Infection Prevention Benefits of Switching to an EWD/AER

Published on:

June 5, 2025

Last updated on:

June 19, 2025

• Expert Q&A

Question:

My facility is using a manual high-level disinfection method to reprocess our flexible endoscopes. What are the infection prevention benefits of switching to an Endoscope Washer-Disinfector/Automated Endoscope Reprocessor (EWD/AER)?

Answer:

Automated high-level disinfection (HLD) is widely recognized as the expected standard of care in flexible endoscope reprocessing for semi critical procedures. Within the realm of endoscopes, EWDs/AERs provide end users with the ability to automatically reprocess flexible, semi-rigid, and sometimes even rigid endoscopes (depending on the manufacturer’s instructions for use (IFU)). Traditionally, manual HLD requires end users to maintain disinfectants in large soaking bins, manipulate endoscopes while submerged in the chemical, and perform copious rinsing procedures. There is greater risk for error given that almost all measuring and monitoring of the process falls onto the shoulders of staff.

From an IP’s standpoint, there is potential risk as ineffective HLD could result in transmission of organisms between patients. Incorrect concentration of disinfectant, soak times, flushing of channels, are all examples of factors that could result in an ineffective HLD cycle. EWDs/AERs offer numerous technologies to ease the physical burden of performing HLD while also reducing measurement and monitoring errors. Depending on the EWD/AER model, benefits may include:

• Minimized exposure to most disinfectants – Disinfectants come pre-packaged in closed containers that are installed into the EWD/AER.

• Temperature tracking – Some EWDs/AERs can track the temperature of the disinfectant and adjust it depending on the required temperature range of the disinfectant.

• Pressure monitoring – Some EWDs/AERs have the capacity to sense pressure changes in the flushing tubing attached to the endoscopes. This alerts the end user that the flushing function may not have been performed appropriately and to re-run the cycle.

• Tracking capabilities – Some EWDs/AERs are equipped with scanning technology that allows staff to use RFID tags or barcode scanning to track endoscopes, reprocessing staff, and other consumables used during HLD to simplify and improve reprocessing documentation.

• Additional cleaning prior to HLD – Many EWDs/AERs also provide an additional cleaning cycle prior to HLD to supplement the manual cleaning performed by a technician.