In 2017, The Joint Commission released new data showing that many hospitals seeking accreditation continue to struggle with meeting infection control Standard IC.02.02.01: “The hospital reduces the risk of infection associated with medical equipment, devices, and supplies.”1 It is well known that the process of cleaning and high-level disinfecting ultrasound probes (which are considered semi-critical devices per the CDC, FDA, and Spaulding Classification) is crucial for infection control and patient safety.2
Proper reprocessing of devices involves a multi-step workflow that must be managed carefully to ensure the risk of contamination is controlled and minimized at every step. Because the process is a progressive workflow, the effectiveness of each reprocessing step is only as reliable as the steps before and after it.
Infection prevention is an ongoing patient safety issue that must be at the forefront of every healthcare worker’s mind. Dedicated infection prevention and control (IPC) specialists are responsible for so many tasks within a healthcare setting – from risk analysis of an infectious patient in isolation, controlling an outbreak, auditing to ensure compliance to guidelines for infection control, educating healthcare workers on updated literature and providing tools to support a department to prevent an infection. But is it just the responsibility of the resident IPC specialist?
Why is it so important to practice sterile technique during vascular access procedures as a part of the overall infection control protocol in ultrasound? Before we help answer that question, let’s look at a few numbers regarding some of the potential complications from vascular access procedures1,2:
Since the spring of 2016, the growth of ultrasound in the United States has erupted with the FDA approval of contrast for liver examinations. The contrast agents used for ultrasound consist of very small bubbles of gas surrounded by a fatty shell. These are smaller than red blood cells, so they can pass through the lungs safely. It is injected into the vascular system and does not filter through the kidneys or cause a contrast reaction that may be seen with CT or MRI contrast agents. The introduction of these micro-bubbles has allowed the visualization of the tiny vessels in the parenchyma of the liver that was previously only studied with B mode and Doppler techniques with limited success. These tiny bubbles are confined to the vascular space, making them a bit different than CT and MRI contrast agents, which rapidly clear from the blood pool into the extravascular space.1
As medical professionals, we constantly evaluate situations, identify problems and take action to ensure the best results. From frontline patient care to environmental safety within the medical center, we strive to avoid unnecessary complications. Understanding the work environment and controlling variables is key to improving workflow and overall outcomes in our daily work.
Patient safety and maintaining The Joint Commission (TJC) accreditation standards are two of the most important (if not THE most important) objectives of today’s healthcare administrators and practitioners. However, they are often two of the most difficult objectives of which to achieve 100% satisfaction or compliance.
When ultrasound is used for point-of-care needle guided procedures, including vascular access or regional anesthesia, it is recommended by the FDA and the CDC that a single-use, disposable probe cover be used on the ultrasound probe for each procedure.
Introducing Automated Disinfection Systems for Ultrasound Transducers
With the steady growth of ultrasound combined with an increasing awareness of infection control practices, medical device manufacturers have recently developed automated reprocessors for ultrasound transducers. Automated disinfection systems help to standardize disinfection processes, improve staff workflow, and meet compliance standards – the sum of which improves patient and staff safety.
"The endoscope should be hung vertically with the distal tip hanging freely in a well-ventilated, clean area, following the endoscope manufacturer's written IFU for storage...Store endoscopes in a manner that will protect them from damage or contamination."