Sowerby Leigh J, Rudmik Luke
Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario.
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Laryngoscope. 2018 Jan;128(1):64-71. doi: 10.1002/lary.26770. Epub 2017 Aug 16.
Nasopharyngoscopes are an essential instrument to otolaryngologists; reprocessing them in a high-value manner is paramount. Although several different techniques for reprocessing exist, all methods yield similar effectiveness. Given equivalent effectiveness outcomes, a cost analysis of four nasopharyngoscope reprocessing techniques was performed.
Cost-minimization analysis.
Four techniques were evaluated: 1) an automated reprocessor using peracetic acid (Steris System 1; Steris Canada Inc., Mississauga, Canada), 2) an automated reprocessor using ortho-phthalaldehyde (OPA) (Cidex OPA; Advanced Sterilization Products, Johnson and Johnson Inc., Markham, Canada), 3) a manually performed accelerated hydrogen peroxide bath (Revital-Ox; Steris Canada Inc.), and 4) a chlorine dioxide wipe (Tristel Trio Wipes System; Tristel plc, Cambridgeshire, U.K.). The costing perspective was a third-party payer that was adjusted to 2014 Canadian dollars. The base-case scenario used an annual volume of 4,153 reprocessing events in a tertiary care setting, and a scenario analysis assessed the impact of volume and capital expense.
The cost per reprocessing event for the Steris (Steris Canada Inc.) automated endoscope reprocessing, Cidex OPA (Advanced Sterilization Products), Revital-Ox (Steris Canada Inc.), and Tristel Trio Wipes (Tristel plc) were $20.58, $14.20, $9.57, and $13.14, respectively. Scenario analysis demonstrated the Tristel Trio Wipes System (Tristel plc) was the least expensive method in practices with low reprocessing volumes (a threshold of less than 6 events per day, or 22 per week), whereas the Revital-Ox (Steris Canada Inc.) system was least expensive at higher volumes and became substantially more so as volumes increased.
A manual accelerated hydrogen peroxide bath offers the least costly approach to nasopharyngoscope reprocessing. The convenience and portability of the Tristel Trio (Tristel plc) system may be a good alternative for low reprocessing volumes, or when rapid turnaround is necessary.
NA. Laryngoscope, 128:64-71, 2018.
鼻咽喉镜是耳鼻喉科医生的重要工具；以高性价比的方式对其进行再处理至关重要。尽管存在几种不同的再处理技术，但所有方法的效果相似。鉴于效果相当，对四种鼻咽喉镜再处理技术进行了成本分析。
成本最小化分析。
评估了四种技术：1）使用过氧乙酸的自动再处理器（Steris System 1；加拿大Steris公司，安大略省密西沙加），2）使用邻苯二甲醛（OPA）的自动再处理器（Cidex OPA；高级消毒产品，强生公司，加拿大万锦市），3）手动进行的加速过氧化氢浴（Revital - Ox；加拿大Steris公司），4）二氧化氯擦拭（Tristel Trio擦拭系统；英国Tristel公司，剑桥郡）。成本计算视角为第三方付款人，并根据2014年加拿大元进行调整。基础案例假设在三级医疗环境中每年进行4153次再处理事件，情景分析评估了处理量和资本支出的影响。
Steris（加拿大Steris公司）自动内镜再处理、Cidex OPA（高级消毒产品）、Revital - Ox（加拿大Steris公司）和Tristel Trio擦拭（Tristel公司）每次再处理事件的成本分别为20.58美元、14.20美元、9.57美元和13.14美元。情景分析表明，对于再处理量较低的实践（每天少于6次事件的阈值，或每周22次），Tristel Trio擦拭系统（Tristel公司）是最便宜的方法，而Revital - Ox（加拿大Steris公司）系统在处理量较高时最便宜，并且随着处理量增加成本大幅降低。
手动加速过氧化氢浴是鼻咽喉镜再处理成本最低的方法。Tristel Trio（Tristel公司）系统的便利性和便携性对于再处理量较低或需要快速周转的情况可能是一个很好的选择。
无。《喉镜》，2018年，第128卷，第64 - 71页。
