CGRN Scope and Equipment Reprocessing 2 — Questions and Answers
Question 1: What endoscope channel is most frequently associated with reprocessing failures and infection transmission?
- Air/water channel
- Suction/biopsy channel
- Elevator channel of duodenoscopes (Correct answer)
- Light guide channel
Correct answer: Elevator channel of duodenoscopes
The elevator channel of duodenoscopes has been most frequently associated with reprocessing failures due to its complex design.
The elevator mechanism has small crevices and tight angles extremely difficult to access with standard brushes. Multiple CRE outbreaks have been linked to contaminated duodenoscope elevator channels. The FDA has encouraged disposable-tip designs.
Question 2: What is the correct sequence of steps in manual endoscope reprocessing?
- Disinfect, clean, rinse, dry
- Pre-clean, leak test, manual clean, rinse, HLD, rinse, dry (Correct answer)
- Rinse, disinfect, clean, store
- Clean, sterilize, rinse, use
Correct answer: Pre-clean, leak test, manual clean, rinse, HLD, rinse, dry
The correct sequence ensures each step builds on the previous one to maximize reprocessing efficacy.
Full sequence: bedside pre-clean, transport, leak test, manual cleaning with enzymatic detergent and channel brushing, rinse, visual inspection, HLD, sterile water rinse, alcohol flush, forced air drying, vertical storage.
Question 3: A biopsy channel brush emerges with frayed bristles. What action should be taken?
- Continue using until scheduled replacement
- Discard immediately and inspect the scope channel for damage (Correct answer)
- Trim the bristles and reuse
- Soak in disinfectant to restore
Correct answer: Discard immediately and inspect the scope channel for damage
A damaged brush must be discarded and the scope channel inspected for damage that may have caused the fraying.
Fraying indicates possible rough spots or kinks in the channel that caught the bristles. This damage can harbor bacteria. Remove the scope from service for professional inspection. Use a new correct-sized brush to complete cleaning.
Question 4: What is the purpose of the alcohol flush step in endoscope reprocessing?
- Additional disinfection
- Facilitate drying by displacing residual water in channels (Correct answer)
- Sterilize the channels
- Lubricate the channels
Correct answer: Facilitate drying by displacing residual water in channels
The 70% isopropyl alcohol flush displaces residual water and facilitates rapid drying.
Residual moisture is the greatest risk factor for bacterial recontamination during storage. Alcohol evaporates faster than water, achieving thorough drying. Combined with forced air drying afterward, this prevents organisms like Pseudomonas from regrowing.
Question 5: How often should AERs be validated for proper function?
- Annually only
- At installation, after maintenance/repair, and at regular intervals per manufacturer recommendations (Correct answer)
- Only when an infection is reported
- Monthly visual inspection is sufficient
Correct answer: At installation, after maintenance/repair, and at regular intervals per manufacturer recommendations
AERs require validation at multiple points in their lifecycle, not just on a single schedule.
Validation includes: installation qualification (IQ), operational qualification (OQ), after any maintenance/repair, routine daily monitoring (MEC testing, cycle parameters, water quality), and periodic performance qualification per manufacturer schedule.
Question 6: What water quality standard is required for the final rinse after high-level disinfection?
- Tap water
- Sterile water, bacteria-free filtered water, or water meeting AAMI standards (Correct answer)
- Distilled water only
- Any potable water
Correct answer: Sterile water, bacteria-free filtered water, or water meeting AAMI standards
The final rinse must use sterile or bacteria-free water to prevent recontamination.
Tap water is NOT acceptable as it may contain Pseudomonas, Legionella, and other waterborne organisms. Acceptable: sterile water, 0.2-micron filtered water, or AAMI ST91-compliant water. Water must be monitored with regular bacterial cultures.
CGRN Scope and Equipment Reprocessing 2
What endoscope channel is most frequently associated with reprocessing failures and infection transmission?