The process of performing high-level disinfection on ultrasound probes - both transesophageal (TEE) and endocavity transducers - possesses unique challenges, and it can often be hard to know exactly what steps to take along the way. Below are some of the key tips to remember when disinfecting transducers to ensure a proper, thorough cleaning for your probes.
Introducing Automated Disinfection Systems for Ultrasound Transducers
With the steady growth of ultrasound and 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.
Why the wait?
Automated endoscopic reprocessors have existed for decades; however, the design of ultrasound probes presented a unique challenge for reprocessing. Since some parts of the transducer cannot contact liquid and a probe cannot be fully submerged in liquid, the development of automated ultrasound disinfection systems was not possible until recently. Advancements in technology have worked around that design nuance with innovative solutions, including the series of ASTRA® reprocessors which received their FDA clearance in 2016.
In recent years, proper storage of ultrasound probes has fallen under the increased scrutiny of compliance surveyors. The Joint Commission (TJC) has defined guidelines on storage for semi-critical devices:
If your facility’s goals are to improve patient safety, ensure compliance and extend the life of your transesophageal (TEE) transducers, then performing an electrical leak test on your TEE probes between each use should be part of your high-level disinfection procedure.
When it comes to disinfecting transesophageal (TEE) probes, the process can be more challenging than other endocavity probes. Let’s touch on some of the key highlights here.
According to The Joint Commission (TJC), the second most commonly cited area for noncompliance in hospitals in 2015 has been related to ‘the reduction of infection risk from equipment, devices, and supplies.’ TJC annually releases the most common cited standards (areas of noncompliance) and this particular infection control standard, IC.02.02.01, has been a ‘leading’ category for noncompliance for the past few years.
While attending a radiology conference, we met an ultrasound manager who shared an experience from her last inspection when objections were raised about her transducer storage system. She kindly shared the photo on the above right of their probe storage system. Can you see the issues with this particular system?
New HLD disinfectants, such as hydrogen peroxide-based HLDs, have emerged that offer some distinct benefits and thus merit review.
As new technologies emerge for disinfection of ultrasound probes, it’s timely to restate the critical importance of pre-cleaning before you disinfect. In short, pre-cleaning is essential, whether you high-level disinfect manually or with an automated system.
The use of automated disinfection devices does not eliminate this crucial step. If pre-cleaning is skipped or performed improperly, the disinfection procedure is compromised.
Cleaning is defined as “removal of visible soil (e.g. organic and inorganic material) from objects and surfaces and normally is accomplished manually or mechanically using water with detergents or enzymatic products.” 1
(Photo above illustrates the pre-cleaning of a TEE ultrasound probe)