If reprocessing an endoscope is like washing a car, then manual cleaning, with its scrubbing and soaking phases, is like washing your car in the driveway, says Nicholas Pellish, RN, administrative director of the Schuylkill Endoscopy Center in Pottsville, Pa. An automatic reprocessor? "Like taking your car to the car wash." If you're in the market for a new endoscope reprocessing system, you're going to be wowed by the latest tracking and documentation technology. Here are 4 benefits early adapters like Mr. Pellish told us you can expect.

1. Fewer manual cleaning steps
One of the challenges of reprocessing flexible endoscopes is that it needs to be done according to protocol every time. Standardization can be difficult because employees' attention to detail can vary depending on each technician's experience, training, work ethic and, let's face it, how soon you need those scopes turned over. This is especially true with the manual steps in scope reprocessing, such as leak testing and flushing.

Now that high-level disinfection has gone high-tech, bending over a sink is no longer a prerequisite to reprocess your flexible endoscopes. At Florida Hospital Zephyrhills, an automated endoscope machine handles most of reprocessing's 3 distinct manual steps: manual cleaning, high-level disinfection in the reprocessor and documentation, says Pam Hubbard, RN, sterile processing department coordinator at the 154-bed hospital. The automatic reprocessor flushes the channels with detergent, water and alcohol and then checks for leaks. "It's vastly different," says Ms. Hubbard.

There's no escaping 1 manual step: bedside cleaning to remove bodily fluids, tissue or other solids that could harden on the scope in the period between removal from the patient and hook-up to the automatic reprocessor.

The new system has streamlined reprocessing in the gastroenterology and urology departments. Before, flexible nephrocystoscopes and urethroscopes were entirely cleaned by hand and then sterilized. Now these smaller scopes can be attached to the automatic reprocessor for cleaning and high-level disinfection. Afterward, the reprocessing tech sterilizes them in hard containers in a low-temperature gas plasma sterilizer, says Ms. Hubbard.

2. Shorter cycles
Automating the process has cut reprocessing time for each scope from 50 minutes to 30 minutes, including documentation, says Ms. Hubbard, stressing that you shouldn't underestimate the importance of automated documentation. "We needed to standardize the process and documentation," she says.

The automated reprocessor also does 2 scopes at a time, compared to 1 at a time for the old reprocessor, she says. Some systems have 2 basins that let you run independent cycles at staggered intervals. With the newer systems, cycle times vary. For example, the latest generation of peracetic acid systems take about 22 minutes, while aldahol systems take about 29 minutes, according to manufacturers.

3. Better documentation
Manual documentation is time-consuming and requires attention to detail. Plus, many facilities have their own home-grown log systems that new employees need to learn.

Automating documentation with a reprocessor's software can speed the process because the staff member doesn't have to pick up a pen and enter data. It can also improve the accuracy of necessary documentation. This is important because surveyors are focusing on documentation of infection control and reprocessing protocols. "Everything is done by computer," says Ms. Hubbard, of her hospital's system that tracks scopes by serial number, user and patient.

Some automatic reprocessing systems, such as those used at the Schuylkill Endoscopy Center, feature radiofrequency identification (RFID) to track the scopes as they pass through the system. Each scope and user has an RFID tag. Each time the tech passes the RFID tag over the scanning pad, the system tracks the scope by serial number and reprocessing tech. This information is automatically routed to the reprocessor's information system. "It won't let you start the cycle until you scan," says Mr. Pellish.

Newer endoscopes come with the RFID tag built into them. Older scopes need to be retrofitted with the tags, says Mr. Pellish. "We know who processed it and when it went into the machine." The only limitation of the system, he says, is that you can't import patient information into the system.

4. Smart cabinets
Cabinets are no longer just well-ventilated places to hang your scopes. Smart endoscope cabinets track your scopes. At the University of Pennsylvania's Perelman Center for Advanced Medicine in Philadelphia, the endoscopy department has a cabinet system that uses RFID technology to track scopes by user, patient, vendor, serial number and time.

The system verifies that reprocessing has been completed properly according to protocol. "It adds accountability," says Claude R. Gibson, CST, manager for instrument processing at the facility.

After a scope's use in the procedure room, the reprocessing tech passes it by the RFID scanner before cleaning and high-level disinfection. The tracking system asks the user to confirm that the cleaning solution in the reprocessing machine was tested for adequate concentration. (Although the solution is designed to maintain its strength for several days, the solution should be checked before each use because the amount of bioburden on scopes can affect the longevity and efficacy of the solution, says Mr. Gibson.) The tech then passes the scope by the scanner before it's attached in the automated processor. If the scope wasn't reprocessed properly, or if a scope has been out of the cabinet for more than 24 hours, an alert can be sent to the supervisor via e-mail or smartphone.

After processing, the system records when the tech hung the scope in the cabinet. According to AORN's Perioperative Standards and Recommended Practices, flexible endoscopes should be reprocessed again if they're stored unused for more than 5 days. If 5 days have passed, the system sends an alert to the manager that the scope should be reprocessed. In the event of an infection control breach, the case can be easily investigated because all the information about the scope, patient and reprocessing tech can be accessed in seconds.