Reprocessing disposable single-use devices: From skepticism to success

ISSUE: The economic pressure to cut healthcare costs is driving facilities to consider reprocessing open but unused medical devices as well as used devices that are expensive. The reuse of disposable medical devices that are labeled “for single-use only” (i.e., single-use devices, or SUDs) raises legal, financial, ethical, and patient safety issues. PROJECT: A SUD reprocessing committee was formed at a university medical center with representation from the following departments: infection control, risk management, accreditation and patient safety, financial management, administration, sterile processing, materials management, procurement services, peri-operative services, radiology, and cardiology. The mission of the SUD reprocessing committee is to establish policies and procedures for the reprocessing of SUDs that will ensure patient safety and quality healthcare. RESULTS: The SUD reprocessing committee established the following policies: 1) Onsite reprocessing is strictly prohibited. 2) Reprocessing may be performed only by FDA-registered third-party reprocessing companies approved by the health system. 3) Each department will determine which SUDs are candidates for reprocessing. 4) Third-party reprocessing must be approved by the SUD reprocessing committee and the hospital infection control committee (HICC). 5) Departmental approval must be obtained for each SUD from the medical director or designated clinical leader based on their expertise in the use of the product. 6) The request to reprocess a SUD must be submitted to the SUD reprocessing committee for approval. 7) The SUD reprocessing committee will submit approved requests to the HICC for final approval. We began reprocessing Category I devices (BP cuffs, SCDs, pulse oximeter sensors, disposable stethoscopes) on June 1, 2003. We began reprocessing Category II devices (bits, burrs, blades, external fixation devices) on April 1, 2004. Beginning in July 2004, fiscal year-to-date savings for both Category I and II devices were $272,565. No patient safety issues related to reprocessing have been identified. LESSONS LEARNED: Successful implementation of reprocessing of SUDs is dependent upon careful analysis of potential risks and benefits. Our SUD reprocessing committee established policies to ensure detailed evaluation prior to approval of reprocessing selected items. SUD reprocessing resulted in substantial cost savings to our health system without compromising the care of patients.