By Robin O. Novak, RN, CIC
There have been many questions posed recently regarding scope
cabinets. What design is best? As our facility upgrades, what
specifications would be critical design elements?
To this date, there has not been any updated guidance in either
SGNA, AORN, or CDC documents. The CDC guideline for disinfection
*Hang endoscopes in a vertical position to facilitate drying.
*Store endoscopes in a manner that will protect from damage
or contamination.
*Develop protocols to ensure that users can readily identify
an endoscope that has been properly processed and is ready
for patient use.
*Do not use the carrying case designed to transport clean and
reprocessed endoscopes outside of the healthcare environment
to store an endoscope or to transport the instrument within
the healthcare environment.
SGNA guidelines: Standards of Infection Prevention in Reprocessing
*Endoscopes must be stored in an area that is clean, well-ventilated
and dust-free in order to keep the endoscopes dry and free
of microbial contamination.
*An endoscope that is not dry must be reprocessed before use.
*Endoscopes should hang freely so they are not damaged by
physical impact.
*Endoscppes should be stored in accordance with the endoscope
and storage cabinet manufacturers' IFU.
*Endoscopes can be stored for 7 days.
*Use storage cabinets that are made of a material that can be disinfected.
*In conventional storage, hang endoscopes in a vertical position
(with caps, valves, and other detachable components removed)
to prevent moisture accumulation and subsequent microbial growth.
*For drying cabinets, follow the cabinet manufacturer's instructions.
*Reusable buttons and valves should be reprocessed and
stored together with the endoscope as a unique set for
tracking purposes.
SGNA gives additional guidance in the Standard of Infection
*Storage areas and other critical areas should be clearly labeled.
*Storage cabinets should have doors, and the interior of the
cabinets must be clean, free of debris, and dry.
*The route from the reprocessor machine to the storage to the
storage cabinet should not cross through the soiled processing area.
AORN guidelines add another layer for endoscope storage:
*Cabinets used for storage of flexible endoscopes should be
situated in a secure location.
*Cabinets should have doors and be located at 3 feet from any sink.
*Flexible endoscopes should be stored in accordance with
the endoscope and storage cabinet manufacturer's IFU.
*A drying cabinet should be used.
*If a drying cabinet is not available, flexible endoscopes may be
stored in a closed cabinet with HEPA-filtered air that provides
positive pressure and allows air circulation around the endoscopes.
*Flexible endoscopes should be stored in a cabinet that is either
designed and intended by the cabinet manufacturer for horizontal
storage of flexible endoscopes or of sufficient height, width and depth
to allow flexible endoscopes to hang vertically without cooling
and without touching the bottom of the cabinet.
*Flexible endoscopes should be stored with all valves open
and removable parts detached but stored with the endoscopes.
*Endoscopes should be clearly identifiable with distinct visual cue
as processed and ready to use.
*Personnel should wear clean, low-protein, powder-free, natural rubber
latex gloves or latex-free gloves when handling processed
flexible endoscopes and when transporting them to and from the
storage cabinet.
APIC recommendations are:
*When storing the endoscope, hang it in a vertical position to facilitate
drying ( with caps, valves and other detachable components
removed as per manufacturer instructions).
*Protect the endoscope from contamination. Store the caps and other
equipment linked to the scope together after HLD to ease in look
back investigations when the HLD cannot be assured.
Manufacturer recommendations vary by manufacturer; however, one
has these types of statements:
*After reprocessing, maintain appropriate transportation and storage
procedures to avoid contamination.
*Store in a cabinet which protects from physical damage.
*Do not store in direct sunlight, at high temperatures, in high humidity
or exposed to X-rays, ultraviolet rays, or ozone.
*Do not store with chemicals or in a gas-generating area.
*Do not coil.
*Make sure adjustable knobs are in the neutral position.
*All equipment must be thoroughly dried prior to storage.
*Keep cabinet doors closed; limit access to stored equipment.
*Store hanging vertically.
*Detach all accessories.
Therefore, you can see although there are some variables to storage conditions, most are in line with the others. It will be important for your facility to review the manufacturer guidelines, the guideline that your facility follows and resolve any disparities.
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