Reusable and disposable medical supplies both have a place in our healthcare system, but when it comes to supporting aseptic practices that help to lower healthcare-associated infection (HAI) rates, disposable medical supplies provide a level of certainty that reusable supplies cannot.
While the U.S. healthcare system works hard to lower infection rates, the war will not be won until HAIs are a rare occurrence. The Centers for Disease Control and Prevention1 (CDC) estimates that each day, one in every thirty-one hospitalized patients battles an HAI. According to a survey in the Journal of the American Medical Association2, during one 24-hour period in 2017, over half of 7,936 ICU patients across 1,150 hospitals around the world had a confirmed or possible infection, with 22% of those patients acquiring an infection in the ICU. Almost one-third of the patients evaluated in the study died in the hospital.
As an ICU nurse manager, you're not only concerned for your patient's safety but for your staff's safety, too. Using disposable hospital supplies can help to stop the spread of infection, save money, and manage hospital resources.
Why Choose Disposable Medical Devices For Infection Control?
No one disputes that reusable hospital supplies can limit healthcare costs and support a cleaner environment. However, the processing that is required to render reusable supplies free of contaminants has multiple touch points. Insufficient reprocessing of medical supplies can leave behind body fluids and tissue, potentially exposing the next patient to an HAI.
According to the U.S. Food and Drug Administration3 (FDA), HAIs resulting from insufficiently cleaned medical devices are a public health concern that continues to inform the FDA's efforts to ensure the safety of reprocessed medical devices. The FDA also reports that the actual number of HAIs caused by contaminated supplies is under-reported, potentially due to a lack of investigation into the causes of HAIs.
In an ICU where an HAI can mean the difference between life and death, access to critical and semi-critical disposable supplies—supplies that may contact sterile body tissue, the bloodstream, mucous membranes, or nonintact skin—substantially limits the risk of cross-contamination. In extreme situations, such as a pandemic, the ability to quickly obtain prepackaged sterile supplies allows staff to keep up with a rising census while limiting their own exposure to highly contagious viruses.
Disposable Supplies Protect Healthcare Workers During a Pandemic
It took a pandemic to show us that good healthcare practices protect not only patients but frontline staff as well. The COVID-19 pandemic drove demand for disposable supplies, such as gowns, gloves, and masks, beyond what manufacturers could produce, leading to a conservation effort that may have failed our frontline healthcare workers. According to the International Journal of Infectious Diseases4, healthcare workers (HCWs) who were reusing PPE while caring for patients with COVID-19 were found to be 83% more likely to be infected than HCWs who had adequate PPE.
Protection from respiratory viruses does not end with having adequate supplies of PPE. As a review article in Neurology and Clinical Neuroscience5 reported, during the pandemic, disposable ventilator circuits were, at times, the only method available to limit aerosolization of COVID-19 virus particles. These disposable circuits were the barrier between the COVID-19 virus and the healthcare workers at the bedside, as long as they were changed out on the schedule set by the manufacturer.
Learn more about GE Healthcare's clinical accessories and how they can play an important role in infection control.
Controlling Costs Starts With Patient Safety
HAIs cost the U.S. healthcare system, payers, and patients billions of dollars every year, according to the CDC6. Recent value-based healthcare initiatives aim to improve patient outcomes while lowering costs.
Under the Centers for Medicare & Medicaid Services' (CMS) Hospital-Acquired Condition Reduction Program7, Medicare payments are tied to quality measures, including infection rates. Hospitals that rank in the lowest-performing quartile receive reduced payments from CMS, providing an incentive to put patient safety first in an effort to reduce in-patient costs and readmission rates.
Some reusable noncritical medical supplies are cost-effective and necessary in today's world. But hospitals and healthcare providers have a duty to find a balance between protecting the environment and providing good infection control. Prioritizing the use of disposable medical supplies in high-acuity settings, such as the ICU, can be a cost-saving measure by reducing rates of infection, length of stay, and readmissions8.
Reduce Resource Costs While Maintaining High Standards of Asepsis
In addition to the direct cost component, the time and resources required to maintain reusable hospital supplies is considerable.
The CDC9 guidelines for processing and sterilizing critical and semi-critical devices are extensive and require the use of disposable chemicals and packaging, multistep processes, labeling, proper storage to prevent exposure to contaminants or damaged packaging, and ongoing inspection. These guidelines require a high level of attention to detail and adherence to industry standards by sterile processing technicians, also referred to as medical equipment preparers, who currently earn a median wage of $18.65 per hour, according to the U.S. Bureau of Labor Statistics10. While the International Association of Healthcare Central Service Material Management 11(IAHCSMM) strives to advance the practice of Sterile Processing, technician positions typically require only a high school diploma and on-the-job training and, according to the IAHCSMM, only four states require professional certification at this time.
Employing adequately trained medical equipment preparers may not be the only challenge a sterile processing department faces. Instructions provided by equipment processing manuals can vary, and their effectiveness, in some cases, is being called into question. According to Biomedical Instrumentation & Technology12, processing instructions for cleaning flexible endoscopes lack an adequate standard for drying the narrow lumens, leaving the decision to the individual institution. Some studies reviewed reported between 83% and 95% of scopes pulled from storage for patient use were found to have residual fluid in the lumens, potentially increasing the risk of bacterial growth.
On the other hand, disposable supplies come in aseptic packaging and only require the time it takes to unpackage them. According to the Official Journal of The American Society for Surgery of the Hand13, a cost comparison of standard endoscopic carpal tunnel release surgery revealed that the total cost when using disposable equipment was 10% lower than when using reusable equipment. The literature review revealed that disposable medical supplies were associated with reduced set up time, reduced operating room time and reduced staff time overall.
Hospitals and healthcare providers make choices daily that impact the bottom line. Reusable medical supplies are a necessary component of a healthcare system that has been tasked with reducing cost and waste, particularly in situations where the risk of infection is low. However, in high-acuity areas where the risk of infection is elevated and can be costly, the use of disposable supplies should be a priority.
1 https://www.cdc.gov/hai/data/portal/index.html
2 https://jamanetwork.com/journals/jama/fullarticle/2763669
3 https://www.fda.gov/medical-devices/products-and-medical-procedures/reprocessing-reusable-medical-devices
4 https://www.ijidonline.com/article/S1201-9712%2821%2900023-0/fulltext
5 https://onlinelibrary.wiley.com/doi/10.1111/ncn3.12482
6 https://www.cdc.gov/hai/eip/antibiotic-use.html
7 https://qualitynet.cms.gov/inpatient/hac
8 https://www.gehealthcare.com/feature-article/in-hospital-infections-increase-odds-of-readmission-for-stroke-patients
9 https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html
10 https://www.bls.gov/oes/current/oes319093.htm
11 https://www.iahcsmm.org/membership/advocacy.html
12 https://meridian.allenpress.com/bit/article/54/3/223/441807/Sterilization-Central-Drying-and-Storage-of
13 https://www.jhandsurg.org/article/S0363-5023%2820%2930535-9/fulltext
