It's time to end manual cleaning of medical scopes, researchers say

Patient safety is top of mind for hospitals as reimbursement is increasingly linked to clinical quality, but one area that has not changed much in the last decade is bacteria breeding on medical scopes. 

The problem is that, based on research conducted at three major hospitals, medical scopes pose an ongoing threat of infecting patients with such bacteria -- even among healthcare providers who adhere to current disinfecting guidelines.

[Also: Olympus on trial in first case alleging contaminated medical scopes caused deadly superbug]

The authors of a new study published in the American Journal of Infection Control put the onus on hospitals, manufacturers and regulators to all do a better job of reducing contamination and, in the short-term, suggested eliminating manual cleaning processes altogether and sterilizing the scopes using gas or chemicals to speed up the process. 

Researchers found 71 percent of these medical scopes, or endoscopes, tested positive for bacteria at the three major hospitals, which were not named. They all had endoscopes that tested positive, and while none of the bacteria were superbugs, the pathogens put patients at a high risk of infection, compounded by the fact that endoscopes are frequently used to view areas deep inside the body.

The study focused on scopes used during lung procedures, colonoscopies and kidney stone removal. These types of endoscopes are different from duodenoscopes, gastrointestinal devices that have issues of their own, having been linked to about 35 deaths since 2013, three of them at UCLA's Ronald Reagan Medical Center.

Part of the issue is the way the endoscopes are designed, which makes it difficult to clean them effectively. Those problems can be magnified by periods of high patient volume, which the authors said can sometimes prompt hospital staff to rush through or skip steps in the cleaning protocol to get a scope ready for the next patient.

Called "reprocessing," skimping on certain safety elements can enable an environment in which bacteria can grow. Unfortunately, the authors said, there's been little to no improvement in this area over the past 10 years.

One of the three hospitals studied met current guidelines for disinfecting scopes, but despite this, 62 percent of its scopes tested positive for bacteria. 

Staff at the other two hospitals committed numerous breaches in protocol and saw 85 and 92 percent of their scopes testing positive for bacteria, respectively.

Some of the safety issues included using the same gloves for both dirty and newly reprocessed scopes, using unclean towels to wipe the scopes, unsterile storage areas and storing the scopes while they were still wet, with the moisture creating prime environs for bacteria.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com