Reprocessing Endoscopes: Are You Wearing Appropriate PPE?

Personal protective equipment (PPE) is dedicated attire and equipment for protection against infections materials. According to the Occupational Safety and Health Administration (OSHA) blood borne pathogen standards, employers must provide proper PPE to its employees and ensure PPE is being used appropriately.1

OSHA is regulatory, therefore if the OSHA standards are not followed a law is being broken and a facility could very well be fined by OSHA if they are not following the standards. Healthcare facilities are, for the most part, very good at providing PPE; however it is not always appropriately used, especially when flexible endoscopes are being reprocessed. Many professional organizations such as the Association of periOperative Registered Nurses (AORN), the Association for the Advancement of Medical Instrumentation (AAMI) and the Society of Gastroenterology Nurses and Associates Inc. (SGNA) have published guidelines, standards and recommendations regarding PPE usage.

In 2018 Ofstead and Associates put together a wonderful poster type document titled Personal protective equipment (PPE) for endoscope reprocessing personnel. This document is available at:  https://www.ofsteadinsights.com/wp-content/uploads/Ofstead_PPE_Instructional_Handout.pdf.2 This is a wonderful resource for any organization, large or small, that reprocesses endoscopes. I highly recommend it be posted in all decontam rooms/areas. It contains step by step instructions, rationales for why the particular piece of PPE is needed and very clear pictures of how to appropriately wear the PPE.

I applaud Cori Ofstead and her team of researchers for putting this wonderful poster together. Unfortunately, appropriate PPE is not always worn or worn correctly, especially when reprocessing in the GI area. This has always baffled me because we know that it is OSHA law which means it is mandatory, second, and even more importantly, the risk of personnel contamination may even be greater than processing other equipment or instrumentation due to the complexities and design of endoscopes.

The Ofstead poster provides a table showing PPE recommendations from SGNA, AORN, and AAMI.  All three of these professional organizations discuss how important it is to follow the OSHA Blood borne Pathogen Standard (CFR 1910. 1030). OSHA requires that each facility have in place an exposure control plan that outlines potential hazards to personnel. In the decontamination area/room these measures must include the use of PPE.3

The poster on PPE for endoscope reprocessing has great illustrational pictures and covers the seven PPE items that personnel must wear which includes:

  1. Scrubs,
  2. Head covers,
  3. Shoe covers,
  4. Impermeable gown,
  5. Fluid –resistant face mask,
  6. Face shield, and
  7. Gloves.

Each of the seven PPE items has its own section with pictures and discussion on why each item is necessary.

Before leaving the decontamination area/room all protective attire should be removed, being very careful to not contaminate the clothing beneath or skin. Immediately after removing all PPE wash hands or use an alcohol-based hand sanitizer.3 It is also important that healthcare organizations provide all personnel with education on the proper PPE use and removal procedures.

Please protect yourself and your staff from bloodborne pathogens by following the OSHA regulations around the required use of PPE in all healthcare settings. Supervisors and managers, it is up to you to make sure your staff know and understand the significance of proper PPE and that it’s use is consistently enforced. Displaying Personal protective equipment (PPE) for endoscope reprocessing personnel poster in every decontam room/area where endoscopes are reprocessed can go a long way in helping with that compliance and decreasing the chance of a fine by OSHA.

REFERENCES

  1. Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings, Centers for Disease Control and Prevention.
  2. Personal protective equipment (PPE) for endoscope reprocessing personnel, available at:  https://www.ofsteadinsights.com/wp-content/uploads/Ofstead_PPE_Instructional_Handout.pdf, accessed 8/6/2019
ANSI/AAMI ST79:2017 Comprehensive guide to steam sterilization and sterility assurance in health care facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2017.
Rose is a past President ASHCSP. She received numerous awards such as AORN’s award for Mentorship in 2012 and Outstanding Achievement in Nurse Education in 2001.  In addition, she received the national 2013 IAHCSMM award of Honor, the Industry Leadership Award from the Massachusetts chapter and the educator of the year award from the Golden West chapter. She was one of the Who’s Who in Infection Prevention in 2006 by Infection Control Today. Ms. Seavey is the author of the book tilted Sterile Processing In Healthcare Facilities: Preparing for Accreditations Surveys, published by AAMI and she serves on several AAMI committees writing standards.

 

Rose Seavey MBA, BS, RN, CNOR, CRCST, CSPDT 
President/CEO Seavey Healthcare Consulting, LLC 

 

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