DECONTAMINATION
OPINION
Ultrasound probes: tackling the risks Bryn Tudor-Owen, from
Nanosonics UK, says that hospitals must tackle the challenges associated with ultrasound probe decontamination in 2022: “Ultrasound scanning has expanded to almost every healthcare department, its utility particularly spotlighted during the pandemic. Managing documented infection risk associated with the use of these devices is important to support patient safety. Ultrasound probes will often contact mucous membranes, non-intact skin (semi-critical devices), sterile tissue and/or the bloodstream (critical devices). These devices require a minimum of validated reprocessing that is bactericidal, virucidal, fungicidal and mycobactericidal (termed ‘high level disinfection’ internationally), and the use of a sterile sheath. One of the key challenges for
decontamination in 2022 will be to locate which hospital departments are using ultrasound. Following this, to profile how ultrasound probes are being used and in which procedures, and which patient tissues they are expected to contact for
currently being developed by CSC to address potential knowledge gaps, while helping departments to identify whether they are achieving the required standards. A group has also been established to produce a modern version of the Microbiological Advisory Committee Manual produced many years ago. Representatives from professional bodies overseeing this development include: Val O’Brien CSC, Graham Stanton IHEEM, Brian Kirk IHEEM Technical Platform, Bob Spencer HIS, Gail Lusardi IPS, Mett Smart IDSc, Helen Griffiths BSG, Victoria Daniel PHW, Ruth Collins AfPP and Sarah Marshall JAG.
OPINION Medical device design: key challenges
Medical device design is a key issue that needs to be addressed in 2022, according to Jimmy Walker. Manufacturers are still designing instruments without sufficient consideration as to how they can be cleaned and decontaminated. Some hospitals have taken control and refused to use these instruments, putting pressure on the manufacturers to address these
infection risk challenges, he revealed. “We can talk about technology and the exciting innovation of the future, but sometimes you have to get the basics right.” he commented. “Even manual instruments are being placed on the market that cannot be properly cleaned. There is a lot of work to be done to address these issues.”
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each procedure. It’s important to identify and close potential infection prevention gaps, to ensure these devices are properly prepared for every patient according to ultrasound infection prevention guidelines from the United Kingdom.
Semi-critical and critical ultrasound probes are routinely reprocessed at the patient point of care. A priority should be adoption of new, automated technologies for these devices, that integrate with the clinical workflow. Automated disinfection methods are standardised and validated, and therefore considered best practice across Europe for semi-critical ultrasound probes. The Robert Koch Institute reaffirmed this, in November 2021, stating that manual wipe disinfection is prone to human factors and there is no known way to validate wipe disinfection on site. Automated devices additionally offer digitised traceability supporting standardisation and quality care. Facilities should ensure selected decontamination processes are compatible with ultrasound probes used in each department to avoid probe damage and voided warranties.”
The old MAC Manual has now been reviewed and agreement has been reached on which topics to use to form the basis of the new training manual. The manual is not intended to duplicate existing standards or guidance documents. However, the target audience is anyone wishing to gain an appreciation of decontamination fundamentals. Keeping text to a minimum, the manual will include images and pictorial methods, including algorithms and flow charts, to support easy reference. The intention is to have the electronic manual as a living document to allow easy amendment and updates as
required. The document will be held on the CSC website with hyperlinks on all other professional body websites directing readers to the CSC website. The aim is to have Version 1 available by Summer 2022 and it has also been agreed that the new manual will be dedicated to Tina Bradley, who originally proposed the project. Protecting staff must also be a priority for 2022 – COVID-19 has driven an increased appreciation of the importance of effective ventilation. Airborne infection transmission is not the only threat posed to staff in the decontamination unit, however. John Prendergast, has been collaborating with Malcolm Thomas, the lead author of the HTM 03-01 (2021) guidance on specialised ventilation for healthcare buildings, to develop a CSC document focusing on the decontamination workplace. While this will consider how ventilation can help to reduce the risk of airborne infection transmission, when performing manual cleaning (for example, through aerosol droplets), it will also provide an insight into the protection of staff working in environments where chemicals such as peracetic acid are used – by implementing improvements in ventilation. The final version of the document is expected to be published early in 2022.
Conclusion Ultimately, 2022 may prove to be a challenging year for decontamination units, with pressure to achieve increased decontamination volumes and faster turnarounds. Patient safety must remain a top priority, despite these pressures, but the safety and wellbeing of decontamination staff must also be given the attention it deserves. Staff will need to be supported as they manage increased workloads and
JANUARY 2022
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