Eurosurveillance, Volume
4, Issue
10,
01 October 1999
Articles
Reuse of single-use sterile medical devices in Danish hospitals after report discourages it
M Christensen, M Meyer, O. B Jepsen
Citation style for this article: Christensen M, Meyer M, Jepsen OB. Reuse of single-use sterile medical devices in Danish hospitals after report discourages it. Euro Surveill. 1999;4(10):pii=57. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=57
Date of submission:
M. Christensen1, M. Meyer2,
O.B. Jepsen1
1 Statens Serum Institut, National Center for Hospital Hygiene,
Copenhagen, Denmark
2 Rigshospitalet, Infection Control Unit, Copenhagen, Denmark |
| Introduction The extent to which sterile medical
devices marked ‘for single-use’ are reused was surveyed recently in 100
hospitals in Denmark, Finland, Norway, and Sweden (1). The same method was used in a
survey of Danish hospitals two years earlier. This has enabled us to compare the results
from the Danish hospitals that took part in both surveys and to study how the report of
the first study, which recommended that disposable devices should not be reused, had
affected policy and practice.
Methods
In both surveys questionnaires were sent to the infection control departments at the
hospitals. The questionnaires were filled in by relevant staff in the respective clinical
units, supervised by the local infection control nurse. The data were computed centrally
at the National Centre for Hospital Hygiene (NCHH). NCHH verified that the suppliers of
the disposable devices acknowledged that the recorded devices were sold for single-use and
were marked accordingly.
Results
Fifty-eight hospitals out of a total of 77 participated in the first survey in 1996. In
1998, 85 hospitals were invited, and a total of 67 hospitals took part. The proportions of
hospitals reporting reuse in 1996 and 1998 were significantly different (c 2 = 24.59, f=1, p<0.001). Forty-eight of the 58
hospitals (83%) that responded in 1996 reported reuse of sterile single-use medical
devices. In 1998, only 25 of 67 hospitals (37%) reported reuse of devices marked for
single-use only. A total of 158 examples of reuse were identified in 1996 and 108 examples
were identified in 1998 (c 2 = 24.59, f=1,
p<0.001). In 1996 half of the hospitals (29) declared that they had no written formal
policy on reuse of single-use medical devices, whereas in 1998, 80% (n=54) of the
hospitals had adopted a restrictive policy.
Although the same types of services were represented in both surveys, the patterns of
reuse differed in the two surveys (table).
Table: Distribution of examples of reuse of single-use medical devices in Danish
hospitals by departments
|
Departments |
Survey 1996 |
Survey 1998 |
|
n |
(%) |
n |
(%) |
Intensive
care |
1 |
0.6 |
2 |
1.8 |
Medical
|
2 |
1.3 |
2 |
1.8 |
X-ray |
4 |
2.5 |
3 |
2.8 |
Anesthesia
|
7 |
4.4 |
12 |
11.1 |
Endoscopy
unit |
18 |
11.5 |
1 |
0.9 |
Ophtalmology
|
21 |
13.5 |
3 |
2.8 |
Surgical
|
63 |
39.7 |
57 |
52.8 |
Cardiology |
15 |
9.5 |
4 |
3.8 |
Other
|
27 |
17 |
24 |
22.2 |
Total |
158 |
100 |
108 |
100 |
| Significant changes were found among ophthalmology,
cardiology, and endoscopy units, and the changes were also reflected in the types of
devices that were recycled (figure ).
In both surveys economic savings was the reason most
commonly given to explain the reuse, but none of the hospitals offered evidence in favour
of this argument. Methods for decontamination of devices labelled ‘single-use’
were not provided by the manufacturers, nor were specific validation studies on file. In
general devices were reprocessed using the methods available in the hospital unit. A few
hospitals monitored the frequency of recycling and inadvertent effects.
Discussion
Reuse of sterile medical devices labelled ‘single-use’ is known to take place
in several countries around the world (1-3). If devices labelled ‘single use’
are reused, the responsibility for adverse effects related to the recycling process is
transferred from the manufacturer to the user and the hospital. It has been suggested,
however, that hospitals should encourage manufacturers to supply information about
suitable decontamination methods that can be tested and validated (4).
If such methods are not available, hospitals should be informed and consider their
policy for reuse of disposable medical devices. The report of the 1996 survey was
distributed widely to Danish hospitals. Results from the repeated survey in 1998 suggest
that the 1996 survey reduced the extent of reuse of single-use devices in Danish
hospitals. |
|
| References 1.
Christensen M, Haustveit G, Hoborn J, Jepsen OB, Ojajärvi J. Re-use of sterile single-use
medical devices. A survey in 100 hospitals in Denmark, Finland, Norway and Sweden January
1998. Zentral Sterilisation 1999; 7: 189-94.
2. Campbell BA, Wells GA, Palmer WN and Martin DL. Reuse of disposable medical devices
in Canadian hospitals. Am J Infect Control 1987; 15: 196-200.
3. Daschner FD, Dettenkofer M. Protecting the patient and the environment - new aspects
and challenges in infection control. J Hosp Infect 1997; 36: 7-15.
4. Working Party of the Central Sterilizing Club. Reprocessing of single use medical
devices. Zentral Sterilisation 1999; 7: 37-48. |
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