Automation and Standardisation of Ultrasound Probe Reprocessing

Hello, I am Olivier Mazille, medical affairs manager for Nanosonics in Europe. Today I am with Peter Cantin to discuss automated disinfection of ultrasound probes. Hi, Peter. Could you tell us about yourself?

Hello, my name is Peter Cantin and I'm a consultant sonographer at Derriford hospital in Plymouth in the UK. I work in a very large 14 roomed ultrasound department, which covers all aspects of general abdominal and gynecological ultrasound. And I've been working there for the last 25 years.

Thanks. And how do you use ultrasound in your daily role Peter?

So I have quite a large role, I do a lot of upper abdominal interventional, head and neck, and gynecology work in my role the only thing I don’t do very much of is Obstetrics.

OK, and could you tell us how and when you are performing high level disinfection for ultrasound probes?

So we use high level disinfection for all of our transvaginal work, and we will occasionally use it for any of our other ultrasound probes if they've come into contact with mucous membranes or bodily fluids, we undertake a lot of gynecological work. So we spend a lot of our time cleaning ultrasound probes to ensure that they're fit for purpose and clean for the next patient.

And may I ask you, how were these probes disinfected before implementation of the automated device?

So we had a wipe system which was compliant with high level disinfection until we implemented the use of an automated system two years ago.

So why did you decide to switch to an automated HLD?

So although the wipes were complying with our current guidelines and we were a bit concerned that the standardization of how the probes were cleaned was difficult to achieve. So because our department is so big and because we have a lot of users of ultrasound probes, perhaps it was becoming more and more difficult to ensure that everybody was trained adequately using the wipe system, and it was becoming even more difficult to make sure that all people were using the probes in the same way.

So although we had reasonably good assurance that our probes were being adequately decontaminated, the standardization of that was causing us some concern.

How does this automated HLD with sonicated hydrogen peroxide device integrate into your workflow?

So when we implemented the device, there was some concern about the time that we were going to spend decontaminating the probes because the cycle takes seven minutes. We have had to change our workflow slightly.

So when the patient has finished their examination and while the assistant is getting the patient off the couch to probe decontamination is already starting to take place at that time. So the seven minutes is generally the seven minutes that we use for decontamination is generally when a patient is getting dressed and leaving the room. That means the probe is ready by the time it's needed for the next patient. So implementing the change did require some changes in the way that we did our work. But those have become well embedded now and haven’t resulted in any reduced workflow.

How and when do you complete traceability and why is traceability important to your facility?

So we have quite robust mechanisms for ensuring that we know exactly how probes have been decontaminated for each particular patient. Each probe has an electronic tag and when we put a probe into the decontamination unit, that probe is scanned so the unit records what time that probe went in. At the end of the cycle, the machine gives us a cycle number, and it also records which operator actually put the probe into the machine.

All of that information is recorded on the bottom of our ultrasound report so that we can cross-reference and know that for any particular patient, we know how the probe was decontaminated, when it was decontaminated and who actually did decontamination process. We've never actually been asked for this for this data previously, but one of the reasons for undertaking automated disinfection was that we could get better traceability of our probes. It could happen that a patient could ask how the probe that was used on them was decontaminated.

And before that, we wouldn't have been able to answer that question. We now have very good mechanisms so that we can cross-reference so if a patient ever comes along with a query, for instance, if she acquires an infection of some description, we'll be able to tell exactly how and when that probe was decontaminated.

Perfect, makes total sense.

So to finish, do we have any recommendations for others who may be looking at implementing automated HLD in their workflow?

Yes, I would suggest talking to your infection control department and your decontamination leads if you have them. When we started talking about transferring from the wipe system to the automated system, our infection control department wanted to see robust laboratory data, which was independent about how well the automated system decontaminated probes. Once they had that, they were very happy then to support us. 

So our decontamination lead was absolutely key in making the business case for an automated system and ensuring that this was pushed through procurement and also helping to set up procedures and policies so that we could use the processes adequately. I think without consulting our infection control department or our decontamination leads it would have been much more difficult to implement the system that we now have.

Thanks a lot Peter, for sharing your experience. It has been very informative, so I wish you a nice remainder of the day. Bye bye.

You're very welcome. Thank you Olivier, bye bye.