A state-wide survey of disinfection techniques for nasendoscopies in Queensland ENT out-patient departments

Abstract

Background: Flexible nasendoscopy is an important part of the diagnostic process in Otorhinolaryngology. Flexible nasendoscopies come in close contact with mucous membranes of the upper aerodigestive tract. Therefore, appropriate and effective disinfection is vital to prevent iatrogenic infection and cross contamination. The lack of official national reprocessing guidelines has led to varying and inconsistent practice amongst ENT centres in Australia. Methods: A questionnaire was sent to 14 Queensland ENT outpatient departments to establish current practice. Results: In total, 50% (N=7) of hospitals used manual disinfection and 50% (N=7) used automated endoscope reprocessors (AEMs). Manual disinfection with Tristel was used in most (N=6) departments and Cidex was used in one hospital. The same disinfection technique was used after hours and in high risk patients (HIV, hepatitis B, hepatitis C, pulmonary tuberculosis) in all hospitals. The efficacy and time to reprocess were the main factors that influenced the disinfection techniques used. The majority (64.3%) of centres cleaned nasendoscopies in the ENT outpatient department and remaining hospitals (35.7%) did so in the Central Sterile Services Department (CSSD). A permanent record of nasendoscopy maintenance, reprocessing and patient tracking system was used in all departments. Conclusions: The disinfection techniques and disinfectant agents vary considerably across ENT outpatient departments in Queensland. Hence, a state wide disinfection guideline would be beneficial to ensure that reprocessing of nasendoscopies is standardised regardless of the technique used across the state.

The Effectiveness of Ultraviolet Smart D60 in Reducing Contamination of Flexible Fiberoptic Laryngoscopes

“…In a busy clinical practice, the same FFL may be used and reprocessed several times per day. Currently, there are no available national and international reprocessing guidelines specific to FFLs, 1 and there are gaps and variations in decontamination practices across ENT settings 2–4 . This may ultimately create a risk for iatrogenic infection.…”

A Manufacturer and User Facility Device Experience Analysis of Upper Aerodigestive Endoscopy Contamination: Is Flexible Laryngoscopy Different?

“…Published guidelines have emphasized the importance of nasopharyngoscope decontamination, 5,6 but few have specified an exact reprocessing protocol comparable to those established for bronchoscopes and duodenoscopes 7–9 . As a result, considerable variability in methods used for reprocessing nasopharyngoscopes exists across hospitals in the United States and internationally 10,11 …”