Why brush, flush and leak-test your endoscopes when automatic reprocessors can do the dirty work for you, delivering efficient cleaning and high-level disinfection at the push of a button? If you're in the market for a new AER, you've got a range of choices that we'll detail for you over the next few pages, from time-tested workhorses to advanced, fully automated models. Keep these basics in mind when you're considering your options.

• Costs. Price varies a great deal from manufacturer to manufacturer and depending on a reprocessor's features. Beyond the acquisition cost, remember to consider the continuing operating costs, which include the necessary disinfectant solutions, filters, alcohol, test strips and other consumables. If your case volume doesn't meet projections, these expenses can swamp your budget. Ask users of the equipment you're considering whether the manufacturer's stated cost-per-cycle is accurate.
• Size and utility. You're not likely to build a new sterile processing department around your new equipment, so make sure the machine will fit into the room's available space. Will it require you to upgrade or augment your plumbing to meet water pressure or water treatment specifications? Is there a sufficient power supply? Does it need outside ventilation, or is it a closed system that traps chemical vapors? If you've got an eye on efficiency, note that some machines can reprocess 2 scopes at once, doubling their capabilities within a footprint.
• Cleaning capabilities. While reprocessing standards still mandate the bedside pre-cleaning of endoscopes immediately following the procedure, some machines claim to be able to eliminate the need for by-hand brushing of scopes upon their arrival in central sterile. By automating the manual cleaning steps in addition to high-level disinfection, you reduce the risk of human error as well as the time it takes to turn scopes around. Equipment offering this function may come at a higher cost, but it may also reduce the expense of your reprocessing labor.
• Disinfectants. Some machines employ proprietary chemicals for high-level disinfection. Some use a combination of multiple chemicals. This specification will affect your cost per cycle and possibly the cycle time itself, as disinfection and rinse cycles differ between machines and between disinfectants. Some reprocessors can heat the disinfectant, which reduces the necessary soak time. If your surgical caseload and schedule demand rapid scope turnovers, consider machines and solutions whose cycles take less time.
• Training and support. Your endoscopes are the linchpin of your facility's operations. If they aren't or can't be reprocessed properly, everything will grind to a halt. Alarm and indicator features on your reprocessor are invaluable for alerting your staff to improperly connected scopes or cycle malfunctions. But don't neglect the basics: the manufacturer's training, support and service contract during and after installation. You're going to want your staff to know the machine, inside and out, and you're going to want assurances of immediate repair or replacement in the event that it ever breaks down. As with cost considerations, confer with other users to find out how satisfied they've been with the manufacturer's support.

Advanced Sterilization Products
Evotech Endoscope Cleaner and Reprocessor
(888) 783-7723
www.aspjj.com
List price: not disclosed
FYI: The Evotech doesn't eliminate the need to pre-clean your scopes at bedside, but it can spare your staff the tedious task of brushing by hand when they employ the cycles that incorporate washing stages in addition to high-level disinfection, says the company. Evotech self-monitors such critical parameters as minimum effective concentration, blocked channels, temperature and pressure during every second of every cycle. Its integrated solution, plus Cidex OPA-C solution and Cidezyme Xtra Enzymatic Detergent, are specially formulated for cleaning and high-level disinfection of heat-sensitive endoscopes.

Custom Ultrasonics
System 83 Plus
(215) 364-1477
www.customultrasonics.com
List price: starts at $27,870
FYI: The System 83 Plus washes scopes and channels during a 3-minute wash phase using a combination of detergent and ultrasonic cavitation to ensure that every processed endoscope is safe for reuse. Unlike AERs that use bifurcated or multiple-branched channel flushing adapters, the System 83 Plus incorporates color-coded adapters to connect scope channels for one-on-one flow. The system is available in 2 models: the single processing chamber Model 2 can accommodate up to 2 endoscopes at a time, while the dual processing chamber Model 9 can reprocess 4 scopes simultaneously. The system can also be equipped with Endologistics bar-coding software, allowing for endoscope tracking from cleaning and storage to safe clinical use.

Minntech Corporation
Medivators Advantage Plus Endoscope Reprocessing System
(763) 553-3300
www.minntech.com
List price: $56,000
FYI: The Advantage Plus has an FDA-cleared cleaning claim: Its wash cycle, which uses Intercept non-enzymatic detergent, eliminates the need for manual brushing and flushing to remove biological and organic soil and to penetrate bacterial biofilm. Single-use, environmentally friendly Rapicide PA High-Level Disinfectant solution is effective at 30 ?C to save time. The Advantage Plus monitors each endoscope channel separately to detect blockages, maintain proper flow and ensure complete disinfection. A computerized detection system eliminates human error in connecting hookups. An on-board data management system enables scope usage tracking and cycle log viewing. Remote diagnostics capabilities provide fast technical support.

Olympus America
OER-Pro
(800) 848-9024
www.olympusamerica.com/reprocessing
List price: $29,000 to $34,000
FYI: The only automatic reprocessor designed by an endoscope manufacturer, the OER-Pro can clean and disinfect 2 flexible endoscopes simultaneously in 29 minutes, says the company. Its advanced cleaning process eliminates 7 of the 11 steps required in manual cleaning, including the labor-intensive and variable flushing of channels with detergent, water and air. Sensor technology performs automated detection functions and is able to automatically halt the process if a leak is discovered. A simple-to-use radiofrequency identification management system allows the tracking of scope serial and model numbers, unit operators and reprocessing times. And a compact, 18-inch-wide footprint minimizes installation requirements, while built-in casters boost mobility.

Steris Corporation
Reliance EPS Endoscope Processing System
(800) 548-4873
www.steris.com
List price: not disclosed
FYI: The Reliance EPS provides a safe and efficient alternative to aldehyde-based high-level disinfection processors and solutions. The system's dry oxidizing chemistry requires no special venting, measuring, mixing or pouring, eliminating staff exposure hazards associated with toxic glutaraldehyde or other agents, while the single-use solution ensures the efficacy of every cycle. Dual-scope capability safely accelerates throughput. "Boot technology" enables virtually connector-less reprocessing. A process indicator verifies that an effective dose of high-level disinfection solution has been generated. One-touch automated thermal and chemical self-decontamination cycles keep biofilm from forming inside the processor, while optional washing phases augment required manual scope pre-cleaning.