Implementation of Best Practice in Endoscope Management by RTs in an Urban University Hospital

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The risk of infection transmission from inadequate handling of reprocessed flexible endoscopes is a safety issue that needs urgent attention. Providing safe and high-quality patient care using best practices as recommended by federal, state, and other regulatory bodies for endoscope reprocessing cannot be overemphasized. Respiratory Therapist (RT’s) staff are considered essential in management of mechanically ventilated patient and non-mechanically ventilated patients. The RT’s also assist with bedside bronchoscopies, intubations, and bedside tracheostomy. Therefore, the RT’s bear a responsibility to adhere to recommended guidelines when managing clean scopes and dirty scopes. Baseline data obtained from direct onsite observation of RT staff with a gap analysis risk assessment tool, showed an improvement was needed in bronchoscope handling by the respiratory staff. An online video based educational application was used to teach the staff and create more awareness on bedside bronchoscope management and transporting. Multiple in person training sections were held by the bronchoscopy nurses with return demonstration from staff as recommended by the Healthcare Infection Control Practices Advisory Committee. Staff knowledge and understanding was evaluated with quizzes at the end of the video training. The team used a competency verification sample checklist from HICPAC to assess staff competency. Compliance in RT’s bronchoscope handling with gloves and transporting of scopes with labeled transport trays improved from baseline of 15% to 80% within a six-month period.



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