Tracking endoscopes throughout their life cycle is vital to a safe reprocessing program. An electronic tracking system that monitors scope location, disinfection cycles, repairs, maintenance, and real-time status may help identify a scope’s relationship to infectious outbreaks, device recalls, and even trends that may indicate a breakdown in processes. As healthcare facilities face increasing pressure to prevent healthcare-associated infections while maintaining operational efficiency, the importance of robust endoscope tracking has never been more critical.

Scope Reprocessing: An Important Barrier Between Patient and Infectious Organisms

Scope reprocessing begins with pre-cleaning immediately after patient use, followed by a hands-on cleaning and visual inspection to ensure the device is clean and in working order. After sterilization or high-level disinfection, the endoscope must be thoroughly dried and stored in a cabinet that prevents contamination. This multi-step process serves as the primary defense against transmitting infectious agents between patients.

Each reprocessing step is critical to reducing the risk of infectious organisms remaining within or on an endoscope. However, even meticulous reprocessing can fail if scopes are improperly dried or stored. The complex internal architecture of flexible endoscopes, with narrow lumens and channels, creates multiple opportunities for contamination if proper protocols are not followed precisely.

The Association for the Advancement of Medical Instrumentation (AAMI) cited research that explored whether reprocessed endoscopes were safe for patient use. In one study, the number of scopes with residual fluid in the lumens was 95%. In another study, the percentage of endoscopes that retained fluid ranged from almost none to 85%. These findings highlight the significant variability in reprocessing effectiveness across different facilities and underscore the need for standardized tracking protocols.

If any fluid remains in or on the device, remaining organisms may thrive and multiply, potentially infecting patients. Biofilm formation can occur rapidly in moist environments, creating persistent contamination that is difficult to eliminate through standard reprocessing. The drying process is just one area where an electronic scope tracking system can help facilities adhere to proper drying and hang times, ensuring compliance with manufacturer recommendations and regulatory standards.

Where Are the Scope Reprocessing Recommendations?

Various leading medical societies have published their guidelines for endoscope reprocessing, but there is no clear consensus across all specialties. This lack of uniformity has created challenges for healthcare facilities trying to implement best practices. Concerns for infectious outbreaks linked to endoscopes have led, in part, to the creation of the Healthcare Infection Control Practices Advisory Committee (HICPAC). HICPAC developed comprehensive recommendations for flexible endoscope reprocessing after receiving advice from leading medical organizations, including:

• Association for the Advancement of Medical Instrumentation (AAMI)
• American Gastroenterological Association (AGA)
• American Society for Gastrointestinal Endoscopy (ASGE)
• Association of periOperative Registered Nurses (AORN)
• Association for Professionals in Infection Control and Epidemiology (APIC)
• Centers for Medicare & Medicaid (CMS)

The HICPAC recommendations cover facility set-up, education of staff, developing policies and procedures, reprocessing steps, how to handle a disinfection failure, and documentation requirements. These guidelines represent the most comprehensive approach to endoscope safety currently available and serve as the foundation for developing institutional protocols.

HICPAC considers documentation and tracking essential to a quality scope reprocessing program. A robust tracking system can assist leadership in responding quickly to a breakdown in processes, an infectious event, or a device recall. The ability to rapidly identify which patients were exposed to a potentially contaminated scope can be crucial in preventing widespread infections and ensuring appropriate patient follow-up.

The method of tracking is up to the institution. While paper documentation is permissible, there are significant drawbacks to recording critical data in this manner. Time pressures and human fallibility can result in incomplete, inaccurate, or illegible documentation. It is challenging to cross-reference data points on a paper log, resulting in missed opportunities to identify issues such as increasing infection rates, skipped processing steps, or expired scopes. Retrieving paper logs during inspections can be time-consuming if the documents are stored outside the endoscopy unit or at a central storage facility.

What Data Should We Track?

An article published in the journal Gastrointestinal Endoscopy Clinics of North America recommends a comprehensive tracking system to aid in tracing infectious outbreaks or quality control issues. Tracking can also ensure consistent maintenance and reprocessing of endoscopes within a facility, supporting both patient safety and regulatory compliance.

The article’s authors offer endoscope documentation recommendations based on HICPAC’s guidelines, including:

• A unique identifier for each scope
• Patient identifiers linked to scope use
• Cleaning times, processes used, maintenance and repair logs
• An inventory of endoscopes and tracking of all movements, including loans
• Identification of any infection control issues with appropriate follow-up

A comprehensive scope tracking system that is easily searched and cross-referenced can assist in identifying trends. Tracking trends can help managers respond to emerging issues, such as increased infection rates or missed processing steps, before they compromise patient safety or regulatory compliance.

Benefits of Electronic Scope Tracking Systems

Electronic tracking of endoscopes can eliminate the burden of maintaining handwritten logs, alert staff to missed steps during reprocessing, and help managers respond to process failures efficiently and effectively. Modern electronic systems can integrate with existing hospital information systems, providing seamless data flow and reducing the risk of transcription errors.

Electronic endoscope storage cabinets can maintain consistent airflow, monitor scope locations, indicate the status of each scope, and display the time left before each scope expires. Monitoring endoscopes in storage can save staff time and reduce the chance that scopes will need to be reprocessed unnecessarily. Advanced storage systems can also track environmental conditions such as temperature and humidity, ensuring optimal storage conditions.

Linking endoscope storage units via a cloud-based platform allows managers to monitor inventory, track scope usage, and receive notifications of expired scopes across multiple locations. This connectivity enables centralized oversight of endoscope fleets across large healthcare systems, improving resource allocation and ensuring consistent standards.

The HICPAC endoscopy reprocessing recommendations, developed in consultation with industry leaders, emphasize the importance of documentation and tracking multiple data points. Healthcare facilities seeking to implement these best practices may benefit from exploring comprehensive solutions like NewCura’s ScopeCycle® Endoscope Tracking Software, which addresses these critical requirements while reducing the risk of overlooking vital steps in scope reprocessing, ultimately supporting better patient outcomes and operational efficiency.