Date of Conferral



Doctor of Nursing Practice (DNP)




Sue Bell


Contamination is a prevalent issue with reprocessed levered endoscopes. The number of infections caused by resistant enterobacteriaceae in patients due to contaminated endoscopes increased to the point that the United States Food and Drug Administration released a safety alert to health care facilities that perform endoscopic retrograde cholangiopancreatography (ERCP). The purpose of this descriptive project was to evaluate if levered endoscopes used in ERCP procedures met high level disinfection criteria, were properly processed, and were germ free after reprocessing. The project was supported by 2 theories: the middle range theory of patient advocacy and the germ theory. Data (counts and percentages) were collected from testing 150 endoscopes at each of 4 facilities within an organization regarding the effectiveness of the reprocessing of the levered endoscopes. According to the project findings, there was a 7% average germ-free failure rate across the sites after the initial reprocessing. The cleaning process of the levered endoscopes allowed bacteria to remain on the scopes after the manufacturer-recommended cleaning was completed at the sites. Standardization of the organization's cleaning process and improvement in the national protocols were recommended. The project supported protecting the safety of endoscopy patients by identifying that the cleaning process could be improved to prevent introduction of infectious bacteria through a procedure. The results will be informative for laboratory staff who clean levered endoscopes, physicians who use the scopes in patient procedures, patients who undergo the procedures, and nurses who are tasked with improving patient safety in perioperative environments.

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