Biofilm
A collection of microorganisms that attach to surfaces and each other to form a colony. The Colony produces a protective gel that is very difficult to penetrate with detergents or disinfectants
Gastroscope
is a flexible endoscope designs to view the interior of the stomach.
Duodenoscope
a flexible scope used to diagnose and treat abnormalities in the duodenum
Colonoscope
a scope used to examine the lower GI tract
Enteroscope
a scope used to examine the small intestine to investigate irregularities such as blocked bowel passages and small bowel tumors
Bronchoscope
scope used to examine the throat, larynx, trachea, and lower airways
Rhinolaryngoscope
a scope to examine upper Airways such as nasal passages nasopharynx, oropharynx, and larynx
Choledochoscope
scope used to visualize the interior of the biliary tract. Also used to visualize gallstones and has been a channel that also allows for accessories for removal of stones
Ureteroscope
scope designed to provide visualization of the ureters that connect the kidney to the urinary bladder
Cystoscope
scope used to examine the inside of the bladder
Hysteroscope
Scope used to provide visualization of the uterus
Deflection
The ability of the tip of a flexible endoscope to bend to increase the area that can be accessed by a physician, visually or with an instrument
Relative humidity should not exceed…
60%
The soiled and decontamination areas should be designed so air flows into the area known as
negative pressure
The soiled and decontamination areas should hold a minimum of __ air exchanges per hour
10
IFU
Manufacturer’s Instructions For Use. Written recommendations provided by the manufacturer of a medical device that provide instructions for safe and effective reprocessing methods for that device
List (3) ways endoscopes can be used to meet patient needs
Routine Screening, Diagnostic Treatment, Therapeutic Treatment
Reprocessing that begins more than (1) hour after the endoscope has been used is called
Delayed Processing
Ethylene oxide sterilization of a flexible endoscope may result in a blown endoscope if
The endoscope is not vented properly
Borescope
scope used to identify soil or damage within a lumen that cannot be seen by the manual visual inspection
Waterproof Tape
can be used to temporarily seal a leaking the endoscope and allow it to be disinfected
Endoscopy
Visual examination of the interior structures of the body is called:
Arthroscope
An example of a rigid endoscope is a/an:
Insertion tube
The portion of the flexible endoscope that enters the body is called:
bronchoscope
examines air passages in the lungs
colonscopes
examine the colon
gastroscopes
examine the small intestine,stomach and esophagus
control body
contains hand controls,: angulation control knobs, elevator/lifter, air/water, suction control valves, remote video switches, biopsy port and focus mechanism.
bending section
articulates to aid insertion into curved areas.
deflection
ability of the tip of a flexible endoscope to bend using control knobs to increase the area that can be accessed by a physician.
microorganisms
are organisms that can only be seen with the aid of a standard or electron microscope.
bacteria
is a single celled microorganisms that multiply by splitting.
symbiotic
are good bacteria that help in some way.
pathogens
are capable of causing disease.
fungi
a diverse group of microorganisms and plants that include microscopic fungi and yeasts. This can include mold, mushrooms, mildews and smuts.
virulence
the ability of a microorganism to overcome a persons immune defenses and cause disease.
gram stain
uses the bacterium’s outer surfaces to determine which color the bacteria will stain.
endospore stain
Endospores look like bubbles when gram stained. Because of their tough protein coats made of keratin, spores are highly resistant to normal staining procedures.
capsule stain
Some bacteria have slimy capsules that give bacteria added protection from a defensive attack of immune cells.
endospore
are tough dormant structure that some bacteria are able to form when cells find themselves in extreme peril conditions and are dying.
anaerobes
Bacteria that do not need oxygen
germinate
refers to the spore process moving from the dormant, highly-protected spore state to an active bacteria in a favorable environment. It is also referred as moving from the spore form back to a vegetative (non-spore) form as we
capsules
are associated with bacterial virulence (the ability for a microorganism to overcome a person’s immune system and cause disease).
diploid
bacteria that are cocci shaped appearing in pairs.
tetrad
bacteria that are cocci appearing in groups of four.
cocci
spiral or ball-shaped bacteria
bacilli
rod shaped bacteria
DNA
carries genetic information of the organism.
capsid
is the protective protein structure housing the DNA and RNA.
Enveloped virus
are a delicate membrane around the capsid that is studded with proteins.
Non-enveloped virus
are viruses without an envelope around the cuspid referred to as naked viruses.
decontamination room parameters
temp: 60°F- 65°F, humidity: 20-60%, air exchanges: 10, air pressure: Negative
safety data sheet
for the chemical steriliant or high-level disinfectant should be consulted for safety requirements.
eye wash stations
should be located within a 10 second walk of the work area to enable workers to reach them quickly in an event of a chemical splash.
sterile storage room parameters
temp: 60°F-75°F, humidity: Above 20%, air exchanges: 4, air pressure: Positive
Preparation/Disinfection room parameters
temp: 68°F-73°F, humidity: 20-60%, air exchanges: 10, air pressure: Positive
aersols
a suspension of ultra-microscopic solid or liquid particles in air or gas; a spray
reprocessing
is the process of rendering a clinically used device safe and ready for reuse.
Personal Protective Equipment (PPE)
is required by the Occupational Safety and Health Administration (OSHA).
gloves
should be long enough to prevent contact with contaminated water.
soiled items
should be transported to the decontamination area as soon as possible after use so the cleaning process can begin.
cleaning
is the removal of soil from the item being reprocessed.
decontamination definition
removing or reducing contamination by infectious organisms or other harmful substances.
enzymes
work best if allowed several minutes for contact time; therefore, they are especially useful in pre-soak or sonic applications with longer contact time.
detergents
are composed of several agents that aid in soil removal.
disinfectants
are not typically recommended as the primary cleaning agents for endoscopes.
biofilm
contains living and non-living microorganisms that can adhere to the surfaces of endoscopes.
Pre-cleaning at the point-of-use
helps remove organic materials, including blood and body fluids, on the endoscope’s exterior and interior surfaces.
leak testing
is the first step in the reprocessing of the endoscope. Must be performed before the endoscope is immersed in reprocessing solutions to minimize damage to the endoscope.
fluid invasion
is a situation where fluid gets inside the internal section of an endoscope.
olestra
synthetic fat used in some foods labeled fat free and leaves a waxy substance stuck to the endoscope
dehiscence
splitting open of a surgical wound along the surgical incision line
Residue
something unintentionally left on or in an endoscope that is not part of the endoscope itself. can seem minor and harmless, but they can be devastating, resulting in complications that can occur almost immediately or not surface for years.
validation
the U.S. Food and Drug Administration (FDA) defines validation as establishing by objective evidence that a process consistently produces a result or product that meets its predetermined specifications.
thrombosis
blood clots
manual cleaning
is the most important step in removing the microbial burden from an endoscope.
simethicone
ingredient in anti-gas medications
adhesions
holding together of two surfaces or parts that are normally separate
cleaning verification tests
are performed after cleaning to verify the effectiveness of a cleaning process at removing or reducing to an acceptable level, organic soil and microbial contamination.
ATP testing
is performed by swabbing sections of the endoscope and inserting the swabbing device into an ATP reader.
delayed reprocessing
is reprocessing activities that begin more than one hour after an endoscope’s use.
leak tests
is an important part of the inspection process because it allows the observer to determine if the tubes and/or channels are intact. It is a fundamental inspection step that allows the observer to determine whether the tubes and/or channels are intact.
borescope
is a device used for visual inspection in areas that are inaccessible by other means.
lumens
pose a cleaning challenge because of their narrow structure that prevents visualization during cleaning.
ventilation cap
pose a cleaning challenge because of their narrow structure that prevents visualization during cleaning.
sterilization
is the process by which ALL forms of microbial life, including bacteria, viruses, spores and fungi are completely destroyed.
high-level disinfection
is the destruction of all vegetative microorganisms, mycobacterium, small non-lipid viruses fungal spores and some bacterial spores.
The Spaulding Classification of medical devices and level of disinfection system
is universally used to determine which type of disinfection or sterilization is appropriate for medical devices.
critical
Enters sterile tissue or vascular system. Examples: Implants & Surgical instruments; Requires: Sterilization
semi-critical
Touches mucus membranes, except dental. Examples: • Flexible Endoscopes, Laryngoscopes & Endotracheal Tubes; Requires: High-Level Disinfection (HLD)
sterile
is to completely devoid of all living microorganisms.
cleaning
is the first step in the multi-step process of sterilization.
instrument air
a medical gas that falls under the general requirements and is filtered to 0.01 micron.
aeration
process by which sterilized packages are subjected to moving air to facilitate removal of toxic residuals after exposure to a sterilizing agent such as ethylene oxide.
plasma
is a state of matter distinguishable from a solid, liquid or gas.
steam sterilizers
all use a combination of air removal, steam and time to accomplish sterilization.
bowie-dick
all use a combination of air removal, steam and time to accomplish sterilization.
cross-contamination
To reduce the risk of damage or __, endoscope should be stored so they do not touch one or another; or touch the bottom or sides of the storage cabinet.
risk assessment
is the process of identifying all risks to and from an activity, and assessing the potential impact of each risk.
cystoscopy
is the examination, diagnosis, or treatment of the urethra & bladder or prostate gland.
Rod Lenses
multiple of these produced from the purest quality glass are positioned between the objective (distal end) and ocular (proximal) lenses though the interior of the endoscope.
statue
is a written law adopted by a legislative body that governs a city, county, state, or country. Failure to comply will result in legal consequences.
regulations
are rules issued by administrative agencies that have the force of law.
standards
are uniform methods of defining parameters for processes, products, services and measurements. May be regulatory or voluntary. Voluntary are strongly suggested but not mandated.
best practice
method or technique that has consistently shown results superior to those achieved by other means.
U.S. Food and Drug Administration
federal agency responsible for ensuring that foods, cosmetics, human and veterinary drugs, biological products, medical devices, and electronic products that emit radiation are safe and effective for public use.
The Centers for Disease Control and Prevention
is a federal agency organized within the U.S. Department of Health and Human Services.
U.S. Department of Transportation
is a federal agency dedicated to ensuring a fast, safe, and efficient transportation system.
The U.S. Environmental Protection Agency
purpose is to protect the human health and environment by writing and enforcing regulations based on laws passed by Congress.
Occupational Safety and Health Administration
operates under the U.S. Department of Labor. Its primary responsibility is to protect workers from occupationally-caused illnesses and injuries.
The Centers for Medicare & Medicaid Services
operates under the U.S. Department of Health and Human Services.
Association for the Advancement of Medical Instrumentation
is a non-profit voluntary consensus organization whose membership is comprised of healthcare technology professionals may be manufacturers, scientist, healthcare organizations, independent healthcare personnel, FDA, or members of another organization that sit on committees or workgroups.
American National Standards Institute
its primary mission is to enhance global competitiveness of U.S. business and the American quality of life by promoting and facilitation voluntary consensus standards and ensuing their integrity.
Association of periOperative Registered Nurses
is a professional organization consisting of perioperative nurses and others who are dedicated to providing optimal care to the surgical patient.
The Association for Professionals in Infection Control and Epidemiology
voluntary international organization whose members work to prevent HAIs in healthcare facilities. Work in conjunction with the CDC to adopt disease and infection prevention.
International Standards Organization
non-government organization with a network of National Standards Institutes representing 163 countries.
Joint Commission
private, independent, nonprofit organization that develops standards for healthcare facilities. TJC personnel evaluate healthcare organizations and programs in the US by conducting on-site surveys every 3 years and is usually unannounced
National Fire Protection Association
international organization that works to reduce the burden of fire and other hazards around the world.
Society of Gastroenterology Nurses and Associates
nonprofit organization of nurses and associates dedicated to the safe and effective practice of gastroenterology and endoscopy nursing.
World Health Organization (WHO)
is an agency of the United Nations that was established in 1948 to further international cooperation in improving health conditions.
United States Pharmacopoeia National Formulary
creates and revises the standards for the purity of medicines, drug substances and dietary supplements.
turnaround
is a situation where a medical device, such as an endoscope or surgical instrument, is used on one patient and is needed immediately for another procedure.
Human factors
examine relationship between human beings and the system with which they interact.
ECRI Institute
a nonprofit patient safety organization, identified “inadequate cleaning of flexible endoscopes before disinfection” as the number one health technology hazard
Reprocessing delays
can make the endoscope more difficult to clean.
misinformation
can lead to failed processes and damaged endoscopes. Always refer to the manufacturers IFU and stick to it.