Dialyzer re-use: a solution for the '90s.

Current economic and fiscal imperatives in health care demand innovative and cost-effective methods of care delivery. At St. Joseph's Health Centre in London, Ontario since 1990 we have been pioneering the process of dialyzer re-use in order to reduce costs while maintaining quality care. This paper will describe the process of introducing dialyzer re-use to our unit with particular emphasis on its implications for staff education, patient communication, capital equipment acquisition and the development of dialyzer re-use methods. The paper will also report the findings of an evaluation study designed to answer the following research questions: What is the effect of successive dialyzer re-uses on the clearance of urea, creatinine and phosphate? What is the incidence of fever developing during a dialysis treatment in a re-use program? What are the cost savings attributable to the introduction of re-use? Discussion of the research findings will focus on patient's and staff's reaction to the practice change and key learnings from our experience.