Explore the vast range of titles available.

Surgical gowns help protect patients from exposure to microorganisms and serve as personal protective equipment for perioperative staff members. Medical textiles, including surgical gowns, are available as reusable and disposable products. Health care facility administrators and leaders who endeavor to use environmentally sustainable practices require current data for decision making. This study analyzed all activities from the extraction of fossil materials from the earth to the end-of-life disposal of reusable and disposable surgical gowns. The researchers included calculations for laundry and wastewater treatment operations and compared the environmental effects of the two surgical gown systems. The study results showed that selection of reusable gowns rather than disposable gowns reduced natural resource energy consumption (64%), greenhouse gas emissions (66%), blue water consumption (83%), and solid waste generation (84%). Perioperative nurses can use this information to assist facility leaders as they make informed decisions related to gown system selection.

Background In China, reprocessing and reuse of single-use medical devices (SUDs) are banned. However, the actual situation has not been reported so far. The study aims to clarify the perceptions and concerns of various sectors of the community on the reuse of SUDs, and whether such practice exists. In addition, we are also wondering how acceptable the respondents are on this matter. Methods A cross-sectional study based on a national survey which was conducted on the professional online questionnaire survey platform ( www.wjx.cn ) from July 26 to August 4, 2015. We analyzed the data according to the work fields, sex, age, education level, professional background and participants’ answers to 49 other questions. Results Five hundred forty-four nationwide respondents belong to nine different work fields. In general, participants had positive attitudes towards the reprocessing and reuse of SUDs. However, many respondents doubted the hygienic and functional safety of the reprocessed SUDs. They also tended to think that the reuse of SUDs should have lower prices and more technical training as well as patient advocacy. Further analysis demonstrated the work fields, education level and professional background of respondents were statistically associated with their responses to certain questions. Conclusions The research indicated that although the reuse of SUDs is prohibited legally in China, there were extensive reprocessing and reuse in hospitals. Most responses tended to accept reprocessed SUDs if safety and low prices were guaranteed. These existing contradictions and the lack of relevant research led to policy makers in China will confront numerous challenges in building and improving this use system of medical devices to meet escalating demands of social sectors.

Objective: to analyze the integrity of N95/PFF2 masks in relation to fiber morphology, porosity, cracks and micro holes, as well as identify visible damage to their structure and components, after seven- and fifteen-day reuse protocols. Method: cross-sectional study. Structural and morphological characteristics of a new N95/PFF2 mask were analyzed in comparison with N95/PFF2 masks (n=10) used in seven- and fifteen-day protocols, through visual inspection and scanning electron microscopy. Results: upon visual inspection, following the seven-day protocol, 40% and 60% of the N95/PFF2 masks showed, respectively, personal identification marks and external and internal dirt. Additionally, 20% exhibited loosening and/or tearing of the straps, while 100% showed some type of damage to the nose clips. In the fifteen-day protocol, all N95/PFF2 masks had dirt, loose straps and damaged nose clips, and 80% had folds. Electronic microscopy revealed an increase in pores and loosening in the weaves from seven days onwards, extending up to fifteen days, with the presence of micro holes and residues. Conclusion: the reuse of N95/PFF2 masks affects their structural and morphological integrity. It is crucial to carry out tests to measure the impact of this practice on the safety of health professionals. Objetivo: analizar la integridad de mascarillas N95/PFF2 con relación a la morfología de las fibras, porosidad, grietas y microagujeros, así como identificar daños visibles en su estructura y componentes, luego de protocolos de reutilización de siete y quince días. Método: estudio transversal. Se analizaron las características estructurales y morfológicas de una mascarilla N95/PFF2 nueva en comparación con las mascarillas N95/PFF2 (n=10) utilizadas en protocolos de siete y quince días, mediante inspección visual y microscopía electrónica de barrido. Resultados: tras la inspección visual, siguiendo el protocolo de siete días, el 40% y el 60% de las mascarillas N95/PFF2 mostraron, respectivamente, marcas de identificación personal y suciedad externa e interna. Además, el 20% presentó aflojamiento y/o desgarro de las correas de sujeción, mientras que el 100% presentó algún tipo de daño en los clips nasales. En el protocolo de quince días, todas las mascarillas N95/PFF2 tenían suciedad, correas de sujeción sueltas y clips nasales dañados, y el 80% tenía pliegues. La microscopía electrónica reveló un aumento de poros y aflojamiento en las tramas a partir de los siete días, extendiéndose hasta los quince días, con presencia de microagujeros y residuos. Conclusión: la reutilización de las mascarillas N95/PFF2 compromete su integridad estructural y morfológica. Es crucial realizar pruebas para medir el impacto de esta práctica en la seguridad de los profesionales de la salud. Objetivo: analisar a integridade das máscaras N95/PFF2 em relação à morfologia das fibras, porosidade, fissuras e micro furos, bem como identificar danos visíveis em sua estrutura e componentes, após protocolos de reutilização de sete e quinze dias. Método: estudo transversal. Características estruturais e morfológicas de uma máscara N95/PFF2 nova foram analisadas em comparação com máscaras N95/PFF2 (n=10) utilizadas em protocolos de sete e quinze dias, por meio da inspeção visual e microscopia eletrônica de varredura. Resultados: na inspeção visual, seguindo o protocolo de sete dias, 40% e 60% das máscaras N95/PFF2 apresentaram, respectivamente, marcas de identificação pessoal e sujidades externas e internas. Além disso, 20% exibiram afrouxamento e/ou rompimento das tiras de fixação, enquanto 100% mostraram algum tipo de dano nos clipes nasais. No protocolo de quinze dias, todas as máscaras N95/PFF2 apresentavam sujidade, tiras de fixação frouxas e clipes nasais comprometidos; 80% possuíam dobras. A microscopia eletrônica revelou aumento dos poros e afrouxamento nas tramas a partir de sete dias, ampliando-se até quinze dias, com presença de micro furos e detritos. Conclusão: a reutilização das máscaras N95/PFF2 compromete a integridade estrutural e morfológica. É crucial realizar testes para mensurar o impacto dessa prática na segurança dos profissionais de saúde.

Duodenoscopy-associated infections occur worldwide despite strict adherence to reprocessing standards. The exact scope of the problem remains unknown because a standardized sampling protocol and uniform sampling techniques are lacking. The currently available multi-society protocol for microbial culturing by the Centers for Disease Control and Prevention, the United States Food and Drug Administration (FDA) and the American Society for Microbiology, published in 2018 is too laborious for broad clinical implementation. A more practical sampling protocol would result in increased accessibility and widespread implementation. This will aid to reduce the prevalence of duodenoscope contamination. To reduce the risk of duodenoscopy-associated pathogen transmission the FDA advised four supplemental reprocessing measures. These measures include double high-level disinfection, microbiological culturing and quarantine, ethylene oxide gas sterilization and liquid chemical sterilization. When the supplemental measures were advised in 2015 data evaluating their efficacy were sparse. Over the past five years data regarding the supplemental measures have become available that place the efficacy of the supplemental measures into context. As expected the advised supplemental measures have resulted in increased costs and reprocessing time. Unfortunately, it has also become clear that the efficacy of the supplemental measures falls short and that duodenoscope contamination remains a problem. There is a lot of research into new reprocessing methods and technical applications trying to solve the problem of duodenoscope contamination. Several promising developments such as single-use duodenoscopes, electrolyzed acidic water, and vaporized hydrogen peroxide plasma are already applied in a clinical setting.

Reprocessing single‐use surgical supplies and devices is an option for hospitals and ambulatory surgery centers (ASCs). The US Federal Government has recognized the practice since 2000, and regulatory oversight has increased dramatically since that time. Reprocessing single‐use devices is safe when personnel use approved methods, and health care facilities can experience significant cost savings by participating in this type of initiative. This article explores reprocessing and its benefits in ASCs, including a review of the oversight that the US Food and Drug Administration currently has for reprocessing and a discussion of the results of studies pertaining to this practice. The article also describes some issues that ASC leaders need to be aware of when considering the implementation of a reprocessing program. Single‐use device reprocessing can be an effective tool for ASC leaders to conserve and manage resources.

Periop Briefing interviewed Jessica Havens, BAN, RN, charge of service for ear, nose, and throat (ENT) and ophthalmology, Seattle Children's Hospital, about her team's project to reduce the costs associated with reprocessing the tonsillectomy and adenoidectomy instrument set by removing infrequently used instruments. Because we were planning to ask the perioperative staff members to be responsible for collecting all of the data, we wanted to make the process as simple as possible for them. The surgeons were all informed by the division chief that we were doing the project; they were receptive to it as well. Because there was no resistance to the counting and data collection process, we did not have to work to obtain the team's buy-in.

PurposeSince the Brazilian current legislation permits the reuse of single-use devices under a validated processing protocol, the main purpose of our study was to develop and validate a method for reusing non-irrigated electrophysiology catheter (EC).MethodsManual and mechanical processing by ultrasonic washer was associated with the use of enzymatic solution and hydrogen peroxide with a final rinse with filtered water. Validation of the cleaning process, as well as catheter integrity, was done by observing the ECs in stereoscopic microscope at ×60 magnification, followed by HemoCheck-S® (HCS) test to monitor the presence of residual blood on their surfaces. Ethylene oxide (EO) was used for sterilization, and the final validations of the processing were performed by assays of sterility, pyrogenicity, and EO residuals. Lastly, a cost-minimization study was performed.ResultsCleaning process demonstrated absence of organic material detectable by HCS at the surfaces of the ECs. Assays for sterility were negative, and assays of EO residuals and endotoxins showed levels under established standards. The number of reuses was settled to a maximum of seven uses for the ECs with handle and ten uses for ECS without handle. The cost-minimization study showed an 84% savings, when considering seven reuses.ConclusionsProcessing of ECs was validated at all stages. Therefore, reuse of ECs under the conditions that we designed was considered safe for patients and cost-effective for our institution.

Purpose The aim of the study was to investigate if ultrasound probes are reusable medical devices that risk becoming contaminated after a patient examination in Japan. Methods The level of bacterial contamination on transvaginal ultrasound (TVU) probes following current routine probe cleaning at a university hospital (site A) and a clinic (site B) in Japan was investigated. Results A total of 98.1% of probes were found to be contaminated at site A (median CFU 40, IQR 10, 132.5) and 94.1% were found to be contaminated at site B (median CFU 50, IQR 20, 85). Of the contaminated probes, 52.9% at site A and 64.6% at site B harbored potentially pathogenic bacteria including methicillin-resistant Staphylococcus aureus (MRSA). Conclusion These findings suggest that there is a high rate of ultrasound probe residual bacterial contamination in Japan.

ABSTRACTBackground Re-use of unused medicines returned from patients is currently considered unethical in the UK and these are usually destroyed by incineration. Previous studies suggest that many of these medicines may be in a condition suitable for re-use. Methods All medicines returned over two months to participating community pharmacies and GP surgeries in Eastern Birmingham PCT were assessed for type, quantity and value. A registered pharmacist assessed packs against set criteria to determine the suitability for possible re-use. Results Nine hundred and thirty-four return events were made from 910 patients, comprising 3765 items worth £33 608. Cardiovascular drugs (1003, 27%) and those acting on the CNS (884, 24%) were most prevalent. Returned packs had a median of 17 months remaining before expiry and one-quarter of packs (1248 out of 4291) were suitable for possible re-use. One-third of those suitable for re-use (476 out of 1248) contained drugs in the latest WHO Essential Drugs List. Conclusion Unused medicines are returned in substantial quantities and have considerable financial value, with many in a condition suitable for re-use. We consider it appropriate to reopen the debate on the potential for re-using these medicines in developing countries where medicines are not widely available and also within the UK.