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Disinfection Practices for Endoscopes and Other Semicritical Items

Published online by Cambridge University Press:  21 June 2016

William A. Rutala ,
Eva P. Clontz ,
David J. Weber  and
Karen K. Hoffmann
William A. Rutala*
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Hospitals, Chapel Hill, North Carolina
Eva P. Clontz
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Hospitals, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Hospitals, Chapel Hill, North Carolina
Karen K. Hoffmann
Affiliation:
Division of Infectious Diseases, Department of Medicine, University of North Carolina (UNC) School of Medicine and the Department of Hospital Epidemiology, UNC Hospitals, Chapel Hill, North Carolina
*
CB # 7030, 547 Burnett-Womack Building, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7030
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Abstract

Objective:

To determine the disinfection practices employed by North Carolina hospitals for endoscopes and other semicritical patient care items and to discuss minimally acceptable disinfection procedures for these items.

Design:

A survey questionnaire was mailed to all North Carolina hospitals to identity their disinfection practices, and a literature review was conducted to ascertain studies that evaluated disinfection techniques for certain semicritical items.

Participants:

Questionnaires were returned by 107 of 167 (64%) North Carolina acute-care hospitals.

Results:

Most hospitals (91%) used a glutaraldehyde-based disinfectant (59%, 2% glutaraldehyde; 29%, 0.13% glutaraldehyde-0.44% phenol-0.08% phenate; 3%, either); half (51%) of the hospitals immersed the endoscope into disinfectant for >20 minutes, but 44% immersed for <10 minutes; nearly all hospitals (97%) disinfected endoscopes at room temperature. Hospitals rinsed the endoscope with sterile water (16%), tap water (54%), tap water followed by alcohol rinse (27%), or other (2%); 58% of the hospitals treated endoscopes from patients infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or Mycobacterium tuberculosis differently (81%, ethylene oxide [ETO] sterilization; 10%, increased exposure time; 10%, other). Twenty percent of the hospitals used an automated washer for processing endoscopic instruments. Rigid endoscopes (e.g., arthroscopes, laparoscopes) were primarily high-level disinfected (57%), ET0 sterilized (17%), or either (13%). The disinfection strategies for other semicritical items (e.g., applanation tonometers, cryosurgical instruments, and diaphragm fitting rings) were highly variable for the responding hospitals.

Conclusions:

This survey indicated the presence of a wide variety of practices for handling semicritical patient care items, many of which are inconsistent with current recommendations. To help establish minimally acceptable disinfection procedures for some patient care instruments (e.g., arthroscopes, laparoscopes, tonometers), the scientific literature was reviewed and recommendations were made.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 5 , May 1991 , pp. 282 - 288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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