Page 66 - policy and procedure infection control

Policies and Procedures on Infection Control

4.7 Disinfenctions of Endoscopes

4.7.1 Introduction
Understanding of infection control in its application to GI endoscopy is important as to prevent
the possibility of transmission of infection. Thus compliance with the disinfection guidelines is
the key factor in determining endoscopic safety, and posed virtually no risk of patient-borne
transmission (Hepatitis C, Hepatitis B, HIV, Salmonella, Psuedomonas aeruginosa,
Enterobacteriacea) or environmental organisms (SARS-CoV, Avian influenza A virus [H5N1]).
Glutaryldehyde has been most commonly used disinfection in endoscopy previously, but
other newer products such as Succine-diadehyde (Gigasept 4%) and Paracetic Acid &
Hydrogen Peroxide (Perascope) has been in the market recently.
The ideal choice of disinfection should be based on the following factors:-

• Effective against a wide range of organisms including blood-borne viruses
• Compatible with endoscopes, accessories and endoscope re-processors
• Non-irritant and safe for users
• Environmentally friendly for disposal
• Stability of the solution for the specified duration of use
• Able to be reused for the specified period
• Cost-effective (include costs of the appropriate automatic endoscopic re-processors
(AER), storage space, conditions required for use, and staff protection measures)
It is of utmost important to protect against chemical used during cleaning and disinfection
in order to avoid from toxic and allergic reactions. Separate purpose-designed rooms for
cleaning and disinfection must be well ventilated and disinfections should be used within
a closed system.

Diseases may also be transmitted from patient to endoscopic personnel. Therefore,
protection from direct contact with the endoscopes and accessories is essential.
For the protection of the staff during the disinfection procedure the following apparel or
equipment has been recommended:-
• Gloves long enough to cover the forearms, preferably sterile gloves to protect arms
from splashes
• Long sleeves waterproof gowns. Preferably should be changed between patients or
when it gets contaminated
• Goggles to prevent conjunctiva irritation and protect the splashes
• Face masks to reduce inhalation of vapour

In local circumstances, training and resources may vary but high standards of disinfection
must always be maintained.

Ministry of Health Malaysia 55