Multipatient use of prefilled disposable oxygen humidifiers for up to 30 days: Patient safety and cost analysis

Abstract

BACKGROUND: Prefilled disposable oxygen humidification units have been shown to decrease the likelihood of contamination when compared to reusable oxygen humidification units. However, prefilled disposable humidifiers are expensive when used for single patients, especially in areas of high turnover, and it is not known whether these units need to be routinely changed before they are empty. The number of patients safely using a prefilled disposable humidifier has not been documented in previously reported work. Are patients at risk of nosocomial infections due to cross- contamination when prefilled disposable oxygen humidifiers are applied to multipatient use? What are the cost benefits of multiple patient use of prefilled disposable oxygen humidifiers? When local practice or physician preference dictates the use of humidification for low-flow oxygen, these questions need to be answered. METHODS AND MATERIALS: Data were collected over two time periods to address changes due to seasonal variations and include area of use, number of patients, and quantitative cultures for aerobic microorganisms (including Legionella). Each disposable humidifier was monitored for a period of 1 month or until only 1 inch of water remained. Costs of using reusable humidifiers and prefilled humidifiers and therapist/nurse time to initiate therapy with both units were compared. During this period, 60 reusable humidifiers were also cultured for aerobic microorganisms and Legionella. RESULTS: We report results on 1,311 of the 1,315 disposable prefilled oxygen humidifiers used. We saw no significant growth in any of the prefilled disposable humidifiers for periods of up to 30 days, with > 100 humidifiers having been used by > 20 patients. CONCLUSIONS: Our results show that prefilled disposable oxygen humidifiers can be used without cross-contamination, on multiple patients, for a period of 1 month. The use of prefilled humidifiers in this way represents a substantial cost saving when compared to reusable humidifiers.