Processamento de endoscópios flexíveis: a execução das etapas sob a ótica dos profissionais
DOI:
https://doi.org/10.5327/Z1414-442520242996%20Palavras-chave:
Gastroscópios, Segurança do paciente, Recursos humanos de enfermagem, Desinfecção, EndoscópiosResumo
Objetivo: Identificar na literatura estudos que abordem o processamento de endoscópios flexíveis no contexto dos desafios apresentados quanto à omissão e dificuldade das etapas e à percepção do processo sob a ótica dos profissionais. Método: Revisão integrativa que incluiu artigos originais, sem recorte temporal inicial, publicados até fevereiro de 2023, disponíveis nas bases de dados Cochrane Library, Scopus, Web of Science, Medical Literature Analysis and Retrievel System Online (Medline) e United States National Library of Medicine (PubMed). Utilizou-se descritores controlados em Ciências da Saúde e estratégia PICO. Resultados: Foram identificados cinco artigos para análise. O teste de vedação, a pré-limpeza, instilação de álcool e limpeza manual foram as etapas mais propensas à omissão (20%). Pré-limpeza (20%), secagem (20%), limpeza manual (40%) e conexão do aparelho à lavadora automatizada (40%) são as etapas mais difíceis. A não visibilidade interna dos canais (20%), falta de conhecimento (40%), o uso excessivo da memória pelos profissionais (40%) e a pressão para concluir o processamento (60%) dificultam a execução das etapas. Conclusão: As etapas omitidas, os fatores contribuintes para omissão e a percepção dos profissionais podem ser indicadores valiosos para a revisão dos serviços e processos, visando a garantia de sua efetividade.
Referências
Collins J. Optimizing the decontamination and reprocessing of endoscopic equipment. Tech Innov Gastrointest Endosc. 2021;23(4):363-70. https://doi.org/10.1016/j.tige.2021.08.002
Beilenhoff U, Biering H, Blum R, Brljak J, Cimbro M, Dumonceau JM, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018. Endoscopy. 2018;50(12):1205-34. https://doi.org/10.1055/a-0759-1629
Fushimi R, Takashina M, Yoshikawa K, Kobayashi H, Okubo T, Nakata S, et al. Comparison of adenosine triphosphate, microbiological load, and residual protein as indicators for assessing the cleanliness of flexible gastrointestinal endoscopes. Am J Infect Control. 2013;41(2):161-4. https://doi.org/10.1016/j.ajic.2012.02.030
Brasil. Ministério da Saúde. DATASUS. Produção ambulatorial do SUS – Brasil – por local de atendimento [Internet]. 2024 [accessed on Mar. 18, 2024]. Available at: https://tabnet.datasus.gov.br/cgi/tabcgi.exe?sia/cnv/qauf.def
Rutala WA, Kanamori H, Sickbert-Bennet EE, Weber DJ. What’s new in reprocessing endoscopes: are we going to ensure “the needs of the patient come first” by shifting from disinfection to sterilization? Am J Infect Control. 2019;47S:A62-6. https://doi.org/10.1016/j.ajic.2019.01.017
Chang WK, Peng CL, Chen YW, Sun CK, Chen CC, Liu TC, et al. Recommendations and guidelines for endoscope reprocessing: current position statement of digestive endoscopic society of Taiwan. J Microbiol Immunol Infect. 2024,57(2):211-24. https://doi.org/10.1016/j.jmii.2023.12.001
Azevedo AS, Tipple AFV, Oliveira ESF, Primo MGB, Guadagnin SVT, Costa DM, et al. Protocolo para processamento de endoscópios flexíveis: qualificando a prática clínica. Goiânia: Cegraf UFG; 2022. 72p. https://doi.org/10.5216/PRO.ebook.978-65-89504-70-2/2022
British Society of Gastroenterology Endoscopy. BSG guidance for decontamination of equipment for gastrointestinal endoscopy [Internet]. 2020 [accessed on Dec. 12, 2023]. Available at: https://www.bsg.org.uk/getattachment/33800384-054e-4109-a015-788a09402bf7/BSG-Decontamination-guidance-2020-update.pdf?lang=en-US
Rauwers AW, Voor In ’t Holt AFVI, Buijs JG, Groot W, Hansen BE, Bruno MJ, et al. High prevalence rate of digestive tract bacteria in duodenoscopes: a nationwide study. Gut. 2018;67(9):1637-45. https://doi.org/10.1136/gutjnl-2017-315082
Scarpaci M, Cosci T, Tuvo B, Guarini A, Iannone T, Zullo A, et al. Good practices on endoscope reprocessing in Italy: findings of a nationwide survey. Int J Environ Res Public Health. 2022;19(19):12082. https://doi.org/10.3390/ijerph191912082
Kenters N, Tartari E, Hopman J, El-Sokkary RH, Nagao M, Marimuthu K, et al. Worldwide practices on flexible endoscope reprocessing. Antimicrob Resist Infect Control. 2018;7:153. https://doi.org/10.1186/s13756-018-0446-6
Yetkin F, Ersoy Y, Kuzucu C, Otlu B, Parmaksiz N, Seckin Y. An outbreak associated with multidrug-resistant Pseudomonas aeruginosa contamination of duodenoscopes and an automated endoscope reprocessor. Biomed Res. 2017;28(13):6064-70.
Bajolet O, Ciocan D, Vallet C, Champs C, Vernet-Garnier V, Guillard T, et al. Gastroscopy-associated transmission of extended-spectrum beta-lactamase-producing Pseudomonas aeruginosa. J Hosp Infect. 2013;83(4):341-3 https://doi.org/10.1016/j.jhin.2012.10.016
Soares JB, Gonçalves R, Banhudo A, Pedrosa J. Reprocessing practice in digestive endoscopy units of district hospitals: results of a Portuguese National Survey. Eur J Gastroenterol Hepatol. 2011;23(11):1064-8. https://doi.org/10.1097/MEG.0b013e328348d5d6
Ofstead CL, Heymann OL, Quick MR, Eiland JE, Wetzler HP. Residual moisture and waterborne pathogens inside flexible endoscopes: evidence from a multisite study of endoscope drying effectiveness. Am J Infect Control. 2018;46(6):689-96. https://doi.org/10.1016/j.ajic.2018.03.002
Marchese V, Di Carlo D, Fazio G, Gioè SM, Luca A, Alduino R, et al. Microbiological surveillance of endoscopes in a southern italian transplantation hospital: a retrospective study from 2016 to 2019. Int J Environ Res Public Health. 2021;18(6):3057. https://doi.org/10.3390/ijerph18063057
Mark J, Underberg K, Kramer R. Results of duodenoscope culture and quarantine after manufacturer-recommended cleaning process. Gastrointest Endosc. 2020;91(6):1328-33. https://doi.org/10.1016/j.gie.2019.12.050
Ofstead CL, Hopkins KM, Buro BL, Eiland JE, Wetzler HP. Challenges in achieving effective high-level disinfection in endoscope reprocessing. Am J Infect Control. 2020;48(3):309-15. https://doi.org/10.1016/j.ajic.2019.09.013
Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008;17(4):758‑64. https://doi.org/10.1590/S0104-07072008000400018
Ofstead CL, Wetzler HP, Snyder AK, Horton RA. Endoscope reprocessing methods: a prospective study on the impact of human factors and automation. Gastroenterol Nurs. 2010;33(4):304-11. https://doi.org/10.1097/SGA.0b013e3181e9431a
Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative review: concepts and methods used in nursing. Rev Esc Enferm USP. 2014;48(2):335-45. https://doi.org/10.1590/S0080-6234201400002000020
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71
Araújo WCO. Recuperação da informação em saúde: construção, modelos e estratégias. ConCI: Conv Ciênc Inform. 2020;3(2):100-34. https://doi.org/10.33467/conci.v3i2.13447
Stetler CB, Morsi D, Rucki S, Broughton S, Corrigan B, Fitzgerald J, et al. Utilization-focused integrative reviews in a nursing service. Appl Nurs Res. 1998;11(4):195-206. https://doi.org/10.1016/s0897-1897(98)80329-7
Hildebrand EA, Branaghan RJ, Neuman BL, Jolly J, Garland TB, Taggart M, et al. An expert perspective of erros in endoscope reprocessing. In: Proceedings of the Human Factors and Ergonomics Society 55th Annual Meeting; 2011. https://doi.org/10.1177/1071181311551155
Hildebrand EA, Branaghan RJ, Wu Q, Jolly J, Garland TB, Taggart M, et al. Exploring human factors in endoscope reprocessing. In: Proceedings of the Human Factors and Ergonomics Society Annual Meeting; 2010. https://doi.org/10.1177/154193121005401219
Foss D, Monagan D. A national survey of physicians’ and nurses’ attitudes toward endoscope cleaning and the potential for cross-infection. Gastroenterol Nurs. 1992;15(2):59-65. https://doi.org/10.1097/00001610-199210000-00003
Sivek AD, Davis J, Tremoulet P, Smith M, Lavanchy C, Sparnon E, et al. Healthcare worker feedback on duodenoscope reprocessing workflow and ergonomics. Am J Infect Control. 2022;50(9):1038-48. https://doi.org/10.1016/j.ajic.2022.01.012
Alfa MJ, Olson N, DeGagne P. Automated washing with the Reliance Endoscope Processing System and its equivalence to optimal cleaning. Am J Infect Control. 2006;34(9):561-70. https://doi.org/10.1016/j.ajic.2006.01.010
Azizi J, Gavette M, Kulkarni K, Drosnock MA. Analysis: overcoming human factors challenges of endoscope culturing with turbulent fluid flow. Biomed Instrum Technol. 2020;54(5):338-44. https://doi.org/10.2345/0899-8205-54.5.338
Barakat MT, Huang RJ, Barnejee S. Comparison of automated and manual drying in the elimination of residual endoscope working channel fluid after reprocessing (with video). Gastrointest Endosc. 2019;89(1):124-32. https://doi.org/10.1016/j.gie.2018.08.033
Society of Gastroenterology Nurses and Associates. Standards of infection prevention in reprocessing flexible gastrointestinal endoscopes [Internet]. Chicago: SGNA; 2018 [accessed on Dec. 05, 2023]. Available at: https://www.sgna.org/Portals/0/SGNA%20Standards%20of%20infection%20prevention%20in%20reprocessing_FINAL.pdf?ver=2018-11-16-084835-387
Madureira RAS, Oliveira AC. Limpeza de endoscópios flexíveis intra-hospitalares: limitações e desafios. Rev Latino-Am Enfermagem. 2022;30:e3685 http://10.1590/1518-8345.5969.3684
Wendorf KA, Kay M, Baliga C, Weissman SJ, Gluck M, Verma P, et al. Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak. Infect Control Hosp Epidemiol. 2015;36(6):634-42. https://doi.org/10.1017/ice.2015.66
Day LW, Muthusamy R, Collins J, Kushnir V, Sawhney M, Thosani NC, et al. Multisociety guideline on reprocessing flexible GI endoscopes and accessories. Gastrointest Endosc. 2021;93(1):11-33.e6. https://doi.org/10.1016/j.gie.2020.09.048
Thaker AM, Kim S, Sedarat A, Watson RR, Muthusamy VR. Inspection of endoscope instrument channels after reprocessing using a prototype borescope. Gastrointest Endosc. 2018;88(4):612-9. https://doi.org/10.1016/j.gie.2018.04.2366
van der Ploeg K, Haanappel CP, Voor In ’t Holt AF, Groot W, Bulkmans AJC, Erler NS, et al. Effect of a novel endoscope cleaning brush on duodenoscope contamination. Endoscopy. 2024;56(3):198-204. https://doi.org/10.1055/a-2193-4481
Azimirad M, Alebouyeh M, Sadeghi A, Khodamoradi E, Aghdaei HA, Alizadeh AHM, et al. Bioburden and transmission of pathogenic bacteria through elevator channel during endoscopic retrograde cholangiopancreatography: application of multiple-locus variable-number tandem-repeat analysis for characterization of clonal strains. Expert Rev Med Devices. 2019;16(5)413-20. https://doi.org/10.1080/17434440.2019.1604215
Hoh CSL, Berry DP. Decontamination and sterilization. Foundation Years. 2006;2(1):10-2. https://doi.org/10.1053/S1744-1889(06)70037-8
Ofstead CL, Hopkins KM, Preston AL, James CY, Holdsworth JE, Smart AG, et al. Fluid retention in endoscopes: a real-world study on drying effectiveness. Am J Infect Control. 2024;52(6):635-43. https://doi.org/10.1016/j.ajic.2024.02.015
Primo MGB, Tipple AFV, Costa DM, Guadagnin SVT, Azevedo AS, Leão-Vasconcelos LSNO, et al. Biofilm accumulation in new flexible gastroscope channels in clinical use. Infect Control Hosp Epidemiol. 2022;43(2):174-80. https://doi.org/10.1017/ice.2021.99
Beilenhof U, Martiny H. Stellenwert moderner Aufbereitungsverfahren in der gastrointestinalen Endoskopie. Gastroenterologe. 2022;17:9-14. https://doi.org/10.1007/s11377-021-00580-w
Petersen BT. Current state and future of infection prevention in endoscopy. Gastrointest Endosc Clin N Am. 2021;31(4):625-40. https://doi.org/10.1016/j.giec.2021.05.001
Shin HY, Jang DH, Jun JK. A nationwide survey on the effectiveness of training on endoscope reprocessing within the national cancer screening program in Korea. Am J Infect Control. 2021;49(8):1031-5. https://doi.org/10.1016/j.ajic.2021.02.005
British Society of Gastroenterology. BSG guidance for decontamination of equipment for gastrointestinal endoscopy. [Internet]. 2020 [accessed on Jan. 02, 2024] . Available at: https://www.bsg.org.uk/clinical-resource/2020-guidance-on-decontamination-of-equipment
Benowitz I, Moulton-Meissner HA, Epstein L, Arduino MJ. The centers for disease control and prevention guidance on flexible gastrointestinal endoscopes: lessons learned from outbreaks, infection control. Gastrointest Endosc Clin N Am. 2020;30(4):723-33. https://doi.org/10.1016/j.giec.2020.06.009
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