SGNA Infection Control and Safety 1 — Questions and Answers
Question 1: According to SGNA guidelines, what is the minimum number of high-level disinfection cycles required for a flexible endoscope after each patient use?
- One complete cycle following thorough manual cleaning (Correct answer)
- Three cycles
- Two cycles
- Five cycles
Correct answer: One complete cycle following thorough manual cleaning
SGNA and AORN guidelines require one complete high-level disinfection (HLD) cycle following thorough manual cleaning with leak testing and channel brushing.
Question 2: Which step in endoscope reprocessing is considered the MOST critical for patient safety?
- Manual cleaning (pre-cleaning and bedside cleaning) (Correct answer)
- High-level disinfection
- Rinsing
- Drying and storage
Correct answer: Manual cleaning (pre-cleaning and bedside cleaning)
Manual cleaning removes 99%+ of bioburden; without thorough cleaning, high-level disinfectants cannot penetrate biofilm and adequately disinfect the scope.
Question 3: What type of personal protective equipment (PPE) is required when manually cleaning contaminated endoscopes?
- Gloves, fluid-resistant gown, face shield, and mask (Correct answer)
- Gloves only
- Gloves and gown only
- Standard surgical mask and gloves
Correct answer: Gloves, fluid-resistant gown, face shield, and mask
Full PPE including gloves, fluid-resistant gown, face shield, and mask is required during manual cleaning to protect against splashing of contaminated fluids.
Question 4: What is the purpose of a leak test during endoscope reprocessing?
- Detect damage to the endoscope's internal channels before disinfection (Correct answer)
- Test disinfectant concentration
- Verify scope is fully dry
- Confirm all accessories are present
Correct answer: Detect damage to the endoscope's internal channels before disinfection
Leak testing detects defects in the endoscope's insertion tube or angulation covers that could allow fluid ingress, damaging internal components and harboring microorganisms.
Question 5: Which organism is most associated with outbreaks linked to inadequate duodenoscope reprocessing?
- Carbapenem-resistant Enterobacteriaceae (CRE) (Correct answer)
- MRSA
- C. difficile
- Pseudomonas aeruginosa
Correct answer: Carbapenem-resistant Enterobacteriaceae (CRE)
CRE outbreaks linked to duodenoscope elevator mechanisms prompted the FDA to mandate enhanced reprocessing protocols and surveillance cultures for duodenoscopes.
Question 6: How should flexible endoscopes be stored after reprocessing and drying?
- Hanging vertically in a ventilated cabinet (Correct answer)
- Coiled in a closed drawer
- Submerged in disinfectant solution
- In sealed plastic bags
Correct answer: Hanging vertically in a ventilated cabinet
Endoscopes should be stored hanging vertically in ventilated cabinets to prevent moisture accumulation, which promotes microbial growth in channels.
SGNA Infection Control and Safety 1
According to SGNA guidelines, what is the minimum number of high-level disinfection cycles required for a flexible endoscope after each patient use?