So if you are reading this, chances are that you know something about JAG. Good because I wanted to ask if you think JAG is a good thing and is it working and are their guidelines the "be all and end all" of endoscopy?
Im the first to stand up and support that everyone should clean and disinfect their scopes along a standard guideline.As long as you land up with a High Level Disinfected insturment that is traceable and documented, why do hospitals require such big expensive pass through machines to get there? A decent well built endoscope reporcessor will offer the same quality for much less. What am I missing here?
JAG accreditation is basically a quality system and confirms your adherence to published standards and best practices. Till now there has been little regulation for reprocessing devices outside HSDU, the JAG standard is aimed to raise standards and introduce national consistency for endoscope reprocessing. After all the risks posed by less-than-clean surgical instruments and endoscopes are the same. I am right in thinking it will not be possible to continue to do certain procedures e.g. bowel cancer screening without JAG accreditation. I also think it is very likely CQC and other bodies will soon be taking a serious look at trustís/organisationís decontamination methods, particularly reprocessing outside HSDU to assess compliance to published standards. We received accreditation in 2008 and I believed vast majority of endoscopy units in the UK are now accredited. With regards to pass-through re processors, this is to comply with new and emerging HTM standards for having validated systems and segregating dirty and clean areas. Its a very expensive exercise to convert existing endoscopy suites to meet these standards and some organisations may struggle to comply.
Thanks for the input. Agreed that a suitable quality system is the best way to go. Although there is a big difference between the risks of less than clean surgical instruments and scopes. Flexible scopes in general are only used in areas of the body that are non sterile.Bums and tums etc.So a HLD status is acceptable.
Surgical telescopes are almost always used in sterile areas like knees, thoracic and abdominal cavaties, therefore require sterilization/ autoclaving. JAG guidlines dont say anything about the type of washer you should use other than that it should comply with HTM 2030 or ISO15883. They do however recommend that there should be a clean and dirty side of decontamination units and scopes should only travel in 1 direction.I believe that spending huge money (number I saw was 500K£)to have a pass through system is a complete waste of money. Bear in mind that not everybody on this forum belongs to the NHS. If carefully controlled, a HTM2030 compliant machine/s can offer the same service.Of course if you are doing >5000 cases per year a pass through system might warrent the big spend. TSS