Let others know...

Personal Protective Equipment for Endoscope Processing
By Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT

Personal protective equipment (PPE) is defined as dedicated attire and equipment for protection against infectious materials.1 Personal protective equipment includes:

  • Gloves to protect the hands
  • Gowns or aprons to protect the skin and clothing
  • Masks and respirators to protect the mouth and nose
  • Goggles to protect the eyes
  • Face shields to protect the entire face

The respirator has been designed to also protect the respiratory tract from airborne transmission of infectious agents.1

According to the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standards, employers must provide proper PPE to their employees and ensure PPE is being used appropriately according to specific tasks or duties being performed.

OSHA requires that each facility has in place an exposure control plan that outlines potential hazards to personnel. In the decontamination area or room, these measures must include the use of proper PPE.2 OSHA is a regulatory requirement; therefore, if the OSHA standards are not followed a law is being broken and a facility could very well be fined for not following the regulations.

Due to the complexities and design of endoscopes, the risk of personnel contamination may be greater than processing other equipment or instrumentation, which is often not as complicated or contaminated as flexible endoscopes can be.

Healthcare organizations are usually very good at providing PPE; nevertheless, staffs are not always using PPE appropriately, including when flexible endoscopes are being reprocessed. As a consultant providing assessments to healthcare organizations, I have often witnessed appropriate PPE not being routinely worn, particularly when reprocessing endoscopes.

Professional organizations such as the Society of Gastroenterology Nurses and Associates, Inc. (SGNA), the Association of periOperative Registered Nurses (AORN), and the Association for the Advancement of Medical Instrumentation (AAMI) have current published guidelines, standards, and recommendations regarding appropriate use of PPE which all healthcare organizations should follow.

Last year Ofstead & Associates published an informative poster titled “Personal Protective Equipment (PPE) for Endoscope Reprocessing Personnel.”3 This is a wonderful resource for any organization, large or small, that reprocesses endoscopes. I highly recommend it be posted in all decontamination rooms and areas. It contains step-by-step instructions, rationales for why the particular piece of PPE is needed, and clear pictures of how to wear the PPE.

The Ofstead poster has an informative table showing the correct PPE recommendations from SGNA, AORN, and AAMI. These three professional organizations discuss how important it is to follow the OSHA Bloodborne Pathogen Standard (CFR 1910.1030).

The “Personal Protective Equipment (PPE) for Endoscope Reprocessing Personnel” poster has wonderful photos and descriptions of proper PPE. The poster covers the seven PPE items that personnel must wear, including:

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

The PPE items have their own sections with discussion on the importance of wearing each item during reprocessing of endoscopes.

Before leaving the decontamination area or room, all protective attire must be removed, being extremely careful to not contaminate the clothing underneath or skin. Directly after removing all PPE, hand hygiene must be performed.3 It is also imperative that healthcare facilites provide all personnel with education on the proper PPE, its proper use, and proper removal procedures. 

The OSHA regulations on the required use of PPE in all healthcare settings are there to protect you and your staff. Supervisors and managers, it is up to you to make sure your staff knows and understands the significance of proper PPE and to ensure the use of PPE. Leaders need to make sure it is consistently being appropriately used and enforced. Displaying this educational poster in every decontamination room or area where endoscopes are reprocessed can be extremely helpful with ensuring compliance. Remember, OSHA is regulatory and is meant to protect the worker; therefore, it is the law, which means it is mandatory and should be regularly monitored.

References

  1. Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings. Available at:https://www.cdc.gov/HAI/pdfs/ppe/PPEslides6-29-04.pdf. Accessed 6/23/2019
  2. 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.
  3. “Personal Protective Equipment (PPE) for Endoscope Reprocessing Personnel” available at: https://www.ofsteadinsights.com/wp-content/uploads/Ofstead_PPE_Instructional_Handout.pdf, accessed 6/23/2019

Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT, is president/CEO of Seavey Healthcare Consulting and formerly the director of the SPD at The Children’s Hospital of Denver. Rose served on the AORN board of directors and is a past president ASHCSP. She received numerous awards and was named as one of the Who’s Who in Infection Prevention by Infection Control Today. Ms. Seavey is the author of Sterile Processing In Healthcare Facilities: Preparing for Accreditation Surveys, published by AAMI. She serves on several AAMI committees helping to write national standards.

Sign up to read Rose Seavey’s feature in NewSplash!

NewSplash is a free weekly digital newsletter dedicated to providing useful information to CS and IP professionals who strive to keep patient safety high.