The Reprocessing and Reuse ofSingle-Use Medical Devices inNewfoundland & Labrador
Bibliographic record
Abstract
The Issue Across Canada, the practice of reusing medical devices intended for single use is evolving. Health institutions that once routinely reused single-use devices (SUDs) that had been reprocessed in-house have moved away from such practices because of growing concerns about patient safety and potential legal liability. In Newfoundland and Labrador (NL), since 2008, three of the four regional health authorities have issued policies that essentially prohibit the reprocessing and reuse of SUDs. Variation exists, however, in the wording of such policies and in the alignment of clinical practice with these policies. The Findings This report is based primarily on the evidence from a single systematic review produced in French by AETMIS1 and subsequently contextualized by us for the province of NL with input from local stakeholders with expertise in infection prevention and control. The study by AETMIS reviewed 19 types of critical2 and semi-critical3 medical devices and found that, with the possible exception of the reuse of hemodialysis membranes in the same patient, there was insufficient evidence to support, in clinical practice, the reprocessing and reuse of the devices reviewed. Moreover, the economic evidence on cost-effectiveness was insufficient to support the reprocessing and reuse of SUDs. Provincially, while most current policies prohibit reuse, local factors identified in the report appear to contribute to the continued potential risk of reuse of SUDs in both public and private health care settings. Reuse of devices reprocessed by third parties in the United States is currently done in several jurisdictions across Canada but, in the absence of strong scientific evidence to support this practice, it is fraught with regulatory, legal and ethical dilemmas as outlined in the full report.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.078 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.008 | 0.011 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".