As a leading voice for GI nursing professionals and infection prevention, the Society of Gastroenterology Nurses and Associates, Inc. (SGNA) is dedicated to providing the healthcare community with information to assist with practice. Patient safety is the top concern for everyone, and the transmission of CRE through ERCP procedures in several sites across the country means that healthcare professionals must be extra diligent.
SGNA and the other GI societies, regulatory agencies, and manufacturers are working together on this critical issue. While long-term solutions are yet to be established, the SGNA urges all endoscopy units using duodenoscopes and other instruments with elevator channels to do the following:
• Work with your Infection Prevention and/or Quality Departments in reviewing all policies and procedures involving reprocessing and ensure these are up to date. They should include the following:
o Perform competency assessments with reprocessing staff to ensure all reprocessing steps are following current SGNA Standards and current manufacturers' guidelines.
o Review staff training and provide device-specific reprocessing instructions.
o Educate all endoscopy staff on CRE infections.
o Document endoscopes used for each procedure.
o Assess your patient population to better understand your facility's risks.
o Consider a one-time post-reprocessing culture of your inventory of elevator equipped endoscopes.
o Note: The FDA's recommendations include a comprehensive quality control program for reprocessing duodenoscopes be put in place, including written procedures for monitoring training and adherence to the program, and documentation of equipment tests, processes, and quality monitors used during the reprocessing procedure.
• Sign up for the SGNA Infection Prevention Champions Program to assess your current infection prevention program and design needed educational interventions. Enrollment has been extended into March to allow your facility added opportunity to become involved in this exceptional program.
The American Society for Gastrointestinal Endoscopy (ASGE) has developed an informative video on the CRE outbreak featuring Bret Peterson, MD FASGE from the Mayo Clinic.