ECRI Blog

Every day, hospitals’ central sterile processing teams rely on water as they clean and sterilize a variety of medical devices. In this blog, ECRI outlines general considerations to support safe and effective water preparation and use.

Water Quality Categories

There are three categories of water used to process medical devices. The first is utility water.  Utility water is suitable for use for point-of-use treatment of a device immediately after patient use, but is not drinking water quality.  Utility water is suitable for use for point-of-use treatment of a device immediately after patient use. The temperature of water used for this purpose should not exceed 45C/113F to prevent coagulation of blood and fixation of proteins on the instrument. This water is used for most parts of medical device processing—including flushing, washing, and intermediate rinsing. The notable exception is the final rinse.

Isolation gowns are a longstanding infection control tool across hospital settings. These garments are intended to safeguard patients and clinicians by preventing the spread of disease-causing microorganisms. But do today’s disposable gowns provide the degree of protection healthcare workers assume? Not necessarily.

ECRI believes there is a disparity between healthcare workers’ perceptions and actual gown performance. Consider, for example, this 2012 survey of infection preventionists. It found that about one-quarter of these professionals encountered strikethrough and 45% encountered tearing of gowns. What’s more, while a sizable portion had seen issues related to disposable gowns, half lacked the training to understand why. 

Natural language processing (NLP) is an increasingly ubiquitous form of artificial intelligence (AI). Best described as where computer science meets linguistics, it uses computational linguistics and machine learning to analyze human language. 

NLP powers virtual assistants like Alexa and Siri, predictive text for emails, spelling and grammar checkers, and sentiment analysis in reviews. In addition to consumer use cases, NLP is used in medicine to identify risk factors, estimate risk, or predict events of disease development or readmissions across cardiovascular, endocrine, metabolic, and neurological diseases. And it’s put to work in patient engagement—with NLP-powered chatbots supporting pharmacy interactions, COVID-19 management, and primary care triage.

Does NLP have a potential role in supporting infection prevention? Let’s explore the possibilities.

​​​​​​​​Vaccinations are an important tool for building immunity to prevent illness, disability, and death resulting from infectious diseases. According to the Centers for Disease Control and Prevention (CDC), 4 million deaths worldwide are prevented by childhood vaccination each year.

As with any medication, errors can occur during the prescribing, preparation, handling, storage, or administration of vaccines. Vaccination errors can affect not only the patient receiving the vaccine but also others who are exposed to the patient if infectious diseases reemerge.

​​​​​​​​Candida auris (C. auris)—an emerging fungus considered an urgent antimicrobial resistance (AR) threat—is on the rise in the United States. According to Centers for Disease Control and Prevention (CDC) data published in the Annals of Internal Medicine, C. auris spread at an alarming rate in U.S. healthcare facilities from 2020 to 2021. In fact, the number of cases resistant to echinocandins in 2021 was about three times that in each of the previous two years.

According to the CDC’s 2022 Special Report: COVID-19 U.S. Impact on AR, there were 171 clinical cases in 2017, 329 cases in 2018, and 466 cases in 2019. In 2020, there were 754 cases—representing a 60-percent increase. The CDC has categorized C. auris as an “urgent” pathogen based on the level of concern to human health. 

​​​​​​​​Proper hand hygiene by healthcare workers is considered to be one of the most important practices for preventing healthcare-associated infections (HAIs) (CDC "Guideline for Hand Hygiene"). HAIs can happen anywhere healthcare is delivered including hospitals; outpatient settings such as doctor's offices, ambulatory surgical centers, and dialysis facilities; and long-term care facilities such as nursing homes and rehabilitation centers. They may be caused by any infectious agent, although most are caused by bacteria, viruses, or fungi (ODPHP).