Implementation of a novel modality for manual high-level disinfection of ultrasound probes: User perceptions and application compliance.

BACKGROUND

Chlorine dioxide (ClO2) foam is a novel modality for performing manual high-level disinfection (HLD) of ultrasound probes used in semi-critical health care procedures. Two midwestern health care systems implemented the compound at 29 clinical ultrasound locations. This study was undertaken to understand users' perceptions of ClO2 and ability to follow application requirements.

METHODS

User perceptions were evaluated using electronic surveys, one given to leadership, the other to users of the product, in September 2025. During October-November 2025, infection preventionists (IPs) evaluated compliance with application requirements through observations in 15 locations, using a checklist matching the manufacturer's instructions for use (IFUs).

RESULTS

The surveys were completed by 12 leaders and 57 users, yielding 54% and 33% response rates, respectively. Survey results were very positive overall, with agreement about adequate training resources, staff competencies, and physical environment. IPs completed 65 observations of compliance with application requirements, averaging 4.3 observations per study site. The most common deviation from the IFUs was failure to use protective eyewear (27, 41%).

CONCLUSIONS

The user surveys revealed high approval of manually applied ClO2 foam for HLD of ultrasound probes. IP observations of routine use similarly confirmed the reliability of the steps required by the manufacturer's IFUs.