Article Content
Definitions
For the purpose of this document, SGNA has adopted the following definitions:
Reprocessing refers to the sequence of cleaning, lubricating (if necessary), and sterilizing (American Society for Testing and Materials [ASTM], 2000) or to the high-level disinfecting steps that will assure that an endoscopic accessory is patient ready (Alvarado, Reichelderfer, & the Association for Professionals in Infection Control and Epidemiology [APIC] Guidelines Committees, 2000; SGNA, 2005).
Water Bottle refers to the water container, cap, and tubing that attaches to a flexible endoscope.
Background
There is limited research available on the proper cleaning and reprocessing of water bottles used in endoscopy. SGNA encourages research on the topic to better define guidelines for the proper reprocessing of the water bottle.
Position
SGNA supports the following positions:
A. Water bottles should be manually cleaned and high-level disinfected or sterilized (according to manufacturer's recommendations) on a daily basis. Prior to storage, there should be no residual fluid or moisture remaining in the water bottle assembly. It is recommended that practitioners thoroughly dry all water bottle surfaces to reduce the potential for bacterial colonization (Alvarado et al., 2000; American Society for Gastrointestinal Endoscopy [ASGE], 1999; SGNA, 2003).
B. Sterile water should be used in the water bottle for all endoscopic procedures (Alvarado et al., 2000; ASGE, 1999).
C. Due to the increased risk of infection, it is recommended that a reprocessed water bottle be used for each endoscopic retrograde cholangiopancreatography (ERCP) (Alvarado et al., 2000; SGNA, 2003).
References
Alvarado, C. J., Reichelderfer, M., & the Association for Professionals in Infection Control and Epidemiology Guidelines Committees. (2000). APIC guideline for infection prevention and control in flexible endoscopy. American Journal of Infection Control, 28, 138-155. [Context Link]
American Society for Gastrointestinal Endoscopy. (1999). Infection control during gastrointestinal endoscopy. Gastrointestinal Endoscopy, 46(6), 836-841. [Context Link]
American Society for Testing and Materials. (2000). Standard practice for reprocessing of reusable, heat-stable endoscopic accessory instruments (EAI) used with flexible endoscopes [Standard]. West Conshohocken, PA: Author. [Context Link]
Society of Gastroenterology Nurses and Associates, Inc. (2003). Gastroenterology nursing: A core curriculum (3rd ed.). Chicago: Author. [Context Link]
Society of Gastroenterology Nurses and Associates, Inc. (2005). Standards of infection control in reprocessing of flexible gastrointestinal endoscopes [Standard]. Chicago: Author. [Context Link]
Recommended Reading
Meenhorst, P. L., Reingold, A. L., & Groothuis, D. (1985). Water-related nosocomial pneumonia caused by Legionella pneumophila serogroups 1 and 10. Journal of Infectious Diseases, 152, 356-364.
Nelson, D. B., Jarvis, W. R., Rutala, W. A., Foxx-Orenstein, A. E., Isenberg, G., Dash, G. P., et al. (2003). Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Infection Control and Hospital Epidemiology, 24(7), 532-537.
Rutala, W. A., & Weber, D. J. (1997). Water as a reservoir of nosocomial pathogens. Infection Control Hospital Epidemiology, 18, 609-616.
Rutala, W. A., Weber, D. J., & the Healthcare Infection Control Practices Advisory Committee. (2003). Position statement: Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. American Journal of Infection Control, 31(5), 309-315.
United States Food and Drug Administration. (2000). Guidance for industry and for FDA staff: Enforcement priorities for single-use devices reprocessed by third parties and hospitals [Guidance]. Rockville, MD: Author.
Wallace, R. J., Jr., Brown, B. A., & Driffith, D. E. (1998). Nosocomial outbreaks/pseudo-outbreaks caused by nontuberculous mycobacteria. Annual Review of Microbiology, 52, 453-490.
Wright, E. P., Collins, C. H., & Yates, M. D. (1985). Mycobacterium xenopi and Mycrobacterium kansasii in a hospital water supply. Journal of Hospital Infection, 6, 175-178.
Acknowledgment
Copyright (C) 2006, Society of Gastroenterology Nurses and Associates, Inc. (SGNA).
This document was prepared and written by the SGNA Practice Committee and adopted by the SGNA Board of Directors in May 2002. Revised in October 2005.
Additional copies can be printed from SGNA's website at http://www.sgna.org.
SGNA Practice Committee 2005-06
Susan Bohlander, BSN, RN, CGRN, Chairperson
Cynthia M. Friis, MEd, RN-BC
Donna Girard, BSN, RN, CGRN
Anne Scroggs, MSN, APRN-BC
LeaRae Herron-Rice, BSN, RN, CGRN
Loralee Kelsey, RN, CGRN
Carol Kraai, MSN, RN, CGRN
Lisa D. Miller, LPN, CGN
Cindy Taylor, MSA, BSN, RN, CGRN
Trina Van Guilder, BSN, RN, CGRN