The Society & College of Radiographers and the British Medical Ultrasound Society release guidance requiring high level disinfection for all semi-critical ultrasound probes
During December 2017, the Society & College of Radiographers and the British Medical Ultrasound Society published their updated Guidelines for Professional Ultrasound Practice requiring the appropriate disinfection or sterilisation of ultrasound probes.1
The guidelines now advise that:
• All ultrasound transducer probes should be cleaned immediately after a scan to remove all organic matter and body fluids.
• Ultrasound probes should then undergo appropriate disinfection or sterilisation.
• All critical probes (probes contacting sterile tissues or blood) should be preferably sterilised, but if sterilisation is not possible, they should be minimally high level disinfected and used with a sterile sheath.
• All semi critical probes (both semi-invasive probes contacting mucous membranes and non–invasive probes contacting non-intact/broken skin) should be high level disinfected either manually or with automated systems.
• High level disinfection is still required when using a sheath as sheaths can have micro-perforations or can break.
The updated guidance draws on best practice infection prevention for ultrasound probes previously published by NHS Wales and Scotland as well as more recent guidance from Ireland’s Health Service Executive as well as the joint guidance from the Australasian College for Infection Prevention and Control and Australasian Society for Ultrasound in Medicine, all of which highlight the importance of high level disinfection of all semi-critical ultrasound probes.2-5
Commenting on the guidelines Michael Kavanagh, Nanosonics’ Chief Executive Officer and President said: “This new guidance from the Society & College of Radiographers and the British Medical Ultrasound Society is a welcome addition to a fast growing number of international guidance documents being released which recognise the importance of high level disinfection of all semi critical ultrasound probes to minimise the risk of cross contamination and improve patient safety.”
He added: “Our trophon system is already being adopted widely in Scotland and Wales and is well positioned to deliver the decontamination requirements of all ultrasound departments and practices across the UK by delivering an automated, validated system that is compatible with over 1,000 ultrasound probes across all major ultrasound companies.”
2. Welsh Health Technical Memorandum WHTM 01-06. Wales, 2014. Decontamination of flexible endoscopes Part C: Operational management (Including guidance on non channelled endoscopes and ultrasound probes).
3. Health Facilities Scotland, NHS National Services Scotland, Health Protection Scotland. Scotland, March 2016. NHSScotland Guidance for Decontamination of Semi-Critical Ultrasound Probes; Semi-invasive and Non-invasive Ultrasound Probes. Document: HPS/HFS Version 1.0.
4. Health Service Executive (HSE) Quality Improvement Division – Decontamination Safety Programme. Ireland, January 2017. HSE Guidance for Decontamination of Semi-critical Ultrasound Probes; Semi-invasive and Noninvasive Ultrasound Probes. Document: QPSD-GL-028-1.
5. Australasian College for Infection Prevention and Control (ACIPC) and the Australasian Society for Ultrasound in Medicine (ASUM). Guidelines for Reprocessing Ultrasound Transducers. Australasian Journal of Ultrasound in Medicine. 2017;20(1):30-40. Available at: http://onlinelibrary.wiley.com/doi/10.1002/ajum.12042/epdf
The European Society of Radiology releases best practice recommendations stipulating mandatory high level disinfection for ultrasound probes
The new guidelines from the European Society of Radiology published in November 2017, result from an initial study by the society which identified a wide range of practices amongst European ultrasound professionals and the need to raise awareness regarding the importance of infection prevention and control measures.1
The society’s “Infection Prevention and Control in Ultrasound – Best Practice Recommendations” highlights the risk of cross-contamination associated with ultrasound procedures when appropriate cleaning and decontamination practices are not followed.
The recommendations stated: “Any equipment in direct patient contact must be cleaned and disinfected prior to first use and after every examination.” It is also stated that “Low level disinfection is sufficient for standard ultrasound on intact skin.
However, for all other minor and major interventional procedures as well as endocavity ultrasound, high level disinfection is mandatory.”
Comparing different decontamination methods was not part of the society’s recommendations scope. However automated systems were mentioned as most favourable due to their ability to deliver a standardised and reprodicble decontamination process which avoids operator associated errors and variations. The trophon® EPR system from Nanosonics was presented positive as a favoured automated system due to its use of hydrogen peroxide.
“This new guidance provides further evidence of the increasing international awareness of the importance of ultrasound probe decontamination to minimise the risk of cross-contamination and improvement of patient safety,” said Michael Kavanagh, Nanosonics’ Chief Executive Officer and President.
“Having a peak body for the European radiology community release this guidance is an important driver to ensure that where local guidelines do not exist or don’t represent best practice, they need to be developed or updated to comply with what is now becoming international best practice,” he added.