CER Decontamination and Manual Cleaning Questions and Answers 5 — Questions and Answers
Question 1: Which organization publishes the primary national guideline used in the US for endoscope reprocessing, including manual cleaning standards?
- The American Medical Association (AMA)
- SGNA (Society of Gastroenterology Nurses and Associates) and AORN jointly (Correct answer)
- The Society for Gastrointestinal Endoscopy (ASGE) alone
- The Environmental Protection Agency (EPA)
Correct answer: SGNA (Society of Gastroenterology Nurses and Associates) and AORN jointly
SGNA and AORN publish widely adopted guidelines for endoscope reprocessing in the US, and adherence to these is considered the standard of care.
Question 2: A detergent manufacturer's IFU specifies a dilution ratio of 1:100. If you are preparing 2 liters of solution, how much detergent concentrate is required?
- 10 mL
- 20 mL (Correct answer)
- 50 mL
- 100 mL
Correct answer: 20 mL
1:100 means 1 part concentrate per 100 parts total solution; 2000 mL ÷ 100 = 20 mL of concentrate.
Question 3: What is the primary risk associated with reprocessing an endoscope that was NOT pre-cleaned at the point of use before transport?
- The scope may sustain cosmetic damage during transport
- Dried bioburden becomes significantly harder to remove, increasing infection risk (Correct answer)
- Transport regulations require a clean scope for containment compliance
- The AER machine sensors will reject a heavily soiled scope
Correct answer: Dried bioburden becomes significantly harder to remove, increasing infection risk
Organic soil dries and bonds to surfaces within minutes of a procedure, creating a protective layer over microorganisms that resists subsequent cleaning and disinfection.
Question 4: Which of the following correctly describes a critical-use endoscope classification under the Spaulding classification scheme?
- Endoscopes that contact intact mucous membranes and require high-level disinfection
- Endoscopes that enter sterile tissue or the vascular system and require sterilization (Correct answer)
- Endoscopes used only on the skin surface requiring intermediate-level disinfection
- All flexible endoscopes regardless of site of use
Correct answer: Endoscopes that enter sterile tissue or the vascular system and require sterilization
Under Spaulding's classification, critical items contact sterile tissue or the bloodstream and must be sterilized; semi-critical items (most flexible endoscopes) contact mucous membranes and require minimum high-level disinfection.
Question 5: What should a technician do when the endoscope manufacturer's IFU and the facility's reprocessing policy conflict regarding manual cleaning steps?
- Follow the facility policy because it is tailored to the local environment
- Follow whichever guideline is more stringent
- Always follow the manufacturer's IFU as it takes regulatory precedence (Correct answer)
- Consult the charge nurse who can override both documents
Correct answer: Always follow the manufacturer's IFU as it takes regulatory precedence
FDA requires that manufacturer IFUs be followed for medical device reprocessing; the facility policy must align with the IFU, and where there is conflict, the IFU governs.
Question 6: What action should be taken with single-use cleaning brushes after completing manual cleaning of one endoscope?
- Rinse with water and enzymatic detergent, then reuse for the next scope
- Discard the brush immediately after single use (Correct answer)
- Autoclave the brush for reuse on a different patient's scope
- Soak the brush in high-level disinfectant between uses
Correct answer: Discard the brush immediately after single use
Single-use brushes must be discarded after each scope because reuse risks cross-contamination and the bristles become damaged and less effective after a single use.
Question 7: During manual cleaning in the decontamination area, why should the endoscope be submerged below the waterline when flushing channels?
- Submersion is optional and only done for scopes with visible blood contamination
- Submersion prevents aerosol and splatter generation that could contaminate the environment and staff (Correct answer)
- It keeps the enzymatic solution warmer and more active during cleaning
- Regulatory standards require submersion only for bronchoscopes, not GI scopes
Correct answer: Submersion prevents aerosol and splatter generation that could contaminate the environment and staff
Cleaning channels while the scope is submerged prevents the generation of aerosols containing potentially infectious material, protecting reprocessing staff and the environment.
CER Decontamination and Manual Cleaning Questions and Answers 5
Which organization publishes the primary national guideline used in the US for endoscope reprocessing, including manual cleaning standards?