ISSUE: Each year, an increasing number of healthcare procedures are performed using endoscopic equipment that is no longer confined to surgical or gastrointestinal departments in the healthcare facility. Inadequate processing of endoscopic equipment has been associated with outbreaks of infection. Infection Prevention and Control Professionals (ICPs) must assess and evaluate the cleaning, disinfection, transport, and storage processes for endoscopes used throughout their healthcare facility. The great diversity of equipment and limited hands-on knowledge require ICPs to seek guidance on best practices to prevent infections associated with endoscopes.

PROJECT: A team of 4 Infection Prevention and Control Professionals (ICPs) and their Medical Director from a large, multi-hospital system developed an Endoscopy Resource Kit to meet the need for concise information. This team met several times over a 2 year period to: determine the endoscopy resource needs of the ICP; identify the types of endoscopes and current methods used for processing them; pool existing tools and resources; research best practices, manufacturer’s recommendations, and professional organization guidelines; and assess the problems or barriers that ICPs face in evaluating endoscope processes.

RESULTS: The team created an Endoscopy Resource Kit that includes: a step-by-step guide; descriptions of the types of endoscopes and how they are used; a sample survey to locate and identify endoscopes and the department where they are being used; a compendium of sample policies for cleaning, disinfecting, and monitoring endoscopes and their automated washers (if used); and the current guidelines and recommendations available from professional organizations and instrument manufacturers. Each hospital within the healthcare system received a copy of the Endoscopy Resource Kit and online access to it.

LESSONS LEARNED: Pooling resources and expertise from various sources in the healthcare system are advantageous when creating an endoscopy resource kit. This team approach revealed the issues ICPs face in identifying and reviewing all aspects of processing endoscopes. It encouraged the sharing of information across departments and hospitals. It resulted in ICPs, physicians, and department staffs taking ownership in a concise, centralized resource kit containing best practices in the processing of endoscopes.