This document was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in Aug 2020.
These guidelines represent a collaborative effort of the American Society for Gastrointestinal Endoscopy (ASGE), the American Association for the Study of Liver Diseases (AASLD), the American College of Gastroenterology (ACG), the American Gastroenterology Association (AGA), the American Society of Colon and Rectal Surgeons (ASCRS), the Ambulatory Surgery Center Association (ASCA), the Association for Professionals in Infection Control and Epidemiology (APIC), the Association of Perioperative Registered Nurses (AORN), the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the Society of Gastrointestinal Nurses and Associates (SGNA), and the Society for Healthcare Epidemiology of America (SHEA). The American Society for Gastrointestinal Endoscopy acknowledges all organizations and members of the American Society for Gastrointestinal Endoscopy Quality Assurance in Endoscopy and Standards of Practice committees that provided input into the guideline development.
Gastrointestinal (GI) endoscopy is highly effective for the prevention, diagnosis, and treatment of many digestive diseases. Endoscopes used in endoscopy are complex, diverse, and essential devices that require meticulous cleaning and reprocessing in strict accordance with manufacturer guidelines before being reused on patients. Multiple risks are associated with endoscopic procedures; one such risk includes patients developing an exogenous infection (ie, pathogen introduced through a contaminated device). Exogenous infections in endoscopy are attributed to a myriad of causes. In general, pathogen transmission related to standard end-viewing endoscopes are associated with a failure to follow established cleaning and disinfection/sterilization guidelines for endoscopes, accessories, or associated equipment or with the use of defective equipment. On the other hand, exogenous infections have occurred in patients undergoing specialized procedures using duodenoscopes, despite following established reprocessing protocols; such observations and findings have raised questions about the optimal methods for the cleaning and disinfection of these unique devices. At the same time, in recent years, concerns have been raised that many of these infectious risks to patients may be underestimated as a result of under-reporting or non-recognition. Consequently, this information highlights the need for clear, evidence-based reprocessing guidelines.
Gaps and variation in implementing infection prevention practices are common in endoscopy units across the United States, and compliance with reprocessing guidelines is inconsistent. Such variation emphasizes the need for standards and updates to infection control guidelines as it relates to GI endoscopes. Several guidelines have covered the topics of safety in endoscopy units, antibiotic prophylaxis before endoscopy,13 and standards for minimizing nonendoscopic infections and developing an infection control program in endoscopy units; together, these guidelines aid in improving infection control practices within endoscopy units. Given the rising concerns of endoscope-related infections, it is imperative to evaluate the current literature and standards for endoscope reprocessing. This guideline contains expanded details related to the critical reprocessing steps of cleaning and drying and incorporates recent evidence as it pertains to improving the reprocessing of GI endoscopes.
Read the full article on the Gastrointestinal Endoscopy journal site
Download the PDF of Multisociety Guideline on Reprocessing Flexible GI Endoscopes and Accessories
This document was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in Aug 2020.
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Guidelines for clinical practice are intended to indicate preferable approaches to medical problems as established by experts in the field. These recommendations will be based on existing data or a consensus of expert opinion when little or no data are available. Guidelines are applicable to all physicians who address the clinical problem(s) without regard to specialty training or interests, and are intended to indicate the preferable, but not necessarily the only acceptable approaches due to the complexity of the healthcare environment. Guidelines are intended to be flexible. Given the wide range of specifics in any health care problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.
Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons and its various committees, and approved by the Board of Governors. Each clinical practice guideline has been systematically researched, reviewed and revised by the guidelines committee, and reviewed by an appropriate multidisciplinary team. The recommendations are therefore considered valid at the time of its production based on the data available. Each guideline is scheduled for periodic review to allow incorporation of pertinent new developments in medical research knowledge, and practice.