The science of disinfection in ARTS (assisted reproductive technology services)

Abstract

ISSUE: Vaginal probes are used in our assisted reproductive technology services (ARTS) during transvaginal sonagraphy. Disposable single-use condom probe covers are used to cover the transvaginal ultrasound transducer head to reduce transmission of bloodborne pathogens. After each use, the probe requires cleaning and high-level disinfection to avoid pathogenic spread from one patient to another. The use of disinfectant wipes and alcohol pads are not adequate to provide high-level disinfection. Because of concerns regarding the potentially harmful effects of the disinfectant used on developing embryos, we began a search for a safer high-level disinfectant. PROJECT: The infection control staff worked closely with the ARTS staff and the probe manufacturer to review available disinfectant products to ensure high-level disinfection for transvaginal probes that was safe for embryos. RESULTS: We found a disinfectant that provided adequate high-level disinfection and was embryo safe for use in ARTS. LESSONS LEARNED: Using a multidisciplinary team approach, close scrutiny, and meticulous examination of our current disinfection process revealed opportunities to improve embryo safety in our choice of disinfectant. We identified a disinfectant that provided embryo-safe high-level disinfection. Working with the probe manufacturer, we received their written permission to use the selected disinfectant on the probe. This was necessary because the disinfectant chosen was not on the list of disinfectants approved for use by the manufacturer for high-level probe disinfection. The use of a disinfectant that has not been approved by the probe manufacturer can void the probe warranty. The identified improvements also included updating policies and procedures, designing a staff competency checklist, and creating quality-control forms for recording the testing of new boxes of test vials and for solution use. We improved our high-level disinfection of transvaginal probes using an embryo safe high-level disinfectant that was approved for use by the probe manufacturer and improved patient safety and quality of care.