Cross Contamination

Cross-contamination from endoscopes to patients are a noted problem throughout endoscopy units across the country. The media has reported exposure to harmful bacteria and viruses following endoscopic procedures from inadequately cleaned scopes, the efficacy of high level disinfectants used in reprocessors and the design of the scopes. Legislatures are now questioning the types of infection control programs within endoscopy units and whether qualified personnel are being hired as endoscope technicians (Mathias, 2014). The problem of cross-contamination are not limited to one type of scope but includes colonoscopies, gastroscopes and duodenal scopes. The complex design of each scope has cause for concern in the formation of biofilm to harden
Systematic Plan for Search of Relevant Evidence Literature resources within the past five years will be researched for interventions in preventing cross-contamination from endoscopes. The Rating System for the Hierarchy of Evidence using ProQuest Nursing and Allied Health Source. The Evidence of Hierarchy uses findings gained from rigorous research or the evidence of best practice. The seven levels of evidence that will be used to indicate whether an intervention will improve the problem. The higher the level provides confidence that the evidence is correct (Melnyk & Fineout-Overhold, 2010).
• Level 1: Evidence from systematic review or meta-analysis of all relevant randomized control trials (RCT’s) of multiple experimental studies.
• Level II: Evidence obtained from well-designed randomized control trials (RCT’s) from single experimental studies.
• Level III: Evidence obtained from well-designed controlled trials without randomization using single quasi-experimental studies.
• Level IV: Evidence from well-designed case-control and cohort studies using case or cohort quasi-experimental
The intervention has shown that enriched training programs with observation of the technician decreases the risk of cross-contamination from endoscopes. Staff should be open to putting into practice the knowledge gained on scope reprocessing. Monitoring of staff would increase the workload for the supervisor but is beneficial for patient safety. The level and quality of manual cleaning using an effective enzymatic detergent is rated at acceptable credibility and fit. The intervention has shown that 2% glutaraldehyde and 4% chlorhexidine are both effective in the breakdown of bioburden. The study reported that one agent was not statistically superior to the other. Both agents are effective in reducing bacteria from scopes. The level and quality of the use of the highest efficacy of high-level disinfectants in automated reprocessors was rated at acceptable credibility and fit. The intervention has shown that PHMB-DBAC provides the same efficacy as OPA. PHMB-DBAC is a superior product in reduction of contact time and side effects. Proposal to changing from OPA would entail a cost analysis of the