1231 CE Online (1)

3. Ensure that the endoscope is completely dry before placing in clean storage! Ensure that the steps for drying the flexible fiberscope and channels have been completed. 4. Place a hang tag on the endoscope and list: disinfection process used, date it was last processed, the scope’s serial number, and the processor’s initials. 5. Ensure that the endoscope is hung in a vertical position and is protected against damage or cross-contamination. 6. Process the flexible endoscope according to the facility’s protocol immediately before using for patient care or as detailed in the facility’s protocol. STERILIZATION AND HIGH-LEVEL DISINFECTION In 1968, Dr. Earle Spaulding developed a classification system for cleaning and reprocessing instruments and equipment according to the level of infection risk associated with their intended use. He divided the risk level into three categories, all related to body contact: critical (entry or penetration into sterile tissue, cavity or bloodstream), semi-critical (contact with intact non-sterile mucosa or non-intact skin) and noncritical (intact skin). Instruments defined as critical should always be sterilized before use. Instruments considered semi-critical should be at least high-level disinfected (HLD) or, ideally, sterilized. Instruments classified as noncritical should be washed and treated with a low- level disinfectant or detergent and water (see Table 1). Table 1 – Spaulding Classification System Spaulding Classification System Body Contact Level of Risk Disinfection Requirements

Entry or penetration into sterile tissue, cavity, or bloodstream Intact non-sterile mucosa or non- intact skin

Critical

Sterilization

Semi-critical

Sterilization or HLD

Intact skin Low-level disinfection Always check the manufacturer’s instructions for material compatibility and sterility efficacy for endoscopes and instruments. Facilities also should refer to the Spaulding Classification when choosing the reprocessing method most appropriate to the risk of infection related to the use of endoscopes and instruments. Use an open tray, rigid container, or Tyvek pouch suitable for terminal sterilization, including sterility assurance indicators, to package the instrument. Wrap in a tray using sterilization wrap or containerize into a rigid container (see Figures 17 and 18). Non-critical

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