Keep It Clean! Infection Control Measures for Vascular Sonographers Amanda Phillips, RVT
Keep It Clean! Outline The Joint Commission General Infection Prevention Probe Reprocessing (Cleaning) Gel
Hospital Acquired Infection > 700,000 HAI About 75,000 died during visit > ½ of HAI occurred outside ICU
Hospital Acquired Infection
The Joint Commission National Patient Safety Goals Goal 7 Reduce the risk of health care associated infections Implement policies and practices aimed at reducing the risk of transmitting multidrug-resistant organisms. These policies and practices meet regulatory requirements and are aligned with evidence-based standards (for example, the Centers for Disease Control and Prevention (CDC) and/or professional organization guidelines). https://www.jointcommission.org/assets/1/6/2018_hap_npsg_goals_final.pdf
The Joint Commission
General Infection Prevention Wash your hands! Hand Santizer Soap and Water
Personal Protective Equipment
Personal Protective Equipment
Personal Protective Equipment Put on new gloves Clean equipment Push machine out of room Remove gloves
Probe Reprocessing (Cleaning)
USA Guidelines 2008 CDC publishes disinfection guidelines. Discusses Endoscopes Doesn t directly discuss ultrasound transducers 2017 AIUM gives Official Statement
Other Countries? Australia and Canada have published standards Europe, working on it Europe Survey to Radiologist 946 responses 65% cleaned the probe between patients https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5110482/
Where is Ultrasound These Days? Radiology Vascular Lab Echo
Where is Ultrasound These Days? Ambulances ED OR Gastroenterology Orthopedics-MSK Urology Anesthesiology
https://www.questionpro.com/a/takesurvey?tt=wh%2bpnpktzcq%3d
https://sdms.egnyte.com/dl/ogsdgfo5mh
Probe Reprocessing LLD Low Level Disinfection HLD High Level Disinfection
https://sdms.egnyte.com/dl/ogsdgfo5mh
https://sdms.egnyte.com/dl/ogsdgfo5mh
https://sdms.egnyte.com/dl/ogsdgfo5mh
Pop Quiz!
Probe 1 High level disinfect Low Level Disinfect
Probe 1 Low Level Disinfect
Probe 2 High level disinfect Low Level Disinfect
Probe 2 High level disinfect Sterile cover
Ultrasound Gel
https://shea-online.org/index.php/journal-news/press-room/press-release-archives/177-contaminated-ultrasound-gel-tied-to-outbreak-of-healthcare-associated-infections
CDC Response April 2012 https://emergency.cdc.gov/coca/reminders/2012/2012apr20.asp
AIUM Official Statement Sterile Gel Sterile single-use gel packets are preferable to nonsterile gel when possible infection is a concern. Such situations include, but are not limited to: All invasive procedures that pass a device through a tissue (eg, needle aspiration, needle localization, and tissue biopsy); All ultrasound examinations performed on neonates; and All ultrasound examinations or procedures performed on nonintact skin or near fresh surgical sites. Sterile or bacteriostatic gel should be considered for endocavitary examinations performed on intact mucous membranes (eg, esophageal, gastric, rectal, or vaginal). http://www.aium.org/officialstatements/57
AIUM Official Statement Nonsterile Gel Single-use gel packets or multidose containers may be used. If multidose containers are used, care should be taken to: Discard and replace multidose containers when empty; these should not be refilled; Appropriately seal the container when not in use; and Avoid direct contact between the gel container dispensing tip and any persons or instrumentation, including the ultrasound transducer. If gel is to be used on a patient who is under droplet or contact precautions, discard the multidose container after use or use a single-use gel packet. http://www.aium.org/officialstatements/57
AIUM Official Statement Gel Warming Dry heat should be the only method used to warm gel. Gel warmers should be cleaned and disinfected regularly according to the manufacturers and infection control policy s requirements. http://www.aium.org/officialstatements/57