Single-Use Device Reprocessing: Balancing Cost Savings, Patient Safety

Michele De Meo, sterile processing manager at Memorial Hospital in York, PA, says her facility has reprocessed external compression sleeves for the past three years. Starting with low-risk devices also allows your facility to test out a vendor to ensure that you are satisfied with the quality and the relationship. ?I believe that if a company has gone through the process required to get their 510(k) and the devices are deemed safe, and the company doesn?t have any quality issues that have been noted, I think for cost savings and for the environment it?s prudent for us to explore those options as long as the quality is the same as a new device,? De Meo says.

Even today there is much more willingness to reprocess SUDs than there was 15?20 years ago, she says. At that time, physicians and health experts were concerned with reprocessing even low-risk devices such as compression sleeves. However, as more data emerge regarding the safety of this process, the more hospitals open up to the idea, and the more common it becomes.

?So it?s been a slow evolution to gain acceptance even with using reprocessed sleeves, and I think the same will occur with other devices; it?s just a slow process,? De Meo says. ?But yes, years ago getting a team on board just to do sleeves was nearly impossible.?

Brown says some hospitals simply collect devices for reprocessing but stop there, choosing not to buy back the reprocessed devices while still saving money and reducing waste at their facilities.

Brown suggests forming a ?green team? within the hospital that includes IC, patient safety, nurse educators, and any staff members who want to get involved with environmentally conscious options. A team approach spreads the initiative across a number of people to collect evidence and present the case to your facility?s management or executive team.

?We want to make evidence-based decisions,? Brown says. ?We don?t want to just do something because it makes less garbage; we need to balance that with safety and risk management and infection control. I think those are valid concerns. So you need to gather the information, find the research, and then once that is all gathered, you realize this is something that really can be done in balance with quality care.?

Just like any program, getting employees to comply with a new initiative is half the battle. In this case, reminding them not to throw away an SUD that your facility has decided to reprocess is usually the primary hurdle.

Simply putting out a bin and telling employees to segregate a particular device will not be enough, Brown says. It requires constant reminders, observation, and hand-holding in a way that is encouraging rather than disciplinary or punitive.

Monitor employees and gently remind them if you see noncompliance with the new policy. It also helps to have a leader in the operating room (OR) suite to train employees and monitor segregation. Getting physicians involved also helps bring awareness to the movement and knowledge and perspective on the issue.

?The physician?s interest or lack of in the OR can really make or break a program, so it?s really important that they are part of it,? Brown says.

She also recommends training housekeepers to keep an eye out for devices that have been thrown away inappropriately. ?[Housekeepers] are the last line of defense,? she says. ?They are never put into a position to reach into a bag and fix things, but they can have the visual?an opportunity to visually inspect bags—so that if they notice an issue, they can reach out to their supervisor and address it.?

Undoubtedly, some employees will remain skeptical of reprocessing. The best way to convince them otherwise is to prove that SUD reprocessing is not only cost-effective, but that it also adheres to patient safety best practices.

The first step may be as simple as pointing to other hospitals that have successfully implemented a reprocessing program. As with many green practices, people within the facility don?t want to be the first to take that step for fear of failure, Brown says.

For example, many facilities on the East and West coasts have begun using reusable sharps containers that are disinfected by a third-party vendor and then shipped back to the facility instead of being discarded. Brown consulted a number of hospitals in the Midwest and faced a lot of resistance to this idea. However, once she explained that many hospitals were actually reusing devices successfully, staff members were more open to trying it.

?I think a lot of times when there is something new or different, hospitals are sometimes scared to take that first step, and once a few try it and it catches on, then you see that groundswell,? Brown says.

You can also point to the regulations and some of the evidence available that proves SUD reprocessing does not affect the health of patients, De Meo says. Show them how the FDA regulates third-party vendors and that it only allows certain devices to be reprocessed. Also, make sure to tell them that reprocessing has been backed by a number of major organizations, including APIC.

?I think that usually wins a person over,? De Meo says. ?If that doesn?t win a person over, it doesn?t matter how much cost savings you can indicate.?