The endoscopy room is considered a "clean area." Therefore, a separate designated area (within the endoscopy room) must be provided for the dirty scope transport bin. The scope must be precleaned immediately after being removed from the patient per The Society of Gastroenterology Nurses and Associates (SGNA) infection control standards.1 This should be done by wiping the scope with a cloth soaked in a prepared detergent followed by suctioning the detergent through the scope channels. The precleaning is done on the top of the scope cart before the scope is placed in the "dirty scope bin" and taken to the scope processing room where it is disinfected per manufacturer and SGNA guidelines.

All endoscopy rooms must have a hand wash station/sink and alcohol hand gel located close to the entrance/exit of the room. The room must have temperature control and the appropriate number of air exchanges per hour.2

Appropriate lighting in the endoscopy room is important. The overhead light is dimmed during the procedure to maximize viewing of images and mucosa on the endoscopy screen. Individual spot lighting must be available for the anesthesia provider, the nurse, and gastroenterology technician to facilitate accurate documentation and specimen identification. The endoscopy room should also be equipped with the following:

* Emergency medications, including reversal medications

* Dual suction

* Oxygen and water sources (sink)

* Storage room for tools such as biopsy forceps, endo-clips, sclerotherapy needles

* Trash and red regulated medical waste bins

* Sharps containers (at least two)

* Dirty linen cart (by the door).

Staffing standards

SGNA standards recommend staffing for endoscopic procedures should include one RN per procedure room to assess and monitor the patient during moderate sedation and analgesia. The RN should remain in the room to provide continuity of care and to assist as needed. There should be one RN and at least one other member of the endoscopy team present (a second RN or technician) during procedures involving patients with multiple comorbidities or pediatric patients, and during complicated procedures due to the risk for unpredictable responses, including adverse reactions to sedative and analgesic medications.3

Protective equipment

Personal protective equipment must be worn at all times during the procedure, including: impervious disposable or reusable gowns, gloves, eye goggles and masks, or one-piece masks with eye shields. These supplies should be kept in a cabinet in the procedure room or immediately outside the room.

Endoscopes

Endoscopes are valuable diagnostic and therapeutic tools that must be handled properly. Bite blocks must always be used in upper endoscopy-even if no teeth are present-for the patient's protection as well as to protect the scope. Once the high-level disinfection process is complete, endoscopes are hung in a ventilated cabinet so that no scopes are touching or loops are formed.

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