Resources for Pre-procedure Scope Testing

Specialties Gastroenterology

Published

Hi all:

I've looked everywhere and cannot find anything on recommendations for testing the function of the scopes before the procedure.

We use compliance kits and I insist my technician put sterile water in the basin and test suction, and air/water after hanging the scope and connecting it. This is a basic responsibility of the technician everywhere else I've worked. She refuses and insists that it is not needed.

I pointed out that we don't want to scramble for another scope if something is not working after the case has started. And she says that she has never seen that happen and if sterile water goes through the scope she has to reprocess it again.

I've made the point that since it was taken out of the cabinet and placed in the procedure room, it would need to be reprocessed again anyway. Besides, the only reason it would be taken out of the room is if it failed the testing.

She just refuses so I'd like to prove her wrong instead of just being the type of manager who says "it's my way or the highway."

Thanks in advance!

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I have only ever dabbled in GI nursing. I hope someone more knowledgeable replies. But my first thought was don't the sales reps come around your clinic? Isn't there an "owners manual" for the scopes that would answer these questions. Or you could even contact the company who makes the scopes via the Internet and get their official instructions on scope care.

I think that would carry more weight with your tech than something your read on Allnurses?

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Maybe you misunderstood. This isn't something you find in an owners manual and it has nothing to do with scope care, it is not even remotely a mandatory step. It is more of a common sense thing - to test all functions of the equipment before using it on a patient, and avoid having to fumble with getting different buttons or valves or an entirely different scope if you know what hits the fan (pun intended).

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Maybe you misunderstood. This isn't something you find in an owners manual and it has nothing to do with scope care, it is not even remotely a mandatory step. It is more of a common sense thing - to test all functions of the equipment before using it on a patient, and avoid having to fumble with getting different buttons or valves or an entirely different scope if you know what hits the fan (pun intended).

That is what we do with our scopes. We set up the OR, connect the scope, then test suction/spray. We also take a few pics and print them out. These steps are done for 2 reasons.

1. You should always check equipment prior to use (or at least check it as much as you possibly can) to make sure it is t faulty.

2. Docs are impatient and they are really impatient when they have to wait because something is broken that could have been completely avoided. Especially scopes. I have witnessed many times OR staff who didn't check the scope make a mad dash to the scope cabinet frantically searching for another one, while Dr.Screams-A-lot is getting more p*ssed by the second. I don't think you'll find your answer in a user manual but you are absolutely correct on the common sense thing. I mean, why would you not want to take an extra step to assure a faulty-free situation, especially in the OR?

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Every GI clinic I have floated to the tech checks the equipment exactly as you and SurgerySiren indicate. It makes no sense not to. My gut tells me you are going to need a rep from the scope company or "official" letter from them stating this is recommended practice for your tech to change her ways.

I appreciate your trying to work with her. You're a good manager, she comes across as sounding like a know it all!

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Thank you so much for the feedback, all! Now I know I'm not crazy :-P

I will discuss with Olympus if they could provide documentation on why this is best practice. At this point I have given her a verbal warning for insubordination (that's another topic!) and ignoring/refusing to perform my requests. I believe she is just reaching for anything and everything to claim I am wrong, saying there are certain things that are not her responsibility. I even offered to test the scope but told her she needed to make sure she does it in my absence if I am unavailable. She has gone so far as to put a 4x4 written with a sharpie "Don't Touch, thank you" It is a little too much!

Thanks again!

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Guidelines for Safety in the Gastrointestinal Endoscopy Unit - NCBI - NIH

Guidelines for Safety in the Gastrointestinal Endoscopy Unit

Olympus:

Cleaning and Disinfection of Endoscopes Policy and Procedures

I'd focus on PATIENT SAFETY aspect of checking equipment prior to use.... avoid procedure delay, sedation time etc.

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The 2016 AORN Standards on Flexible Endoscopes, Recommendation VII " Flexible endoscopes, accessories, and associated equipment should be visually inspected for cleanliness, integrity, and function before use, during the procedure, after the procedure, after cleaning and before disinfection or sterilization." The SGNA statements to do with RN delineation and supervision imply and the documentation standards imply checking the scopes pre-procedure.

Checking equipment is a normal part of this person's job and done everywhere I have ever worked.

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