MMHD Safe Practices

 

In an effort to decrease any fears or concerns related to the recent “superbug” found in Duodenoscopes at UCLA, MMHD wants to help our community understand how safe our practices are.

• All colonoscopes and endoscopes used at MMHD receive mechanical cleaning prior to disinfection. 

• Flexible endoscopes are cleaned with manufacturer-approved exzymatic cleaner immediately following use. 

• The channels are irrigated and brushed.

• A leak test is then completed, checking for any inconsistencies in the integrity of the scope.

• The scope is then placed in the Steris S1E and an EPA registered disinfectant and chemical monitoring strip is placed in the unit to disinfect together. The Steris S1E Processor is the top of the line automated machine for high level disinfection.

• When the automated disinfecting system has completed its’ cycle, a receipt is printed to ensure appropriate pressure, time and disinfection concentration were present.

• The serial number of the scope and a patient sticker is attached to each receipt.

These steps are followed according to the Steris S1E automated machine user manual, according to the endoscope disinfecting recommendations, and FDA recommendations.

MMHD has gone the extra mile in that we run a biological on a weekly basis.  The Series S1E does not require a biological test, however, MMHD has been in the habit of running these since prior to its’ purchase in 2012 and so we have continued doing so.  To run a biological – we place a chemical monitoring strip into an incubator and monitor for 24 hours for growth.  MMHD has consistently had a “no growth” strip.

All staff processing these scopes have yearly training and competencies completed.

MMHD uses a HD Colonoscope and a Gastroscope.  The scopes that were used in the UCLA hospital were Duodenoscopes.  These scopes are different in their use and their design. 

The Duodenoscope used at the UCLA hospital where the “superbug” outbreak took place did not have FDA approval.  “The manufacturer of a medical instrument at the center of a recent ‘superbug’ outbreak in Los Angeles did not receive federal clearance to sell the device, according to officials from the Food and Drug Administration.” ¹   

 The scopes are cleaned and disinfected at MMH mechanically by hand and then placed into the Series S1E automated machine.  The scopes at UCLA  “are cleaned by hand with liquid disinfectants.”…. The article then goes on to say that they are now using the automated machines ”In addition to the FDA and manufacturer cleaning guidelines, automated machines are now used”. ²

1:  http://www.dailynews.com/health/20150305/superbug-endoscope-used-at-ucla-and

2: “Superbug” Outbreak at UCLA Medical Center / HealthMap, The Disease Daily Feb 27, 2015

-Lisa Akin, MMDH Surgical Services Manager