Achieving High Reliability in High-Level Disinfection of Flexible Endoscopes at Walter Reed National Military Medical Center

Over 18 million diagnostic and therapeutic procedures are performed using flexible endoscopes in the United States every year (Peery et al., 2012). According to the U.S. Food and Drug Administration (FDA), the complex design of flexible endoscopes may impede cleaning and expose patients to the risk of infection (FDA, 2015). The intricate design of flexible endoscopes involves multiple narrow lumen channels designed to accommodate the passage of instruments, air, tissue, and fluids along the length of the device. The occurrence of infections associated with endoscopes and increased noncompliance with The Joint Commissions (TJC) Infection Prevention and Control Standard IC.02.02.01 warrants an in-depth evaluation of how endoscopes are being reprocessed in healthcare facilities in the U.S. (TJC, 2015). TJC responded to reprocessing inaccuracies by developing the High Level Disinfection (HLD) and Sterilization BoosterPak (TJC, 2015). The goal of TJCs BoosterPak is to provide a tool for healthcare organizations to guide the implementation of regulatory standards and evidence-based guidelines for HLD and sterilization to minimize the potential risk of infection transmission to patients" (TJC, 2015, p. 3).