Behind the mask: Clinician practices and attitudes on reprocessing positive airway pressure (PAP) devices

There are no evidence-based guidelines concerning reprocessing of positive airway pressure (PAP) devices between users. Consequently, current practices are based on local policies and interpretation of manufacturer instructions. As many PAP users start with loaned equipment, understanding PAP device hygiene is a priority. Little is known about PAP device reprocessing procedures or clinician confidence in reprocessing procedures across Australia.

An online anonymous survey was administered to clinicians involved in reprocessing PAP devices between users. This survey was sent to both targeted clinicians known to provide non-invasive ventilation (NIV) and openly circulated to any clinician managing PAP devices via mailing lists, to understand current practices.

There was a response rate of 41 % (20/49) for targeted respondents with a total of 66 completed responses. 53 % of respondents had >10 years of experience with 86 % providing NIV. Confidence in NIV machine reprocessing in institutions was 81 mm (IQR 70-90.5 mm) on a 100 mm visual analogue scale. Less than 30 % of respondents described specific cleaning processes for multi-resistant organisms (MROs). A device isolation period before reissue occurred at 26 % of sites providing home NIV. Thematic analysis identified waste concerns due to mandated single use items, uncertainty about MROs and evolving requirements for tracking of equipment.

This is the first known survey investigating PAP reprocessing practices by experienced clinicians, showing limited procedural variability with variable confidence in procedures used. Evidence-based guidelines are needed to reduce uncertainty and practice variability with consideration of risk mitigation and principles of sustainable healthcare.