Thinking of sterilizing bronchoscopes instead of reprocessing them? Switching has its own set of challenges.

A new study shows not only that hospitals that disinfect and reuse bronchoscopes pay considerably more per instrument than if they had purchased a sterile, single-use bronchoscope, but they also use reprocessing practices that don’t meet current standards, often by personnel lacking adequate training.

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The simple solution, then, is to switch to sterilization, right? While the study recommends hospitals consider using sterilization or single-use bronchoscopes to prevent spreading infection to patients through contaminated bronchoscopes, sterilization comes with its own set of challenges.

Those include longer turnaround times, expensive machinery and additional supplies.

The study, “Managing Bronchoscope Quality and Cost: Results of a real-world study,” was conducted by Cori L. Ofstead, MSPH; Krystina M. Hopkins, MPH; John E. Eiland, RN, MS; and Harry P. Wetzler, MD, MSPH. It builds on a related study last year, published in Chest Journal, that examined the effectiveness of the cleaning processes for reusable bronchoscopes.

Bronchoscopes, a type of endoscope, are delicate instruments that enable practitioners to see the airways to the lungs and perform interventions such as lung biopsies or removing pus and tumors. Reusable bronchoscopes also pose a high risk of cross-contamination. Sterile, single-use bronchoscopes can combat the spread of antibiotic-resistant bacteria.

The study focused on four accredited hospitals diverse in size and location. One site regularly sterilized bronchoscopes and the process required several extra steps, including thorough drying, packaging, loading and initiating the cycle. The turnaround time was 142 minutes, 46 minutes longer than the high-level disinfection steps used in reprocessing.

Sterilization machines used by hospitals in the study range from $116,000 to $135,000, far more on average than capital outlays for automated endoscope reprocessors, or AERs, which run for $20,000 to $50,000. Additional supplies needed includes sterilization trays, wraps and dust covers, sterilant and chemical and biological indicators.

The study recommends that facilities obtain sterile, single-use bronchoscopes in “routine procedures,” after hours and in emergency situations, and in hospital departments that cannot ensure bronchoscopes will be cleaned immediately.

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