In every facility, endoscope reprocessing teams find themselves pressed between two conflicting demands. The first is for a thorough decontamination of every piece of equipment. The second, while a bit less obvious, is for a rapid turnaround in order to maintain efficiency.

These twin goals put reprocessing technicians in a difficult position. Rushed to keep up output, they may miss critical steps for cleaning, or commit errors that they might otherwise avoid. This may be behind some of the contamination observed in postmarket surveillance.

Or technicians may simply not have the time to complete every prescribed cleaning step. In a recent survey of nearly 2,500 reprocessing technicians, 40 percent reported feeling pressure to work quickly, and 26 percent said they don’t have enough time to thoroughly perform reprocessing instructions.

The findings take on added urgency as the Food and Drug Administration recommends that hospitals and endoscopy facilities transition to duodenoscopes with innovative designs to boost patient safety.

Single-use endoscopes would help facilities skirt much of this time pressure. But the benefits of scopes with disposable components aren’t as clear. In the end, the proper disposal of endcaps might add to—not subtract from—technicians’ workloads.

There’s also the question of how to manage the disposable components themselves.

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ERCP is a procedure in high demand. More than 500,000 Americans receive it every year. A shift to non-reusable scopes, then, amounts to a non-negligible burden on the environment. It’s incumbent on socially responsible organizations to reduce their ecological impact.

This is especially true for hospitals, as research has shown that the healthcare industry’s own pollution and waste have a significant negative impact on public health outcomes. Disposable duodenoscopes complicate the issue.

Infection-prevention departments must also consider the cost of disposal itself. The typical hospital faces millions of dollars in recurring waste management costs. Only time will tell how much fully- or partially-disposable duodenoscopes will add to that fiscal responsibility. This must be accounted for as organizations weigh the advantages of new approaches to ERCP.

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