Manual Disinfection End User Survey

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* 3. Product(s) Used

GUS Disinfection Soak Station for Endoscopes

GUS Disinfection System for Transesophageal (TEE) Probes

GUS Disinfection System for Endocavity Probes

Disinfection Soaking Cup

TEE Probe Manual Disinfection and Storage System

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* 4. Item Number(s) Used

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* 5. Probe or Scope Types Used

General Purpose Probe

Transesophageal Probe (TEE or TOE Probe)

Transvaginal Probe

Transrectal Probe

Endoscope

Bronchoscope

Laparoscope

Cystoscope

ENT Scope

Other (please specify)

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* 6. Type of High-Level Disinfectant Chemical Used

Glutaraldehyde

Hydrogen Peroxide

OPA

Peracetic Acid

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* 7. Rate satisfaction on a scale of 1 to 5 (1 being the lowest level of satisfaction & 5 being the highest level of satisfaction)

	1-Low Satisfaction	2	3	4	5-High Satisfaction
Based on product design, how well does the soaking station secure the probe during use?	Based on product design, how well does the soaking station secure the probe during use? 1-Low Satisfaction	Based on product design, how well does the soaking station secure the probe during use? 2	Based on product design, how well does the soaking station secure the probe during use? 3	Based on product design, how well does the soaking station secure the probe during use? 4	Based on product design, how well does the soaking station secure the probe during use? 5-High Satisfaction
Comment
Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices?	Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices? 1-Low Satisfaction	Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices? 2	Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices? 3	Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices? 4	Based on product design, how well does the product support your facility high-level disinfection policy for reusable devices? 5-High Satisfaction
Comment
How satisfied are you with the quality of this product?	How satisfied are you with the quality of this product? 1-Low Satisfaction	How satisfied are you with the quality of this product? 2	How satisfied are you with the quality of this product? 3	How satisfied are you with the quality of this product? 4	How satisfied are you with the quality of this product? 5-High Satisfaction
Comment
How well does this disinfection system protect the user from chemical exposure (including fumes or spills)?	How well does this disinfection system protect the user from chemical exposure (including fumes or spills)? 1-Low Satisfaction	How well does this disinfection system protect the user from chemical exposure (including fumes or spills)? 2	How well does this disinfection system protect the user from chemical exposure (including fumes or spills)? 3	How well does this disinfection system protect the user from chemical exposure (including fumes or spills)? 4	How well does this disinfection system protect the user from chemical exposure (including fumes or spills)? 5-High Satisfaction
Comment

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* 8. Based on your clinical expertise, do you believe there is added infection risk associated with the use of this disinfection system?

Yes (if yes, please explain in Comment box below)

Comment

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* 9. Based on your clinical expertise, do you believe there is an added risk of probe damage associated with the use of the disinfection system?

Yes (if yes, please explain in Comment box below)

Comment

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* 10. Based on your clinical expertise, do you believe there is an added risk of chemical exposure specifically associated with the use of this disinfection system?

Yes (if yes, please explain in Comment box below)

Comment

Manual Disinfection End User

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* 1. Country

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* 2. Facility

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* 3. Product(s) Used

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* 4. Item Number(s) Used

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* 5. Probe or Scope Types Used

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* 6. Type of High-Level Disinfectant Chemical Used

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* 7. Rate satisfaction on a scale of 1 to 5 (1 being the lowest level of satisfaction & 5 being the highest level of satisfaction)

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* 8. Based on your clinical expertise, do you believe there is added infection risk associated with the use of this disinfection system?

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* 9. Based on your clinical expertise, do you believe there is an added risk of probe damage associated with the use of the disinfection system?

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* 10. Based on your clinical expertise, do you believe there is an added risk of chemical exposure specifically associated with the use of this disinfection system?

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* 11. Please provide your email address in order for CIVCO to respond to any concerns.