Hemodynamic single-use devices (SUD), namely cardiac catheters, are reused worldwide and in India, where cost and aggressive intervention take priority over infection prevention. An important issue associated with the reprocessing of any SUD is the potential for subsequent transmission of infectious agents. The reprocessing and sterilization methodology of reuse of SUD is often left to the discretion of the nursing staff, and sterility issues can be overlooked.
Rao, et al. (2013) sought to evaluate reprocessing and sterilization methodology and to develop guidelines and oversee their implementations that result in standardized practices and improve the safety of hemodynamic device reuse.
The infection control team took over the responsibility of the process initially in this small pilot study. A robust cleaning and sterilization process protocol based on basic microbiological principles was developed and tested for bacterial, viral and endotoxin remnants before using on patients. Initially 20 cardiac angiogram patients (consent was taken) were followed up for three months for any adverse events with reuse policy in place. Clinicians' feedback was taken and modification made in the process at the end of study. It was extended to a full-fledged protocol and implemented.
This system has in place for the past five years and there are no adverse events reported on follow-up (more than 8,000 angiograms so far). The facility performs 12 angiograms per day and reuse is 75 percent. The protocol implementation has resulted in determining the number of times each catheter can be reused. The process is continuously audited and compliance to the protocol is 100 percent.The researchers say the steps for repossessing are easy, adaptable, outcome-measurable, sustainable and cost-effective in resource-limited settings.
Reference: Rao R, Mani R, et al. Oral presentation O031 at 2nd International Conference on Prevention and Infection Control (ICPIC 2013): Reprocessing of single-use hemodynamic catheters in cardiology -- we do but how best to do it. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):O31 doi:10.1186/2047-2994-2-S1-O31.