AHS 2020 TJC GI Scope Reprocessing & SPD

The area under the sink are free of dust and debris

Endoscopes we’re disconnected from leak tester - and were removed completely from submersion

GI endoscope reprocessing staff performed daily flow validation testing on endoscope flushing device

SPD HLD GI flexible endoscopes, test strips used to verify effectiveness of disinfectant used in automated endoscope reprocessing devices are dated with a revised expiration date upon opening, contrary to strip IFU.

In sterile processing department where staff perform HLD of GI flexible endoscopes the test strips used to verify the effectiveness of disinfectant in automated endoscope reprocessing devices are dated with revised expiration date upon opening in accordance with IFU

GI staff use the enzymatic cleaner per the IFU and the temperature of the water is 68-104 F.

GI staff follow IFU for daily decontamination process. Use enzymatic cleaner to decontaminate the flushing device, tubing and attachments. And documentation of process is present.

In GI nurse station glucometer kits contained reagents and are labeled with 3 months use by date.

GI reprocessing staff rinse endoscope after washing in detergent solution and flushing the scope in accordance with the IFU.

GI endoscope reprocessing staff perform daily flow validation testing on endoscope flushing device in accordance with IFU.

GI scope reprocessing staff follow IFU for the automated endoscope reprocessing device using enzym

In sterile processing department automated HLD device used to clean endovaginal ultrasound probes documentation is kept daily for chemical indicator pass per IFU.

Transesophagael echocardiogram probes are stored in a location that is free of dust and debris.

All other areas are observed compliant.