Is your sterile processing (SP) department in need of a new ultrasonic washer-disinfector? Maybe you’ve been limping along your old dinosaur model for years, but the needs of your department and the surgery volumes have changed and it’s simply not cutting it anymore. In this article, we will walk you through the types of ultrasonics on the market today, understanding your asset-to-need ratio, and some considerations to help increase the odds of getting capital equipment approval from decision makers at your facility.

Types of ultrasonics 

According to AAMI ST79/2017 Selection of mechanical cleaning and disinfection equipment, there are several types of ultrasonic cleaners:

  1. Ultrasonic cleaning equipment
  2. Ultrasonic irrigators
  3. Ultrasonic irrigator washers
  4. Ultrasonic irrigator washer-disinfectors1

The type of ultrasonic your facility needs will vary based on the instrumentation you have in-house, surgical volumes, and surgical specialties that take place.

Understanding your asset-to-need ratio

When it comes to purchasing an ultrasonic, you must first determine what type of ultrasonic you need based on your facility. For example, if you are a high-volume orthopedic facility or one that reprocesses multiple robotic arms, your need may be very different than that of an ambulatory surgery center that primarily performs simple outpatient general procedures.

Case volumes will also be a key factor in equipment type needed. Are you a high-volume facility with more than 10 ORs and a case volume of more than 50 a day? You’ll need to bring in a larger unit that has higher load capacities than if you have plenty of turn time between cases and lower volumes.

Additional considerations may include:

  • Can the ultrasonic run a mixed load (da Vinci, orthopedic, lumen, and nonlumen instrumentation)?
  • What is the weight capacity?
  • How long is the cycle and does it provide thermal disinfection and critical water final rinse?

Regarding critical water, AAMI Standards TIR34 Rinsing states:

Tap water is often adequate for rinsing and removing soil loosened by the cleaning process and for rinsing and removing detergent residues, provided that it meets the requirements for Utility Water. However, if the quality of the tap water could cause corrosion, tarnishing, or salt deposits, it might be necessary to use various water treatment processes (e.g., softening, deionization) to ensure that devices are not damaged and that the ensuing disinfection or sterilization process will be effective. For devices that will contact the bloodstream of other sterile areas of the body, the final stage in rinsing requires water that does not have excessive levels of organics (e.g., endotoxins or other microbial constituents); therefore, Critical Water is recommended.2

Justify it 

Now that you understand the types of ultrasonic washer-disinfectors and some additional guidelines and industry standards, you might have a better idea what units will meet your needs from a clinical perspective. Here comes the fun part—getting approval for the unit.

Building a case for your needs will require more than an email and a request filtered through multiple chains of command. The C-Suite is all about a business outcome and how your proposal can benefit the organization as a whole. How will approving your capital request help them with their problems? Find an angle that they can connect with. This has three parts:

  • Define the patient safety risk you want to address. For example, let’s say your department needs a borescope—a small video scope used to examine lumened devices. Without it you cannot ensure that devices are safe for patient use, the liability of bioburden left inside could exceed the investment of the device itself, and specific IFUs call for it to be used to assure sterility.
  • Second, define the potential benefits of adding this asset to inventory. In this case, it verifies that the device used on patients meets all sterility parameters, and it reduces the likelihood of a citation from regulatory agencies.
  • Finally, describe how this capital acquisition fits into your organization’s mission. For example, take the mission of Cedars-Sinai: “Quality patient care is our priority. Providing excellent clinical and service quality, offering compassionate care, and supporting research and medical education are essential.”3

This mission directly states that quality patient care, excellent clinical quality, and medical education are top priorities. For example, by having an ultrasonic washer-disinfector, we can help ensure that clinical quality is delivered, and the nurses can continue to deliver compassionate care without being slowed down by unexpected debris, case delays, and liabilities. When writing your proposal, speak directly to how your department needs align with the mission.

Partner with vendors

Your vendors can and will be your best friend when it comes to building a case for your purchase, and they can provide you with the numbers and metrics your higher-ups will need to see. Remember, you don’t have to be the technical expert and know every product specification. Let them do the leg work and help build your financial case.

Questions to ask your vendors:

  1. How does your product fulfill patient safety needs?
  2. What differentiates your device from others that are similar?
  3. Can you help me build a financial case that will convince my decision maker? Remember, sales representatives are trained to help build your case—no need to reinvent the wheel.
  4. Do you have photos, IFUs, or case studies that support my case?

If you ask these questions, and partner with your vendor to build your case, it can never hurt. They can also usually help you make a case to purchase.

Having the correct ultrasonic washer-disinfector in your department will increase efficiency, elevate patient safety, and aid your facility in remaining compliant. Hopefully, after reading this article, you can now identify the types of ultrasonics, get a grasp on your need-to-asset ratio, be better able to justify and present your need, and you are armed with how to best partner with vendor representatives. The correct ultrasonic, presented in the right way, may help you get that archaic dinosaur ultrasonic booted from your facility for good!

Note: All AAMI Standards & Guidelines should be readily available in your facility. If you do not have a copy, the direct regulations can be purchased at the ANSI Webstore.


1. ANSI/AAMI ST79:2017 Comprehensive guide to steam sterilization and sterility assurance in health care facilities. Washington, DC. Selection of mechanical cleaning and disinfection equipment, p. 46.

2. ANSI/AAMI TIR34: 2014/(R)2017 Water for the reprocessing of medical devices. Washington, DC. Rinsing, p. 18.

3. Cedars-Sinai. n.d. “Our Mission, Vision and Values.” Accessed September 22, 2022.