Reprocessing status of flexible bronchoscopes in 202 intensive care units in Hubei province, China: a multicentre cross-sectional study.

Abstract

Background: Unstandardised reprocessing procedures for flexible endoscopes can lead to infection outbreaks and threaten the lives of ICU patients. Despite recent updates to technical specification, there was a paucity of studies on the current status of flexible endoscopic reprocessing, particularly concerning flexible bronchoscopes (FB). This study aimed to assess the current practices of reprocessing FBs in ICUs in Hubei Province, China.

Methods: A cross-sectional study was conducted utilizing convenience sampling from October 11, 2024, to December 6, 2024, in the ICUs of 216 hospitals in Hubei Province, China. A self-developed questionnaire was distributed through an online survey platform to either the person in charge of the ICU or the frontline technicians. The information regarding the reprocessing of FBs was collected, including general characteristics, personnel and training, layout and facilities, reprocessing operations, and reprocessing quality monitoring.

Results: The content validity index of the questionnaire was 0.94. There were 202 valid questionnaires collected with a validity rate of 93.52%, including 158 ICUs in tertiary hospitals and 44 in secondary and primary hospitals. The ICUs of tertiary hospitals were better than the ICUs of secondary and primary hospitals in terms of the number of FBs available, the number of dedicated technicians, the opportunity for training, the availability of some equipment and facilities (ultrasonic cleaners, whole tube irrigators, etc.), and some reprocessing operations (FB sterilisation method and storage cabinet sterilisation frequency) (P < 0.05).

Conclusions: There were variations in FB reprocessing practices across ICUs in hospitals of all levels in Hubei, along with some common issues. Most ICUs were standardised in personnel training, operation, and recording, and ICUs in tertiary hospitals behaved better than in secondary and primary hospitals. However, there remained a need for improvement in the layout of the reprocessing environment, equipment configuration, and quality monitoring. Future research could apply implementation science to identify barriers and propose strategies to align practice with guidelines.