Closing the gap in ultrasound probe hygiene: Improving ultrasound probe decontamination through evidence-based interventions

Background and aim: Ultrasound is integral to many aspects of healthcare. Patient harm can occur when ultrasound decontamination is not adequate. Evidence-based guidance exists to inform operators of appropriate practice. A clinical audit was performed to assess compliance with these standards in an acute hospital. Methods: An assessment tool was developed to capture data across multiple domains to evaluate compliance with ultrasound reprocessing standards. Key variables included operator identity, professional role, and location, alongside procedure type and Spaulding classification to ensure correct risk stratification. Infection prevention and control nurses observed ultrasound procedures, categorising probes as critical, semi-critical or non-critical and assessed whether the correct level of decontamination was applied. Adherence to manufacturer instructions for use and local standard operating procedures was evaluated. Traceability of reprocessing was examined. Compliance was summarised as proportions by year and by Spaulding category with statistical analysis performed in Python. Between audit cycles, a multi-modal quality improvement plan was devised and implemented. Results/discussion: Between the pre- and post-intervention phases, adherence to appropriate disinfection selection and technique improved significantly overall (p < 0.0001) and specifically in critical and non-critical probes. In all six areas that were fully subject to the interventions and re-audit, there was improvement. In the one area subject to re-audit where staff did not participate in training programmes, there was a decline in compliance, supporting that the availability of a standard operating procedure and appropriate equipment is not sufficient on its own but that training of operators is a key contributing factor to improvement.