Throughout hospitals and health systems, a variety of departments utilize ultrasound equipment. Due to expansion in applications and smaller point of care options for this diagnostic imaging modality, the use of the technology continues to grow. Though many clinicians may be familiar with what ultrasound equipment is, they may not be as familiar with the gel products used to properly operate these systems as well as important infection control practices related to them.
Last month there was a national recall of ultrasound gel products due to bacterial contamination. It’s clear that bacterial infections can pose serious threats to patients, including leading to death. That’s why infection prevention efforts are expanding to ultrasound gel products.
Here are three essential considerations to ensure proper infection control practices related to ultrasound gel products:
Sterile vs. Non-Sterile Gel—One safety control measure that can be added to a facility’s protocol is the implementation of single-use sterile packets when indicated. The Centers for Disease Control and Prevention advises that health care facilities always use single-use sterile ultrasound gel packets for ultrasonography used in preparation for, or during, transcutaneous procedures such as placement of central and peripheral intravenous lines, amniocentesis and paracentesis. The sterile gel is also intended to be used when the patients’ skin is not intact if the patient is in the neonatal intensive care unit or during an endocavitary exam. The non-sterile gel can be used for other indications when the skin is intact and is available in single-use packets or in large containers (that can be used to refill non-sterile bottles). To reduce cross-contamination, ensure the tip of the bottle should not come into contact with the patient’s skin.
Proper Storage—To prevent decontamination of the ultrasound gel, it is wise to implement safety measures around how the product is stored and maintained. The recommended shelf life for an opened container of ultrasound gel is 28 days. New bottles should always be dated and initialed by clinical personnel to ensure it is discarded in the appropriate timeframe. If your facility utilizes gel warmers, bottles should never be stored with the opening facing down.
Patient Safety Measures—Ultrasound probe covers are another essential component to lessen the risk of infection. The covers are intended to act as a barrier between the probe and the patient. Based on the exam being performed, clinicians should still follow the guidelines on whether sterile or non-sterile gel products should be used in conjunction with the probe cover. The probe cover is not intended to replace the need for sterile gel products. Once the exam has been completed, the clinician should then follow the disinfection guidelines to properly clean the probe by using either a low-level disinfection solution (LLD), high-level disinfection (HLD), or sterilization.
Further complicating the patient safety imperative in this growing diagnostic imaging modality, the reduction in radiology reimbursements over the years may make implementing and adhering to safety control measures more costly. The recent Medicare Physician Fee Schedule Proposed Rule will reduce radiology reimbursements anywhere from 2–14% for diagnostic imaging procedures. There are ways to manage these growing costs by standardizing the spend of your gel and probe cover products throughout your health care facility.
First you will need to identify which departments are utilizing surgical lubricant jelly, ultrasound gel and ultrasound probe covers. Utilize this information to see if there is room to consolidate spend to a single supplier who offers more than just one of these products. For example, there are some suppliers in the market who sell ultrasound gel and surgical gel. There are other suppliers that sell gel products and probe covers. Standardizing to a single supplier in multiple departments is a great way for hospitals and health systems to maximize cost savings. In addition, private label options that might be available through a group purchasing organization also can help save money while maintaining quality.
If you’d like to learn more or have additional questions, feel free to email me.
