4 reasons to rethink disposable ECGs lead wires

Dec. 22, 2021

Infection prevention (IP) has been top of mind for clinicians as they have worked to stem the spread of SARS-CoV-2 (COVID-19) among their patient populations. While developing and implementing infection prevention (IP) protocols specifically aimed at COVID-19, many clinicians have taken a step back to examine their facility’s overall approach to combatting healthcare acquired infections (HAI).

In light of research showing high levels of bacterial contamination of certain reusable patient interfaces,1,2 U.S. hospitals have increasingly switched to single-patient use monitoring accessories such as non-invasive blood pressure (NIBP) cuffs, pulse oximetry probes, and disposable ECG wires.3,4 Nonetheless many hospitals continue to utilize reusable versions of many other high volume, low cost consumables.

For example, few have converted from reusable to single patient use electrocardiogram (ECG) electrodes.5 This is despite the fact that it has been shown that reusable ECGs can harbor dangerous microbes, including vancomycin-resistant enterococci (VRE). For example, in one study, researchers found 77% of “supposedly clean” wires were contaminated with antibiotic-resistant bacteria.6

The cost to treat a single patient with an HAI can be as high as nearly $50,0007 and is no longer reimbursed by CMS. As they rethink their IP strategies, a growing number of hospitals are reevaluating this risk area.

Here are four reasons to rethink disposable ECGs beyond infection risk alone:

1. Patient care and satisfaction

The trend of consumer driven healthcare and the role of the patient in deciding where he or she will be treated has increased competition among healthcare provider organizations. Research from Accenture found, “U.S. hospitals that deliver ’superior’ customer experience achieve net margins that are 50 percent higher, on average, than those of hospitals providing ‘average’ customer experience.”8

Healthcare institutions want the best for their patients and strive to be considered high-quality in their communities. Therefore, these institutions put patient care and safety first in every choice that they make. This includes using the best quality capital equipment along with the best quality accessories. 

High-quality, disposable ECG lead wires free of wear and tear can reinforce to the patient the quality and safety of a healthcare institution’s care delivery. As patients increasingly research hospital infection rates and complications, it is even more important to avoid HAIs related to reusable devices.

2. Clinical efficacy and staff satisfaction

Another downside of reusable ECGs compared with disposable is durability and reliability. The internal wires fray over time, leading to artifact on the electrocardiogram tracing.9 Clinicians can become frustrated as they look to find fault with the monitor when in reality a deteriorating ECG lead wire set is the cause.

When an ECG fails, the clinician has to take off the lead wires and put on new ones, which can prolong care delivery and cause additional patient discomfort. It’s important to note that less “patient touches” can drive higher patient satisfaction rates and decrease the opportunity of nosocomial infections.

A study performed in cardiac telemetry units found significantly fewer false-alarms with disposable ECG versus reusable, with the researchers concluding that disposable ECG “may save nurses time, decrease alarm fatigue and improve patient safety.”10

3. Patient care continuity

Today, technology is available where you can secure for your patient a disposable ECG set and a disposable NIBP cuff that can be used from admission to discharge. Adapters enable these disposable items to be used across various brand monitors and have been tested and validated with these manufacturers’ devices.

Therefore, if a patient moves from one brand of monitor in the ER to a different brand in the ICU, the same disposable cuff and ECG set can move with him or her. This approach supports continuity of care, with clinical staff not having to switch lead wires each time the patient is moved. There are also potential cost savings benefits from using a single ECG lead set throughout the patient’s stay, rather than having to use multiple forms of this item due to monitor incompatibility.

4. Supply standardization and savings

Health systems and hospitals are increasingly working to standardize on supplies in an effort to reduce complexity and costs. Those that use ECG lead wires from various companies must engage in the procure-to-pay (P2P) process with each manufacturer, manage each brand’s inventory and find adequate storage space to house the variety of items.

By standardizing on one brand of disposable ECG lead wires, you can streamline your P2P and inventory management processes, while reducing storage requirements. Supplier consolidation can also enable you to capitalize on bulk buy discounts for this particular item.

To further reduce complexity and generate greater savings, consider standardizing on one manufacturer that has capital equipment and consumables/accessories for multiple areas of the hospital (e.g., anesthesia, ventilation, monitoring, etc.) and the service to support these items. Conclusion Supply costs, care quality and financial outcomes are always top of mind for healthcare organizations. While it may be a rather small, inexpensive item compared with many of the other items you procure and use in your organization today, an ECG lead set can have a big impact in many different areas. Taking the time to rethink disposable ECGs lead wires could result in far reaching benefits for your organization, staff and patients. 

References
1 Walker N, Gupta R, Cheesbrough J, Blood pressure cuffs: friend or foe? Journal of Hospital Infection, June 2006, https://www.sciencedirect.com/science/article/abs/pii/S0195670106000430
2 de Gialluly C, Morange V, de Gialluly E, Loulergue J, van der Mee N, Quentin R. Blood pressure cuff as a potential vector of pathogenic microorganisms: a prospective study in a teaching hospital. Infect Control Hosp Epidemiol. 2006 Sep;27(9):940-3. doi: 10.1086/507284. Epub 2006 Aug 21. PMID: 16941320. https://pubmed.ncbi.nlm.nih.gov/16941320/
3 As Disposables Become More Popular, Hospital-based Sleep Labs Discuss What to Expect, Sleep Review January 15, 2018, https://www.sleepreviewmag.com/practice-management/money/financial-management/disposables-sleep-labs-what-to-expect/
4 Disposable Medical Supplies Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2018 – 2026, Transparency Market Research, https://www.transparencymarketresearch.com/disposable-medical-supplies-market.html
5 ECG equipment, Wired for infection? Nursing, December 2006, https://journals.lww.com/nursing/Fulltext/2006/12000/ECG_equipment__Wired_for_infection_.56.aspx
6 Houghton D, ECG equipment Wired for infection? Nursing 2006, https://journals.lww.com/nursing/Fulltext/2006/12000/ECG_equipment__Wired_for_infection_.56.aspx
7 Schmier JK, Hulme-Lowe CK, Semenova S, et al. Estimated hospital costs associated with preventable health care-associated infections if health care antiseptic products were unavailable. Clinicoecon Outcomes Res. 2016;8:197-205. Published 2016 May 13. doi:10.2147/CEOR.S102505 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874552/
8 U.S. Hospitals that Provide Superior Patient Experience Generate 50 Percent Higher Financial Performance than Average Providers, Accenture Finds, Accenture, May 11, 2016, https://newsroom.accenture.com/news/us-hospitals-that-provide-superior-patient-experience-generate-50-percent-higher-financial-performance-than-average-providers-accenture-finds.htm
9 How single-use electrocardiography lead wires can help improve patient safety & reduce costs, Becker’s Hospital Review, May 28, 2020, https://www.beckershospitalreview.com/infection-control/how-single-use-electrocardiography-lead-wires-can-help-improve-patient-safety-reduce-costs.html?oly_enc_id=4424G0600690D0Y
10 Albert NM, Murray T, Bena JF, Slifcak E, Roach JD, Spence J, Burkle A. Differences in alarm events between disposable and reusable electrocardiography lead wires. Am J Crit Care. 2015 Jan;24(1):67-73; quiz 74. doi: 10.4037/ajcc2015663. PMID: 25554556. https://pubmed.ncbi.nlm.nih.gov/25554556/