Ultrasound probe reprocessing automation: Supporting infection prevention

Automation of ultrasound probe reprocessing can support infection prevention by mitigating risk of human error, increasing compliance to guidelines, and decreasing exposure to chemical sterilants that could potentially cause health related issues in patients and staff.  Automated methods are validated, ensuring efficacy is met with each cycle and this standardizes the reprocessing workflow, making it easier for staff to get through increasing clinical workloads efficiently.  Standardization is ever more important given ultrasound is now used in almost every healthcare department.1 Automated HLD methods also offer digitized traceability, supporting compliance with National standards and quality improvement programs at facilities.2 

I have been working with a hospital in Atlanta, Georgia that has implemented automated ultrasound probe high level disinfection (HLD) using the trophon2® in all departments with ultrasound guided semi-critical and critical procedures. They preferred this method over manual methods to ensure there were no issues with traceability in the documentation. trophon reduces manual record keeping that is needed for soaking by automatically producing detailed parameter and interaction data. This significantly saved time and reduced documentation errors in departments that were previously soaking. Since their adoption of this machine, they feel like they are providing the best care to their patients by ensuring a consistent standard of care while also being compliant with national and TJC standards.

Automated reprocessing ensures that critical parameters such as temperature, contact time and concentration are met with each cycle.  These parameters are more easily monitored automatically.3   Manual methods do not offer this level of consistency or quality assurance. Manual methods rely on the user to manually check and document key critical parameters, and to ensure that all surfaces of the probe body and handle are contacted for the right time specified on the label to achieve efficacy. With validated, automated ultrasound probe reprocessing the operator has peace of mind that the efficacy endpoints are met every time on all surfaces of the probe, which mitigates risk of human error. 

The risks of human error during manual disinfection are often underestimated. Manual disinfection methods are inherently variable, the effects of which may become amplified under high clinical workload. Failure to adhere to recommended protocols is one of the primary causes of infection transmission.4 A study from endoscopy found in 45% of cases two or more manual reprocessing steps are skipped when sufficient time is not available. 5 The same study found 75% of reprocessing staff reported pressure to work quickly, which could impact the success of each step.5 Being aware of and attentive to staff’s time constraints is imperative to improve patient safety and reduce the potential for infection transmission. Staff welcome reprocessing automation as it is a standardized process and permits more hands-off time in order to accomplish other tasks.   

Providing staff with the best possible products to perform their tasks easily and efficiently is a critical step towards an effective infection prevention plan.  The use of automated reprocessing has offered increased compliance with published guidelines in endoscopy settings.5 Automated systems are designed to offer containment of chemical sterilants which reduces the potential of exposure for staff compared to manual reprocessing.6 Automated reprocessing can also digitally capture reprocessing records offering a streamlined traceability solution. Custom data such as date, time, operator, probe identifier, sterilant, minimal effective concentration/chemical indicator testing result, and cycle count must be captured for semi-critical and critical probes and linked to the patient.  Having traceability is a must with these types of procedures to document the probe was appropriately reprocessed before use. 

Automated ultrasound probe reprocessing enables standardization and quality control, which can contribute to greater staff and patient outcomes.  Mitigation of risks is imperative in all areas of infection control, and automation can support you and your facility in achieving this goal.

The trophon technology consists of trophon EPR and trophon2 which both share the same core technology of sonically activated hydrogen peroxide.

Authored by: Jackie Perez, MPH
Clinical Application Specialist

  1. Carrico, R. M., et al. (2018). "Ultrasound probe use and reprocessing: Results from a national survey among U.S. infection preventionists." Am J Infect Control 46(8): 913-920.
  2. AAMI ST58:2013 Chemical sterilization and high-level disinfection in health care facilities
  3. Cowen, A. E. (2001). "The clinical risks of infection associated with endoscopy." Canadian Journal of Gastroenterology, 15(5), 321-331
  4. Rutala, W. A., & Weber, D. J. (2004). Reprocessing endoscopes: United States perspective. Journal of Hospital Infection, 56(Suppl. 2), S27-S39.
  5. Ofstead, C. L., et al. (2010). "Endoscope reprocessing methods: a prospective study on the impact of human factors and automation." Gastroenterol Nurs 33(4): 304-311.
  6. CDC 2008. Guideline for disinfection and sterilization in healthcare facilities.
Traceability: what, why and how?