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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(11): E1627-E1632
DOI: 10.1055/a-1535-1238
Original article

Accreditation program for gastrointestinal endoscopes reprocessing in Italy: An on-site survey

Giancarlo Spinzi
1   Gasastroenterology and Endoscopy Department, Valduce Hospital, Como – Italy
,
Angelo Milano
2   Gastroenterology and Endoscopy Department, Chieti University, Chieti – Italy
,
Piero Brosolo
3   Gastroenterology and Endoscopy Department, Pordenone Hospital, Pordenone – Italy
,
Paola Da Massa Carrara
4   Gastroenterology and Endoscopy Department, Pistoia Hospital, Pistoia – Italy
,
Maurizio Labardi
5   Gastroenterology and Endoscopy Department, Firenze Hospital, Firenze – Italy
,
Alberto Merighi
6   Gastroenterology and Endoscopy Department, Ferrara Hospital, Ferrara – Italy
,
Luisa Riccardi
7   Gastroenterology and Endoscopy Department, Perugia Hospital, Perugia – Italy
,
Francesco Torresan
8   Gastroenterology and Endoscopy Department, Bologna University, Bologna – Italy
,
Maurizio Capelli
9   Kiwa-Cermet Statistical Department, Bologna-Italy
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Abstract

Background and study aims Endoscope reprocessing has been associated with a variable failure rate. Our aim was to present an overview on current practices for reprocessing in Italian facilities and discuss the principle critical points.

Methods In 2014 the Italian Society for Digestive Diseases implemented an accreditation program in collaboration with an independent organization for certification and with the Italian Association for Endoscopy Technical Operators. During a 1-day site visit of the endoscopy center, two endoscopists, one nurse, and the representative of the certification body evaluated the endoscope reprocessing.

Results As of July 1, 2020, 28 endoscopy centers had been accredited. Ten centers are completing the measures to correct deficiencies found at the visit. Three centers withdrew from the program. The accreditation program has found variations between the various centers, confirming the poor compliance with guidelines. Major deviations from the standards, established by the model before the site visit according to national and international guidelines, concerned instrument cleaning (44.7 % of the centers), instrument storage (23.7 %), and microbiological tests (31.6 %).

Conclusions Our overview demonstrated the lack of many reprocessing phases, which are important to prevent endoscopy-associated infections. Accreditation can achieve a transformation in quality and safety of reprocessing with the Italian centrally-led approach.

Supplementary material



Publication History

Received: 26 December 2020

Accepted: 10 June 2021

Article published online:
12 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2021; 53(12): 1293-1293
DOI: 10.1055/a-1561-6433

 

  • References

  • 1 Spaulding EH, Kemmons EX. Chemical disinfection. Am J Nurs 1958; 58: 1238-1212
    PubMedGoogle Scholar
  • 2 Nelson DB, Jarvis WR, Rutala WA. et al. Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Infect Control Hosp Epidemiol 2003; 24: 532-537
    CrossrefPubMedGoogle Scholar
  • 3 Gillespie TG, Hogg L, Budge E. et al. Mycobacterium Cholonae isolated from rinse water within an endoscope washer-disinfector. J Hops Infect 2000; 45: 332-334
    PubMedGoogle Scholar
  • 4 FDA executive summary: effective reprocessing of endoscopes used in Endoscopic Retrograde Cholangio-Pancreatopraphy(ERCP) procedure 2015. http://www.fda.gov/downloads/UCM445592.pdf
    PubMedGoogle Scholar
  • 5 FDA Endoscopic Retrograde Cholangiopancreatography (ERCP) duodenoscope. FDA safety communication. Design may impede effective cleaning. 2015 http://www.fda.gov/safety/UCM434922.htm
    PubMedGoogle Scholar
  • 6 Larsen S, Kalloo A, Hutfless S. The hidden cost of colonoscopy including cost of reprocessing and infection rate: the implication for disposable colonoscopies. Gut 2020; 69: 197-200
    CrossrefPubMedGoogle Scholar
  • 7 Wang P, Xu T, Ngamvengphong S. et al. Rates of infection after colonoscopy and oesophago-gastroduodenoscopy in ambulatory surgery centres in the USA. Gut 2018; 67: 1626-1636
    CrossrefPubMedGoogle Scholar
  • 8 Tavernise S. Deadly CRE germs linked to hard-to-clean medical scopes. The New York Times 19.02.2015; A14
    PubMedGoogle Scholar
  • 9 Beilenhoff U, Biering H, Blum R. et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: position statement of the European Society of Gastrointestinal endoscopy (ESGE) and European Society of Gastroenterology Nurses Associates (ESGENA)-Update 2018. Endoscopy 2018; 50: 1205-1234
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Dunkley I, Griffiths H, Follows R. et al. UK consensus on non-medical staffing required to deliver safe, quality-assured care for patients undergoing gastrointestinal endoscopy. Frontline Gastroenterol 2019; 10: 24-34
    CrossrefPubMedGoogle Scholar
  • 11 British Society of Gastrointestinal Guidelines for Decontamination of equipment for gastrointestinal endoscopy 2016. http://www.Bsg.org.uk/clinical-guideline/general/guidelines-for-decontamination-of-equipment-for-gastrointestinal-endoscopy-html
    PubMedGoogle Scholar
  • 12 Spinzi G, Milano A, Brosolo P. et al. The Italian Society for Digestive Endoscopy (SIED) Accreditation and quality improving project based on international standards. Endosc Int Open 2020; 8: E338-E345
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Linee Guida pulizia e disinfezione in Endoscopia-update 2011. www.anoteanigea.it/linee-guida-public/linee-guida-pulizia-e-disinfezione-in-endoscopia
    PubMedGoogle Scholar
  • 14 Peterson BT, Cohen JC, Hambrick RD. et al. Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2016 update. Gastrointest Endosc 2017; 85: 282-294
    CrossrefPubMedGoogle Scholar
  • 15 Speer T, Alfa M, Cowen A. et al. Endoscope disinfection update: a guide to resource-sensitive reprocessing. April 2019 WGO. http://guide.medlive.cn
    PubMedGoogle Scholar
  • 16 Thaler AM, Muthusamy VR, Sederat A. et al. Duodenoscope reprocessing practice patterns in US endoscopy centers: a survey study. Gastrointest Endosc 2018; 88: 612-619
    CrossrefPubMedGoogle Scholar
  • 17 Kenters N, Tartari E, Hopman J. et al. Worldwide practices on flexible endoscope reprocessing. Antimicrob Resist Infect Control 2018; 7: 153
    CrossrefPubMedGoogle Scholar
  • 18 McCafferty CE, Aghajani MJ, Abi-Hanna D. et al. An update on gastro-intestinal endoscopy-associated infections and their contributing factors. Ann Clin Microbiol Antimicrob 2018; 17: 36
    CrossrefPubMedGoogle Scholar
  • 19 Cheung DY, Jang BIK, Kim SW. Multidisciplinary and multi-society practice guidelines on reprocessing flexible gastrointestinal endoscopes and endoscopic accessories. Clin Endosc 2020; 53: 276-285
    CrossrefPubMedGoogle Scholar
  • 20 Park JBG, Yang JN, Lim YJ. et al. Survey of endoscope reprocessing in Korea. Clin Endosc 2015; 48: 39-47
    CrossrefPubMedGoogle Scholar
  • 21 Moses FM, Lee JS. Current gastrointestinal endoscope disinfection and QA practices. Dig Dis Sci 2004; 49: 1791-1797
    CrossrefPubMedGoogle Scholar
  • 22 Soares JB, Goncalves R, Banhudo A. et al. Reprocessing practice in digestive endoscopy units of district hospitals: results of a Portuguese National Survey. Eur J Gastroenterol Hepatol 2011; 23: 1064-1068
    CrossrefPubMedGoogle Scholar
  • 23 Aumeran C, Poincloux L, Souweine B. et al. Multidrug-resistant Klebsiella pneumoniae outbreak after endoscopic retrograde cholangiopancreatography. Endoscopy 2010; 42: 895-899
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Tian H, Sun J, Guo S. et al. The effectiveness of drying on residual droplets, microorganisms, and biofilms in gastrointestinal endoscope reprocessing: a systematic review. Gastroenterol Res Pract 2021; 2021: 6615357
    CrossrefPubMedGoogle Scholar
  • 25 Jung M, Beilenhoff U. Hygiene: the looming Achilles heel in endoscopy. Visc Med 2016; 31: 21-28
    CrossrefPubMedGoogle Scholar
  • 26 Gastmeier P, Vonberg RP. Klebsiella spp. in endoscopy-associated infections: we may only be seeing the tip of the iceberg. Infection 2014; 42: 15-21
    CrossrefPubMedGoogle Scholar
  • 27 Colbert CY, Diaz-Guzman E, Meyers JD. et al. How to interpret surveys in medical research: a practical approach. Cleve Clin J Med 2013; 80: 423-425
    CrossrefPubMedGoogle Scholar
  • 28 Fan F, Li Y, Zhang Y. et al. Chest pain center accreditation is associated with improved in-hospital outcomes of acute myocardial infarction patients in China: findings from the CCC-ACS project. J Am Heart Assoc 2019; 8: e013384
    CrossrefPubMedGoogle Scholar
  • 29 Devkaran S, O’Farrell PN, Ellahham S. et al. Impact of repeated hospital accreditation surveys on quality and reliability, an 8-year interrupted time series analysis. BMJ Open 2019; 9: e024514
    CrossrefPubMedGoogle Scholar