Video Auditing of Duodenoscope Reprocessing Contributes to High Performance in a Tertiary Care Center
Bret T. Petersen, MD, MASGE, reviewing Raphael KL, et al. Endoscopy 2020 May 14.
Lapses in reprocessing of flexible endoscopes have been demonstrated in many environments and are thought to contribute to the transmission of infection between patients.
The authors assessed the feasibility of offsite video auditing of duodenoscope reprocessing in a tertiary care center. Performance of 44 steps in 7 distinct phases of reprocessing was scored in near real time using validated Olympus TJF-Q180V cleaning and disinfecting checklists. Complete satisfactory performance of all steps was required before clinical reuse of the instruments. Cycles failing 100% performance prompted complete reprocessing. During the 16-month period that 743 duodenoscope reprocessing cycles were audited, 99.9% of the steps were deemed visible and assessable. The mean time required to complete each audit was 38.3 minutes, and the mean turnover time was 76.1 minutes, without any procedure delays occurring due to a lack of duodenoscope availability. Overall per-step compliance was 99.5%. Whereas 10.7% of endoscopes required an additional reprocessing cycle, none required more than two total cycles. The authors reported that remote video auditing was feasible and promoted ongoing high-level reprocessing in their center.
COMMENTContinuous monitoring of process performance and monitoring of partial and finished product quality are common in many industries. Others have described the benefits of monitoring endoscope reprocessing as a prompt for real-time discussion and training. While not likely to eradicate transmission of infections, this modality may help standardize the human elements that contribute to reprocessing failure. The use of artificial intelligence to assist with video auditing, at reduced cost, may be feasible.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Raphael KL, McNoble E, Goldbeck J, Stiles M, Miller LS, Trindade AJ. Remote video auditing in the endoscopy unit for evaluation of duodenoscope reprocessing in a tertiary care center. Endoscopy 2020 May 14. (Epub ahead of print) (https://doi.org/10.1055/a-1157-8861)
