Safety in the Gastrointestinal Endoscopy Unit

Publication Date: January 30, 2014
Last Updated: March 14, 2022

Recommendations

FACILITIES

Architectural Layout

Endoscopic Procedure Room
  1. Actual marking of the site is not required for endoscopic procedures because endoscopy does not involve lateral right-left distinction levels such as those found in spinal procedures or those done on multiple structures such as fingers or toes. Before starting an endoscopic procedure, the patient, staff, and performing physician should verify the correct patient and procedure to be performed.
  2. A reliable and adequate source for oxygen is required. Sources may include in-wall or free-standing oxygen. In some units, carbon dioxide may be used for insufflation of the GI lumen, but this is not a requirement.
  3. A suction source for the equipment and patient must be present either in-wall or portable. For tubing and portable suction, the manufacturer’s guidelines must be followed.
  4. An uninterruptible source of power, supplied either by a generator or battery source is required. The purpose of a secondary power source is to allow completion of the current procedure in the event that the primary power source malfunctions. Procedures should not be started when the only source of power is the secondary source.
  5. Units must practice fire safety in adherence with the NFPA 101 Life Safety Code, which also dictates the number and type of electrical outlets tied to the generator. The NFPA 101 Life Safety Code recommends that not all outlets be tied to the generator in case the generator fails to disengage once power is restored.
  6. The unit’s defibrillator and crash cart should be checked at the beginning of each day to ensure that all components are functional, fully stocked, and readily accessible.
  7. The routine monitoring of temperature and humidity within the endoscopic procedure area, although advocated by CMS to theoretically curtail growth of microorganisms and reduce fire hazard, has not been associated with safety outcomes in endoscopic units. In the absence of published guidelines on the optimal ranges for these parameters, routine monitoring of temperature and humidity is not currently warranted.
  8. Puncture-resistant containers for biohazardous materials and sharps should be located so that sharps are not passed over the patient.
  9. If special therapeutic procedures are planned, specific room features may be required, such as leaded walls when flat-table fluoroscopy is utilized.
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Endoscopic Recovery Area
The recovery bays should provide privacy and sufficient space for monitoring and care. The minimum space per bay has not been established. Unit facilities must be able to provide the level of recovery appropriate to the level of sedation utilized.
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Storage of Supplies
1. Sterile supply items such as intravenous (IV) solutions should be protected from splash contamination during environmental cleaning (8-10 inches off the floor), damage from compression (stacking only ridged containers), and water damage (no storage under sinks).
2. Units should have a process for periodically verifying that supplies marked with an expiration date have not expired. Compliance with this process should be documented.
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Overview

Title

Safety in the Gastrointestinal Endoscopy Unit

Authoring Organization

American Society for Gastrointestinal Endoscopy