Cost savings and quality improvement--single-use suture instruments?
OBJECTIVE
To determine if the instruments found in single-use suture kits are of satisfactory quality when compared with re-useable instruments and to determine the cost implications of changing to these kits.


METHODS
Audit of established practice, followed by trial of new suture kits and their introduction to the department. The new practice was then audited. A cost analysis was conducted.


RESULTS
The audit showed numerous problems with the traditional suture kits (instruments were breaking or no longer suitable for suturing wounds). A trial of single-use instruments demonstrated them to be high quality and provided new instruments each time. A repeat audit at one year post-introduction demonstrated no identifiable problem with the new suture kits. The subjective impression of staff was of an improvement compared to the old kits. Costs of sterilising suture instruments were determined and it was found that single use suture kits were cost effective. Assuming an average usage of 150 kits per month, at pound 4.45 each cost for sterilisation, and a total cost of pound 3.05 each for a single-use suture kit plus dressing pack per patient, this yielded a projected cost saving of pound 2520.00 per annum. The actual cost saving was pound 1981.00 that year. The shortfall was due to overestimation of average usage.


CONCLUSIONS
Single use instruments would appear to be safe and cost effective in the emergency department setting.
Harden
J L
JL
Emergency Department, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom. john.harden@nhs.net
Hiscox
J A
JA
D017046:Cost Savings; D004209:Disposable Equipment / Q000191:economics*; D004867:Equipment Design; D006801:Humans; D011785:Quality Assurance, Health Care; D013242:Sterilization / Q000191:economics; D013537:Sutures / Q000191:economics* / Q000592:standards*; D006113:United Kingdom; D014947:Wounds and Injuries / Q000191:economics / Q000601:surgery*