+its the endoscope before retracting. g. 6epeats brushing until no debris is *isible on the brush h. <ith an ,6C! endoscope, deflects and cleans around the ele*ator. i. Carefully, uses a soft brush to brea$ up any bloc$age present at the tip of the air-%ater channel #D. Attaches cleaning adapters to the endoscope and co*ers the biopsy port. #E. 7mmerses the endoscope , suctions in and soa$s the endoscope in en1ymatic solution for the manufacturers recommended amount of time (3. 6insing 6inses the endoscope and all remo*able parts as applicable" under running %ater to remo*e residual en1ymatic solution. (#. Alushes all channels %ith %ater ((. !urges all channels %ith air (2. 6emo*es e+cess %ater from the e+terior of the endoscope to pre*ent dilution of high&le*el disinfectants used in the ne+t step. Note: The endoscope may need to be ompletely dried at this point if being processed by an A,6 or other system. I(.

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En'oscope Disinfecting

#. Aor )anual disinfecting a. 7mmerses the endoscope in disinfectant b. =sing the cleaning adapters fills all channels completely until no bubbles appear. c. !lace all *al*es, remo*able parts, and any reusable brushes in disinfectant
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Performance Criteria
d. Co*ers basin %ith tightly fitting lid e. Chec$s instructions for the correct immersion time Sporo+G23min, gluteraldehydeG(3min, Cide+ 5!AG#( min, )etrocyde G @3 mins." and sets timer f. <hen immersion is complete, purges channels %ith air to remo*e the disinfectant (. Aor Automated ,ndoscope 6eprocessor: a. Aollo%s the manufacturers instructions to connect the endoscope to the re&processor b. !laces the *al*es and other remo*able parts including re&usable brushes in the re& processor, if possible other%ise parts must be manually high&le*el disinfected c. Attaches channel cleaning connectors d. Aor ,6C! endoscopes, the ele*ator %ire channel must be accessed manually e. Aollo%s manufacturers instructions for the high&le*el disinfectant f. Sets the machine for the recommended time 2. 6insing Thoroughly rinse the e+terior surface of the endoscope %ith %ater. @. Alush all channels %ith %ater or sterile %ater. 4. 6inse all *al*es and other remo*able parts in %ater or sterile %ater. B. <ith an automated re&processor, ensures that rinsing is performed by machine. C. Drying !urge all channels %ith air D. !rior to storage, flush all channels %ith C3H & E3H alcohol to facilitate drying if non&sterile rinse %ater %as used E. !urge all channels %ith air. #3. 6emo*al all cleaning adapters and de*ices ##. Dry the e+terior %ith a soft, dry lint free cloth. #(. 6emo*es personal protecti*e gear. #2. <ashes hands before lea*ing reprocessing room. #@. Storage :angs fle+ible endoscopes *ertically in a %ell& *entilated area. #4. Stores endoscope in a protected manner. Do not store in case. a. 6emo*e %ater resistant cap if used. b. Attach *enting cap for storage if needed. #B. Stores remo*able parts separately. i.e. air-%ater I suction buttons, biopsy caps, %ater&resistant caps". #C. Demonstrates process for routine soa$ing bin cleaning and storage %hen not in use.

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Comments:

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Overall Evaluation of Demonstration Meets Expectations Does not Meet Expectations

Observer Name: ____________________ Observer Signature: ________________

6utala, <.A., <eber, D.J., and the :ealthcare 7nfection Control !ractices Ad*isory Committee. (33D". Guideline for Disinfection and Sterilization in Healthcare Facilities , 2008. Centers for Disease Control and !re*ention. !etersen, F.T., Chennat, J., Cohen, J., Cotton, !.F., 8reen%ald, D.A., ;o%als$i, et. al. (3##". ASGE-SHEA Guideline: Multi-society uideline for re!rocessin fle"i#le astrointestinal endosco!es. $nfection %ontrol and Hos!ital E!ide&iolo y , 2( B".

DI!C&)IME": All data and information pro*ided by the 5regon !atient Safety Commission is for informational purposes only. The 5regon !atient Safety Commission ma$es no representations that the patient safety recommendations %ill protect you from litigation or regulatory action if the recommendations are follo%ed. The 5regon !atient Safety Commission is not liable for any errors, omissions, losses, inKuries, or damages arising from the use of these recommendations.

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