Focus on quality control
The pandemic has increased the health and safety awareness of the healthcare staff and put an increased focus on infection control, PPEs, decontamination of N95s, donning and doffing, and ensuring that proven validated biocidal detergents/disinfectants are in use.
Recently, there have been numerous reports highlighting how ultrasound transducers have different pathogens on them and can potentially cause patients to get infected.
While discussing the ‘Importance of high-level disinfection for ultrasound probe’, Robert De Jong, RDMS, RVT, FAIUM, FSDMS. Owner & Independent Consultant, Bob DeJong, LLC, Baltimore, Maryland, U.S., said: “There are a couple of articles that have already shown issues with ultrasound contaminating patients, and the research is still ongoing. We still have a long way to go to understand how ultrasound could potentially be causing harm to patients.”
De Jong stressed that one of the tenets of patient safety is making sure all of the equipment is properly disinfected. “Unfortunately, in some instances, people rush and don’t do the disinfection process thoroughly,” he said.
“That leaves our next patient open to getting infected. As healthcare workers, we have to make sure we’re protecting ourselves and our patients, by washing our hands properly. I think if we had taken the disinfection process more seriously, then COVID-19 might not have spread as quickly. We need to take a step back and say, I know it takes extra time, but we have to do that to protect our patients, ourselves and our families.”
When it comes to disinfecting ultrasound equipment, he highlighted that when scanning through intact skin and if the patient doesn’t have a surgical post-op wound or open sores, low-level disinfection can be done.
However, if the transducer touches body fluids or mucous membranes, then high-level disinfection would need to be carried out even if a transducer cover was used.
Some of the technological advancements in sterile processing over the last few years include software traceability, barcoding, and aligning real-time equipment data to track and trace.
If the transducer touches body fluids or mucous membranes, then high-level disinfection would need to be carried out even if a transducer cover was used
Some others include validation on equipment, challenging and monitoring equipment; how to reduce and eliminate risks, develop controlled ISO 8 Cleanrooms where inspection and packaging tasks are carried out and revalidation of Cleanrooms; and quarterly Environmental Monitoring where reusable medical devices are exposed to the environment.
When asked if technology could help in making ultrasound safer, he shared the example of a device available in the market today that uses sophisticated hydrogen peroxide to disinfect. It allows you to put the transducer into a cabinet, press the button and seven minutes later you’ve got a high-level disinfected transducer.
The important thing about this device is that it also disinfects the handle, which can be contaminated and is often neglected.
He concluded: “I think the ultrasound community needs to start taking disinfection more seriously. There are still some factions that don’t believe they are infecting their patients and are still doing low-level disinfection when they ideally should be carrying out high-level disinfection.”
According to Geraldine McNulty, MSc, Decontamination Lead/Medical Device & ISO 13485:2016 Hospital Representative, Kings College Hospital, Dubai Hills, the future of the CSSD, would involve more intricate medical devices, for example, robotic surgery, and the importance of creating and maintaining Medical Device Files for each device, incorporating pictorials of the device, pictorials of tray assembly, IFUs, on-going training and competencies.
“CSSDs are becoming more like a manufacturing plant with strict controls and monitoring in place. I encourage every CSSD department to strive for the Gold Standard ISO 13485:2016 and achieve it,” she added.