A nationwide survey of reprocessing, facilities and nursing personnel in Italian endoscopy units

Background: In endoscopy, dedicated nursing roles have developed with the growing availability of sophisticated procedures for diagnosis and therapy in gastrointestinal conditions. Endoscopy centres must maintain high standards in terms of facilities, education and staffing to ensure the safety and quality of patient care. Aim: Italy's National Association of Endoscopic Technical Operators-National Association of Gastroenterology and Associated Nurses (ANOTE-ANIGEA) conducted a nationwide survey to assess whether these standards were being met in centres across the regions. Method: A specific questionnaire was prepared and distributed to ANOTE-ANIGEA associates, and data were statistically analysed by using chi-square test or Fisher's test, as appropriate. Results: A total of 176 endoscopy units were surveyed. A recovery room and a distinct dirty-clean area were lacking in 15% and 45% of centres respectively. In 19% of centres, reusable devices were reprocessed with high-level disinfection rather than sterilisation, while reprocessing was not traceable in 23% of centres. The different centres employed a median of six endoscopy nurses, while in a third of centres only one nurse was employed per endoscopy room. In as many as 56% of centres, reprocessing was carried out exclusively by nurses, as no other trained staff were available. Significant differences emerged when comparing data of centres from northern, central and southern Italy, with centres in the south more likely not to meet expected standards. Conclusions: Particular concerns were found regarding reprocessing, especially the lack of a distinct 'dirty-clean' route and/or dedicated reprocessing staff in several centres.