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From: TSS (
Subject: Endoscope probe reveals "haphazard" sterilization standards
Date: November 26, 2004 at 9:15 am PST

-------- Original Message --------
Subject: Endoscope probe reveals "haphazard" sterilization standards
Date: Fri, 26 Nov 2004 11:24:15 -0600
From: "Terry S. Singeltary Sr."
Reply-To: Bovine Spongiform Encephalopathy

##################### Bovine Spongiform Encephalopathy #####################

Patients Association 25.11.2004
Endoscope probe reveals "haphazard" sterilization standards

The sterilization of Britains endoscopes is revealed as haphazard and
lacking, in a survey unveiled today by the Patients Association to MPs
and Peers in the House of Commons.

The poll, among healthcare professionals, reveals that five per cent of
those questioned didnt clean their instruments between patients; more
than a half reuse the sterilising fluid; many endoscopes never make it
to the Central Sterile Department at the end of each clinic; and there
are no uniform guidelines on who is responsible, or just what they
should do.

The poll also shows that 35 per cent of those questioned had never even
heard of the Chief Medical Officers 2003 report Winning Ways, which
identified intensified control measures as essential to defeat
healthcare associated infection.

The Patients Association survey was conducted among NHS trusts
infection control staff, consultant microbiologists, senior clinical
nurses, consultant gastroenterologists, decontamination managers,
Central Sterile Services Department managers, risk managers, charge
nurses, and theatre managers and staff in endoscopy units throughout the
UK in October 2004.

A total of 1496 questionnaires were sent nationwide, and 180 replies
received, from 53 per cent of English NHS Trusts - but none from Scots
or Welsh units.

It was designed to reveal the infection control and decontamination
practices of medical devices, and showed that 96 per cent of the
respondents rank this high on their priority list, and 95 per cent say
they sterilize the endoscopes after each patient use. However:

∑ Standards vary on who is responsible for sterilisation  51 per cent
stated the endoscope nurse, but one in three said the healthcare
assistant and 19 per cent said either another nurse or even someone else
who was not a nurse

∑ Between 60 and 70 per cent of respondents indicated that they re-used
the sterilizing agents after each patient. The primary reason for re-use
is the claim that effectiveness remains the same, secondly because of
Trust policy, followed by the cost of alternatives. One respondent said
it was due to the unpleasant odour of the re-useable agents

∑ A full 80 per cent of respondents said they do not send the
appropriate endoscopes to the Central Sterile Department for sterilizing
at the end of each clinic

∑ There is currently no test for vCJD, yet one respondent thought there
was, and it was in use

The survey also asked if patients were informed about infection control,
and 68 per cent of respondents said no, or only if requested.

Three per cent of respondents said there was no education and training
for the infection control of endoscopy procedures, and four per cent do
not know if education and training have been implemented.

Claire Rayner, President of the Patients Association, said: Even this
limited survey reveals a picture of haphazard systems and standards in
what should be one of the most rigidly policed area of decontamination.
There is clearly enough evidence here to prompt a full survey, including
Scotland and Wales, and standardise best practice.

We hope that the results and the issues raised at the meeting on
infection control and medical device decontamination in the House of
Commons will stimulate further debate  transformed into real action -
about the vital need to minimise the risk of infection to patients
undergoing invasive procedures.

Shadow Health Secretary Andrew Lansley CBE MP, who is hosting the event
said: The Patients Association survey highlights a vital issue. The
rules of invasive procedures and the standards of decontamination of
equipment can have a major impact on a patients exposure to infection.

Publishing reports from the Department of Health must be accompanied by
action in hospitals if we are to achieve the standards of safety and
cleanliness which patients rightly demand.

I welcome the Patients Associations work in representing patients
interests in delivering cleaner hospitals.

More information:

Evidence For CJD/TSE Transmission Via Endoscopes

... Gastro-intestinal endoscopy is unlikely ... be a vector for the
transmission of sporadic
CJD as infected ... dangerous to the future of human health...TSS SHORT


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