INFECTION PREVENTION According to Thording, “the single-use
device reprocessing industry is comprised of highly sophisticated medical device re-use companies that have FDA clear- ance to reprocess single-use devices for hospitals. With this, a third category has emerged alongside reusables and dispos- ables; the single-use reprocessed device. Hundreds of medical devices, from OR devices to patient care devices and car- diology devices have received clearance to be reprocessed (these are “single-use” labeled devices that can cost thousands of dollars). They have been cleared by FDA to be reprocessed and sold to hospitals because their functionality and patient safety characteristics are similar to a new device.”
Pandemic to Post-pandemic The impact of COVID-19 on the healthcare supply chain caused an increased focus on the reusable versus disposable debate, as hospitals and facilities were soon scram- bling with the ways and means to have all the necessary supplies available. “In many ways, the pandemic changed the single-use mindset in US healthcare,” states Thording. “Product shortages emerged (and some of these continue today), that have made supply chain and other hospital staff question the exten- sive use of disposable devices. The les- son learned from the pandemic is that providers need to ask manufacturers to stop focusing on designing products for single use and start developing prod- ucts that can be reprocessed and reused. Today, the trend is going in the opposite direction, which is not sustainable, neither from an environmental standpoint, from a patient care standpoint, or from a cost standpoint.” In September of last year, the Agency
for Healthcare Research & Quality came to the same conclusion, stating that “Reliance on single-use disposable medical supplies and devices not only leaves health systems vulnerable to supply chain disruptions, as seen with the COVID-19 pandemic, but they are frequently cited as contain- ing higher life cycle emissions per use compared with equivalent application of reusable alternatives. Healthcare orga- nizations should strongly encourage and facilitate resource stewardship.” Now that we appear to be entering a post-pandemic era, strategies and tactics are continuing to evolve in favor of repro- cessing devices.
According to Thording, “we still see supply shortages really challenging
hospitals, to the point where at times, it is hard for them to conduct important procedures because key devices are not available. As a regulated single-use device reprocessing company, we often get calls from hospitals asking us to send a repro- cessed device, because, ‘we either use a reprocessed device, or I have to go tell the doctor that we have to cancel the pro- cedure.’ Reprocessing provides a means for hospitals to fi nd a stop-gap solution in supply shortage situations, but more importantly, the re-use of devices simply increases supply chain resilience, which impacts not only physician satisfaction but also patient care quality. Many of our hospital partners are realizing this and signing up for more extensive reprocess- ing programs.
Not all devices can be reprocessed and reused. Some are simply too tech- nically complex, fragile, or physically/ mechanically impossible to clean. Some devices should be disposable. The point is this: Manufacturers have, over the past decades, focused on making more and more devices disposable (or single-use), and this trend needs to be reversed. Over- reliance on disposable devices creates great vulnerabilities, increases environ- mental harm, and they simply cost too much. While manufacturers change their strategies, single-use device reprocessing provides a safe, regulated solution for hospitals when it comes to certain types of devices. Reprocessing has become a very advanced practice, and even very delicate devices can often be reprocessed.”
A steady balance
Maintaining an appropriate and effec- tive balance in the types of medical devices, whether reusable or disposable, is proving to be a diffi cult one to achieve and maintain. According to Marie H. Wilson, MSN, RN, CIC, Infection Preventionist and Chair of APIC’s Communications Committee, “the pandemic has empha- sized the need for balance between single-use and reusable items in health- care. While organizations may prefer single-use products because of the decreased risk of trans- mission due to reprocess-
Marie H. Wilson
ing errors, this risk needs to be balanced with the risk of the product not being available. We’re having to produce tiered plans to ensure supply stocks to continue care, requiring nimble purchasing
22 February 2023 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
departments and training resources when a product shift occurs.” In order to develop strategies and tactics for properly using reusables and single- use-only products, Wilson added that it is vital to have regular practices and methods that enable smooth processing across an entire facility. “Ensure there is a routine process for
product evaluation by key stakeholders in the organization, including an Infection Preventionist,” Wilson continued. “These don’t have to laborious meetings, as I’ve seen them successfully managed via a form sent through email. “Additionally, if at all possible, limit the ability for new (and potentially unapproved) products from entering the healthcare setting. Ensure staff have at least an awareness that an approval pro- cess exists.
“Finally, one of the most valuable les- sons out of the pandemic is the develop- ment of robust tiered contingency plans ready to be deployed at a moment’s notice. Consider drafting a list of prod- ucts required to continue providing care and explore possible alternatives so key stakeholders may evaluate/approve prior to shortages. Theoretically, this allows for quick pivots in purchasing to secure supplies in times of shortages. We’re also seeing a shift/inclination to invest more in reusable items (for example, laundered gowns for personal protective equipment) where appropriate.”
The bottom line Cost-effectiveness is the primary issue that hospitals and healthcare facilities focus on in determining whether or not to use disposable or reusable medical devices. In addition to medical gowns and PPE, scalpels are one of the more frequently used items that are offered as reusable as well as single-use equipment. Some of the pros of reusable scalpels include the ability to sterilize them after each use which provides cost-effective benefi ts. However, this cost-effectiveness relies upon proper autoclavability. On the other hand, disposable scalpels ensure bacteria is not transmitted due to their single use. Although, cost is more of an issue with disposable scalpels because they have to keep being purchased. All things considered, it is clear that
there is still plenty of space for both reusable and disposable devices in the healthcare industry, and it is an issue that deserves strict attention to assure that the best option is always taken. HPN
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