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Re: Single Use vs Reusable Pt Equipment

#70713 Quote
Glenys Harrington
Participant

Author:
Glenys Harrington

Email:
infexion@ozemail.com.au

Organisation:
Infection Control Consultancy (ICC)

State:

Hi Jackie,

Is it possible for you to y include the full references details with your comments?

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

H: +61 3 96902216

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Dear All
An interesting and useful dialogue. From my recent experience in the UK, financial penalties certainly focus the executive mind on outcomes.
The Gurses et al paper has some interesting and informative perspectives to offer our “industry”!
Shifting approaches without financial penalties appears to be problematic, though targets can lead to ‘train wrecks’ (Morton et al 2010) and there are lots of these.
Reuse of single use items must surely be one of our more difficult battles
Cheers

Jackie Miley

Project Coordinator Infection Prevention
Infection Prevention and Epidemiology

The Alfred
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Melbourne 3000 Australia

Jackie

Jackie Miley MSc, PG Cert Public Health, Cert Infection Control, Dip Rn. Practice Educator

Senior Lecturer Infection Prevention and Control
Subject Coordinator MSc Infection Prevention and Control

Oxford Brookes University
Faculty of Health and Life Sciences
Room S1/12
Department of Biological and Medical Sciences
Gipsy Lane Campus
Headington
Oxford OX3 0BP
jmiley@brookes.ac.uk

Coordinator – Audit and Surveillance Forum. Infection Prevention Society UK

Have you seen?

Publication of the IPS audit and surveillance competences

Jane McNeish, Catharine Pym, Sandra Beaumont, Jackie Miley

Journal of Infection Prevention July 2013 14: 122-124, first published on May 14, 2013 doi:10.1177/1757177413486736

On 9 January 2014 11:26, Joe-Anne Bendall wrote:

Hi Cath
Great debate to start the New Year
I think each hospital has different risks. For example, here we can allocate MRO pts their own BP machine, tourniquet etc. The equipment is cleaned when the patient is discharged as part of the terminal cleaning process. With the focus on the health $, I am not sure we could sustain the costs associated with the costs for purchase, storage and disposal of single use items.

We are currently developing a local health district policy for the cleaning of shared patient care equipment. This should help with reducing the risks of sharing equipment.

Thanks

Joe-Anne Bendall

(Monday/Thursday/Friday)
Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|| ph +61 2 9382 7199 |page 22070 via switch 9382 7111| ( Fax 93827510 |(
Mobile 0418984255 | | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

—–Original Message—–

Thanks Irene and Terrie
Whilst I appreciate Terrie’s position coming from his role with a provider of reusable waste equipment my question was more specifically about equipment used on patients for clinical care so things like BP cuffs, ECG leads and tourniquets. The various responses are interesting and please keep them coming as debate and expression are good for us as is an appreciation for the past (and yes I qualify and feel “oldie” as well 🙂 Cheers Cath

Regards
Cath

Dr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd

Adjunct Professor
Griffith University, School of Nursing and Midwifery
http://www.infectioncontrolplus.com.au

—–Original Message—–

Hi all,
as a fellow “oldie” I agree with Terry’s assessment of the trends over the years. I also support the final point about the issues involved in the decision making process. What has always puzzled me is how to accurately measure the environmental impact of either disposable or re-usable items?

Irene Wilkinson
Manager, Infection Control Service,
Communicable Disease Control Branch
SA Health
11 Hindmarsh Square,
Adelaide SA 5000
________________________________________

Hi Cath,
I had not heard of a movement back to single use items so I will be interested to hear members’ responses on this topic. For oldies like me it has been interesting to see the disposable/reusable “cycle” over the decades.

* in the 60’s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;

* in the 70’s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;

* In the 80’s and 90’s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;

* Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members’ comments

Best regards, Terry

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
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Happy new year all

As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

So my questions are:

1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

Regards
Cath

Dr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Cath@infectioncontrolplus.com.au

Adjunct Professor
Griffith University, School of Nursing and Midwifery

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