High-Level Disinfection

A Barnes-Jewish Hospital nurse disinfecting equipment

In the United States, approximately 46.5 million surgical procedures and even more invasive medical procedures are performed each year, according to The Centers for Disease Control. Each procedure involves contact by a medical device or surgical instrument with a patient’s sterile tissue or mucous membranes. A major risk of all such procedures is the introduction of pathogens that can lead to infection.

Disinfection and sterilization are essential for ensuring that medical and surgical instruments do not transmit infectious pathogens to patients. Because sterilization of all patient-care items is not necessary, health-care policies must identify, primarily on the basis of the items’ intended use, whether cleaning, disinfection, or sterilization is indicated.

In 2015, Barnes-Jewish Hospital infection prevention department reviewed its high-level disinfection (HLD) processes and developed a policy to ensure compliance. The team began collaborating with departments to provide additional oversight for HLD practices. Work included projects with interventional pulmonology, and a partnership with the perioperative service to standardize HLD practices. This led to a pilot study to trial trophon EPR, a high-level disinfection system, to continue to evaluate HLD and make recommendations to provide the highest level of care and best practices.

The infection prevention team also collaborates regularly with Washington University infectious disease physicians to evaluate practice and recommend improvements in an ever-changing health care environment.

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