Thomas E Szymczak, PT, Safety, Consultant, President, Thomas J Small, MD, General, Surgeon, Medical, Director. Vortek Surgical, Indianapolis, IN.
INTRODUCTION
Encountering GI bacteria, bloodborne pathogens, and OPIM is predictable and preventable during endoscopic GI procedures. As many of the most infectious, environmentally-transmitted bacteria originate from the GI tract, effective management is of critical importance. However, implementation of processes employed to contain such pathogens and prevent dissemination into post-procedural care environments has not been described or standardized.
Currently available guidelines suggest the links between an endoscopy and an infection are often inadequately implemented aseptic and hygienic techniques (ASGE). Though these procedures are often performed as a diagnostic tool for C. difficile or similar infectious bacteria, colonization or carrier status is often unknown prior to most procedures. The manipulation of a flexible endoscope and use of any biopsy forceps or snares employed present significant and ongoing opportunity for contamination of the procedure gurney, exposed linens, and patient via contact with the scope and gloved hands.
DESCRIPTION
Endoscopic GI procedures, though not aseptic, are by performed in an environment of care where enteric contact isolation precautions apply. Adequate preventative measures to improve the hygiene during these procedures should include implementation of the recommended protective barriers to prevent cross-contamination of exposed surfaces on the gurneys, rails, and linens. In the alternative, interim disinfection of gurneys, changing of linens, and cleaning of exposed patient surfaces should be performed prior to moving a patient and gurney into PACU/recovery. Interim cleaning and decontamination is a time-intensive process, requiring avoidable movement of a sedated patient and results in delays in procedure room turn times.
The ENDODRAPE® Endoscopy Containment Systems (Vortek Surgical) provide a simple solution to efficiently and effectively managing these risks and containing pathogens and OPIM during endoscopic GI procedures. The ENDODRAPE® systems are comprised of a comprehensive, fluid resistant barrier that is quickly deployed prior to the start of a procedure. This barrier establishes a “Zone of Protection” (similar to the aseptic fields implemented in sterile surgical environments), shielding the patient, linens, and gurney surfaces from contamination during the procedure. This disposable barrier prevents bacteria and secretions from contacting the underlying surfaces, allowing for confidence of containment and ease of cleanup upon removal after completion of the procedure.
The Patented ENDODRAPE® systems, specifically designed for use in GI endoscopy, incorporate a number of procedure enhancing components, including: a modifiable scope guard to protect expensive endoscopes from damage and limit the common need for “wrestling” the scope during advancement and withdrawal; Integrated pockets for containing snares and biopsy forceps; Readily accessible gauze sponges in its integrated gauze pocket; and an optional reinforced accessory pad to facilitate patient repositioning.
After completion, the ENDODRAPE® is quickly removed and disposed of along with any contamination, disposable supplies and accessories. The implementation of the ENDODRAPE® establishes a functional protective barrier in an integrated self-contained system that promotes procedural process flow and equipment protection.
CONCLUSION:
The ENDODRAPE® Endoscopy Containment Systems provide a simple to implement and use, cost effective solution to balancing the needed advancement in infection control processes and efficiency requirements of GI endoscopy.