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Chemical indicator test strips have been in use since the 1950s for a variety of purposes, and in this case, they represent a weak link in the chain of requirements for consistent high-level disinfection of endoscopes. This is because with most AERs, MRC monitoring with a test strip is a step that can be easily missed or done incorrectly. Other than the ASP AEROFLEX ™ AER, the nearly universal method for MRC monitoring is the test strip, a chemical indicator that changes color in accordance with whether the concentration of biocide has crossed the MRC threshold.
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While endoscopy procedure volume growth has prompted the purchase and use of more AERs, almost all AERs lack the ability to automatically test and track one of the most important variables in the HLD process: MRC monitoring. 6 ,7 Eliminating potential threats to successful flexible endoscope reprocessing remains a top priority. A review of FDA and CMS reports reveals non-compliance with proper MEC testing protocols have negatively impacted patient outcomes 2, while additional studies have found that GI endoscopy is an important risk factor for the transmission of Carbapenem-resistant Enterobacteriaceae (CRE) and related superbugs. The risks associated with biocide failure in the reprocessing of flexible endoscopes are significant.
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If this occurs, the biocide is said to have fallen below its Minimum Recommended Concentration(MRC). If the biocide concentration level falls below the amount necessary to kill or inactivate microorganisms that are present on the scope, there can be a failure in the AER’s high-level disinfecting process. As a result, manufacturers’ Instructions for Use (IFUs) for single and multiple use biocides recommend MRC testing for every cycle. 17 It is also critical to monitor the biocide concentration for every cycle in AERs using single-use biocides since concentration levels may diminish in these systems as well. Many AERs reuse the biocide for multiple cycles and after each cycle, the biocide’s effectiveness is reduced to a varying degree, depending in part on microbial and organic matter loads present on the scopes being reprocessed. To meet the increased procedure demand, endoscopy centers have responded with investment in tools and staff to manage the expanding workload, and the AER is playing a tireless role in ensuring endoscopes are available and properly disinfected as needed.Ĭritical to the effectiveness of AERs is the assurance that the concentration level of the biocide (high-level disinfectant) is adequate to achieve high-level disinfection in every cycle.
MONITOR AER MANUAL
This rise in endoscope use places strain on an already challenged reprocessing environment, where pressure to increase volumes of scopes prepared for the next procedure invites compromises in manual cleaning and disinfection procedures, which has been well documented in recent peer-reviewed research. According to a study published by iData in 2019, there were 31 million GI endoscopy procedures performed in the United States alone in 2018 4, and there is every reason to expect continued procedure growth over the next 2-3 years. This is in no small part due to the rapid rise in endoscopy procedure volumes over the past several years 3. This has a ripple effect throughout the chain of support services which enable supplies, capital equipment and instruments to be ready and available when the patient and physician are scheduled for an endoscopy procedure. The AUTOSURE ™ MRC Monitor is a novel automated concentration measurement system grounded in mature chemistry and colorimetry a summary technical explanation is presented in this document.Įndoscopy centers have become laser-focused on keeping procedure rooms fully scheduled to maximize the use of resources and patient throughput.
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With the introduction of the ASP AEROFLEX ™ AER with AUTOSURE ™ MRC Monitor, automatic MRC testing for every cycle is a standard feature, designed to increase compliance and patient safety and reduce the risk of healthcare-acquired infections during endoscopy procedures. Yet, despite advancements in technology over the last decade, AER operators are still required to manually test biocide minimum recommended concentration (MRC) levels during every cycle using a test strip. Reprocessing flexible endoscopes in today’s fast-paced clinical environment demands consistent, effective high-level disinfection (HLD) using automated endoscope reprocessors (AERs).