Ultrasound Disinfection Trends: Why Automation Is the Future
Ultrasound is a critical diagnostic and interventional tool across healthcare settings—but as its use continues to grow, so does the importance of proper probe reprocessing. Infection prevention, staff safety, workflow efficiency, and regulatory expectations are influenced by how effectively ultrasound probes are disinfected between uses.
Considerations such as published guidelines, documented infection risks, and operational workflow requirements are commonly referenced when evaluating reprocessing options. Currently, healthcare facilities use a range of approaches for probe reprocessing, including both manual methods and automated disinfection systems, the latter of which has grown in popularity in recent years. 1
Why Does Ultrasound Probe Reprocessing Matter for Infection Control?
Even procedures commonly viewed as routine carry infection risks if reprocessing is inadequate. According to the Spaulding Classification System, transducers that are classified as being 'semi-critical' devices (i.e. any instrument that contacts mucous membranes or nonintact skin ) are required to undergo high-level disinfection. 2
Lapses in reprocessing protocols have been associated with contamination events and infection outbreaks in certain settings. These risks underscore why consistent and reliable disinfection practices are a foundational element of patient safety.
How Does Manual Probe Reprocessing Work Today?
Manual high-level disinfection has long been the standard method for ultrasound probe reprocessing. While manual methods are often perceived as straightforward, they are frequently time-consuming and labor-intensive, with hidden costs that can directly impact clinical efficiency. A 2013 study found that an automated disinfection system saved an average of 7.5 hours per week compared to a manual reprocessing system, enabling more exams to be performed in less time and potentially increasing revenue. 3
Beyond efficiency, manual reprocessing introduces variability. Each step depends on staff adherence, training, and consistency—leaving room for error that can compromise patient safety.
What Are the Hidden Risks of Manual Probe Reprocessing?
Beyond being time-intensive and potentially more expensive 3 than automated systems, manual probe reprocessing has been associated with meaningful safety concerns. 4
Research indicates that the complexity of manual workflows increases the likelihood of operator error, as staff must complete multiple—often intricate—steps in the correct order and with precise technique. Even small deviations can undermine the effectiveness of the disinfection process, and may increase contamination and transmission risk. 4
Probe handles are especially vulnerable during manual cleaning protocols, as they are frequently overlooked or inconsistently disinfected. This oversight can lead to substantial bacterial contamination, including the presence of healthcare-associated (nosocomial) pathogens. 4 In fact, published studies report that up to 80% of non-disinfection probe handles may remain contaminated with potentially dangerous organisms even after disinfection. 5
What Do Current Guidelines Say About Manual vs. Automated Reprocessing?
Several leading healthcare organizations support the use of automated probe reprocessing in place of manual methods, emphasizing its benefits in terms of standardization, safety, and effectiveness. These include:
- The Centers for Disease Control and Prevention (CDC) notes that automated reprocessing of endoscopes offers various benefits compared to manual methods, particularly in promoting reproducibility, standardization, and minimizing the risk of missed steps during disinfection. 6
- The Society of Diagnostic and Medical Sonography (SDMS) similarly states that “automated processes are preferable due to the reduced risk of operator error.” 7
- This perspective is further reinforced by ECRI Institute, which highlights the ease of use, improved disinfection effectiveness, and enhanced chemical safety associated with automated systems. ECRI also recognizes automated reprocessors as an acceptable alternative to manual high-level disinfection, noting their potential to reduce risks related to chemical fumes and spills and support more efficient disinfection cycles. 8
- The Association for the Advancement of Medical Instrumentation (AAMI) also supports the use of automated reprocessing. Its TIR99 guidance states that manual high-level disinfection is not the preferred reprocessing method due to safety concerns and potential process variability. The document emphasizes that automated systems offer a safer approach, helping to reduce exposure to chemicals and better control cycle parameters. 9
Why Are More Facilities Moving Toward Automated Reprocessing?
Automation directly addresses many of the challenges inherent in manual reprocessing:
Improved Safety
Automated systems can minimize exposure to toxic chemicals and consequently reduce the risk of safety risks – for both operators and patients. 10
Reduced Possibility of Human Error
Manual reprocessing involves numerous steps that must be executed precisely. Automated systems control critical variables such as chemical concentration, temperature, and contact time can reduce operator-dependent variability.
Time and Cost Efficiency
By streamlining workflows and reducing manual labor, automated reprocessing has also been shown improve throughput and decrease downtime, resulting in the potential for time savings, cost reductions, and increased exam capacity (although results may vary by department and process design). 3
Standardization, Documentation, and Compliance
One of the most significant advantages of automation is consistency. Many automated systems simplify this by automatically recording critical data that would otherwise require manual tracking, offering built-in standardization, documentation, and record-keeping
One study, published in Gastroenterology Nursing, found that fully automated systems achieved 75.4% compliance with standard operating procedures, compared to just 1.4% with manual reprocessing of endoscopes - highlighting the dramatic difference automation can make in real-world compliance. 11
What Role Will Automation Play in the Future of Ultrasound Reprocessing?
As ultrasound use continues to expand and infection prevention standards evolve, automation is becoming a central part of the future of probe reprocessing, one that offers a path forward and aligns with emerging guidelines.
Ultrasound probe reprocessing plays a critical role in infection prevention, but manual methods has the potential to introduce variability, inefficiencies, and potential safety risks. Growing evidence and industry guidance highlight the advantages of automated systems—including improved consistency, reduced operator-dependent variability, enhanced safety, and better workflow efficiency. While manual high-level disinfection remains a valid option, many healthcare facilities are increasingly exploring automation as a way to strengthen compliance, streamline processes, and support more reliable reprocessing outcomes.
References:
- Kühnel C, Gühne F. Visualization of Effectiveness: The Use of a Set of Colored Cleaning Wipes for Visible Disinfection of Ultrasound Probes. Hygiene. 2024;4(2):189-196. doi:10.3390/hygiene4020015
- Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. Table 3.3.3, Spaulding classification of equipment decontamination. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536426/table/ch3.tab7/
- Johnson S, Proctor M, Bluth E, et al. Evaluation of a Hydrogen Peroxide-Based System for High-Level Disinfection of Vaginal Ultrasound Probes. Journal of Ultrasound in Medicine. 2013;32(10):1799-1804. doi:10.7863/ultra.32.10.1799
- Buescher DL, Möllers M, Falkenberg MK, et al. Disinfection of transvaginal ultrasound probes in a clinical setting: comparative performance of automated and manual reprocessing methods. Ultrasound in Obstetrics & Gynecology. 2016;47(5):646-651. doi:10.1002/uog.15771
- Ngu A, McNally G, Patel D, Gorgis V, Leroy S, Burdach J. Reducing transmission risk through high-level disinfection of transvaginal ultrasound transducer handles. Infection control and hospital epidemiology. 2015;36(5):581-584. doi:10.1017/ice.2015.12
- CDC. Guidelines for Disinfection and Sterilization in Healthcare Facilities, 2008.
- SDMS. Sonographer Best Practices for Infection Prevention and Control: Reprocessing in the Ultrasound Transducer
- ECRI. Cleaning and Disinfecting Diagnostic Ultrasound Transducers: Our Recommendations
- AAMI TIR99:2024, Processing of dilators, transesophageal, and ultrasound probes in health care facilities
- Vickery K, Gorgis VZ, Burdach J, Patel D. Evaluation of an automated high-level disinfection technology for ultrasound transducers. Journal of infection and public health. 2014;7(2):153-160. doi:10.1016/j.jiph.2013.09.008
- Ofstead CL, Wetzler HP, Snyder AK, Horton RA. Endoscope reprocessing methods: a prospective study on the impact of human factors and automation. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates. 2010;33(4):304-311. doi:10.1097/SGA.0b013e3181e9431a
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