Reuse of Medical Devices: Implications for Infection Control

Shuman, Emily; Chenoweth, Carol E.

doi:10.1016/j.idc.2011.09.010

Cited by 31 publications

(32 citation statements)

References 18 publications

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“…If working models of safe sterilization and reprocessing can be achieved, it will be of use to both the patient and the environment. On the other hand, Shuman and Chenoweth (2012) believe that there may be cost savings, but that the degree to which savings are offset by adverse events is uncertain. More research is needed to help answer these important questions.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Catheters: The Reprocessing, Cleanliness and in vitro Biofilm Formation by <i>Enterococcus faecium</i> in a Continuous Flow Model

Silva¹,

Oliveira²,

Guizi³

et al. 2015

American Journal of Infectious Diseases

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Reprocessing single-use devices to cut costs is a common practice in hospitals around the world. In Brazil, there are few studies of reprocessing hemodynamic catheters and thus, this study aimed to evaluate the effectiveness of reprocessing hemodynamic catheters before and after biofilm formation in vitro using a continuous flow model. We used a sterility test and Scanning Electron Microscopy (SEM) to assess the presence of microorganisms, residue and integrity of a New (NC) and Reprocessed (RC) hemodynamic catheter, before and after in vitro biofilm formation by a clinical isolate of Enterococcus faecium (strain 155). NC was considered the negative control. The sterility test did not show the presence of microorganisms in either catheters used as a negative control (NC and RC). On the other hand, changes in integrity were observed by SEM in the RC, with a large number of microcracks and recesses, indicating that this would get worse after reprocessing. After biofilm formation and subsequent sterilization by ethylene oxide, both catheters were examined by SEM and RC showed a dense array of exopolysaccharide and substantial organic waste material, which was not evident in NC, showing changes in surface integrity. Ethylene oxide sterilization is very efficient in the sterilization process but the reprocessed catheters after biofilm formation by strain 155, showed marked surface changes, which increases the adhesion of organic matter and compromises the cleaning process in reprocessing. The results can be used as a parameter for hospitals and companies that reprocess catheters, to develop protocols for standardized and systematic surveillance in reusing materials recommended for single use to prevent infections.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic Catheters: The Reprocessing, Cleanliness and in vitro Biofilm Formation by <i>Enterococcus faecium</i> in a Continuous Flow Model

Silva¹,

Oliveira²,

Guizi³

et al. 2015

American Journal of Infectious Diseases

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“…Reprocessing of single-use devices is often problematic because of lack of standardized procedures, and adverse events related to device contamination or damage do occur. Such events can potentially offset any cost savings gained through reuse (Shuman et al, 2012). In many developing and transitional countries, reuse of cheap single-use devices (needles, syringes, surgical gloves) is common, leading to large numbers of unsafe interventions, specifically injections, and, as a consequence, infection with hepatitis B, C or HIV.…”

Section: Discussionmentioning

confidence: 99%

Spending of medical devices in Slovakia

Malovecka

Vidrová

Mináriková

et al. 2014

Acta Facultatis Pharmaceuticae Universitatis Comenianae

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Medical devices (MD), together with pharmacotherapy are supportive treatment of many acute and chronic diseases. MD as a part of medical technologies lead to more effective treatment, faster patient recovery and a reduced risk of complications. Many MD are reimbursed from public health insurance funds entirely; for others, particularly advanced functional types of MD, there must be patient participation on price or they can buy them according own decision (direct sale). The target of this study is to analyze the data from paid databases of National Center for Health Information (NCHI) that collects the outputs of provided healthcare. The most recent data were from 1.1.2013 to 30.9.2013. According to NCHI, apart from community pharmacies, there are 226 registered establishments that sold MD until 30.9.2013. Their specialization included dispensing MD (n=163), dispensing orthopaedic devices (n=48) and dispensing audioprosthetic devices (n=15). In the observed period, average monthly spending on MD were 10.1 million packages and 14 million €. Average monthly spending on reimbursed MD were 8.8 million packages and 12.9 million €. The groups with the largest shares were MD for incontinence and urinary retention, 7.7 million packages (86.9%) and 3.9 million € (30.7%); plasters and bandaging materials, 0.5 million packages (6.0%) and 1.3 million € (10.1%); MD for ostomies, 0.4 million packages (4.5%) and 1 million € (8.0%); and the MD for diabetics group, 0.1 million packages (1.4%) and 1.6 million € (12.8%). Direct sales of MD per month on average reached 1.3 million packages and 1.1 million €. The groups with largest shares were MD for incontinence and urinary retention, 629,660 packages (50.3%) and 291,919 € (26.2%); plasters and bandaging materials, 388,111 packages (31.0%) and 227,119 € (20.4%); and MD for diabetics, 56,014 packages (4.5%) and 81,721 € (7.3%).

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“…Recent studies are showing that utilization of single-use medical devices is increasingly considered to be materially and economically wasteful (Hailey, Jacobs, Ries, & Polisena, 2008;Rutala & Weber, 2001;Shuman & Chenoweth, 2012;Suter, Yueng, Johnston, & Suter, 2009 (Eckelman, Mosher, Gonzalez, & Sherman, 2012;Forbes McGain, McAlister, McGavin, & Story, 2012;Overcash, 2012). In addition, others have utilized the LCA methodology to investigate hospital procedures, such as hysterectomies and C-sections (Bilec, Landis, Shrake, Thiel, & Woods, 2012;Campion et al, 2012).…”

Section: Reducing Environmental Impacts Through Reusementioning

confidence: 99%

“…With regards to the LCAs on medical products, they have shown that reprocessed medical devices are environmentally favorable over disposable medical devices (Hailey et al, 2008;Rutala & Weber, 2001;Shuman & Chenoweth, 2012;Suter et al, 2009). It should be noted, however, that these results are predicated upon proper execution of reuse protocols and procedures (Hailey et al, 2008;Rutala & Weber, 2001;Shuman & Chenoweth, 2012;Suter et al, 2009). …”

Section: Reducing Environmental Impacts Through Reusementioning

confidence: 99%

“…The LCA system boundaries did not include the production of the autoclave or the ultrasonic cleaning device, since it has been shown that these types of equipment have negligible contribution to the overall outcome of LCAs (Hailey et al, 2008;Rutala & Weber, 2001;Shuman & Chenoweth, 2012;Suter et al, 2009). The functional unit was defined as one reusable dental bur, where the maximum number of uses was 30 (or in the case of a SUD, the equivalent functional unit would be 30 disposable dental burs).…”

Section: Scope System Boundary and Inventory Analysismentioning

confidence: 99%

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