Costs involved in compliance with new endoscope reprocessing guidelines
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: In March 2022, the Association for the Advancement of Medical Instrumentation (AAMI) released the American National Standards Institute (ANSI)/AAMI ST91:2021, their latest update on comprehensive, flexible, and semirigid endoscope reprocessing. These updated standards recommend the sterilization of high-risk endoscopes when possible and provide new recommendations for the precleaning, leak testing, manual cleaning, visual inspection, automated reprocessing, drying, storage, and transport of endoscopes. Methods: ANSI/AAMI ST91:2021 was compared with ANSI/AAMI ST91:2015 for major reprocessing differences that result in either time and/or cost increases. Time estimates were captured by explicit recommendation inclusion or taken from the literature. All the costs were estimated using publicly available resources. Results: The updated standards represent a potential 24.3-minute and 52.35 to 67.57 United States dollars increase per procedure in terms of reprocessing time and spending, respectively, not including capital investments. Capital costs per procedure were highly dependent on the procedure volume of the facility. Conclusions: The new AAMI standards recommend several major changes, such as sterilization, for facilities to reprocess and manage endoscopes between uses. As more facilities increase their reprocessing methods to reflect the updated standards, they do so at a cost and introduce several delays. As the reprocessing landscape evolves, facilities should consider their true costs and alternative solutions, such as single-use endoscopes.
Abstract
Background/Aims: In March 2022, the Association for the Advancement of Medical Instrumentation (AAMI) released the American National Standards Institute (ANSI)/AAMI ST91:2021, their latest update on comprehensive, flexible, and semirigid endoscope reprocessing. These updated standards recommend the sterilization of high-risk endoscopes when possible and provide new recommendations for the precleaning, leak testing, manual cleaning, visual inspection, automated reprocessing, drying, storage, and transport of endoscopes. Methods: ANSI/AAMI ST91:2021 was compared with ANSI/AAMI ST91:2015 for major reprocessing differences that result in either time and/or cost increases. Time estimates were captured by explicit recommendation inclusion or taken from the literature. All the costs were estimated using publicly available resources. Results: The updated standards represent a potential 24.3-minute and 52.35 to 67.57 United States dollars increase per procedure in terms of reprocessing time and spending, respectively, not including capital investments. Capital costs per procedure were highly dependent on the procedure volume of the facility. Conclusions: The new AAMI standards recommend several major changes, such as sterilization, for facilities to reprocess and manage endoscopes between uses. As more facilities increase their reprocessing methods to reflect the updated standards, they do so at a cost and introduce several delays. As the reprocessing landscape evolves, facilities should consider their true costs and alternative solutions, such as single-use endoscopes.
참고문헌 (19)
- Spaner SJ, "A brief history of endoscopy, laparoscopy, and laparoscopic surgery", J Laparoendosc Adv Surg Tech A, 7, pp.369~373 (1997)
- "MAUDE: Manufacturer and User Facility Device Experience" (2022)[URL]
- Garrett J, "Sterile, single-use bronchoscope reduces associated readmission rates and infection risk : a retrospective clinical analysis", Chest, 160, pp.A516~ (2021)
- Mouritsen JM, "A systematic review and cost effectiveness analysis of reusable vs. single-use flexible bronchoscopes", Anaesthesia, 75, pp.529~540 (2020)
- Joint Commission Perspectives, "Full-year 2019 top standards noncompliance data", Joint Commission Perspectives, ~ (2020)
- "Factors affecting quality of reprocessing" (2018)[URL]
- "Flexible bronchoscopes and updated recommendations for reprocessing: FDA safety communication" (2021)[URL]
- "Update: change in reprocessing methods with certain Karl Storz urological endoscopes-letter to health care providers" (2022)[URL]
- Bomman S, "Economic burden of enhanced practices of duodenoscopes reprocessing and surveillance : balancing risk and cost containment", Endosc Int Open, 9, pp.E1404~E1412 (2021)
- "ANSI/AAMI ST91:2021; Flexible and semi-rigid endoscope processing in health care facilities" (2022)[URL]
- "Occupational employment and wages, 31-9093 medical equipment preparers" (2021)[URL]
- "A glimpse at the true cost of reprocessing endoscopes" (2017)[URL]
- Omidbakhsh N, "Flexible gastrointestinal endoscope processing challenges, current issues and future perspectives", J Hosp Infect, 110, pp.133~138 (2021)
- Montero MC, "High-level disinfection evaluation in the ambulatory setting", Am J Infect Control, 51, pp.225~226 (2023)
- Larsen S, "Rate and impact of duodenoscope contamination : a systematic review and meta-analysis", EClinicalMedicine, 25, pp.100451~ (2020)
- Ofstead CL, "The utility of lighted magnification and borescopes for visual inspection of flexible endoscopes", Am J Infect Control, 51, pp.2~10 (2023)
- "MAUDE adverse event report: Olympus Medical Systems Corp. bronchoscope unknown. Report Number 2951238-2022-00340" (2022)[URL]
- Andersen CØ, "The cost of flexible bronchoscopes : a systematic review and meta-analysis", Pharmacoecon Open, 6, pp.787~797 (2022)
- Das A, "A cost-effectiveness analysis of exalt model D single-use duodenoscope versus current duodenoscope reprocessing methods", Tech Innov Gastrointest Endosc, 24, pp.16~25 (2022)