Endoscope Cleaning and Disinfection (Sterilization) Standard Operating Procedure

I. Preprocessing  

1. Immediately wipe off surface contaminants with a damp gauze after use, and repeatedly flush with water and air for 10 seconds.

2. Remove the endoscope and attach the waterproof cover, then send it to the cleaning and disinfection room.
II. Leak Test  
A leak test should be performed before cleaning and disinfection. Wet testing is generally selected; dry testing is used in emergencies.
III. Water Wash
1. Place the endoscope in the water wash tank, thoroughly rinse under running water, and scrub the body and operating section with gauze. Change the gauze after each use.  

2. Remove the biopsy port valve, suction button, and air/water injection button. Thoroughly brush the biopsy channel and the suction tube of the light guide with a clean brush at least three times. During brushing, the brush should be visible at both ends, and any contaminants on the brush head should be cleaned. Each cleaning brush should be used once and then disinfected. Remove various valves and buttons, rinse them with clean water, and wipe them dry.  

3. Install the full-channel perfusion device, pipe plug, waterproof cap, and suction device, and repeatedly aspirate the biopsy channel using the suction device.  
4. Connect a 50ml syringe to the full-channel perfusion device and aspirate clean water into the water injection pipe.
5. Use the suction device to dry the biopsy channel and wipe the endoscope body dry.  
6. After use, endoscopy accessories such as biopsy forceps, cytobrushes, dissecting knives, guidewires, lithotripters, baskets, angiography catheters, foreign body forceps, etc., should be placed in clean water first, and the inner surface of the forceps blades and the joints should be brushed with a small brush, then cleaned and dried.
IV. Enzymatic Wash
1. Place the dried endoscope in the enzymatic wash tank, use a syringe to aspirate 100ml of enzymatic cleaning solution, flush the air/water injection pipes, use the suction device to aspirate the enzymatic cleaning solution into the biopsy channel, soak for 2-5 minutes, and wipe the operating section with the enzymatic cleaning solution. Use a new enzymatic cleaning solution for each endoscope.  
2. Soak the dried accessories, various buttons, and valves in the enzymatic cleaning solution; the accessories should be cleaned in an ultrasonic cleaner for 5-10 minutes.
V. Cleaning
After soaking in the enzymatic cleaning solution, rinse the endoscope with a high-pressure water gun, rinsing all channels and the outer surface of the endoscope. Then use an air gun to blow dry the various channels and wipe the outer surface of the endoscope with a clean cloth.  
VI. Disinfection or Sterilization 
1. When using disinfectant immersion disinfection or sterilization, the cleaned and dried endoscope should be placed in the disinfection tank and completely immersed in the disinfectant, and each channel should be filled with disinfectant using a syringe.  
2. For non-fully immersed endoscopes, the operating section should be wiped with clean water and then disinfected with 75% ethanol.  

3. Refer to the Ministry of Health's "Technical Specifications for Endoscope Cleaning and Disinfection" or the product instructions for disinfectants and disinfecting equipment for disinfection and sterilization time.  

4. Endoscope accessories should be sterilized after each use. Pressure steam sterilization is preferred, but ethylene oxide or other sterilization methods that meet the relevant regulations of the health administrative department can also be used.  
5. After cleaning relevant items, sterilize the trays, dressing basins, etc., using pressure steam; reusable mouthpieces, injection bottles, and connecting tubes should be disinfected by soaking in disinfectant; reusable mouthpieces should be rinsed with running water; injection bottles and connecting tubes should be rinsed with sterile water and dried for later use. Sterile water should be added to the injection bottle during use and replaced daily.  
6. Before cleaning and disinfection using a disinfection machine, the endoscope should be cleaned according to the requirements of pre-processing, leak testing, water washing, enzymatic washing, and cleaning.
VII. Rinsing
1. Cleaning and disinfection personnel change gloves, take out the disinfected endoscope, and use an air gun or syringe to blow out the disinfectant in each lumen.  
2. Transfer the endoscope to the rinsing tank, clean the outer surface of the endoscope with gauze under running water, and repeatedly aspirate clean water to rinse each channel.  
3. Endoscopes that have been disinfected by immersion in chemical disinfectants should be thoroughly rinsed with sterile water before use.

VIII. Storage  
1. Sterilized endoscopes and accessories should be stored as sterile items.
2. Disinfected endoscopes should be hung in an endoscope cabinet or room, and the bending angle fixing knob should be in the free position.
3. The inner surface of the storage cabinet should be smooth, seamless, and easy to clean. It should be wiped and disinfected once or twice a week.
IX. Other  
1. After cleaning, suction bottles and suction tubes should be disinfected by soaking in disinfectant, thoroughly brushed, and dried for later use.

2. Cleaning tanks, enzymatic washing tanks, and rinsing tanks should be wiped with disinfectant after brushing.

3. Disinfection tanks should be thoroughly brushed when changing disinfectants.

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