Public Health Agency of Canada
www.publichealth.gc.ca
Surveillance Project for the Re-Use of Single-Use Medical Devices in Canadian Health Care Facilities
CANADIAN NOSOCOMIAL INFECTION SURVEILLANCE PROGRAM
October 2001
FINAL REPORT
The Canadian Nosocomial Infections Surveillance Program (CNISP) conducted a survey of health care institutions in Canada in order to determine the extent of the re-use of single use medical devices (SUMeD's). A total of 67 critical and semi-critical medical devices and 17 other SUMeD's used in respiratory procedures were surveyed. In December 2000, 741 questionnaires surveys were mailed to all acute-care hospitals in Canada. The questionnaire was designed to measure the extent of re-use of the SUMeD, the cleaning procedures used and the number of times the SUMeD was re-used before being discarded. The administrative policies which govern the re-use of SUMeD's within the hospital were also addressed.
As of April 15th, 2001, 421 surveys were returned and completed for a response rate of 57%. The distribution of the response by province is described in Table 1. An additional 18 questionnaires were received over the summer of 2001. These were not included in the analysis. Tables 2 to 14 describe the findings of this study. Table 15 lists the SUMeD's that were surveyed but not analysed for this report.
Table 1. Distribution of the surveys received according to the province of origin, n = 421
| Province | Number
mailed n = 741 |
Number returned
(%) n = 421 |
| Newfoundland | 18 | 8 (44) |
| Nova Scotia | 32 | 19 (59) |
| Prince Edward Island | 7 | 5 (71) |
| New Brunswick | 22 | 17 (77) |
| Quebec | 133 | 67 (50) |
| Ontario | 189 | 102 (54) |
| Manitoba | 69 | 51 (74) |
| Saskatchewan | 84 | 53 (63) |
| Alberta | 95 | 54 (57) |
| British Columbia | 84 | 30 (36) |
| Northwest Territories | 5 | 3 (60) |
| Yukon | 3 | 2 (67) |
| Unknown, did not have a postal code | 10 |
Table 2. Distribution of the surveys received according to selected characteristics, n = 421*
| Characteristics | Number received (%) |
| Type of institution | |
| Adult acute, pediatric acute and long term care | 162 (39) |
| Both adult and pediatric acute care | 84 (20) |
| Adult acute and long term care | 48 (11) |
| Adult acute care only | 21 (5) |
| Pediatric acute care only | 6 (1) |
| Long term care only | 18 (4) |
| not answered | 82 (20) |
| Number of beds, n = 403 (removed 18 Long term care institutions) | |
| Mean ± Standard deviation | 178 ± 259 |
| Median (Range) | 75 (3-2247) |
| Over 250 beds | 79 |
| Between 75 and 250 beds | 85 |
| Between 36 and 74 beds | 69 |
| 35 beds or less | 170 |
| Institutions with re-use committee, n = 403* | 41 (10) |
| Re-use committee according to bed size† | |
| Over 250 beds, n = 79 | 30 (38) |
| Between 75 and 250 beds, n = 85 | 7 (8) |
| Between 36 and 74 beds , n = 69 | 4 (6) |
| 35 beds or less, n = 170 | 0 (0) |
| Re-use committee according to type of institution‡ | |
| Adult acute, pediatric acute and long term care, n = 162 | 14 (9) |
| Both adult and pediatric acute care, n = 84 | 12 (14) |
| Adult acute and long term care, n = 48 | 9 (19) |
| Adult acute care only, n = 21 | 6 (29) |
| Pediatric acute care only, n = 6 | 0 (0) |
| not answered, n = 82 | 0 (0) |
| Re-use committee by province | |
| British Columbia, n = 30 | 6 (20) |
| Alberta, n = 49 | 2 (4) |
| Saskatchewan, n = 53 | 0 (0) |
| Manitoba, n = 51 | 6 (12) |
| Ontario, n = 99 | 11 (12) |
| Quebec, n = 62 | 6 (10) |
| New Brunswick, n = 17 | 5 (29) |
| Nova Scotia, n = 18 | 4 (22) |
| Prince Edward Island, n = 5 | 0 (0) |
| Newfoundland, n = 8 | 1 (13) |
| Territories, n = 5 | 0 (0) |
| unknown, n = 6 | 0 |
* 18 institutions
were Long term care only and were removed from the denominator for
the analysis.
† p value < 0.001, there is statistically
significant difference in re-use committee according to the bed
size.
‡ p = 0.25, there is no statistical difference
between the type of institution and the presence or not of a re-use
committee.
Table 3. Anaesthesia Equipment
| Number of Institutions using SUMeDs (%) out of 403 | Ventilator circuits, n = 202 (50%) | Endotracheal tube, n = 291 (72%) |
| No. (%) | No. (%) | |
| Re-used | 105 (52) | 4 (1) |
| Type of Processing | ||
| cleaned and disinfected | 68 | 0 |
| cleaned and sterilized | 33 | 4 |
| cleaned only | 4 | 0 |
| Disinfectant/Sterilization Used | ||
| glutaraldehyde | 17 | 0 |
| quaternary ammonium compounds | 5 | 0 |
| steam autoclave | 7 | 2 |
| ethylene oxide gas | 11 | 1 |
| pasteurization | 68 | 0 |
| hydrogen peroxide | 1 | 0 |
| ortho-phthalaldehyde | 2 | 0 |
| other | 12 | 1 |
| Number of times re-used | ||
| 1 to 5 | 31 | 0 |
| 6 to 10 | 26 | 0 |
| 11 to 20 | 11 | 1 |
| over 20 | 36 | 1 |
| not answered | 1 | 2 |
| Total number of procedures | ||
| 1 to 10 | 4 | 0 |
| 11-100 | 13 | 2 |
| 101-1000 | 34 | 1 |
| over 1000 | 47 | 0 |
| not answered | 7 | 1 |
| Written protocol | ||
| No | 56 | 1 |
| Yes | 27 | 1 |
| Included | 22 | 1 |
| Reuse by province | ||
| British Columbia | 8 | 1 |
| Alberta | 10 | 0 |
| Saskatchewan | 13 | 1 |
| Manitoba | 10 | 0 |
| Ontario | 27 | 0 |
| Quebec | 21 | 2 |
| New Brunswick | 1 | 0 |
| Nova Scotia | 4 | 0 |
| Prince Edward Island | 4 | 0 |
| Newfoundland | 2 | 0 |
| Territories | 1 | 0 |
| Unknown | 4 | 0 |
Table 4. Cardiology Equipment
| Number of Institutions using SUMeDs (%) out of 403 | Cardiac Angiocatheters n = 56 (14%) |
Electrophysiology Catheter n = 33 (8%) |
Balloon
Catheter n = 59 ( 15%) |
| No. (%) | No. (%) | No. (%) | |
| Re-used | 2 (4) | 9 (27) | 1 (2) |
| Type of Processing | |||
| cleaned and disinfected | 0 | 1 | not answered |
| cleaned and sterilized | 2 | 8 | |
| cleaned only | |||
| Disinfectant/Sterilization Used | |||
| glutaraldehyde | 0 | 1 | not answered |
| steam autoclave | 0 | 0 | |
| ethylene oxide gas | 2 | 5 | |
| Sterrad | 0 | 1 | |
| Steris | 0 | 0 | |
| other | 0 | 2 | |
| Number of times re-used | |||
| 1 to 5 | 1 | 2 | not answered |
| 6 to 10 | 1 | 5 | |
| 11 to 20 | 0 | 0 | |
| over 20 | 0 | 1 | |
| not answered | 0 | 1 | |
| Total number of procedures | |||
| 1 to 10 | not answered | 1 | not answered |
| 11-100 | 2 | ||
| 101-1000 | 4 | ||
| over 1000 | 1 | ||
| not answered | 1 | ||
| Written protocol | |||
| No | 0 | 2 | not answered |
| Yes | 0 | 6 | |
| Included | 1 | 0 | |
| not answered | 1 | 1 | |
| Reuse by province | |||
| British Columbia | 0 | 0 | not answered |
| Alberta | 0 | 1 | |
| Saskatchewan | 0 | 1 | |
| Manitoba | 0 | 0 | |
| Ontario | 2 | 3 | |
| Quebec | 0 | 3 | |
| New Brunswick | 0 | 0 | |
| Nova Scotia | 0 | 1 | |
| Prince Edward Island | 0 | 0 | |
| Newfoundland | 0 | 0 | |
| Territories | 0 | 0 | |
Table 4a. Cardiology Equipment con't
| Number of Institutions using Single Use Medical Device (%) out of 403 | Guidewire n = 100 (25%) |
Pacemaker n = 118 (29%) |
Transducer n = 113 (28%) |
| No. (%) | No. (%) | No. (%) | |
| Re-used | 5 (5) | 3 (3) | 2 (2) |
| Type of Processing | |||
| cleaned and disinfected | 0 | 0 | 1 |
| cleaned and sterilized | 5 | 3 | 0 |
| cleaned only | 0 | 0 | 1 |
| Disinfectant/Sterilization Used | |||
| glutaraldehyde | 0 | 0 | 1 |
| steam autoclave | 2 | 0 | 0 |
| ethylene oxide gas | 1 | 3 | 0 |
| Sterrad | 2 | 0 | 0 |
| other | 1 | 0 | 1 |
| Number of times re-used | |||
| 1 to 5 | 2 | 2 | 0 |
| 6 to 10 | 0 | 0 | 1 |
| 11 to 20 | 0 | 0 | 1 |
| over 20 | 1 | 1 | 0 |
| not answered | 2 | 0 | 0 |
| Total number of procedures | |||
| 1 to 10 | 0 | 2 | 0 |
| 11-100 | 1 | 1 | 0 |
| 101-1000 | 0 | 0 | 0 |
| over 1000 | 1 | 0 | 1 |
| not answered | 3 | 0 | 1 |
| Written protocol | |||
| No | 0 | 2 | 1 |
| Yes | 2 | 0 | 0 |
| Included | 0 | 0 | 0 |
| not answered | 3 | 1 | 1 |
| Reuse by province | |||
| British Columbia | 0 | 0 | 0 |
| Alberta | 1 | 1 | 0 |
| Saskatchewan | 0 | 0 | 1 |
| Manitoba | 2 | 1 | 1 |
| Ontario | 0 | 1 | 0 |
| Quebec | 1 | 0 | 0 |
| New Brunswick | 0 | 0 | 0 |
| Nova Scotia | 0 | 0 | 0 |
| Prince Edward Island | 0 | 0 | 0 |
| Newfoundland | 1 | 0 | 0 |
| Territories | 0 | 0 | 0 |
Table 5. Electrophysiology Equipment
| Number of Institutions using SUMeDs (%) out of 403 | Concentric
Needles n = 42 (10%) |
EEG
Needle-Bonnet n = 19 (5%) |
| No. (%) | No. (%) | |
| Re-used | 10 (24) | 3 (16) |
| Type of Processing | ||
| cleaned and disinfected | 0 | 1 |
| cleaned and sterilized | 10 | 1 |
| cleaned only | 10 | 1 |
| Disinfectant/Sterilization Used | ||
| alcohols | 0 | 1 |
| steam autoclave | 1 | 1 |
| ethylene oxide gas | 7 | 0 |
| Sterrad | 1 | 0 |
| not answered | 1 | 1 |
| Number of times re-used | ||
| 1 to 5 | 1 | 0 |
| 6 to 10 | 2 | 0 |
| 11 to 20 | 2 | 1 |
| over 20 | 2 | 1 |
| not answered | 3 | 1 |
| Total number of procedures | ||
| 1 to 10 | 1 | 0 |
| 11-100 | 1 | 0 |
| 101-1000 | 4 | 2 |
| over 1000 | 1 | 0 |
| not answered | 3 | 1 |
| Written protocol | ||
| No | 5 | 3 |
| Yes | 2 | 0 |
| Included | 1 | 0 |
| not answered | 2 | 0 |
| Reuse by province | ||
| British Columbia | 1 | 0 |
| Alberta | 2 | 1 |
| Saskatchewan | 2 | 0 |
| Manitoba | 1 | 1 |
| Ontario | 3 | 0 |
| Quebec | 0 | 0 |
| New Brunswick | 0 | 0 |
| Nova Scotia | 0 | 1 |
| Prince Edward Island | 1 | 0 |
| Newfoundland | 0 | 0 |
| Territories | 0 | 0 |
Table 6. Gastroenterology Equipment
| Number of Institutions using SUMeD (%) out of 403 | Sclerotherapy Needles, n = 126 (31%) | Snares, n = 118 (29%) | Hot Biopsy Forceps, n = 64 (16%) | Microevasive Biopsy Forceps, n = 52 (13%) |
| No. (%) | No. (%) | No. (%) | No. (%) | |
| Re-used | 9 (7) | 42 (36) | 37 (58) | 30 (58) |
| Type of Processing | ||||
| cleaned and disinfected | 2 | 8 | 11 | 4 |
| cleaned and sterilized | 7 | 34 | 26 | 26 |
| cleaned only | 0 | 0 | 0 | 0 |
| Disinfectant/Sterilization Used | ||||
| glutaraldehyde | 6 | 7 | 11 | 5 |
| alcohol | 1 | 0 | 1 | 1 |
| quaternary ammonium compounds | 0 | 1 | 0 | 0 |
| steam autoclave | 2 | 14 | 9 | 9 |
| ethylene oxide gas | 4 | 14 | 14 | 12 |
| Sterrad | 2 | 2 | 2 | 2 |
| Steris | 2 | 10 | 5 | 6 |
| flash steam | 1 | 1 | 4 | 2 |
| hydrogen peroxide | 0 | 0 | 0 | 0 |
| ortho-phthalaldehyde | 0 | 1 | 3 | 2 |
| other | 0 | 1 | 0 | 0 |
| Number of times re-used | ||||
| 1 to 5 | 5 | 11 | 5 | 5 |
| 6 to 10 | 1 | 9 | 4 | 5 |
| 11 to 20 | 2 | 7 | 3 | 1 |
| over 20 | 1 | 11 | 22 | 15 |
| not answered | 0 | 4 | 3 | 4 |
| Total number of procedures | ||||
| 1 to 10 | 3 | 0 | 6 | 1 |
| 11-100 | 5 | 13 | 11 | 3 |
| 101-1000 | 1 | 17 | 18 | 13 |
| over 1000 | 0 | 5 | 1 | 9 |
| not answered | 0 | 7 | 1 | 4 |
| Written protocol | ||||
| No | 7 | 28 | 19 | 9 |
| Yes | 0 | 5 | 9 | 11 |
| Included | 2 | 6 | 7 | 4 |
| not answered | 0 | 3 | 2 | 6 |
| Reuse by province | ||||
| British Columbia | 2 | 2 | 5 | 3 |
| Alberta | 1 | 7 | 7 | 5 |
| Saskatchewan | 0 | 1 | 2 | 2 |
| Manitoba | 0 | 2 | 4 | 3 |
| Ontario | 4 | 10 | 6 | 5 |
| Quebec | 1 | 12 | 8 | 5 |
| New Brunswick | 0 | 3 | 0 | 0 |
| Nova Scotia | 1 | 2 | 1 | 1 |
| Prince Edward Island | 0 | 0 | 0 | 0 |
| Newfoundland | 0 | 1 | 2 | 2 |
| Territories | 0 | 0 | 0 | 1 |
| unknown | 0 | 2 | 2 | 3 |
Table 6a. Gastroenterology Equipment- con't
| Number of Institutions using SUMeDs (%) out of 403 | Guidewires, n = 103 (26%) | Dilators (esophageal), n = 73 (18%) |
Polyp retrieval forceps, n = 80 (20%) | Sphincterotome, n = 71 (18%) |
| No. (%) | No. (%) | No. (%) | No. (%) | |
| Re-used | 44 (43) | 37 (51) | 49 (61) | 38 (54) |
| Type of Processing | ||||
| cleaned and disinfected | 15 | 19 | 10 | 3 |
| cleaned and sterilized | 29 | 18 | 39 | 35 |
| cleaned only | 0 | 0 | 0 | 0 |
| Disinfectant/Sterilization Used | ||||
| glutaraldehyde | 12 | 16 | 5 | 1 |
| quaternary ammonium compounds | 2 | 2 | 0 | 0 |
| steam autoclave | 7 | 5 | 15 | 2 |
| ethylene oxide gas | 20 | 13 | 17 | 25 |
| Sterrad | 7 | 0 | 3 | 7 |
| Steris | 3 | 5 | 6 | 2 |
| flash steam | 0 | 1 | 0 | 0 |
| pasteurisation | 1 | 1 | 0 | 0 |
| ortho-phthalaldehyde | 2 | 1 | 1 | 1 |
| hydrogen peroxide | 0 | 0 | 2 | 0 |
| other | 1 | 0 | 0 | 0 |
| Number of times re-used | ||||
| 1 to 5 | 17 | 9 | 7 | 19 |
| 6 to 10 | 6 | 5 | 11 | 10 |
| 11 to 20 | 4 | 3 | 9 | 7 |
| over 20 | 11 | 19 | 17 | 0 |
| not answered | 6 | 1 | 5 | 2 |
| Total number of procedures | ||||
| 1 to 10 | 7 | 8 | 8 | 4 |
| 11-100 | 15 | 21 | 13 | 13 |
| 101-1000 | 16 | 4 | 19 | 19 |
| over 1000 | 2 | 1 | 4 | 0 |
| not answered | 4 | 3 | 5 | 2 |
| Written protocol | ||||
| No | 29 | 25 | 25 | 24 |
| Yes | 6 | 6 | 9 | 11 |
| Included | 5 | 5 | 10 | 1 |
| not answered | 4 | 1 | 5 | 2 |
| Reuse by province | ||||
| British Columbia | 4 | 1 | 2 | 4 |
| Alberta | 4 | 2 | 3 | 3 |
| Saskatchewan | 5 | 5 | 6 | 5 |
| Manitoba | 1 | 2 | 4 | 1 |
| Ontario | 11 | 9 | 18 | 10 |
| Quebec | 8 | 9 | 8 | 8 |
| New Brunswick | 2 | 1 | 2 | 2 |
| Nova Scotia | 4 | 3 | 4 | 3 |
| Prince Edward Island | 0 | 0 | 0 | 0 |
| Newfoundland | 2 | 1 | 2 | 0 |
| Territories | 0 | 0 | 2 | 0 |
| unknown | 3 | 3 | 0 | 2 |
Table 7. Equipment in the Neonatal Unit
| Number of Institutions using SUMeD (%) out of 403 | Feeding bottles, n = 192 (48%) | O2 Masks, n =209 (52%) | Ambubag, n = 93 (23%) | Breast pump Kit, n = 115 (29%) |
| No. (%) | No. (%) | No. (%) | No. (%) | |
| Re-used | 12 (6) | 38 (18) | 60 (65) | 65 (57) |
| Type of Processing | ||||
| cleaned and disinfected | 2 | 29 | 41 | 16 |
| cleaned and sterilized | 8 | 6 | 13 | 45 |
| cleaned only | 2 | 3 | 6 | 4 |
| Disinfectant/Sterilization Used | ||||
| glutaraldehyde | 0 | 9 | 13 | 5 |
| alcohols | 0 | 1 | 2 | 1 |
| quaternary ammonium compounds | 2 | 1 | 8 | 3 |
| chlorine | 0 | 2 | 1 | 1 |
| steam autoclave | 5 | 1 | 2 | 36 |
| ethylene oxide gas | 1 | 0 | 4 | 7 |
| Sterrad | 0 | 0 | 0 | 2 |
| Steris | 1 | 1 | 1 | 1 |
| pasteurization | 0 | 17 | 18 | 8 |
| ortho-phthalaldehyde | 0 | 0 | 3 | 1 |
| other | 0 | 2 | 6 | 3 |
| not answered | 3 | 0 | 0 | 0 |
| Number of times re-used | ||||
| 1 to 5 | 4 | 8 | 8 | 9 |
| 6 to 10 | 1 | 6 | 7 | 10 |
| 11 to 20 | 0 | 2 | 4 | 4 |
| over 20 | 3 | 9 | 29 | 28 |
| not answered | 4 | 13 | 12 | 14 |
| Total number of procedures | ||||
| 1 to 10 | 2 | 2 | 14 | 10 |
| 11-100 | 5 | 8 | 17 | 16 |
| 101-1000 | 1 | 11 | 15 | 20 |
| over 1000 | 0 | 7 | 2 | 4 |
| not answered | 4 | 10 | 12 | 15 |
| Written protocol | ||||
| No | 1 | 22 | 31 | 29 |
| Yes | 3 | 4 | 5 | 11 |
| Included | 3 | 6 | 9 | 11 |
| not answered | 5 | 6 | 17 | 14 |
| Reuse by province | ||||
| British Columbia | 1 | 2 | 1 | 4 |
| Alberta | 0 | 2 | 4 | 4 |
| Saskatchewan | 2 | 2 | 7 | 9 |
| Manitoba | 1 | 0 | 10 | 8 |
| Ontario | 4 | 14 | 17 | 22 |
| Quebec | 2 | 8 | 7 | 7 |
| New Brunswick | 0 | 3 | 3 | 2 |
| Nova Scotia | 1 | 0 | 5 | 4 |
| Prince Edward Island | 0 | 2 | 0 | 1 |
| Newfoundland | 0 | 1 | 1 | 1 |
| Territories | 0 | 0 | 0 | 0 |
| unknown | 1 | 4 | 5 | 3 |
Table 8. Pulmonary/Respiratory Equipment
| Number of Institutions using SUMeD (%) out of 403 | Nebulizer
Reservoir n = 280 (69%) |
Nebulizer Tubing, n = 296 (73%) | Nasal prongs, n = 312 (77%) |
| No. (%) | No. (%) | No. (%) | |
| Re-used | 87 (31) | 66 (22) | 44 (14) |
| Type of Processing | |||
| cleaned and disinfected | 55 | 42 | 31 |
| cleaned and sterilized | 22 | 11 | 8 |
| cleaned only | 10 | 13 | 5 |
| Disinfectant/Sterilization Used | |||
| glutaraldehyde | 16 | 5 | 17 |
| alcohols | 1 | 3 | 5 |
| quaternary ammonium compound | 3 | 3 | 1 |
| chlorine | 2 | 0 | 1 |
| steam autoclave | 4 | 0 | 1 |
| ethylene oxide gas | 10 | 5 | 3 |
| Sterrad | 1 | 0 | 0 |
| pasteurization | 39 | 38 | 8 |
| ortho-phthalaldehyde | 1 | 1 | 1 |
| other | 14 | 7 | 5 |
| Number of times re-used | |||
| 1 to 5 | 18 | 15 | 5 |
| 6 to 10 | 26 | 15 | 13 |
| 11 to 20 | 6 | 4 | 4 |
| over 20 | 30 | 27 | 21 |
| not answered | 7 | 5 | 1 |
| Total number of procedures | |||
| 1 to 10 | 3 | 1 | 0 |
| 11-100 | 16 | 14 | 10 |
| 101-1000 | 29 | 26 | 22 |
| over 1000 | 30 | 22 | 10 |
| not answered | 11 | 3 | 2 |
| Written protocol | |||
| No | 39 | 37 | 27 |
| Yes | 24 | 13 | 10 |
| Included | 18 | 13 | 6 |
| not answered | 6 | 3 | 1 |
| Reuse by province | |||
| British Columbia | 2 | 2 | 4 |
| Alberta | 8 | 10 | 3 |
| Saskatchewan | 7 | 6 | 5 |
| Manitoba | 12 | 7 | 1 |
| Ontario | 26 | 17 | 13 |
| Quebec | 19 | 14 | 7 |
| New Brunswick | 4 | 4 | 2 |
| Nova Scotia | 4 | 4 | 2 |
| Prince Edward Island | 1 | 0 | 1 |
| Newfoundland | 1 | 1 | 2 |
| Territories | 0 | 1 | 0 |
| unknown | 3 | 0 | 4 |
Table 9. Radiology Equipment
| Number of Institutions using SUMeDs (%) out of 403 | Liver Biopsy Needle, n = 130 (32%) | Bile Duct Stone Extractor, n = 57 (14%) |
| No. (%) | No. (%) | |
| Re-used | 3 (2) | 16 (28) |
| Type of Processing | ||
| cleaned and disinfected | 1 | 1 |
| cleaned and sterilized | 2 | 15 |
| cleaned only | 0 | 0 |
| Disinfectant/Sterilization Used | ||
| glutaraldehyde | 0 | 1 |
| steam autoclave | 2 | 3 |
| ethylene oxide gas | 2 | 10 |
| Sterrad | 0 | 1 |
| Steris | 0 | 1 |
| other | 0 | 1 |
| Number of times re-used | ||
| 1 to 5 | 2 | 19 |
| 6 to 10 | 0 | 2 |
| 11 to 20 | 0 | 1 |
| over 20 | 1 | 4 |
| Total number of procedures | ||
| 1 to 10 | 1 | 6 |
| 11-100 | 2 | 5 |
| 101-1000 | 0 | 4 |
| not answered | 0 | 1 |
| Written protocol | ||
| No | 2 | 10 |
| Yes | 1 | 3 |
| Included | 0 | 2 |
| not answered | 0 | 1 |
| Reuse by province | ||
| British Columbia | 0 | 0 |
| Alberta | 0 | 0 |
| Saskatchewan | 1 | 5 |
| Manitoba | 0 | 1 |
| Ontario | 1 | 2 |
| Quebec | 1 | 4 |
| New Brunswick | 0 | 1 |
| Nova Scotia | 0 | 0 |
| Prince Edward Island | 0 | 1 |
| Newfoundland | 0 | 0 |
| Territories | 0 | 0 |
| unknown | 0 | 2 |
Table 10. Neurosurgery Equipment
| Number of Institutions using Single Use Medical Device (%) out of 403 | Stereotactic Brain Biopsy Needle, n = 15 (4%) |
| No. (%) | |
| Institutions who re-use | 5 (33) |
| Type of Processing | |
| cleaned and disinfected | 0 |
| cleaned and sterilized | 5 |
| cleaned only | 0 |
| Disinfectant/Sterilization Used | |
| iodophor | 1 |
| ethylene oxide gas | 3 |
| Sterrad | 1 |
| Number of times re-used | |
| 1 to 5 | 0 |
| 6 to 10 | 2 |
| 11 to 20 | 0 |
| over 20 | 3 |
| Total number of procedures | |
| 1 to 10 | 3 |
| 11-100 | 2 |
| 101-1000 | 0 |
| not answered | 0 |
| Written protocol | |
| No | 3 |
| Yes | 1 |
| Included | 1 |
| Reuse by province | |
| British Columbia | 0 |
| Alberta | 1 |
| Saskatchewan | 1 |
| Manitoba | 0 |
| Ontario | 2 |
| Quebec | 1 |
| New Brunswick | 0 |
| Nova Scotia | 0 |
| Prince Edward Island | 0 |
| Newfoundland | 0 |
| Territories | 0 |
Table 11. Laparoscopic Surgery Equipment
| Number of Institutions using Single Use Medical Device (%) out of 403 | Laparoscopic Scissors, n = 91 (23%) | Lapaaroscopic Babcock, n = 53 (13%) | Laparoscopic Trocar, n = 128 (32%) | Laparoscopic Multi-seal Reducer, n = 87 (22%) |
| No. (%) | No. (%) | No. (%) | No. (%) | |
| Re-used | 49 (54) | 27 (51) | 23 (18) | 15 (17) |
| Type of Processing | ||||
| cleaned and disinfected | 0 | 0 | 0 | 0 |
| cleaned and sterilized | 49 | 27 | 23 | 15 |
| cleaned only | 0 | 0 | 0 | 0 |
| Disinfectant/Sterilization Used | ||||
| glutaraldehyde | 1 | 0 | 0 | 1 |
| quaternary ammonium compound | 0 | 0 | 1 | 0 |
| steam autoclave | 9 | 6 | 11 | 2 |
| ethylene oxide gas | 23 | 14 | 11 | 11 |
| Sterrad | 9 | 4 | 0 | 0 |
| Steris | 6 | 2 | 1 | 1 |
| plasma | 2 | 0 | 1 | 0 |
| flash steam | 1 | 0 | 2 | 0 |
| other | 1 | 1 | 2 | 1 |
| Number of times re-used | ||||
| 1 to 5 | 11 | 9 | 7 | 4 |
| 6 to 10 | 18 | 3 | 3 | 3 |
| 11 to 20 | 5 | 3 | 3 | 2 |
| over 20 | 12 | 8 | 9 | 6 |
| not answered | 3 | 4 | 1 | 0 |
| Total number of procedures | ||||
| 1 to 10 | 11 | 10 | 5 | 1 |
| 11-100 | 17 | 7 | 9 | 7 |
| 101-1000 | 16 | 7 | 7 | 6 |
| over 1000 | 3 | 0 | 2 | 1 |
| not answered | 2 | 3 | 0 | 0 |
| Written protocol | ||||
| No | 33 | 20 | 18 | 13 |
| Yes | 9 | 2 | 3 | 1 |
| Included | 3 | 3 | 2 | 1 |
| not answered | 4 | 2 | 0 | 0 |
| Reuse by province | ||||
| British Columbia | 3 | 0 | 2 | 1 |
| Alberta | 5 | 1 | 3 | 2 |
| Saskatchewan | 3 | 2 | 2 | 0 |
| Manitoba | 2 | 4 | 4 | 1 |
| Ontario | 12 | 5 | 4 | 2 |
| Quebec | 10 | 4 | 2 | 4 |
| New Brunswick | 1 | 1 | 1 | 1 |
| Nova Scotia | 4 | 3 | 3 | 3 |
| Prince Edward Island | 3 | 2 | 1 | 1 |
| Newfoundland | 2 | 2 | 1 | 0 |
| Territories | 0 | 0 | 0 | 0 |
| unknown | 2 | 3 | 0 | 0 |
Table 11a. Laparoscopic Surgery Equipment- con't
| Number of Institutions using SUMeDs (%) out of 403 | Laparoscopic Dissecting Hook, n = 36 (9%) | Laparoscopic Endo Sciz, n = 50 (12%) | Laparoscopic Endo Shears n = 66 (16%) |
Lapaoscopic Endo Grasp n = 46 (11%) |
| No. (%) | No. (%) | No. (%) | No. (%) | |
| Re-used | 18 (50) | 22 (44) | 27 (41) | 24 (52) |
| Type of Processing | ||||
| cleaned and disinfected | 0 | 0 | 0 | 0 |
| cleaned and sterilized | 18 | 22 | 27 | 24 |
| cleaned only | 0 | 0 | 0 | 0 |
| Disinfectant/Sterilization Used | ||||
| glutaraldehyde | 0 | 0 | 1 | 1 |
| quaternary ammonium compound | 1 | 0 | 0 | 0 |
| steam autoclave | 8 | 5 | 4 | 4 |
| ethylene oxide gas | 7 | 7 | 10 | 14 |
| Sterrad | 2 | 6 | 7 | 3 |
| Steris | 0 | 3 | 4 | 3 |
| plasma | 0 | 0 | 1 | 3 |
| flash steam | 3 | 0 | 0 | 0 |
| other | 1 | 2 | 1 | 0 |
| Number of times re-used | ||||
| 1 to 5 | 1 | 5 | 8 | 8 |
| 6 to 10 | 5 | 8 | 11 | 4 |
| 11 to 20 | 4 | 2 | 3 | 6 |
| over 20 | 6 | 3 | 5 | 4 |
| not answered | 2 | 4 | 0 | 2 |
| Total number of procedures | ||||
| 1 to 10 | 1 | 5 | 4 | 5 |
| 11-100 | 4 | 7 | 11 | 8 |
| 101-1000 | 9 | 4 | 10 | 7 |
| over 1000 | 1 | 1 | 2 | 3 |
| not answered | 3 | 5 | 0 | 1 |
| Written protocol | ||||
| No | 13 | 12 | 20 | 17 |
| Yes | 2 | 5 | 6 | 3 |
| Included | 1 | 1 | 1 | 1 |
| not answered | 2 | 4 | 0 | 3 |
| Reuse by province | ||||
| British Columbia | 1 | 1 | 1 | 3 |
| Alberta | 2 | 1 | 1 | 1 |
| Saskatchewan | 2 | 0 | 3 | 3 |
| Manitoba | 3 | 1 | 1 | 3 |
| Ontario | 3 | 10 | 12 | 9 |
| Quebec | 2 | 4 | 6 | 3 |
| New Brunswick | 2 | 1 | 0 | 0 |
| Nova Scotia | 2 | 1 | 1 | 0 |
| Prince Edward Island | 0 | 0 | 0 | 0 |
| Newfoundland | 1 | 0 | 0 | 0 |
| Territories | 0 | 0 | 0 | 0 |
| unknown | 0 | 3 | 2 | 3 |
Table 12. Orthopaedic Surgery Equipment
| Number of Institutions using Single Use Medical Device (%) out of 403 | Full Radius Tip, n = 62 (15%) |
| No. (%) | |
| Re-used | 9 (15) |
| Type of Processing | |
| cleaned and disinfected | 1 |
| cleaned and sterilized | 8 |
| cleaned only | 0 |
| Disinfectant/Sterilization Used | |
| glutaraldehyde | 1 |
| steam autoclave | 2 |
| ethylene oxide gas | 3 |
| Sterrad | 3 |
| flash steam | 1 |
| Number of times re-used | |
| 1 to 5 | 6 |
| 6 to 10 | 2 |
| not answered | 3 |
| Total number of procedures | |
| 1 to 10 | 1 |
| 11-100 | 4 |
| 101-1000 | 2 |
| not answered | 2 |
| Written protocol | |
| No | 8 |
| Yes | 0 |
| Included | 0 |
| not answered | |
| Reuse by province | |
| British Columbia | 1 |
| Alberta | 0 |
| Saskatchewan | 1 |
| Manitoba | 2 |
| Ontario | 3 |
| Quebec | 1 |
| New Brunswick | 0 |
| Nova Scotia | 1 |
| Prince Edward Island | 0 |
| Newfoundland | 0 |
| Territories | 0 |
Table 13. Urology Equipment
| Number of Institutions using Single Use Medical Device (%) out of 403 | Urodynamic Catheters, n = 88 (22%) | Transducers, n = 47 (12%) |
| No. (%) | No. (%) | |
| Re-used | 11 (13) | 11 (23) |
| Type of Processing | ||
| cleaned and disinfected | 1 | 1 |
| cleaned and sterilized | 10 | 7 |
| cleaned only | 0 | 3 |
| Disinfectant/Sterilization Used | ||
| glutaraldehyde | 1 | 1 |
| alcohols | 0 | 3 |
| steam autoclave | 0 | 1 |
| ethylene oxide gas | 6 | 5 |
| Sterrad | 3 | 1 |
| hydrogen peroxide | 1 | 0 |
| other | 1 | 1 |
| Number of times re-used | ||
| 1 to 5 | 3 | 2 |
| 6 to 10 | 1 | 3 |
| 11 to 20 | 1 | 1 |
| over 20 | 3 | 2 |
| not answered | 3 | 3 |
| Total number of procedures | ||
| 1 to 10 | 1 | 0 |
| 11-100 | 1 | 5 |
| 101-1000 | 5 | 4 |
| over 1000 | 1 | 0 |
| not answered | 3 | 2 |
| Written protocol | ||
| No | 6 | 7 |
| Yes | 3 | 3 |
| Included | 0 | 1 |
| not answered | 2 | |
| Reuse by province | ||
| British Columbia | 2 | 2 |
| Alberta | 1 | 1 |
| Saskatchewan | 2 | 3 |
| Manitoba | 3 | 0 |
| Ontario | 2 | 3 |
| Quebec | 0 | 1 |
| New Brunswick | 0 | 0 |
| Nova Scotia | 1 | 1 |
| Prince Edward Island | 0 | 0 |
| Newfoundland | 0 | 0 |
| Territories | 0 | 0 |
Table 14. Miscellaneous Equipment
| Number of Institutions using Single Use Medical Device (%) out of 403 | Paracentesis Needle, n = 171 (42%) |
| No. (%) | |
| Re-used | 5 (3) |
| Type of Processing | |
| cleaned and disinfected | 0 |
| cleaned and sterilized | 5 |
| cleaned only | 0 |
| Disinfectant/Sterilization Used | |
| steam autoclave | 3 |
| ethylene oxide gas | 1 |
| other (drx) | 1 |
| Number of times re-used | |
| 1 to 5 | 2 |
| 6 to 10 | 0 |
| 11 to 20 | 2 |
| over 20 | 1 |
| Total number of procedures | |
| 1 to 10 | 4 |
| 11-100 | 0 |
| 101-1000 | 0 |
| over 1000 | 1 |
| Written protocol | |
| No | 3 |
| Yes | 0 |
| Included | 1 |
| not answered | 1 |
| Reuse by province | |
| British Columbia | 0 |
| Alberta | 0 |
| Saskatchewan | 1 |
| Manitoba | 1 |
| Ontario | 1 |
| Quebec | 2 |
| New Brunswick | 0 |
| Nova Scotia | 0 |
| Prince Edward Island | 0 |
| Newfoundland | 0 |
| Territories | 0 |
Table 15. List of single use medical devices that were surveyed and not listed in the previous tables
| Category | Type of Medical Device | Description |
| Anaesthesia | Non-critical | Oral airways End-tidal CO2 tubing Bite block Intubating stylettes |
| Dermatology | Semi-critical | Electrocautery tip (hyfrecator) |
| Dialysis | Non-critical | Recirculating connector Clamp for PD catheter Plastic adaptor for CVC's |
| Gastroenterology | Critical | Cytology brushes Coagulation electrohemostatis catheter Endoscopy baskets Balloon extractor Loop electrode |
| Semi-critical | Esophageal stent Bite block |
|
| Neonatalogy | Non-critical | ECG leads Pulse oximeter probes Humidifer tubing |
| Ophthalmology | Semi-critical | Eye drops |
| Pulmonary/Respiratory | Non-critical | Mouthpieces for pulmonary function tests Methacholine reservoir Methacholine tubing Aerochamber Tracheostomy tubing Medication nebulizer T-piece |
| Laparoscopic equipment | Critical | Cavitron micro needle tip Allis clamp Lung forcep Hassan Ultracision 1-seal reducer Knife down 5 Endo lung duval Versaports Surgiport Surgineedle Endo dissect Endo dissector roticulator Endo close Thoracoport |
| Semi-critical | Laparoscopic sleeves | |
| Orthopedic Surgery | Critical | Anspatch tip (planer) |
| Urology | Semi-critical | Penile ring (plethysmography) |
| Colorectal Surgery | Semi-critical | Rectal manometry catheter Manometry tubing |
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