Disinfection


procedure and the room must be returned to a “clean” state ready for the next patient. The use of automated technologies can streamline this segregation of dirty and clean processes. For example, handling of a dirty probe can occur only when the room is “dirty” (i.e. as the patient leaves the room), and handling of the clean probe then only occurs after the room has been turned over and is ready for the next patient (i.e. a “clean” state). Furthermore, using single-use storage


covers protects the probe by providing a barrier to contamination from handling and the environment. Use of these covers completes the clinical workflow for safe POC reprocessing.


Improving and standardising processes The best way to ensure safe and effective reprocessing of ultrasound probes at point of care is through improvement and standardisation. UK and Irish experts in infection prevention and decontamination have developed a consensus document called the Ultrasound Infection Prevention Toolkit. This free toolkit, available free of charge at: www.ultrasoundinfectionprevention.org.uk is product agnostic and helps infection prevention staff locate ultrasound machines in their facility, conduct risk assessments, and develop or improve reprocessing policies. When taking into account key considerations around automation, traceability, safety and workflows, point of care reprocessing of ultrasound probes can help protect patients from infection risk.


Practice.” Revision 3, December 2018.


8. European Society of Radiology (ESR) 2017. Infection prevention and control in ultrasound - best practice recommendations from the European Society of Radiology Ultrasound Working Group.


9. Spaulding EH. Chemical disinfection of medical and surgical materials. Disinfection, sterilization and preservation. 1968. Lawrence C, Block SS. Philadelphia (PA0, Lea & Febiger: 517-531.


10. Health Protection Scotland (HPS), Health Facitlities Scotland (HFS). NHS Scotland Guidance for Decontamination of Semi-Critical Ultrasound Probes; Semi-invasive and Non-invasive Ultrasound Probes. Version 1.0. March 2016.


11. Health Service Executive (HSE) Quality Improvement Division 2017. HSE Guidance for Decontamination of Semi-critical Ultrasound Probes; Semi-invasive and Noninvasive Ultrasound Probes. Document: QPSD-GL-028-1.


12. WHTM 01-06. 2014- Decontamination of flexible endoscopes Part C: Operational management, NHS Wales Shared Services Partnership – Specialist Estates Services: 74.


13. Keys, M., et al. Efforts to Attenuate the Spread of Infection (EASI). Crit Care Resusc. 2015:17(1): 43-46.


14. Oide, S., et al. Incidence of residual bacterial contamination of transvaginal ultrasound probes. J Med Ultrason 2019 ; 46(4): 475-479.


CSJ


References 1. NHS England. Diagnostic imaging dataset 2019-20 data. Available at www.england.nhs.uk/ statistics


2. Lau YH, See KC. Point-of-care ultrasound for critically-ill patients: A mini-review of key diagnostic features and protocols. World J Crit Care Med. 2022; 11(2):70-84.


3. Ultrasound Guidelines: Emergency, point- of-care and clinical ultrasound guidelines in medicine. Ann Emerg Med. 2017;69(5):e27–54


4. Recker F et al. Point-of-care ultrasound in obstetrics and gynecology. Arch Gynecol Obstet 2021; 303(4):871-876.


5. Mengel-Jørgensen T, Jensen MB. Variation in the use of point-of-care ultrasound in general practice in various European countries. Results of a survey among experts. Eur J Gen Pract. 2016;22(4):274–277.


6. Collins K et al. Point-of-care ultrasound in obstetrics. AJUM 2019; 22(1): 32-39.


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46 www.clinicalservicesjournal.com I March 2023


15. Buescher DL, et al. Disinfection of transvaginal ultrasound probes in a clinical setting : comparative performance of automated and manual reprocessing methods. Ultrasound Obstet Gynecol 2016;47(5): 646-651.


16. Leroy S, et al. Infectious risk of endovaginal and transrectal ultrasonography: systematic review and meta-analysis. J Hosp Infect 2013;83(2): 99-106.


17. M’Zali F et al. Persistence of microbial contamination on transvaginal ultrasound probes despite low-level disinfection procedure. PLoS One 2014; 9(4):e93368.


18. Scott D et al. Risk of infection following semi- invasive ultrasound procedures in Scotland, 2010 to 2016 : A retrospective cohort study using linked national datasets. Ultrasound 2018;26(3):168-177.


19. Gery A et al. Investigation of Serratia marcescens surgical site infection outbreak associated with perioperative ultrasonography probe. J Hosp Infect 2021; 111:184-188.


20. Buetti N et al. Ultrasound guidance and risk for central venous catheter-related infections in the intensive care unit : a post hoc analysis of individual data of 3 multicentre randomized trials. Clin Infect Dis 2020. doi: 10.1093/cid/ ciaa1817


21. RKI 2020. Aufbereitung von Medizinprodukten mittels Wischtuechern.


About the author


Olivier Mazille is a microbiologist and joined Nanosonics in early 2020 as senior medical affairs manager EMEA. He is passionate in developing and delivering educational programmes around infection prevention, especially about cross-infections caused during ultrasound procedures. With a career spanning over a 20 year period, he held various positions at Merck KgaA (Millipore division, dedicated to microbiological quality controls in the pharma industry), before joining Medtronic where he managed the Medical Science team EMEA, in charge of professional education of surgeons on minimally invasive procedures. Since 2020, with patients’ safety in mind,


Olivier is focusing on raising awareness of the risk associated with ultrasound procedures if not performed according to the relevant guidelines.


22. RKI 2021. Valideirung der abschliessenden Desinfektion von semikritischen Medizinprodukten mittels Wischdesinfektion.


23. Hoge Gezondheidsraad (2019). Aanbevelingen inzake de infectiepreventie en het beheer van warmtegevoelige endocavitaire endoscopen en medische hulpmiddelen: 104.


24. Statens Serum Institut 2013. Principper for anvendelse af desinfektionsmidler i sundhedssektoren i Danmark.


25. Werkgroep Infectie Preventie 2017. Reiniging, desinfectie en sterilisatie van medische hulpmiddelen voor hergebruik niet-kritisch, semi-kritisch of kritisch gebruik: 56.


26. Ministere des Solidarités et de la Santé 2019. Proposition technique du groupe de travail national. Prevention du risqué infectieux associe aux actes d’echographie endocavitaire


27. Carrico RM et al. Ultrasound probe use and reprocessing: Results from a national survey among U.S. infection preventionists. Am J Infect Control 2018; 46(8):913-920.a


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