Endoscopic Ultrasound (EUS) Endoscopes Cleaning And Disinfection Checklist

Endoscopic Ultrasound (EUS) Endoscopes Cleaning and Disinfection Checklist This checklist is designed for use solely as a customer educational tool and is not intended to replace or in any way modify the Olympus instruction manual/reprocessing manual. Be sure to follow the detailed steps outlined in the reprocessing manual that was included with your Olympus equipment when purchased. While Olympus' training may be used in support of a facility's overall competency program, it shall not constitute certification of the facility's CDS protocol. Olympus shall in no event be held responsible for a facility's proper performance of CDS protocol nor for a facility staying current with ongoing CDS instructional changes and corresponding training updates. Facility owners of Olympus equipment are fully responsible for complying with industry CDS standards and manufacturer's proper use and CDS instructions.

Facility name Date Endoscope Models: Check each model reviewed during this session.  GF-UC140P-AL5

 GF-UCT140-AL5

 GF-UM160

 GF-UE160-AL5

 GF-UCT180

Facility-verified Competency (Authorised Staff Member Name) Instructor Name Title Signature Date

Staff Member Name Signature Date

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Pre Cleaning

Demonstrated

Wear appropriate personal protective equipment.

1. Turn off the video system centre, light source, and ultrasound system. 2. Remove and discard the balloon if attached. 3. Using a detergent-soaked cloth, wipe down the insertion tube, and gently wipe the ultrasonic transducer.

4. Turn ON the suction source. 5. Attach the biopsy valve cap. 6. Immerse the distal tip in detergent, and depress the suction valve to first stage to aspirate the detergent for 30 seconds.

7. Depress the suction valve completely to aspirate detergent for 30 seconds. 8. Remove the distal tip from detergent solution, and depress the suction valve to first stage to aspirate air for 10 seconds.

9. Depress the suction valve completely to aspirate air for 10 seconds. 10. Turn OFF the suction source and turn ON the light source. 11. Depress the air/water valve completely. 12. Switch OFF the airflow regulator on the light source. 13. Remove the air/water valve. 14. Attach the air/water channel cleaning adaptor, and set the airflow to HIGH. 15. Immerse the distal end of the insertion tube in water. 16. Depress the air/water channel cleaning adaptor for 30 seconds. 17. Release the air/water channel cleaning adaptor for 10 seconds or more. 18. Turn OFF the light source. 19. For the GF-UCT180 scopes: a. Attach the washing tube to the elevator channel plug. b. Using the 5 ml syringe, slowly flush detergent solution through the elevator wire channel several times until no bubbles exit the distal end.

c. Using the 5 ml syringe, slowly flush water through the elevator wire channel several times.

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d. Using the 5 ml syringe, slowly flush air through the elevator wire channel several times until a steady stream of bubbles exits the distal end.

20. Disconnect the ultrasonic cable, vidoescope cable, endoscope and accessories; attach the water-resistant cap/s.

21. Transport to reprocessing area. Comments:

Leakage Testing 1. Fill an appropriately sized basin with clean water. 2. Connect the leakage tester to the air source, turn the air source on, and confirm that

Demonstrated

air is being emitted. Confirm the leak tester is dry.

3. Depress pin inside connector cap to confirm that air is being emitted. 4. Confirm that the leakage tester's connector cap and venting connector are dry. 5. Connect the leakage tester to either of the water resistant caps on the endoscope. 6. Ensure bending section has inflated. Completely immerse the endoscope in water. 7. Observe for 30 seconds while angulating the bending section, and confirm that there is no location on the endoscope from which a continuous series of bubbles emerges.

8. If a continuous series of bubbles emerges from any location, remove the endoscope from the water, and contact Olympus for further instructions.

9. If no leak is detected, remove the endoscope from the water and turn OFF the air source. 10. Remove the endoscope from water, and turn OFF the air source. 11. Disconnect the leakage tester from the air source. 12. Wait 30 seconds or until the bending section contracts to its pre-expansion size. 13. Disconnect the leakage tester connector cap from the venting connector. Comments:

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Manual Cleaning 1. Fill an appropriately sized basin with fresh detergent solution prepared as

Demonstrated

recommended by the manufacturer.

2. Completely immerse the endoscope in detergent solution. 3. Use a soft brush or lint-free cloth to thoroughly clean all external surfaces. 4. For GF-UCT180 perform the following brushing in the detergent solution. a. Turn the elevator control lever all the way in the opposite direction of the “U” direction.

b. While holding the distal end, brush the groove of the interior of the forceps elevator with the cleaning brush (MAJ-1534) until all debris is removed.

c. Look at the left side of the instrument channel opening from the distal end. Brush the interior of this part with the cleaning brush (MAJ-1534) until all debris is removed.

d. Look at the right side of the instrument channel opening from the distal end. Brush the interior of this part with the cleaning brush (MAJ-1534) until all debris is removed.

e. Move the elevator control lever in the “U” direction to raise the forceps elevator. f. While holding the distal end, brush both sides of the forceps elevator and the opposite side of the groove of the forceps elevator with the cleaning brush (MAJ1534) until all debris is removed.

g. Brush the distal end of the endoscope by using the cleaning brush (MAJ-1534). h. Move the elevator control lever all the way in the opposite direction of the “U” direction to lower the forceps elevator.

i. Immerse the distal end in detergent solution. Operate the elevator control lever to raise and lower the forceps elevator 3 times.

j. With the forceps elevator raised, flush the interior of the forceps elevator with detergent solution using the 30 ml syringe.

5. Brush the suction, instrument and balloon channels/cylinders/ports until no visible debris remains.

a. Use the channel-cleaning brush to brush the suction channel in the insertion tube. b. Use the channel-cleaning brush to brush the suction channel in the universal cord. c. Use the BW-400L to brush the balloon channel. d. Use the channel-opening cleaning brush to brush the suction cylinder. QR 07.0 V1.0 April 2017

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e. Use the channel-opening cleaning brush to brush the instrument channel port. 6. Attach the suction cleaning adaptor to the instrument channel port. 7. Attach the suction valve to the endoscope. 8. Attach a source of suction to the suction connector. 9. Immerse the distal end and weighted end of suction cleaning adaptor in detergent. 10. Turn ON the suction source, and depress the suction valve to the first stage for 30 seconds.

11. Remove the distal tip and suction/channel cleaning adaptor from the detergent solution, and then depress the suction valve to first stage to aspirate air for 30 seconds.

12. Immerse the distal end and the weighted end of the suction cleaning adaptor in detergent.

13. Depress the suction valve completely, and aspirate detergent for 30 seconds. 14. Remove the distal tip and the suction/channel cleaning adaptor from the detergent solution; then depress the suction valve completely to aspirate air for 30 seconds.

15. Turn OFF the suction source, and disconnect the suction tube. 16. Disconnect the suction valve and the suction-cleaning adaptor. Reprocess them as described in Section 7.9, Cleaning, Disinfection and Sterilisation Procedures for Removable Parts and Cleaning/Reprocessing Equipment.

17. Attach the channel plug and injection tube to the endoscope. 18. Immerse the suction port of the injection tube in the detergent solution. 19. Attach a 30 ml syringe to the air/water channel port on the injection tube, and inject 150 cm3 of detergent into the air/water and balloon channels.

20. Detach the injection tube and channel plug, and leave all items immersed. 21. For the GF-UCT180 scopes: a. Attach the washing tube to the elevator channel plug. b. Using the 5 ml syringe, inject 15 mls of detergent solution. c. Disconnect the washing tube from the endoscope, and immerse it in detergent solution.

22. Wipe all external surfaces with a lint-free cloth. 23. Soak for the time and at the temperature specified by the detergent manufacturer. QR 07.0 V1.0 April 2017

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24. Remove the endoscope and equipment from the detergent solution. 25. Inspect all reprocessing equipment. If debris remains on reprocessing equipment, ultrasonically clean at 33--48 kHz for 5 minutes.

26. Immerse endoscope and equipment in clean water, and gently agitate to rinse. 27. Attach the channel plug and injection tube to the endoscope. 28. Attach a 30 ml syringe to the suction port on the injection tube, and inject 150 mls of water into the suction and balloon channels.

29. Attach a 30 ml syringe to the air/water channel port on the injection tube, and inject 150mls of water into the air/water and balloon channels.

30. Remove the endoscope with all the equipment from the water. 31. Cover the distal end and control section of the endoscope with a clean, lint-free cloth. 32. Use a 30 ml syringe to inject 150 mls of air into each port on the injection tube. 33. For the GF-UCT180 scopes: a. Attach the washing tube to the elevator channel plug. b. Using the 5 ml syringe, inject 5mls of clean water and then 10 mls of air. c. Disconnect the washing tube from the endoscope. 34. Disconnect the channel plug and injection tube. 35. Use a clean, lint-free cloth to thoroughly wipe and dry the external surfaces of the endoscope and reprocessing equipment.

36. Inspect for visible debris; if debris remains, repeat manual cleaning procedure. Comments:

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Automated Endoscope Reprocessor (AER) High-Level Demonstrated Disinfection AER Type: High Level Disinfectant Type:

1. Test the potency of the disinfectant solution according to the manufacturer's instructions. 2. Inspect the connections according to the AER manufacturer's instructions. 3. Verify that the proper connector is being used for the endoscope being reprocessed. 4. Attach the endoscope connectors/adaptors to the AER and endoscope as per the AER manufacturer's instructions.

5. Operate the AER according to the AER manufacturer's instructions. 6. Ensure the endoscope is soaked in disinfectant solution according to the disinfectant manufacturer's recommendations for time and temperature.

7. Remove the endoscope promptly after the AER cycle is completed. 8. Perform the terminal steps that the AER does not perform (e.g. alcohol and air purge). FOR FACILITY INTERNAL USE ONLY! Olympus personnel are unable to demonstrate use of individual manufacturer's AER.

Comments:

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Manual High Level Disinfection Demonstrated 1. Fill an appropriately sized basin with disinfectant solution. 2. Test the potency of the disinfectant solution according to the manufacturer's instructions. 3. Attach the channel plug and injection tube to the endoscope. 4. Completely immerse the endoscope and equipment in disinfectant solution. 5. Attach a 30 ml syringe to each port on the injection tube, and inject at least 150 mls of disinfectant into the air/water, suction, and balloon channels.

6. Confirm that no bubbles exit the distal tip. 7. For the GF-UCT180 scopes: a. Using the washing tube and the 5 ml syringe, flush 15 mls of disinfectant solution through the elevator wire channel.

b. Confirm that no bubbles exit the distal end of the endoscope. c. While the scope is immersed in disinfectant solution, raise the forceps elevator and flush the vicinity of the forceps elevator with disinfectant solution by using the 30ml syringe.

8. Disconnect all equipment from the endoscope. 9. Remove any bubbles that adhere to the surfaces with a clean lint-free cloth. 10. Soak the endoscope and all equipment for the time and at the temperature recommended by the disinfectant manufacturer.

11. Re-attach the channel plug and injection tube to the endoscope. 12. Remove the injection tube's suction port from the disinfectant. 13. Attach a 30 ml syringe to each port on the injection tube, and inject 150 mls of air. 14. For the GF-UCT180 scopes, attach the 5 ml syringe to the washing tube, and flush the elevator wire channel with 15 mls of air.

15. Remove the endoscope and equipment from the disinfectant solution. 16. Disconnect all equipment from the endoscope. Comments:

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Rinsing after Manual High Level Disinfection 1. Fill a basin with sterile water. 2. Completely immerse the endoscope and equipment in the water. 3. Wipe all external surfaces with a lint-free cloth. 4. Attach the channel plug and injection tube to the endoscope. 5. Attach a 30 ml syringe to each port on the injection tube, and inject 150 mls of water. 6. For the GF-UCT180 scopes: a. Attach the washing tube to the elevator channel plug. b. Using the 5 ml syringe, inject 15 mls of sterile water into the elevator wire channel. 7. Remove the endoscope and equipment from the water. 8. For the GF-UCT180 scopes: a. Using the 30 ml syringe, flush the air/water and suction channels with 150mls of air. b. Using the 5 ml syringe, flush the elevator wire channel with 15 mls of air. c. Disconnect the injection tube only. Connect a sterile suction tube from the suction

Demonstrated

pump to the suction connector on the endoscope. Turn the suction pump ON and aspirate air for at least 15 seconds.

d. Turn the suction pump OFF and disconnect all equipment from the endoscope. e. Use a sterile, lint-free cloth to thoroughly wipe and dry the external surfaces of the endoscope and all equipment.

Comments:

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Alcohol Flush

Demonstrated

1. Attach a reprocessed channel plug and injection tube to the endoscope. 2. Immerse the injection tube's suction port in 70% isopropyl or ethyl alcohol. 3. Attach a 30 ml syringe to each port of the injection tube, and inject 150 mls of alcohol. 4. Remove the suction port from the alcohol. 5. Use a 30 ml syringe to flush through each port of the injection tube with 150 mls of air. 6. For the GF-UCT180 scopes: a. Using the 5 ml syringe, flush the washing tube with 15 mls of alcohol through the elevator wire channel.

b. Using the 5 ml syringe, flush the washing tube with 15 mls of air through the elevator wire channel.

7. Disconnect all equipment from the endoscope. 8. Wipe all external surfaces with a sterile lint-free cloth moistened in alcohol. 9. Attach a reprocessed channel plug and injection tube to the endoscope. 10. Attach a 30 ml syringe to inject 150 mls of air into the air/water and balloon channels. 11. For the GF-UCT180 scopes: using the washing tube and the 5 ml syringe, flush 15 mls of air through the elevator wire channel.

12. Disconnect the injection tube, and connect a clean suction tube to the suction connector.

13. Aspirate air for 15 seconds. 14. Disconnect all equipment from the endoscope. 15. Wipe all external surfaces with a sterile, lint-free cloth. 16. Use sterile cotton swabs to dry the inside of the air/water and suction cylinders and instrument channel port.

Comments:

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Endoscope Storage 1. Remove all valves and removable parts from the endoscope.

Demonstrated

2. Ensure that angulation locks are in the free position. 3. Store the endoscope in a well-ventilated cabinet. 4. Hang the endoscope so that the universal cord and insertion tube are hanging vertically and the distal tip of insertion tube is hanging freely.

Comments:

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