A CQI Programme to improve the system for reprocessing endoscopes in operating theatre of Cardiothoracic Surgical Department (CTSD-OT), Queen Mary Hospital.

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Abstract Summary
Abstract ID :
Submission Type
Authors (including presenting author) :
Lo CY(1), Fung SH(1), Wong LY(1)
Affiliation :
(1)Cardiothoracic Surgical Department (CTSD), Queen Mary Hospital
Introduction :
CTSD-OT performed 550 bronchoscopy and bronchoscope assisted intubation yearly. Acquired bronchoscopic infections although rare can cause serious complication in immunocompromised patients especially lung transplant patients. A reliable, high quality endoscopes reprocessing system can minimize infection risks to patients. To achieve this goal, a continuous programme that supports training, competencies, quality measurement is necessary. An improvement project concerning the system for reprocessing bronchoscopes in CTSD-OT has started in 2016.
Objectives :
(1) To ensure patient care assistants (PCA) is competent of reprocessing bronchoscopes used in CTSD-OT. (2) To ensure there is sufficient readable education and training material for personnel involved in the reprocessing of bronchoscopes. (3) To ensure the final rinse-water of automated endoscope reprocessor (AER) used CTSD-OT for reprocessing of endoscopes meets the Hospital Authority‘s recommended standard. (4) To minimize the risks of infections related to bronchoscopes reprocessing.
Methodology :
Workflow of reprocessing bronchoscopes, its service gap and possible causes of problems was evaluated. Improvement strategies were included: (1) A Chinese version guideline for reprocessing bronchoscopes, routine maintenance and trouble-shooting guide of AER were created as daily working guideline and educational material for PCA. (2) All personnel involved in the reprocessing of bronchoscopes, including nurse-trainers and PCA receive ongoing education, training and assessment of competency of bronchoscopes’ reprocessing. (3) Annual assessment is performed to verify all patient care assistants’ competencies of bronchoscopes’ reprocessing. Total viable counts of the AER final rinse-water was performed quarterly.
Result & Outcome :
From October 2016 to October 2018, 9 final rinse water samples were collected from the AER for microbiological surveillance. All samples demonstrated acceptable results which met the Hospital Authority‘s recommended standard. 12 PCA were recruited for the competency test of bronchoscopes’ reprocessing by the end of 2018 with 100% passing rate was achieved. They were also interviewed, 100% respondents found that the Chinese version working guideline were beneficial for them to achieve competency and solve problems during reprocessing of bronchoscopes. There is no reported infectious case related to procedure with the use of bronchoscopes in CTSD-OT. In conclusion, the system for bronchoscopes reprocessing is generally improved in terms of training, competency assessment and quality measurement. Continuous assessment and improvement will carry out to maintain high quality system for endoscopes reprocessing.

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