Most medical offices offering endoscopic services are so busy with patients and endoscopy procedures that the time between the pre-cleaning and manual cleaning is not even given a second thought as there is none. A stacked patient schedule doesn't allow for down time, but what happens if there's an anomaly. Some rare situation that arises where there's a longer delay than there ever should be and your system and protocols are tested. Are you ready for that? 

In these rare situations, if there's no protocol in place you may be at risk of a failure of your AER being able to perform its job properly just because of unforeseen delays or unavoidable mis-haps in your office. It's always a good time to review and consider your in-office systems and policies when it comes to patient safety. There are simple methods that can be implemented to make sure this never becomes an issue.

How Much Time Can Lapse Between Pre-Clean and Manual Cleaning

Typically, when a medical clinic buys an AER they consider the time it takes the device to reprocess their flexible endoscopes after being used. This is critical of course and should be considered carefully, especially in busy offices. Endoscope reprocessers like the DSD EDGE™ take as little as 22 minutes for a full processing turnaround. But there are situations that may lead to additional mandatory cleaning which burns additional time you may not be accounting for. For example, if an endoscope is left idle for too long between the pre-clean at the bedside and the manual clean, additional cleaning may be necessary to adequately remove contaminants. This situation reduces your offices efficiency and productivity by adding time for additional cleaning. This is of course a variable but you may want to consider it when reviewing the average time reprocessing actually takes.

In almost all cases, the moment an endoscope is removed from the patient it should be pre-cleaned. In fact, most manufacturers indicate that the maximum amount of time that should lapse between pre-clean and the manual clean is no more than 60 minutes.

Delays in cleaning as mentioned previously can require what's called "Delayed Reprocessing". This process involves an extended soaking time of the flexible endoscope allowing for contaminants to loosen prior to manual cleaning. The issues and risks stem from the possibility of bioburden sitting on the endoscope and drying or hardening which may then make it more difficult, or impossible to remove those contaminants during the manual cleaning. This is a critical failure in systems and policies that puts patients at risk.

The manual cleaning is considered by most the most critical step. However, if the contaminants have hardened the high-level disinfection / liquid chemical sterilization may not work properly. As mentioned, this sometimes is caused by the scope not being properly cleaned beforehand in a timely manner. To avoid this situation, some manufacturers recommend starting a 60-minute timer the moment that pre-cleaning is completed. This is a very simple policy to put in place to make sure nothing like this happens at your office. This way the risk of growth of biofilm and other contaminants is minimized increasing the patient's safety.

Endoscopy Cleaning Bottom Line

According to most manufacturers the maximum amount of time once the scope is removed from the patient that should lapse between the pre-clean and the manual cleaning is no more than 60 minutes. With this in mind, it's critical to make sure that you do not exceed this time for your patient's safety without taking additional cleaning and disinfecting measures.