HospitalInspections.org

Based on observations, record review and interview the facility failed to ensure that the flexible scopes were maintained in a safe and sanitary operating condition. This failed practice has the potential for the flexible scopes to become damaged and unsanitary and puts patients at risk for an infection. The findings are:

A. On 06/07/16 at 9:00 am during observation of Operating Room (OR) #2, the flexible "Olympus" brand scopes were hanging on the wall (not in a cabinet) with black trash bags over them.

B. On 06/07/16 at 11:00 am during observation of OR #2, the black trash bags had been removed from the flexible scopes and replaced with a large bag from Medline (a medical supply company).

C. On 06/07/16 at 3:20 pm during observation of the terminal cleaning of OR #2, one of four flexible scopes was uncovered and staff member #18 sprayed cleaning solution around the scopes. Staff member #18 was also observed cleaning the walls all around the scopes.

D. Record review of the Olympus manual revealed the following instruction entitled "Storage and Disposal 8.1 Precaution": "After reprocessing, maintain appropriate transportation and storage procedures to keep reprocessed endoscopes and accessories away from contaminated equipment. If the reprocessed endoscopes or accessories become contaminated before subsequent patient procedure, they could pose an infection control risk to patients and/or operators who touch them." "Store the endoscope and accessories in an endoscope storage cabinet which also protects the equipment from physical damage."

E. Record review of the facility policy entitled "Reprocessing Flexible Endoscopes," dated 09/29/15, revealed the following protocol: "Storage: Hang endoscopes vertically in the well-ventilated, dust-free area and covered with a clean plastic covering until needed. Do not store in cases."

F. On 06/07/16 at 3:45 pm during interview, Staff Member #18 stated he doesn't clean the wall behind the scopes, he only cleans around the scopes. He also stated he was told/trained to not spray (cleaning solution) on the scopes but to spray (cleaning solution) around the scopes. When asked about the one scope that was not covered and the possibility of spraying cleaning solution on the scope, Staff Member #18 stated, "I don't touch them [the scopes]."

G. On 06/08/16 at 2:00 pm during interview, Staff Member #2 stated the scopes should be in a cabinet and not in bags. Staff Member #2 also stated that Staff Member #18 should have told someone that the one scope was not covered.