Setting the Standard: A collaborative approach to improving the reprocessing of Transesophageal Echocardiogram Probes

Ms Julie Rieck1

1Illawarra Shoalhaven Local Health District, Wollongong, Australia


In response to the publication of Australian New Zealand Standard 4187:2014 Reprocessing of reusable medical devices in health service organisations (AS/NZ 4187) a review of the reprocessing methods of Transesophageal Echocardiogram (TOE) probes within the Cardiac Diagnostics Unit (CDU) of a 500 bed hospital was undertaken. The review highlighted significant gaps in processes and opportunities for improvement.


In order to effectively evaluate the reprocessing environment and processes an audit was completed. An assessment of all available documentation occurred including reviews of instrument tracking records, associated policies and procedures and staff education and training records.  Feedback from staff regarding reprocessing methods was collected which indicated that CIDEX® OPA was not the most suitable or preferred mode of reprocessing.


A collaborative approach between CDU staff and the infection prevention and control team was used to explore and implement improvement strategies.

Immediate changes included de-cluttering the reprocessing environment, establishing clear workflows and improved environmental cleaning.  Longer term changes included the successful transition from the use of CIDEX® OPA to the Tristel Wipes system, improved instrument tracking processes, the establishment of staff education and competency based training regimes and development of associated policies and procedures.

An audit of compliance with AS/NZ 4187 was completed shortly after the improvement strategies were implemented and this audit will be repeated to ensure improvements are maintained.


Improved reprocessing systems, enhanced staff training and education and robust equipment tracking methods have reduced the possible risks to the organisation and improved the service provided to patients.


Julie Rieck is an Infection Prevention and Control Clinical Nurse Consultant working at the Illawarra Shoalhaven Local Health District. She studied at the Wollongong University and has completed Graduate Certificates in both Public Health and Infection Control.

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