Gastrointestinal endoscopy services in Salvador, Bahia: analysis in the light of patient safety

Authors

  • Eliana Auxiliadora Magalhães Costa Profa. Doutora Titular da Universidade do Estado da Bahia. http://orcid.org/0000-0002-2389-0734
  • Jaqueline Brasil Universidade do Estado da Bahia
  • Rebeca Assis Universidade do Estado da Bahia

DOI:

https://doi.org/10.5327/Z1414-4425202227769

Keywords:

Endoscópios, Segurança do paciente, Eventos adversos.

Abstract

ABSTRACT: Objective: To analyze the incidence of adverse events related to gastrointestinal endoscopic procedures. Method: Multiple case study in Type III gastrointestinal endoscopy outpatient services, in the city of Salvador, Bahia, analyzing: Patient Safety Centers (Núcleos de Segurança do Paciente – NSP); adverse events and endoscopic decontamination. Results: 28.5% of the gastrointestinal endoscopy outpatient services in the city participated in the study. There are NSPs, which work according to Patient Safety Plans, but without a dedicated professional. Only one service monitors patients after endoscopy, which makes it difficult to identify adverse effects after procedures in these organizations. Basic patient safety protocols exist in most services. The total incidence of adverse effects is 0.3%; and 0.8% for upper digestive endoscopy and colonoscopies. Bacteremia, abdominal pain, bleeding, and intestinal perforation are the most frequent damages. All services have a good organofunctional structure for cleaning and disinfecting endoscopes. Conclusion: The services have NSPs and implement recommended safety protocols. The adverse effects identified are in line with the literature; however, these data may be underreported, since these services do not have an active surveillance system for adverse events after endoscopic examinations.

Author Biographies

Eliana Auxiliadora Magalhães Costa, Profa. Doutora Titular da Universidade do Estado da Bahia.

Pós Doutora em Saúde Pública. Profa. Titular da Universidade do Estado da Bahia.

Jaqueline Brasil, Universidade do Estado da Bahia

Discente do Curso de Enfermagem. Universidade do Estado da Bahia

Rebeca Assis, Universidade do Estado da Bahia

Discente do Curso de Enfermagem. Universidade do Estado da Bahia

References

Day LW, Muthusamy VR, Collins J, Kushnir VM, Sawhney MS, Thosani NC, Wani S. Multisociety guideline on reprocessing flexible GI endoscopes and accessories. Gastrointestinal Endoscopy. 2021; 93(1). https://doi.org/10.1016/j.gie.2020.09.048

American Society for Gastrointestinal Endoscopy. Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update. Gastrointestinal Endoscopy 2017;85(2):282-300. https://doi.org/10.1016/j.gie.2016.10.002.

Snyder GM, Wright SB, Smithey A, Mizrahi M, Sheppard M, Hirsch EH et al. Randomized comparison of 3 high-level disinfection and sterilization procedures for duodenoscopes. Gastroenterology 2017;153:1018-25. https://doi.org/10.1053/j.gastro.2017.06.052

Society of Gastroenterology Nurses and Associates. Standards of Infection Prevention in Reprocessing Flexible Gastrointestinal Endoscopes. Chicago;2018. [acessado em 20. Out.2020]. Disponível em: https://www.sgna.org/Portals/0/SGNA%20Standards%20of%20infection%20prevention%20in%20reprocessing_FINAL.pdf?ver=2018-11-16-084835-387

Kovaleva J. Infectious complications in gastrointestinal endoscopy and their prevention. Best Practice & Research Clinical Gastroenterology.2016;30(5):689-704. https://doi.org/10.1016/j.bpg.2016.09.008

Wang P, Xu T, Ngamruengphong S, Makary MA, Kalloo A, Hutfless S. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut. 2018;;67:1626–1636. https://doi.org/10.1136/gutjnl-2017-315308

Muscarella L. F. Risk of transmission of carbapenem-resistant Enterobacteriaceae and related bacterial biofilms an “superbugs” during gastrointestinal endoscopy. World J Gastrointest Endosc 2014; 6(10):457-74. [acessado em 23. Abr.2020]. Disponível em: http://nascecme.com.br/2014/wp-content/uploads/2017/03/Updated-guidance-for-the-Prevention-of-CRE...pdf

Kovaleva J., Peters F. T. M., Mei H. C., Gedener J. E. Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy. CMR 2013; 26(2): 231-54. https://doi.org/10.1128/cmr.00085-12

Rutala WA, Weber DJ. ERCP Scopes: What Can We Do to Prevent Infections? Infection Control & Hospital Epidemiology. 2015; 36(6). https://doi.org/10.1017/ice.2015.98

American Society for Gastrointestinal Endoscopy. ASGE guideline for infection control during GI endoscopy. Gastrointestinal Endoscopy. 2018; 87 (5):1176-79. https://doi.org/10.1016/j.gie.2017.12.009

Lee DH, Kim DB, Kim HY, Baek HS, Know SY, Lee HL el al. Increasing potential risk of contamination from repetitive use of endoscope. American Journal os Infection Control 2015; 43: 13-17. https://doi.org/10.1016/j.ajic.2015.01.017

Hervé RC, Keevll CW. Persistent residual contamination in endoscope channels: a fluorescence epimicroscopy study. Endoscopy 2016; 48:609-616. https://doi.org/10.1055/s-0042-105744

Muthusamy VR. Enhanced reprocessing of duodenoscopes: is doing more better? Gastroenterolology. 2017;53(4):892-94. https://doi.org/10.1053/j.gastro.2017.08.053.Epub2017 sep1.

Brandabur JJ, Leggett JE, Wang L, Bartles RL, Baxter L, Diaz GA, Grunkemeier GL, et al. Surveillance of guidelines practices for duodenoscope and linear echoendoscope reprocessing in a large healthcare system. Gastrointest Endosc 2016;84:392-9. https://doi.org/10.1016/j.gie.2016.03.1480

Yin RK. Estudo de Caso. Planejamento e Métodos. 3. ed. Porto Alegre: Bookman; 2005.

Agência Nacional de Vigilância Sanitária. ANVISA. Resolução RDC No. 06 de 10 de Março de 2013. Dispõe sobre os requisitos de boas práticas para o funcionamento de acesso por orifícios naturais. Brasília. Diário Oficial. 06 mar; 2013.

Agência Nacional de Vigilância Sanitária. ANVISA. Resolução RDC No.36 de 25 de Julho de 2013. Institui ações para a segurança do paciente em serviços de saúde e dá outras providências. Brasília. Diário Oficial. 25 jul; 2013.

Costa EAM, Moreira LL, Chagas T, Barreto M. Eventos adversos em endoscopia gastrointestinal: uma coorte de 62.088 procedimentos realizados. Vigil. sanit. Debate. 2019;7(3):25-30. https://doi.org/10.22239/2317-269X.01294

Reumkeus A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanus S. et al. Post-colonoscopy complications: A systematic review, time trends and meta-analysis of population-based studies. Am J Gastroeneterol 2016;111(8):1092-101. https://doi.org/10.1038/ajg.2016.234

Heeg P. Reprocessing endoscopes: material recomendatios with a special emphasis on cleaning – The German perspective. Journal of Hospital Infection 2004;56 S 23-26. https://doi.org/10.1016/j.jhin.2003.12.034

Psaltikidis EM. Desinfecção de produtos para saúde. In: Associação Paulista de epidemiologia e Controle de Infecção Relacionada à Assistência à Saúde. APECIH. Limpeza, Desinfecção e Esterilização de Produtos para Saúde. 4ª. ed. São Paulo: APECIH, 2011.

Padoveze MC, Luz de RA. Limpeza, Desinfecção e Esterilização: aspectos gerais. In: Associação Paulista de epidemiologia e Controle de Infecção Relacionada à Assistência à Saúde. APECIH. Limpeza, Desinfecção e Esterilização de Produtos para Saúde. 4ª. ed. São Paulo: APECIH, 2011.

Published

2022-06-07

How to Cite

Magalhães Costa, E. A., Brasil, J., & Assis, R. (2022). Gastrointestinal endoscopy services in Salvador, Bahia: analysis in the light of patient safety. Revista SOBECC, 27. https://doi.org/10.5327/Z1414-4425202227769

Issue

Section

ORIGINAL ARTICLES