INTO THE WASH Automated endoscope reprocessors can save you time and labor while delivering spotless results.

Automated endoscope reprocessors have been around for as long as I've been working in the GI department, and the technology just keeps improving. Their efficient, thorough, consistent cleaning and high-level disinfection means rapid scope turnarounds for providers, less labor and risk for techs and safe, quality care for patients. AERs are workhorses, but when it's time for your facility to upgrade, here's how to decide which one works for you.

• See it in use. Since an AER depends on plumbing connections and other preparations to operate, it's not reasonable to temporarily install a range of models at your facility for on-site trials. Your best bet is to check them out elsewhere, visiting other facilities to see them in action and talk about them with GI managers and reprocessing techs. You should be able to find hospitals or endoscopy centers in your area that are using the types you're considering. It's just a matter of contacting your local professional peers or asking reps to make introductions for you.

During your visit, watch the process closely. How do the scopes get hooked up? What's the length of the reprocessing cycle? Ease of use and speed of turnover are both keys to efficiency. While some AERs require the use of a particular disinfectant solution, others allow a choice of options. Find out how the staff decided on the solution they're using. Oftentimes it comes down to cost or exposure time.

• The big question. In addition to questioning them on the pros and cons of the machines they chose, be sure to ask users if they would purchase them again. You might uncover some insights you wouldn't get by researching technical specs online or laying hands on the equipment in an exhibit hall. During a site visit last year, one manager told me she wouldn't make the same choice again. Her smaller AER seemed like an advantage at first, she said, but scopes had to be coiled so tightly inside the machine that she was afraid it was damaging them.

• Cost and confidence. Some AERs offer options that add to their cost but may deliver more efficiency. For example, some models don't require the brushing of scopes before they're placed in the machine; high-powered flushing takes care of the manual cleaning for you. This can save time, but I've met a lot of GI managers who still prefer their scopes to be manually brushed and don't use this feature, even after spending the extra money on it, which is hardly beneficial from a budgetary perspective.

On the other hand, the utility of equipment that offers continuous leak testing or employs a computerized system that tracks scopes and cycle details cannot be understated. When we were in the market for a new AER, I wanted to make sure it did a thorough job quickly, so an automated alcohol flush at the end of the cycle to facilitate drying was extremely appealing. No longer would this extra step take our techs extra time and effort. It has been a great help.

Advanced Sterilization Products
Evotech ECR
aspjj.com
(888) 783-7723
Pricing: $40,000 to $45,000
FYI: Advanced Sterilization Products's Evotech Endoscope Cleaner and Reprocessor (ECR) sidesteps the labor-intensive and time-consuming process of manual cleaning before scope turnaround. While bedside pre-cleaning is still necessary, Evotech automates the cleaning and high-level disinfection process, eliminating tedious brushing and delivering safe, fast, consistent reprocessing cycles. The system features dual independent basins with rotating spray arms and viewing windows, individual pumps for each endoscope channel, a printer and optional bar code scanner for monitoring and tracking, an optional built-in alcohol flushing component and a foot pedal that enables hands-free lid opening to prevent contamination.

Langford IC Systems
Langford Instrument Processor
licsystems.com
(813) 220-8622
Pricing: Negotiable fee-per-use arrangement
FYI: The only endoscope cleaner that operates without the use of connectors, the Langford Instrument Processor will validate cleaning results to a predetermined level well below 6.4 micrograms of protein per square centimeter, as established by the Food & Drug Administration, thus thoroughly preparing scopes for high-level disinfection or terminal sterilization. A push/pull technology creates a fluid dynamic that shears soil from both internal and external surfaces of endoscopes. Manual cleaning is not necessary, other than a post-procedure wipe-down and manual leak testing.

Medivators
Advantage Plus Endoscope Reprocessing System
medivators.com
(800) 328-3345
Pricing: not disclosed
FYI: Medivators's dual-basin Advantage Plus reprocessor monitors each endoscope channel separately for leaks, blockages and proper flow to ensure complete high-level disinfection. A computerized detection system prevents human error in selecting and connecting hookups, while the onboard data management system makes endoscope tracking, cycle log reviews and reprocessing quality assurance easy. An FDA-cleared cleaning claim eliminates the need for manual brushing and flushing. Continuous automated leak testing and a programmable alcohol flush are standard functions. And the single-use, environmentally friendly disinfectant's use at a low 30 ?C temperature saves time and ensures compatibility.

Olympus America
OER-Pro
medical.olympusamerica.com
(800) 848-9024
Pricing: $32,500
FYI: Olympus's OER-Pro is the only reprocessor designed by an endoscope manufacturer, ensuring optimal compatibility between the scope, the reprocessor and the chemistry. It is FDA-cleared to automate 7 of the 11 steps required in manual endoscope cleaning, including the flushing of channels with detergent, water and air, the most time-consuming and error-prone aspects of the process. It can simultaneously clean and disinfect up to 2 flexible endoscopes in as little as 26 minutes, getting them back into physicians' hands faster to increase patient turnover. The OER-Pro is also equipped with a radiofrequency identification management system, which enables accurate endoscope tracking by recording the scopes' serial and model numbers, the cycle operator and the time of reprocessing.

Steris
Reliance EPS
steris.com
(800) 548-4873
Pricing: not disclosed
FYI: Steris's Reliance Endoscope Processing System (EPS) and Reliance DG oxidizing chemistry offer a safe alternative to aldehydes. The unit safely accelerates throughput with an easy-to-load, virtually connector-less dual scope reprocessing chamber. Optional washing phases augment required manual scope pre-cleaning. The Reliance EPS's dry oxidizing chemistry eliminates staff exposure hazards associated with aldehyde-based high-level disinfecting solutions, diminishes chemical exposure, and requires no special venting, measuring, mixing or pouring.