2001 OPEN FORUM Abstracts
FLEXIBLEFIBEROPTIC BRONCHOSCOPE LEAK DETECTION AND ASSOCIATED REPAIR COST REDUCTIONS
JohnE. Hahesy MS,RRT,CPFT ? Don Renaghan RRT Respiratory Care Services ? StanfordHospital & Clinics ? Stanford, California
Introduction: A progressive increase in the incidence of flexible fiberoptic bronchoscope damage (267% over four years) and associated repair costs prompted a review of handling and damage assessment procedures. Fluid invasions through undetected leaks were noted as the most frequent and costly type of damage. Implementation of a program to detect internal instrument channel and exterior leaks with a Minimus II manometer system (Rudolf Riester GmbH & Co.) eliminated the occurrence of fluid invasions and resulted in a considerable reduction in repair costs.
Methods: Beginning with fiscal year 1995/96 a retrospective review of the type and frequency of flexible fiberoptic bronchoscope damage was performed. The recurrent type of damage was directly attributable to fluid invasion through the instrument channel. Fluid invasion induced damage created lens impaired image quality and CCD chip failure that contributed significantly to the cost of basic leak repairs. The review also confirmed that fluid invasions occurred through undetected leaks during the preliminary cleaning process.
Implementation: The Minimus II manometer system for leak detection was acquired and procedural changes to perform dry and wet leak testing prior to cleaning were implemented. All RCP bronchoscopy assistants and supply reprocessing staff were trained in this leak detection procedure.
Results: Since the implementation of the leak detection program, the incidence of fluid invasions from undetected leaks has been eliminated. In addition, overall costs for flexible bronchoscope repairs directly related to fluid invasion have been significantly reduced.
Conclusion: Early leak detection procedures with a manometer system, including both dry and wet techniques, can greatly reduce concurrent damage to flexible fiberoptic bronchoscopes. Reduction of concurrent damage also translates into significant repair cost reductions.