GUIDES AND ARTICLES
Recommendations and guidelines for the reprocessing of certain endoscopes types have changed in 2021 and 2022. Now the recently published Association for the Advancement of Medical Instrumentation (AAMI) standards have reclassified the reprocessing of flexible endoscopes as high-risk, and recommend additional steps when reprocessing these devices.
AAMI points to growing reports of multi-drug resistant organism (MDRO) transmission resulting in patient infection and high rates of mortality along with numerous healthcare-associated infections (HAIs) being linked to the use of contaminated endoscopes as to why the standards were updated. The new standards supports sterilizing all flexible endoscopes (semi-critical and critical) due to : 1)high microbial load after patient procedures, 2) complex design of flexible endoscopes, and 3)risk for biofilm formation.
Although endoscopes play a vital role in the effective delivery of health care and offer patients many benefits, the risks associated with iatrogenic transmission via endoscopes continue to be of significant concern. 1
Semi-critical devices come in contact with mucous membranes or non-intact skin. These include high-risk endoscopes such as duodenoscopes, bronchoscopes, ureteroscopes and cystoscopes.
AAMI recognizes the infection risk endoscopes can present to the patient and states: “It is advised that flexible and semi-rigid endoscopes to be used in semi-critical applications be sterilized prior to use.”
Acknowledging that transitioning from high level disinfection to sterilization can be a complex process, the committee encourages health care facilities partner with endoscope, reprocessor and sterilizer manufactures to help elevate the standard of endoscope processing.
This latest AAMI guidance comes after the 2021 FDA safety communication recommending the use of single-use endoscopes.
1. National Standard. ANSI/AAMI ST91:2021. Flexible and semi-rigid endoscope processing in health care facilities.
With over 5 million tons of medical waste being disposed of annually1, we’re very aware of the impact single-use medical devices can have on our environment. But did you know there is more to the story? Below are 4 misconceptions about the potential environmental impact of single-use bronchoscopes.
Misconception #1: Single-use bronchoscopes create greater landfill waste than reusable bronchoscopes.
The waste generated from reprocessing endoscopes is often overlooked, as reprocessing usually occurs in a separate department. One study showed that 337 grams of PPE2 can end up in the trash after reprocessing one endoscope. Although that number can be cut down by reprocessing more than one scope at a time, it doesn’t account for the chemicals, additional equipment, or staff time that is also required for reprocessing. Furthermore, costs associated with treating infections from inadequately processed bronchoscopes3 can also add to the environmental impact of using reusable bronchoscopes.
Misconception #2: All single-use scopes contribute the same amount of waste to landfills.
The BFlex™ bronchoscope was designed with the environment in mind by making the cable reusable, and by using minimal packaging. Most single-use bronchoscopes include a disposable cable, which can add up to 83% more waste4 that can end up in landfills.
Misconception #3: Single-use bronchoscopes can’t be recycled.
Many single-use medical devices are composed of hard-to-recycle plastics. Because of this, finding recycling solutions can be problematic. That’s why Verathon has partnered with Sharps Compliance’s TakeAway Recycle System. Their process uses plastics as a fuel source for generating electricity, in a process known as waste-to-energy conversion. By keeping single-use devices out of the landfill, you can provide the best of both worlds to your patients – reducing cross-contamination while creating less waste for our planet. Learn more about the program here.
Misconception #4: Two separate systems must be purchased and maintained for bronchoscopy and video laryngoscopy.
By combining bronchoscopy and video laryngoscopy in one system, the Total Airway Solution by Verathon offers two systems in one, which means fewer systems to purchase, maintain, and dispose of at end-of-life, resulting in a lower impact to the environment.
To learn more about Verathon’s wide range of single-use medical devices, request a quote or demo here.
2. Sørensen, B. L., Grüttner H. 2018. “Comparative Study on Environmental Impacts of Reusable and Single-Use Bronchoscopes”. AJEP, 2018; 7(4) 55-62. http://www.sciencepublishinggroup.com/journal/paperinfojournalid=163&doi=10.11648/j.ajep.20180704.11
3. Terjesen, C.L., et al. “Early Assessment of the Likely Cost Effectiveness of Single-Use Flexible Video Bronchoscopes.” PharmacoEconomics (2017). 1:133-141.
4. Data on file per DR-TRM-0154 / REV-00. Comparison of packaged weight of 3 single-use scope models.
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