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CER Online Lesson Plans

This series of self-study lessons on Sterile Processing topics was developed by the International Association of Healthcare Central Service Materiel Management (IAHCSMM). The lessons provide ongoing education focusing on the handling and maintenance of endoscopes. These CER lesson plans offer continuing education for CER and CRCST renewals.


IAHCSMM Members receive access to lesson plans at a discounted rate.

To familiarize yourself with our library, please review the CER lesson plan descriptions below. Once you’re ready to access the lesson plans, simply sign in to the store, add the lesson plans to your cart and proceed to checkout. Member discounts will reflect as you add lesson plans to your cart and complete the check-out process.

Upon successful check-out, you will have immediate access to view the content through your IAHCSMM Account. Following each reading, there will be a quiz to take in order to receive credit toward your renewals. Please Note: IAHCSMM does not manually grade any paper quiz submissions, and to achieve credit, all quizzes must be completed online.

Available Lesson Plans

518-Raising the Bar: New Standards for IFU Development
Introduction: Developing and validating the instructions for use (IFU) for processing (cleaning, disinfecting and/or sterilizing) medical devices by a healthcare facility is a significant responsibility of medical device manufacturers (MDMs). The U.S. Food and Drug Administration (FDA) requires that these instructions be validated—not just for efficacy but also so the healthcare facility can practically implement the instructions.
517-Preventative Maintenance for Automated Equipment and Accessories for Endoscopy
Introduction: There are many types of automated equipment and accessories used in conjunction with endoscopy and endoscope processing. Attention must be given to these items to ensure they continue to remain in good working condition. If products are used that are not in good repair, there is potential to cause injury or harm to the patient, including infection transmission and even death.
516-Ultrasound Probes: Common Processing Steps and Challenges
Introduction: In the previous lesson (CER 515), we identified different types of ultrasound probes, the varied clinical practice settings, and existing processing guidelines and standards. This lesson focuses on the actual processing for these reusable medical devices and highlights common challenges they present.
515-Ultrasound Proves: Types, Uses & Guidelines/Standards
Introduction: In the not too distant past, the most common example for a patient undergoing an ultrasound prove procedure was a pregnant mother; the probe against the abdomen allows indirect imaging of the developing baby. Nowadays, the clinical use of ultrasound imaging has skyrocketed in both inpatient and outpatient settings.
514-Standards Development in the Age of COVID-19
Introduction: The COVID-19 pandemic has proven challenging for virtually everyone across the globe. As the virus spread from country to country and region to region, the overwhelming response was to shut down all but the most essential activities. While healthcare was, understandably, deemed an essential business, many of the "normal" business activities were not.
513-The Importance of Bronchoscope Processing
Introduction: With the emergence of respiratory illnesses, such as the current COVID-19 pandemic, the effective processing of bronchoscopes has never been more critical for delivering safe patient care. With more than 500,000 procedures performed annually, bronchoscopes are valuable medical devices that enable minimally invasive diagnosis and therapeutic interventions that improve patient outcomes.
512-Workflow and Logistics in Flexible Endoscope Processing Areas
Introduction: An important cross-contamination prevention strategy is the proper workflow and design of the endoscope processing area. Workflow in that area should be unidirectional from the decontamination area to the clean area and then to the storage area. Workflow patterns should be designed to contain contaminants and prevent damage to endoscopes, all while minimizing employee exposure to pathogens and chemicals.
511-Leak Testing: An Essential Step in Flexible Endoscope Reprocessing and IFU Adherence
Introduction: Flexible endoscopes present one of the most difficult reprocessing challenges faced by Sterile Processing (SP) professionals today. With intricate designs and delicate components, these instruments are difficult to keep in optimal working order. While there are many variations of endoscopes, depending on their intended use, they all have one key commonality: sealed sections that should never be exposed to fluids.
510-Endoscopy and Endoscope Processing: An Overview and Update
Introduction: Whether a novice or veteran for processing flexible endoscopes, a review and update are periodically helpful to maintain best practices. Additionally, recent years have brought increased awareness for, and scrutiny of, processing these reusable devices. The independent nonprofit organization ECRI Institute has listed flexible endoscopes on each of their annual top ten medical device hazard lists since 2013.
509-Microbial Surveillance of Flexible Endoscopes
Introduction: Outbreaks of bacterial infection associated with endoscopes are often attributed to improperly reprocessed endoscopes; however, recent reports have identified carbapenemresistant Enterobacteriaceae (CRE) transmission associated with persistently contaminated duodenoscopes for which no breaches in reprocessing were identified.
508-PPE for Endoscope Reprocessing: Regulations, Standards & Responsibilities
Introduction: Processing flexible endoscopes is one of the biggest challenges facing reprocessing departments today. Those challenges include delayed reprocessing, issues of inadequate manual cleaning, inadequate or non-existent cleaning verification, among others. One aspect of flexible endoscope reprocessing that shouldn’t be challenging, yet often is, is the selection and use of personal protective equipment (PPE).
507-Visual Inspection of Flexible Endoscopes
Introduction: The consequences of using contaminated endoscopes on patients have been well documented in the news media over the last several years. These lapses have highlighted the need to do more to ensure these devices are safe for patients. Visual inspection is a crucial step in every endoscope manufacturer’s instructions for use (IFU).
506-Storage and Transport of Flexible Endoscopes
Introduction: In accordance with ANSI/AAMI ST90, Processing of health care products—Quality management systems for reprocessing in health care facilities, healthcare facilities should establish a comprehensive quality assurance (QA) and safety program to monitor all aspects of device processing, including all flexible endoscopes.
505-Drying of Flexible Endoscopes
Introduction: Effective drying of endoscopes reduces the risk of microbial contamination following high-level disinfection (HLD). If moisture remains in the channel of the endoscope and these endoscopes are stored wet while exposed to the environment, there is a possibility for recontamination of the device by the environment and replication of any remaining bacteria.
504-Cleaning Verification for Flexible Endoscopes
Introduction: Healthcare facilities should establish a comprehensive quality assurance and safety program to monitor all aspects of endoscope processing. This program should incorporate both visual inspections and testing of the equipment to identify conditions that may affect the cleaning or disinfection processes.
503-Leak Testing
Introduction: Flexible endoscopes are complex and sophisticated devices. That complexity and sophistication makes them a wonderful tool for diagnostic and therapeutic procedures; however, it also makes endoscopes difficult to process and susceptible to damage. In addition to being thoroughly and diligently cleaned, most flexible endoscopes must also be leak tested each time they are processed.
502-The Importance of Point-of-Use Cleaning and Handling
Introduction: Infections and outbreaks associated with contaminated flexible endoscopes continue to occur and studies have shown that many facilities do not follow standards and instructions for use (IFU). The 2018 ECRI Top 10 Health Technology Hazards lists endoscope reprocessing failures as its number two concern.
1-The Dangers of Dirty Flexible Endoscopes
Introduction: An outbreak has been traced to a contaminated endoscope at Hospital A. Several patients were notified that a contaminated flexible endoscope may have been used for their endoscopy procedures at Clinic B. One need only search “contaminated endoscopes” on the internet to find information regarding incidents where contaminated (unsafe) endoscopes have been used in patient procedures.

IAHCSMM offers only online grading for the lesson plans. Mailed submissions to IAHCSMM will not be graded and will not be granted a point value. Quizzes may be graded by a manager/supervisor as an in-service worth 1 CE per quiz passed with a 70% or higher (proper documentation of the in-service is required for re-certification, and IAHCSMM does not provide answer keys for any of the lesson plans). Purdue University offers a subscription series for the CRCST and CIS Lesson Plans (available online or through correspondence paper/pencil grading).