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ISRN Endoscopy
Volume 2013 (2013), Article ID 495039, 7 pages
Research Article

How to Improve Reprocessing of Flexible Endoscopes Nationwide? Data from the German Colorectal Cancer Screening Program

1Innere Klinik mit Gastroenterologie, Karl-Olga-Krankenhaus, Hackstraße 61, 70190 Stuttgart, Germany
2Gastroenterologische Gemeinschaftspraxis, Bahnhofsplatz 2, 55116 Mainz, Germany
3School of Public Health, Tropical Medicine and Rehabilitation, James Cook University, Townsville, QLD 4811, Australia

Received 13 July 2012; Accepted 11 September 2012

Academic Editors: C. Boselli, B. Braden, A. Kahokehr, A. Maleddu, H. Sarel, and D. Stoyanov

Copyright © 2013 Eckhart Fröhlich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Aims. International studies revealed prevalences of around 50% of microbiological contaminations in reprocessed flexible endoscopes. In Germany a system was installed where the qualification for refund for colonoscopies was made conditional on successfully passing twice annually a microbiological surveillance test of reprocessed endoscopes. This study is an implementation and outcome evaluation as well as a general discussion of the quality assessment assurance in colonoscopy in Germany. Methods. German data from 2003–2008 were analysed: number of endoscopic units performing therapeutic and/or screening colonoscopies; results of all microbiological surveillance tests of reprocessing quality; number of failed surveillance tests and retests; number of qualifications for refund from the public health system cancelled due to repeated failure of microbiological surveillance tests. Results. After the introduction of the quality assessment assurance, the percentage of failed microbiological surveillance tests dropped significantly and steadily from close to 17% to below 5%. Conclusions. This study evidences (1st) the successful implementation of the quality assessment assurance in Germany and (2nd) a substantial improvement in the quality of reprocessing flexible endoscopes achieved by these measures.