HARD-TO-CLEAN The elevator of the duodenoscope is difficult to clean. Piedmont Healthcare uses a nylon brush to get the job done.

Toothbrush Trick
A Cheap Way to Clean Your Duodenoscopes

With the recent outbreak of bacterial contamination traced back to reprocessed duodenoscopes, there's been a big push to ensure these hard-to-clean scopes are free from debris. Piedmont Healthcare in Atlanta, Ga., has been using a cheap solution to clean their $30,000 scopes for years, says Karl Allen, RN, BSN, CNML, the clinical manager of perioperative services.

After use, staff clean the scope bedside using water and a detergent. They then hand the scope off to the endoscope reprocessing department. There, a tech uses a nylon brush similar to a toothbrush to meticulously clean the scope, scrubbing around the end of the scope, especially in and around the elevator, a notoriously difficult spot that can harbor bacteria.

"This is done in a fresh sink full of water, to limit the amount of splashing and the risk of debris coming in contact with our tech," says Mr. Allen. "After that, we continue to follow the manufacturer's instructions and society guidelines on duodenoscope reprocessing. We reprocess scopes using an automated endoscope reprocessor and, finally, hang them to dry in a closed, vented scope cabinet."

The idea to use the "toothbrush" to clean the tricky scopes came from a longtime tech who found that the brush — which is used frequently in central sterile processing — cleaned the scope better than other options, says Mr. Allen.

The toothbrushes from Healthmark (No. 3181-P Nylon Brush) come in packs of 10 and list for $1.15 apiece. While manufacturers often supply brushes for cleaning the scopes, Piedmont has found that the toothbrush's durable handle and tough nylon bristles can better scrub the nooks and crannies.

— Kendal Gapinski