The Reprocessing and Reuse of Single-Use Medical Devices in Newfoundland & Labrador

Bornstein, Stephen and Butler, J. and Kean, R. (2010) The Reprocessing and Reuse of Single-Use Medical Devices in Newfoundland & Labrador. Project Report. Newfoundland and Labrador Centre for Applied Health Research (NLCAHR).

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Abstract

The Issue Across Canada, the practice of reusing medical devices intended for single use is evolving. Health institutions that once routinely reused single-use devices (SUDs) that had been reprocessed in-house have moved away from such practices because of growing concerns about patient safety and potential legal liability. In Newfoundland and Labrador (NL), since 2008, three of the four regional health authorities have issued policies that essentially prohibit the reprocessing and reuse of SUDs. Variation exists, however, in the wording of such policies and in the alignment of clinical practice with these policies. The Findings This report is based primarily on the evidence from a single systematic review produced in French by AETMIS1 and subsequently contextualized by us for the province of NL with input from local stakeholders with expertise in infection prevention and control. The study by AETMIS reviewed 19 types of critical2 and semi-critical3 medical devices and found that, with the possible exception of the reuse of hemodialysis membranes in the same patient, there was insufficient evidence to support, in clinical practice, the reprocessing and reuse of the devices reviewed. Moreover, the economic evidence on cost-effectiveness was insufficient to support the reprocessing and reuse of SUDs. Provincially, while most current policies prohibit reuse, local factors identified in the report appear to contribute to the continued potential risk of reuse of SUDs in both public and private health care settings. Reuse of devices reprocessed by third parties in the United States is currently done in several jurisdictions across Canada but, in the absence of strong scientific evidence to support this practice, it is fraught with regulatory, legal and ethical dilemmas as outlined in the full report.

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