…what does this really mean? What about “discard after single use”? There are long lists of medical devices that are labeled with this statement. What I am referring to is the statement printed on the packaging of disposable syringes or on the syringe itself.

Ok, I know what you are thinking. Isn’t it a given that nurses know what this mean? Well, I’m not sure and I know that this is not a prevailing practice in acute care settings, but infusion therapy is delivered in many other clinical settings where some infection control practices may be overlooked for whatever reason.

As a nurse consultant, I work with physicians’ offices providing infusion services where I have the opportunity to visit and evaluate their infusion process and services. In several locations, I have observed that some nurses reuse syringes. When asked why they reuse the syringe, the reply I get is either – “why not? I use (re-use) it for the same patient or I use (re-use) for the same medication I previously withdrew.” When I pointed out that the label on the syringe has the “single use only” statement, I get the “deer in the headlight” look. Honestly, it never occurred to me that a nurse would ever re-use a syringe. I am not implying that this is a common practice in physician based infusion centers. I am simply stating that I have seen first hand a few RN’s do this. This practice and thought process has bothered me so much that I couldn’t forget about it. I needed to find evidence so I did an extensive research. However, all I found in the literature is the reference to the reuse of medical or surgical invasive devices, nothing on the re-use of syringes. One thing I did find is a definition from the FDA CDRH.

The definition from the CDRH (Centers for Devices and Radiologic Health, a division of the FDA) of a single-use device, also referred to as a disposable device, is intended for use on one patient during a single procedure. It is not intended to be reprocessed (cleaned, disinfected/sterilized) and used on another patient. The labeling may or may not identify the device as single use or disposable and does not include instructions for reprocessing. 1

Clearly, this definition means…do not reuse. Sometimes, little thought is given when measures are taken in an effort to reduce costs. I get “cost effectiveness” but not to the degree it compromises sterility and infection control practices. It was also pointed out to me that the practice is not illegal, but is it ethical? As registered nurses, we have a duty to do no harm and to promote good and act in the best interest of our patients. There is no doubt that reuse of single use only devices has a direct impact on patient safety, increased infection risk, and threat to product quality. Would you reuse a syringe if the patient is your mother or loved one?

Reference:
1. Labeling Recommendations for Single-Use Devices Reprocessed by Third Parties and Hospitals; Final
Guidance for Industry and FDA (July 30, 2001), available at http://www.fda.gov/cdrh/comp/guidance/1392.html.

Disclosure: The pictures are intended to show the label on the product or packaging only and not intended to implicate the manufacturer of the device.