评价三级医院冠状动脉成形术中一次性心脏用品重复使用的医生接受度的研究

Pushpi Rani, Humera Irshad, Sajad Rashid, Satyanarayana Nimma
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引用次数: 0

摘要

人们期望保健提供者具有成本效益地提供高质量的病人护理,特别是在发展中国家。贴有“仅限一次性使用”标签的医疗器械理想情况下不应重复使用,但由于其成本较高,可以考虑重复使用。对一次性设备的严格管制的再处理提供了这样做的机会,并有可能对环境废物产生有利影响。本研究的目的是评估医生对冠状动脉血管成形术中重复使用一次性心脏材料的接受程度。一份自行设计的开放式问卷由一组心脏病专家进行标准化,以评估医生对冠状动脉血管成形术中重复使用一次性心脏用品的接受程度。对心脏病专家进行了单独访谈,并对他们的回答进行了分析。心脏病专家意识到一次性血管成形术被重复使用。大多数人对一次性用品的灭菌感到满意,并认为它对患者是安全的。心导管重复使用5-6次,球囊重复使用3-4次。30%的患者手术时间增加了10-15分钟。相比之下,15%的患者使用重复使用的心导管和球囊,其容量增加了约40-50毫升。1%的患者出现导管物理完整性缺损,即导管尖端磨损/微骨折。在手术过程中,2%的患者观察到球囊收缩功能障碍,而1%的患者观察到球囊从球杆断裂和缠结。8%的患者在血管成形术中出现球囊破裂。使用可重复使用的一次性血管成形术的患者中约有1.5%出现感染。3%的一次性重复使用患者出现血栓形成,这是血管成形术后最常见的不良事件。有患者因球囊缠结而被送往急诊手术/冠状动脉搭桥手术的病例,约0.1%的患者被发现有此类并发症。保健专业人员可以安全地重复使用一次性心脏用品,特别是在发展中国家,由于预算限制,只要重复使用不超过3-5次,并遵守有效的消毒方法。
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A Study to Assess the Acceptance of Doctors toward the Practice of Reusing of Cardiac Disposables in Coronary Angioplasty in a Tertiary Care Hospital
Health-care providers are expected to deliver quality patient care cost-effectively, especially in developing countries. Medical devices labeled “single use only” should ideally not be reused but, can be considered for reuse due to their higher cost. Stringently regulated reprocessing of the single-use device provides an opportunity to do so along with the potential to have a favorable impact on environmental waste. The aim of this study is to assess the acceptance of doctors toward the practice of reusing cardiac disposables in coronary angioplasty. An open-ended and self-designed questionnaire was prepared and was standardized by a panel of cardiologists to assess doctors’ acceptance toward reusing cardiac disposable in coronary angioplasty. The cardiologists were interviewed individually, and the responses were analyzed. The cardiologists were aware that the angioplasty disposables were being reused. The majority were satisfied with the sterilization of disposables and were of the opinion that it was safe for the patients. Cardiac catheters were reused 5–6 times while the balloons were reused 3–4 times. An increase in procedure time of 10–15 min was observed in 30% of patients. There was an increase, in contrast, volume of about 40–50 mL with reused cardiac catheters and balloons which was observed in 15% of patients. Defect in the physical integrity of the catheter, that is, tip abrasion/microfracture was observed in 1% of patients. Deflation dysfunction of the balloon during the procedure was observed in 2% of patients, while breakage of the balloon from the shaft and entanglement of the balloon was observed in 1% of patients. Balloon rupture during angioplasty was observed in 8% of patients. Around 1.5% of patients undergoing angioplasty with reused disposables presented with infections. Thrombosis was observed in 3% of patients with reused disposables, and it was the most common adverse event post-angioplasty. There were cases where the patients were sent for emergency surgery/coronary artery bypass graft surgery due to balloon entanglement and about 0.1% of patients were found to have such a complication. Cardiac disposables can be safely reused by health-care professionals, especially in developing nations due to their budget constraints, provided it is reused no more than 3–5 times and efficient methods of sterilization are observed.
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