The researchers performed a cost-minimization analysis on four ENT endoscope reprocessing and high-level decontamination methods:
- Ortho-phthalaldehyde solution
- Accelerated hydrogen peroxide solution
- Chlorine dioxide wipe
- UV Smart D60
Researchers recommended the decontamination protocol for each method according to the manufacturer’s guidelines.
UV technology decontamination involved manually pre-cleaning the ENT endoscope with a soaked wipe (with water) for 20s and then exposing the ENT endoscope to UV-C light for 60s.
The researcher used a time-driven, activity-based micro-costing approach, accounting for reprocessing costs, staffing requirements, and capital depreciation. The primary outcome measure was the annual reprocessing cost for each method.
The scientists gathered data on the cost information from manufacturers while the time costs were derived from manufacturer reprocessing protocols and the Ontario Medical Association (OMA) Physician’s Guide to Uninsured Services.
The researchers designed survey questions using the cost information and other relevant data, including the use of ENT endoscopes in community practice. The survey had 14 questions related to clinic size, ENT endoscope volume, scope reprocessing method, and maintenance.
They emailed the electronic surveys to 42 community otolaryngologists registered through the Canadian Society of Otolaryngology—Head and Neck Surgery.
The researchers used the responses to calculate the mean reprocessing volumes per surgeon for the financial model. They also analyzed survey respondents’ self-reported compliance with manufacturer recommendations for reprocessing.
Results of the study
One reprocessing cycle refers to the process of decontaminating one scope after use on a patient. For ENT endoscopes soaked in a disinfecting solution, a cleaning wipe is necessary at the point of care after each use to remove any gross debris. The researchers included the labor costs required for the physician or health care staff to actively participate in the decontamination procedures, such as wiping, transferring, and rinsing the scopes.
The following is the breakdown of the reprocessing cost per cycle:
Physician processing: $38.59
Clinic staff processing: $5.51
Accelerated hydrogen peroxide solution
Physician processing: $26.47
Clinic staff processing: $4.42
Chlorine dioxide wipe
Physician processing: $30.53
Clinic staff processing: $11.23
UV Smart D60
Physician processing: $22.74
Clinic staff processing: $6.21
UV Smart D60 disinfection had the lowest labor costs and the shortest scope downtime because it does not require an enzyme bath or soaking with a water disinfectant.
The annual cost per reprocessing for each method includes the following:
- UV Smart D60: $58,942.08
- Ortho-phthalaldehyde solution: $68,610.24,
- Accelerated hydrogen peroxide solution: $79,133.76
- Chlorine dioxide wipe: $100,025.
The study revealed that UV-based technology for disinfecting ENT endoscopes was the most cost-efficient reprocessing method in a high-volume ENT practice of 2592 reprocessing events per year or more.
Disinfecting through the UV Smart D60 is a productive and efficacious method for disinfecting medical devices. UV-based technology also minimizes the cost of reprocessing ENT endoscopes in high-volume ENT clinics (starting from 2592 reprocessing events per year).
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