Endoscope cleaning...

Re: Endoscope cleaning...

Sal the 1st — Sat, 06 Feb 2010 00:38:19 GMT

if you have got a vet thats a bit 'jack flash' when it comes to scrubbing up try accidentally (purely accidentally you understand) brushing their hand or catching their hand before they can start - and make it obvious by saying 'oops accidentally caught you there' - two quick scrubs are better than one. You can slow them down so you get to finish your patient prep before they start surgery by not putting the blade on the kit until you have finished the prep. Makes them chunter a bit but at least you get chance to prep. another one is to put the gloves out but not open the outer wrap and say something along the lines 'oops silly me but never mind by the time you have finished scrubbing up I will be finished here and ready with your gloves'

One vet called me 'Ditsy' for long enough - Ditsy I most definitely am not , manipulative - well thats probably very true (in a good way)

Re: Endoscope cleaning...

Freckle — Sat, 06 Feb 2010 00:30:26 GMT

[quote user="sal the 1st"]

no I wasnt offended - and I can see you are frustrated, sometimes you just got to be a bit sneaky tho to get what you want or make things happen in the way you would like - its a bit like playing a game sometimes and sometimes to make it work the only way you can effect a change is to convince the other person it was their good idea

good luck and dont let it get to you

[/quote]

i wholeheartedly hear what you are are saying sal....

but AGHHHHH!!!! vet nurses are trained to do their stuff! we shouldn't have to get vets to agree with us on matters of sterility - you vets do your diagnosing etc, we will provide the environment to let that happen!

let me scrub the patient for at least 5 mins before you get in there witha scalpel! and hello? a quick wash of your hands with hibi does not do the same job as a proper scrub!

i'm sorry - the reason i have such issues with my current employer, is because i have worked in a place where everything is done by the book......

.............its hard to see things done at a substandard level without voicing it - my gob gets me in trouble tho :(

Re: Endoscope cleaning...

Sal the 1st — Sat, 06 Feb 2010 00:04:10 GMT

good luck and dont let it get to you

Re: Endoscope cleaning...

Freckle — Fri, 05 Feb 2010 23:55:41 GMT

[quote user="Maisy"]

I would agree with Sal, you do seemrather frustrated with your colleagues!

Why not see if you can arrange a lunchtime meeting with various reps (for instance Medichem) so they could put this information across to the others? Most reps are happy to come round and do lunchtime CPD and at least this way it can act as a refresher. Medichem for instance have some really useful Trigene/Medizyme charts that they can give you so no excuse for lax dilutions!

I know it can be frustrating when others do one thing and you do another but are all the staff at your practice really just idle or do they just have different opinions on how things should be done? Its good to follow how procedures etc should be done but practice does change and opinions differ so its doesn't necessarily mean they're in the wrong all the time.

Good Luck!

[/quote]

Thanks for your replies. I am indeed rather frustrated at work, and am not gifted socially, so unfortunatley I tend to say what I am thinking!

I have tried to bring things up at nurse meetings before, but my general social ineptitude usually gets the better of me.....

my replies to this thread, and my starting the dilution rates thread, are just me letting off steam! i hope no one was offended that i said that in my experience most nurses are blase' re dilution rates.....

... my experience is all i have to go on though, and i have worked in 5 plus practices.... in all of them the nurses (QVNs too) looked at me like i had two head when i mentioned dilution rates :(

i am not qualified yet, but i am at college... it bothers me to see things that are drummed into us at college being waylaid on a daily basis at work...

in an ideal world..... why can it not be an ideal world in practice? why can we not be allowed to do the job we are trained to do?

Re: Endoscope cleaning...

Vicky RVN — Tue, 02 Feb 2010 11:11:16 GMT

So true!

Re: Endoscope cleaning...

Nick Shackleton — Mon, 01 Feb 2010 21:07:11 GMT

[quote user="Fluffy"]

I have always used medizyme followd by meddis.

I find it hard to understand how equipment that costs thousands can then be 'cleaned' on the cheap - asking for trouble if you ask me....

[/quote]

I couldn't agree with you more. I think we spent equal to a one bedroom flat on our set up!

Re: Endoscope cleaning...

Laura Ringsell — Mon, 01 Feb 2010 20:50:03 GMT

I have always used medizyme followd by meddis.

I find it hard to understand how equipment that costs thousands can then be 'cleaned' on the cheap - asking for trouble if you ask me....

Re: Endoscope cleaning...

Nick Shackleton — Sun, 31 Jan 2010 19:32:14 GMT

Hi there

We have a cleaning station that allows you full pump medizyme or medis through all the channels of the scope so that it is fully disinfected/cold sterilised.

We store the medis between usage in a sealed bucket.

I don't like reusing medizyme due to contaminants from the scope.

With regards to ET tubes we use hibiscrub to clean followed by 30mins soaking in Milton. this solution is also in a sealed bucket and changed weekly.

ET tubes and oesophageal stethoscopes are cleaned/sterilised in this manner and thoroughly rinsed and dried before usage.

Re: Endoscope cleaning...

Nicola Smith — Sun, 31 Jan 2010 19:23:49 GMT

We use medizyme followed by meddis for endoscope - as advised by people who supplied our endoscope. I would like to use meddis for the et tubes and would be ideal as can be stored - how do you store it between use and what do you put things like et tubes in to soak. Using a cat litter tray to do endoscope at the moment but very awkward and throw stuff away after as can't store it in that.

I am very conscious of et tube hygiene. We are currently soaking in safe 4 solution then rinsing thoroughtly after but I don't feel this is ideal as this may be irritnat if not rinsed properly.

Re: Endoscope cleaning...

Maisy — Sun, 31 Jan 2010 08:51:00 GMT

I would agree with Sal, you do seemrather frustrated with your colleagues!

Good Luck!

Re: Endoscope cleaning...

Sal the 1st — Sat, 30 Jan 2010 23:58:27 GMT

Freckle, please dont take this the wrong way - I get the message you are frustrated but there are ways and ways of doing things and getting the message across - sometimes if you want to influence an outcome you have to do it by a roundabout route. I can see you are a conscientious person and you are wanting to do things the right way which is how it should be in a perfect world - sadly the world we live in is less than perfect and sometimes we just have to make the best of what we have got. I do hope none of your colleagues are following this thread - it isnt going to do you any favours, I know its hard sometimes that people dont seem to be taking in the points you are raising but if you adopt a critical attitude they are even less likely to listen.

As to the vets well I guess its up to them what kind of sutures they feel are suitable for a procedure - and yes it can be awkward if the client is expecting something different but you could try mentioning at admit that the wound may have either external or sc sutures depending on what the vet feels is best for their pet at the time of surgery ( not depending on which vet does the op as this may put clients off seeing a certain vet if they feel they arent getting as good a job - and that isnt fair on the vet). Maybe the vet doing nylon sutures isnt happy doing sc or maybe they have other reasons ?- I know of vets that wont use them or use them and then still put in interrupted sutures because they are worried the wound may dehisc.

try bringing this subject up at a nurses meeting or a staff meeting - but in a more constructive way and who knows? - there may be something good comes from it

Re: Endoscope cleaning...

Freckle — Sat, 30 Jan 2010 21:31:40 GMT

[quote user="Maisy"]

[quote user="Freckle"]

oh meant to add - we get rid of our medizyme and meddis each day - mostly coz the other nurses throw it away! if it was up to me i would keep a tub of meddis for a week or so.

does everyone always check the dilution rates of things? most people i have worked with don't bother, but surely it's imperative!?

[/quote]

Why not suggest that everything is followed a particular way if you always end up doing different things? Show your head nurse the data sheets and see about implementing some new procedures so that everyone is doing the same. Maybe they don't know exactly what's best to use and why!

[/quote]

i have tried speaking to HN about things regarding sterilisation before, quoted the data sheet etc, but he just doesn't do anything with it! the place is so disorganised - there are no real practice protocals - each vet or nurse does as they see fit! some bitch spays go home with a row of too tight nylon sutures, some go home with a lovely wound of sc pds - so frustrating, and so difficult to explain to clients that pooch may or may not have actual stitches depending on the vet...

the suture thing is just an example - there are no protocals, and all the vets/nurses just do their own thing! drives me nuts, but at least it allows me to do the best i can, with my current knowledge. if we all worked the way theHN does then everything would be washed in hibi, ga charts wouldn't get filled in, and pre-meds not written down - aghhh!

the vets don't seem to notice the negligence coz they are often just as bad themself! one vet in particular can't be doing with the fuss of weighing animals, so just guesstimates their drug doses, even for ga and nsaids in geriatrics!!!! (unless i get in there first!!)

aggghhhh! RANT!

Re: Endoscope cleaning...

Maisy — Sat, 30 Jan 2010 21:12:32 GMT

[quote user="Freckle"]

oh meant to add - we get rid of our medizyme and meddis each day - mostly coz the other nurses throw it away! if it was up to me i would keep a tub of meddis for a week or so.

does everyone always check the dilution rates of things? most people i have worked with don't bother, but surely it's imperative!?

[/quote]

Re: Endoscope cleaning...

Vicky RVN — Sat, 30 Jan 2010 21:02:17 GMT

Lol!

Re: Endoscope cleaning...

Freckle — Sat, 30 Jan 2010 21:01:41 GMT

hooray for measuring jugs!!!!!

Re: Endoscope cleaning...

Freckle — Sat, 30 Jan 2010 21:01:03 GMT

eek! thankfully our scope doesn't get used too often, and its even rarer that i am the one cleaning it, so fingers crossed it is ok..... tho prob bunged up with hibi, unrinsed, and full of infection from previous patients!! grrr!

lol (if i don't laugh i'll cry!)

Re: Endoscope cleaning...

Vicky RVN — Sat, 30 Jan 2010 21:00:38 GMT

[quote user="Freckle"]does everyone always check the dilution rates of things? most people i have worked with don't bother, but surely it's imperative!?[/quote]

Yes i have seen that this doesn't always happen! I'm there with my measuring jug!

Re: Endoscope cleaning...

Nick Shackleton — Fri, 29 Jan 2010 21:43:41 GMT

[quote user="Freckle"]

eeek! thats not so good nick! i think i once tried to look up the optimum temp for medizyme and meddis and couldn,t get any info, so always use cold or lukewarm water.

[/quote]

you know the enzymatic action you were talking about actually eats away at the rubber!

Re: Endoscope cleaning...

Freckle — Fri, 29 Jan 2010 21:43:16 GMT

oh meant to add - we get rid of our medizyme and meddis each day - mostly coz the other nurses throw it away! if it was up to me i would keep a tub of meddis for a week or so.

does everyone always check the dilution rates of things? most people i have worked with don't bother, but surely it's imperative!?

Re: Endoscope cleaning...

Freckle — Fri, 29 Jan 2010 21:40:41 GMT

eeek! thats not so good nick! i think i once tried to look up the optimum temp for medizyme and meddis and couldn,t get any info, so always use cold or lukewarm water.

Re: Endoscope cleaning...

Nick Shackleton — Fri, 29 Jan 2010 21:35:52 GMT

Another thing don't use hot water when diluting medizyme as this accelerates it's action and can destroy the rubber covering of endoscopes deeming them useless!!!!

Re: Endoscope cleaning...

Freckle — Fri, 29 Jan 2010 21:24:21 GMT

i have always believed that medizyme is enzymatic, so it breaks down all the gunk in et tubes and scopes but doesn't sterilse them, and that meddis does do cold sterilisation.

have also been taught that chlorhex is bad for cleaning et tubes etc as not only is it irritant, but if not rinsed correctly it can actually block the tube if it a small one. (have actally seen this happen - the vn monitoring the cat didn't notice that the bag wasn't moving for a good couple of minutes, and the cat ended up with brain damage - since then i have been EXTREMELY cautious!)

personally, i use medizyme for 30 mins, scrub, rinse, then into meddis for 30 mins and finally rinse copiusly. my colleagues however don't do this, and often just use chlorhex or trigene!

Re: Endoscope cleaning...

Sal the 1st — Fri, 29 Jan 2010 21:08:01 GMT

tell me about it - likewise cidex

Re: Endoscope cleaning...

S-J — Fri, 29 Jan 2010 21:06:41 GMT

we use gigasept for our endoscope only one use only. just make sure ur careful with the concentration, i mis read it once whilst cleaning endoscope in an enclosed room with door shut. oh my god wont be doing that again.

Re: Endoscope cleaning...

Nick Shackleton — Fri, 29 Jan 2010 20:50:18 GMT

Surely if you cleaned out a mucky endoscope after a colonoscopy surely you can't reuse that medezyme to then clean some ET tubes???

The guy who showed us how to clean and sterilise our endoscopes told us we had to throw it away after every use.