The infection preventionist brings a unique and vital perspective to the product selection process by mediating pressure on resource utilization
( e . g ., reuse of medical devices ), evaluating and reducing infection risks associated with product change , ensuring patient safety , and providing expertise in clinical literature review .” of infections , clinical trials have yielded mixed results ; they also observed a variance in CAUTI rates among hospitals and nursing units within the system . Further review revealed variances in the nursing protocol / policy for aseptic insertion of indwelling catheters . As Premier ( 2020 ) explains , “ With the help of the value analysis team and clinical education staff , the health system elected to standardize the nursing protocol / practice and provide enhanced education to staff in lieu of purchasing a more expensive product . They were able to decrease the CAUTI rate and sustain it . In this example , a change in process addressed the problem . Because the value analysis team and clinical education staff revealed a better solution , purchasing a new product was no longer the only or best option .”
Kilgore recommends that before recommending a product or medical device , the clinician should look consider the following :
➊ What is the quality of the product compared to what is already in use at your facility or is this a completely new product / device ?
➋ Does this address the greatest threat of real harm to the patients ?
➌ Are there potential unintended side effects / complication of using this product or device ?
➍ Is there an FDA-approved indication ?
➎ Have there been any review recalls and FDA citations ?
➏ Does the product or device require EPA registration ?
➐ Is the vendor a part of your group purchasing organization ( GPO )?
➑ What is the cost to make this change ?
➒ How difficult is it to educate staff to use safely on patients ?
Adding to this list may be the need to keep in mind current pandemic- and healthcare supply chain-related challenges . “ During the pandemic , hospitals experienced a severe shortage of personal protective equipment ( N95s , surgical / procedure masks , gloves , isolation gowns ), disinfectant products and other critical devices ( ventilators , tubing etc .),” Kilgore reminds clinicians . “ A way to increase visibility is to always have greater transparency between supply chain and stakeholders / end-users . Another recommendation would be to not limit yourself to only one vendor in your institution ’ s GPO for products .”
When evaluating new purchasing requests , Premier ( 2020 ) says value analysis teams can use the following guiding questions to assess the problem and potentially offer alternate solutions :
• What problem are we trying to solve ? Is there a problem to solve ?
• What possible root causes exist ? Is there a process / practice element that contributes to the problem ?
• Is the problem ’ s existence or severity variable across our facilities / departments ?
• Is clinical practice standardized across our facilities / departments ?
• What outcome is measured , or can be measured , to monitor improvement ?
According to Premier ( 2020 ), “ The goal of this exercise is to explore the problem and shape the best response ( process and / or product ). This exploration will lead the team to more questions , followed by more research to refine the opportunity and its value . Expanded exploration allows the team to collect different perspectives from various stakeholders , test assumptions and answer outstanding questions . The end output will be a solution that focuses on a validated problem .”
Halvorson and Chinnes ( 2009 ) concur , noting , “ As economic pressures in healthcare increase , the philosophy of product selection must continue to be objective , scientific , and need-based . Because many elements must be considered when products are being selected for use in the healthcare setting , it is likely that the product evaluation committee will continue to play an important role in improving patient outcomes , promoting employee safety , and affecting the organization ’ s bottom line . The infection preventionist brings a unique and vital perspective to the product selection process by mediating pressure on resource utilization ( e . g ., reuse of medical devices ), evaluating and reducing infection risks associated with product change , ensuring patient safety , and providing expertise in clinical literature review .”
References :
Miller BE and Kelly RE . Product Evaluation . APIC Text of Infection Control & Epidemiology , 3rd edition , 2009 .
Halvorson CK and Chinnes LF . Collaborative Leadership in Product Evaluation . AORN J 2007 ; 85 ( 2 ): 334-352 .
Premier . Value Analysis Guide . Fourth Edition , 2020 .