Reprocessing and Reuse of Single-Use Medical Devices: A National Survey of Canadian Acute-Care Hospitals

A national survey investigated the current practices of reprocessing and reusing single-use medical devices in Canadian acute-care hospitals. Our response rate was 72% (413 responses), and 28% of hospitals reprocess single-use devices. The results showed that Canadian hospital practices have not changed much in the past decade.

Download Full-text

Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study

BMJ Open ◽

10.1136/bmjopen-2018-028740 ◽

2019 ◽

Vol 9 (10) ◽

pp. e028740 ◽

Cited By ~ 1

Author(s):

Andrea Niederhauser ◽

Stephanie Züllig ◽

Jonas Marschall ◽

Alexander Schweiger ◽

Gregor John ◽

...

Keyword(s):

Acute Care ◽

Response Rate ◽

Urinary Catheter ◽

Acute Care Hospitals ◽

Evidence Based ◽

Improvement Project ◽

Staff Members ◽

Indwelling Urinary Catheter ◽

Current Practices

ObjectiveTo evaluate changes in staff perspectives towards indwelling urinary catheter (IUC) use after implementation of a 1-year quality improvement project.DesignRepeated cross-sectional survey at baseline (October 2016) and 12-month follow-up (October 2017).SettingSeven acute care hospitals in Switzerland.ParticipantsThe survey was targeted at all nursing and medical staff members working at the participating hospitals at the time of survey distribution. A total of 1579 staff members participated in the baseline survey (T0) (49% response rate) and 1527 participated in the follow-up survey (T1) (47% response rate).InterventionA multimodal intervention bundle, consisting of an evidence-based indication list, daily re-evaluation of ongoing catheter need and staff training, was implemented over the course of 9 months.Main outcome measuresStaff knowledge (15 items), perception of current practices and culture (scale 1–7), self-reported responsibilities (multiple-response question) and determinants of behaviour (scale 1–7) before and after implementation of the intervention bundle.ResultsThe mean number of correctly answered knowledge questions increased significantly between the two survey periods (T0: 10.4, T1: 11.0; p<0.001). Self-reported responsibilities with regard to IUC management by nurses and physicians changed only slightly over time. Perception of current practices and culture in regard to safe urinary catheter use increased significantly (T0: 5.3, T1: 5.5; p<0.001). Significant changes were also observed for determinants of behaviour (T0: 5.3, T1: 5.6; p<0.001).ConclusionWe found small but significant changes in staff perceptions after implementation of an evidence-based intervention bundle. Efforts now need to be targeted at sustaining and reinforcing these changes, so that restrictive use of IUCs becomes an integral part of the hospital culture.

Download Full-text

Reprocessing and Reuse of Single-Use Medical Devices Used During Hemodynamic Procedures in Brazil: A Widespread and Largely Overlooked Problem

Infection Control and Hospital Epidemiology ◽

10.1086/590357 ◽

2008 ◽

Vol 29 (9) ◽

pp. 854-858 ◽

Cited By ~ 10

Author(s):

Jorge M. Buchdid Amarante ◽

Cristiana M. Toscano ◽

Michele L. Pearson ◽

Virginia Roth ◽

William R. Jarvis ◽

...

Keyword(s):

Adverse Events ◽

Medical Devices ◽

Surveillance System ◽

Response Rate ◽

Limited Resource ◽

Interventional Cardiology ◽

Questionnaire Response ◽

Brazilian Society ◽

Cardiac Catheters ◽

Single Use

Background.Several medical devices used during hemodynamic procedures, particularly angiographic diagnostic and therapeutic cardiac catheters, are manufactured for single use only. However, reprocessing and reuse of these devices has been reported, to determine the frequency of reuse and reprocessing of single-use medical devices used during hemodynamic procedures in Brazil and to evaluate how reprocessing is performed.Design.National survey, conducted from December 1999 to July 2001.Methods.Most of the institutions affiliated with the Brazilian Society of Hemodynamic and Interventional Cardiology were surveyed by use of a questionnaire sent in the mail.Results.The questionnaire response rate was 50% (119 of 240 institutions). Of the 119 institutions that responded, 116 (97%) reported reuse of single-use devices used during hemodynamic procedures, and only 26 (22%) reported use of a standardized reprocessing protocol. Cleaning, flushing, rinsing, drying, sterilizing and packaging methods varied greatly and were mostly inadequate. Criteria for discarding reused devices varied widely. Of the 119 institutions that responded, 80 (67%) reported having a surveillance system for adverse events associated with the reuse of medical devices, although most of these institutions did not routinely review the data, and only 38 (32%) described a training program for the personnel who reprocessed single-use devices.Conclusions.The reuse of single-use devices used during hemodynamic procedures was very frequent in hospitals in Brazil. Basic guidance on how to reuse and reprocess single-use medical devices is urgently needed, because, despite the lack of studies to support reusing and reprocessing single-use medical devices, such devices are necessary in limited-resource areas in which these practices are current.

Download Full-text

A national survey: transporting patients within Australian hospitals.

Australian Health Review ◽

10.1071/ah000108 ◽

2000 ◽

Vol 23 (4) ◽

pp. 108 ◽

Cited By ~ 1

Author(s):

Robert Cook ◽

Glenn Gardner ◽

Anne Gardner

Keyword(s):

National Survey ◽

Response Rate ◽

Telephone Survey ◽

Financial Resources ◽

Considerable Variability ◽

Patient Transport ◽

Emotional Aspects ◽

Current Practices

A telephone survey was conducted to describe current practices and policies of patient transport in Australian hospitals.The survey had a 94% response rate. Results showed considerable variability and ambiguity throughout the samplein both practice and policy. Findings also indicated that criteria used for transport practices were predominantlyshaped by physiological and technological considerations. Factors related to human and financial resources, as well aspsychological and emotional aspects of the patient's condition, received little attention.

Download Full-text

END-OF-LIFE CARE DURING THE NATIONAL OPIOID CRISIS: A NATIONAL SURVEY OF HOSPICE PROVIDERS

Innovation in Aging ◽

10.1093/geroni/igz038.3464 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S954-S955 ◽

Cited By ~ 1

Author(s):

John Cagle ◽

Mary Lynn McPherson ◽

Jodi Frey ◽

Paul Sacco ◽

Orrin Ware ◽

...

Keyword(s):

National Survey ◽

Response Rate ◽

National Data ◽

Home Death ◽

Policy And Practice ◽

Non Profit ◽

Drug Shortages ◽

The Past ◽

Drug Diversion ◽

Opioid Diversion

Abstract No national data exist on drug shortages, missing medications, opioid diversion, and opioid diversion prevention in hospice. We conducted a national survey of hospices (administered June-September, 2018). We randomly selected 600 hospices to survey representatives about: (1) care for patients/families with substance use disorder (SUD) (2) drug shortages; (3) instances of drug diversion; and, (4) drug disposal practices. Surveys were conducted by phone and online. Sample weights were used to adjust for non-response. A total of 371 hospices completed surveys (response rate=62%), 63% of which were administered by phone. Half (50%) of agencies were mid-sized (26-100 patients) and non-profit. Two thirds (66%) of hospices reporting that medications either “never” or “rarely” go missing. On average, there were 0.80 reported cases of confirmed diversion per agency within the past 90 days. Although a majority of hospices (78%) screen patients for SUD, only 43% screen informal caregivers. Just under half (42%) of hospices reported drug shortages over the past year. A minority (8%) of hospices stopped prescribing certain medications altogether due to concerns about diversion. 52% of hospices reported that employees are not allowed to dispose of medications after a home death. Agency representatives estimated that, after a home death, unused opioids were left in the home 32% of the time. On average, hospices have nearly one case of opioid diversion per quarter. Hospices are experiencing medication shortages and restrictions on medication disposal. Changes are needed in policy and practice to address these challenges.

Download Full-text

National survey of the impact of drug shortages in acute care hospitals

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/61.19.2015 ◽

2004 ◽

Vol 61 (19) ◽

pp. 2015-2022 ◽

Cited By ~ 38

Author(s):

Amanda M. Baumer ◽

Angela M. Clark ◽

David R. Witmer ◽

Shirley B. Geize ◽

Lee C. Vermeulen ◽

...

Keyword(s):

Acute Care ◽

National Survey ◽

Acute Care Hospitals ◽

Drug Shortages ◽

The Impact

Download Full-text

Urinary Catheter Indications in the United States: Results from a National Survey of Acute Care Hospitals

Infection Control and Hospital Epidemiology ◽

10.1017/s0899823x0019405x ◽

2014 ◽

Vol 35 (S3) ◽

pp. S96-S98 ◽

Cited By ~ 2

Author(s):

M. Todd Greene ◽

Hiroko Kiyoshi-Teo ◽

Heidi Reichert ◽

Sarah Krein ◽

Sanjay Saint

Keyword(s):

United States ◽

Urinary Incontinence ◽

Acute Care ◽

National Survey ◽

Urinary Catheter ◽

Outlet Obstruction ◽

Acute Care Hospitals ◽

The United States ◽

Urinary Catheters ◽

Appropriate Use

In a survey of acute care hospitals across the United States, we found that many hospitals use indwelling urinary catheters for reasons that are not medically necessary (eg, urinary incontinence without outlet obstruction and patient/family requests). Our findings highlight an opportunity to reduce unnecessary catheter use through promoting awareness of appropriate use.

Download Full-text

National survey of the status of infection surveillance and control programs in acute care hospitals with more than 300 beds in the Republic of Korea

American Journal of Infection Control ◽

10.1016/j.ajic.2006.01.003 ◽

2006 ◽

Vol 34 (4) ◽

pp. 223-233 ◽

Cited By ~ 24

Author(s):

Hyang Soon Oh ◽

Hai Won Chung ◽

Joung Soon Kim ◽

Sung Il Cho

Keyword(s):

Acute Care ◽

National Survey ◽

Acute Care Hospitals ◽

Republic Of Korea ◽

Control Programs ◽

Infection Surveillance ◽

The Status ◽

The Republic ◽

And Control

Download Full-text

Implementation of Antimicrobial Stewardship Policies in U.S. Hospitals: Findings from a National Survey

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2014.50 ◽

2015 ◽

Vol 36 (3) ◽

pp. 261-264 ◽

Cited By ~ 17

Author(s):

Monika Pogorzelska-Maziarz ◽

Carolyn T. A. Herzig ◽

Elaine L. Larson ◽

E. Yoko Furuya ◽

Eli N. Perencevich ◽

...

Keyword(s):

Acute Care ◽

Antimicrobial Stewardship ◽

Online Survey ◽

Response Rate ◽

Acute Care Hospitals ◽

National Sample ◽

Teaching Hospitals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Annual Survey

OBJECTIVETo describe the use of antimicrobial stewardship policies and to investigate factors associated with implementation in a national sample of acute care hospitals.DESIGNCross-sectional survey.PARTICIPANTSInfection Control Directors from acute care hospitals participating in the National Healthcare Safety Network (NHSN).METHODSAn online survey was conducted in the Fall of 2011. A subset of hospitals also provided access to their 2011 NHSN annual survey data.RESULTSResponses were received from 1,015 hospitals (30% response rate). The majority of hospitals (64%) reported the presence of a policy; use of antibiograms and antimicrobial restriction policies were most frequently utilized (83% and 65%, respectively). Respondents from larger, urban, teaching hospitals and those that are part of a system that shares resources were more likely to report a policy in place (P<.01). Hospitals located in California were more likely to have policy in place than in hospitals located in other states (P=.014).CONCLUSIONThis study provides a snapshot of the implementation of antimicrobial stewardship policies in place in U.S. hospitals and suggests that statewide efforts in California are achieving their intended effect. Further research is needed to identify factors that foster the adoption of these policies.Infect Control Hosp Epidemiol 2014;00(0): 1–4

Download Full-text

Smoking Inside Canadian Acute Care Hospitals

Canadian Respiratory Journal ◽

10.1155/2006/139359 ◽

2006 ◽

Vol 13 (5) ◽

pp. 266-268

Author(s):

Trevor Bardell ◽

Peter M Brown

Keyword(s):

Smoking Cessation ◽

Acute Care ◽

Hospital Pharmacy ◽

Overall Response Rate ◽

Response Rate ◽

Psychiatric Patients ◽

Acute Care Hospitals ◽

Current Policy ◽

Overall Response ◽

Smoking Policies

OBJECTIVE: To assess smoking policies at Canadian acute care hospitals.METHOD: A questionnaire was designed, piloted and faxed to all acute care hospitals in Canada. The questionnaire was designed to address the following: what is the current policy regarding patient smoking? Are staff and/or visitors allowed to smoke inside the hospital? Is there a separate policy for psychiatric patients? Are smoking cessation products available at the hospital pharmacy? Is the policy governed by regional or municipal legislation?RESULTS: A total of 852 hospitals were included in the study. Of these, 476 responded to the questionnaire, for an overall response rate of 56%. Twenty-seven per cent of respondents allowed patient smoking inside the hospital. While staff smoking was not allowed inside most hospitals (93%), 32% of hospitals in Quebec allowed staff to smoke inside the building. Thirty per cent of hospitals had a separate policy for psychiatric patients, and 27% of hospitals had provisions for visitor smoking. Sixty-seven per cent of hospitals were able to offer patients smoking cessation products while they were in hospital.CONCLUSIONS: Many Canadian hospitals continue to allow smoking inside their facilities. There is considerable variation in hospital smoking policies across the country.

Download Full-text