High-level disinfection evaluation in the ambulatory setting

Area of Science:

• Infection Prevention and Control
• Medical Device Reprocessing
• Urology Practice Management

Background:

• High-level disinfection (HLD) is critical for preventing infections associated with reusable medical devices.
• The study was prompted by the discovery of expired chemical test strips used in the HLD process at an outpatient urology clinic.
• Ensuring proper HLD is essential for patient safety and regulatory compliance.

Purpose of the Study:

• To investigate the root causes of breaches in the HLD process for flexible cystoscopes and transrectal prostate biopsy probes.
• To identify contributing factors to failures in medical device reprocessing.
• To evaluate the effectiveness of current infection prevention protocols in an outpatient urology setting.

Main Methods:

• An audit of the HLD process was conducted following the identification of expired chemical test strips.
• Infection Prevention (IP) specialists assessed the reprocessing procedures for flexible cystoscopes and transrectal prostate biopsy probes.
• Staff interviews and procedural reviews were likely employed to identify systemic issues.

Main Results:

• Multiple breaches in the reprocessing of flexible cystoscopes and transrectal prostate biopsy probes were identified.
• Expired chemical test strips were being used, indicating a failure in quality control.
• Key contributing factors included deficiencies in staff training, inadequate availability of necessary supplies, and insufficient staff supervision.

Conclusions:

• The HLD process in the observed urology practice was compromised by significant procedural breaches.
• Gaps in training, supply chain issues, and lack of oversight contributed to the identified failures in medical device reprocessing.
• Immediate interventions focusing on staff education, resource management, and supervision are necessary to ensure safe HLD practices.