Decontamination of Ultrasound probes

Decontamination of Ultrasound probes:
Transoesophogeal (TOE)
Transrectal (TRU)
Transvaginal (TVU)
Gillian Irvine
Senior Nurse Infection Control, HFS
April 2014
Introduction
• National HFS Review
Background
Aim
Method
Findings
Proposed
Recommendations
US probe decontamination April 2014
Background
• Incident- patient died in March 2011 due to an acute
‘Hepatitis B’ infection
www.wales.nhs.uk/sitesplus/863/opendoc/189315
• Medical Device Alert Ref: MDA/2012/03737(MDA)
issued in June 2012.
• Enquiries to HFS regarding the decontamination of
TOE, TRU and TVU probes.
US probe decontamination April 2014
TOE, TRU and TVU probes are classified as semi critical devices,
requiring high level disinfection under the Spaulding
classification.
US probe decontamination April 2014
HFS National Review
Aims:
• To identify current decontamination practice for TOE,
TVU and TRU probes through a national review.
• To produce a national report containing
recommendations to NHSScotland Health Boards.
US probe decontamination April 2014
Method
• Questionnaire 1

sent to ICMs at 15 boards.
 12 boards responded
Questionnaire 2
sent
to 67 departments decontaminating
semi invasive ultrasound probes.
47 departments responded
US probe decontamination April 2014
Findings- TOE
70
• Most departments use small
numbers of TOE probes.
Number of TOE probes and
frequency of use p/w
60
50
40
• Number of TOE probes available
is a close match to number of
procedures carried out each
session.
No. of probes
30
20
10
Av. No. procedures
0
1
2
3
4
5
6
7
8
9
10
11
12
Department ID
Number of makes and models of
TOE in use
•No preferred model reported
7
6
5
4
3
2
1
0
Number of sites
using make
Philips
US probe decontamination April 2014
GE
Siemens
Unspecified
No of models in
use per
manufacturer
TRU
• Most departments use small
numbers of TRU probes.
30
Number of TRU probes and
frequency of use p/w
Number of probes
20
• Number of TRU probes available
is a close match to number of
procedures carried out each
session.
10
Av. NO. procedures
p/w
0
Department ID
• BK Medical appears to be
most popular make for
TRU probes
Number of makes and models of
TRU in use
7
6
5
4
Number of
sites using
make
3
2
1
0
Number of
models in use
US probe decontamination April 2014
TVU
• Numbers of TVU probes is very
variable with from 1 to131
procedures p/w.
140
120
Number of TVU probes and
frequency of use p/w
100
Av. No. of
procedures
80
• Most departments only have 1
TVU probe per treatment room.
60
No. of probes
40
20
0
Siemens appears to be most
popular make for TVU probes
Number of makes and models
of TVU in use
20
18
16
14
12
10
8
6
4
2
0
Number of sites using
make
Number of models in
use
US probe decontamination April 2014
Current Challenges in the Management
of Decontamination
There are many challenges in the
decontamination of Ultrasound
probes:
• Clinical environment,
• Equipment set up
• Construction
•
•
•
•
Available time
Traceability
Material compatibility
MDIs
US probe decontamination April 2014
Current Decontamination Practice
TOE
8%
8%
Manual immersion
disinfectant
23%
38%
23%
Manual immersion
detergent
TRU
Manual immersion
detergent
18%
Manual wiping with
Detergent and disinfectant
18%
9%
27%
Number using wipes
claiming to be both
28%
Manual immersion HLD
Manual wiping with
Detergent and
disinfectant
Number using wipes
claiming to be both
Manual immersion HLD
Number using Automated
EWD
TVU
20%
Manual immersion
detergent
20%
2%
20%
38%
Manual immersion
disinfectant
Manual immersion
disinfectant
Manual wiping with
Detergent and
disinfectant
Number using wipes
claiming to be both
Manual immersion HLD
US probe decontamination April 2014
Essential requirements
It is important that all stages of the process are carried out and that
at the point of use reprocessed devices are free from:
•residues
of previous procedures
•residues
from the decontamination process
•adventitious
contamination e.g. particulates and microbial
contamination
•management
must also ensure staff responsible for ultrasound
probe decontamination are appropriately trained in
decontamination practices.
US probe decontamination April 2014
Decontamination of TOE, TVRS and TRUS
Probes
Tristel wipes
Enzymatic
Low level
High level-toxic
Tristel wipes
Detergents
New machines
Disinfectants
US probe decontamination April 2014
Interim Recommendations
Order of Preference
1. Automated process, preferably in EWD
2. Compatible Multi Wipe System
Use probe sheath
Always consult manufacturer’s instructions and
carry out risk assessment
US probe decontamination April 2014
Summary
•Identified variability in:
Clinical practice
Manufacturer’s Instructions For Use
Compatibility of detergent and disinfectant
solutions.
•Future Work
US probe decontamination April 2014
Thank You
Enquiries to
[email protected]

Download Report