Authors (including presenting author) :
Li P M, Au W K and Tsui PCB
Affiliation :
Department of Paediatric Cardiology, Queen Mary Hospital
Introduction :
Use of TEE probe on patients is not infrequent in the PCCL. Manual decontamination of TEE probe with the Tristel Trio Wipes System, which is a three-part decontamination system for non-lumened medical devices, is carried out by competent staff. A proper decontamination is crucial to prevent cross infection as transmission of infections after upper gastrointestinal endoscopy and bronchoscopy was reported. As the British Society of Echocardiography recommended that (1) appropriate use of disinfectants, (2) clear delineation of ‘clean’ and ‘dirty’ areas in TEE probe decontamination and (3) training and provision of staff to engage in quality assurance audit were important, an improvement program in decontamination of TEE probe based on the recommendations was initiated in June 2018 in order to refine the technique and training.
Objectives :
1.To reinforce the use of disinfectant adhering to the instructions of manufacturer 2.To prevent recontamination of TEE probe 3.To introduce more variety of training materials
Methodology :
The improvement work includes the followings: 1.The manufacturer of the Tristel Trio Wipes System introduced and demonstrated the appropriate use. 2.Consolidate the concept of ‘Clean’ and ‘Dirty’ 2.1 Two separated trolleys are utilized to clearly delineate a ‘clean’ and ‘dirty’ areas instead of using one trolley and changing sterile drapes in between three parts of decontamination. 2.2 The workflow had been reengineered such as consistency of wiping directions from probe handle to tip rather than in different wiping directions in three-part decontamination. 3.Enrich the training material means:The aid of video and photo-guided instruction book are introduced. 4.After completion of the training including theory and demonstration, the trained nurses were assessed for competency of probe decontamination through practical return demonstration.
Result & Outcome :
1.The appropriateness on the use of disinfectant was reinforced by demonstration of the manufacturer. 2.The use of two trolleys to separate clean and dirty areas and establishment of clear workflow reduced the confusion and thus minimized chance of recontamination. 3.All 5 newly trained nurses agreed that the training with clear workflow helped them acquire the skill easily. They all passed the assessments. They can perform proper decontamination so the risk of cross infection between patients is reduced and thus promotes the patient safety. Conclusion The effectiveness of TEE probe decontamination is enhanced by the emphasis of the appropriate use of disinfectant and prevention of recontamination. Continuous monitoring and yearly assessment for proper decontamination have to be implemented in order to refresh the skill and maintain the quality of care.
