There are between 75 and 100 intricate steps involved in the proper reprocessing of flexible endoscopes. That means there are countless opportunities for staff to miss critical steps that prevent cross contamination, infection and, in the worst of cases, a patient’s entirely avoidable death. “In 99% of the cases when patients are exposed to pathogens because biofilm is on the scopes, it’s because there was a missed step during reprocessing,” says Albert R. Knight, MAJ, AN, DNP, APRN, AGCNS-BC, CMSRN, CNOR, a perioperative clinical nurse specialist stationed with the U.S. Army at the Landstuhl Regional Medical Center (LRMC) in Germany. “And it’s all because there’s still not a standardized process across the board.”

Dr. Knight has dedicated a significant amount of time and effort to raising awareness about the importance of standardization in flexible endoscope reprocessing. In fact, he’s pushing for a “standard of practice” — much like the WHO’s Surgical Safety Checklist — that reprocessing personnel can use at the local, national and even global level. 

In the meantime, you should rely on industry guidelines, instructions for use (IFU) from the makers of endoscopes and reprocessing equipment and robust internal policies to prevent variations in endoscope reprocessing and ensure that these complex instruments are cleaned the exact same way every time they’re used. Here are the major areas to include in the policies.