When your sterile processing department receives a tray of ultrasound probes, what happens next and why?
On the Below the Hospital podcast, host Garland-Rhea Grisby Sr. of Sutter Health interviewed Kathleen McMullen, APIC fellow and executive director of infection prevention and sterilization at Mercy, about the science that informs best practices for processing ultrasound probes.
McMullen’s work has a broad reach within her health facility, and she frequently spends time with housekeepers, anesthesiologists, nurses, therapists and SPD staff. Her work with sterile processing often involves ensuring alignment with manufacturer instructions for use (IFUs), industry guidelines and other best practices.
Ultrasound probes are used in non-invasive procedures such as checking on a pregnant patient or locating a vein for an IV placement. Because they do not break the skin, “you’re always going to use a gel to help out with visualizing whatever it is under the skin you’re trying to find.” After a given procedure, the probes are subjected to a low-level disinfection process. In fact, McMullen has found that the gel is often “the biggest challenge for ultrasound probe disinfection.”
Because ultrasound probes used like this receive a Spaulding Classification of non-critical, they are then subjected to what McMullen described as “the lowest or the least amount of disinfection that we need to do to devices in healthcare.” Probes are usually disinfected by “using a disinfecting wipe to make sure you’re removing that ultrasound gel and then using a fresh wipe to make sure you’ve really disinfected that probe.”
However, if an ultrasound probe encounters non-intact skin, low-level disinfection is no longer appropriate. For a probe like this, high-level disinfection is required before any future use on a patient’s intact skin. According to McMullen, “ultrasound probes are a great example of how AAMI, APIC and other organizations use evidence to inform their guidance.”
AAMI’s Endoscope Working Group, or ST-WG84, is no stranger to spirited debate over what the scientific evidence suggests is the best course of action. Grisby said, “I believe that was one of the more brutal discussions.” But after reviewing a wealth of data and academic literature on central line-associated bloodstream infections, the group eventually reached consensus on the lack of evidence that low-level disinfection is a risk factor for central line-associated bloodstream infections. Per Grisby, “And at the end of it all, what does the data say? What does the data support? Then therein lies our consensus.”
What is one thing that McMullen would change about her job as an infection preventionist? She would like to get more questions from the sterile processing department. After all, sterile processing is a team sport. “Do not be scared of your infection preventionists … we’re just there as an extra set of eyes.”
Want more Below the Hospital? You can find the show on Spotify, Apple Podcasts, and on the AAMI YouTube channel.
