Sustainability innovation
Foundation Trust and Polyco Healthline. The PiP has registered design rights both in the UK and selected international territories and is a registered medical device with the Medicines and Healthcare Products Regulatory Agency (class 1 In-Vitro Device for the collection of urine) and hence CA-mark approved.
The case for change The introduction of the PiP offers several benefits based on the experience of the Somerset Health system, though these may vary according to local practices. Potential savings in consumables spend:
At SFT, annual savings of approximately £1,900 have been realised through reduced use of individual plastic items along the end-to-end MSU collection and urinalysis pathway. At SFT the streamlined process saves on
average 20-seconds every time a healthcare assistant has assisted a patient in providing a MSU sample, that equates to around 117 hours of healthcare assistant (HCA) time saved per year that has now been re-allocated to front line patient care. The efficiency of MSU sample turnaround time has been improved, as previously pathology laboratory technicians had to decant urine from a 30ml red top boric acid tube into a urinalysis tube. The new process ensures that the correct sized tube containing the MSU sample is received directly from the care setting. For two acute sites, this represents a time saving of 264 hours of laboratory technician time a year that has been re-directed to other critical tasks. In a carefully controlled microbiological safety study, the PiP produced MSU sample contamination rates of below 1% which were the same as the rates observed when MSU sample collection was made using a sterile plastic vessel. The standards for the microbiological
healthcare for the collection of a MSU sample where a Urinary Tract Infection (UTI) is suspected including the use of pulp products that are non-sterile, which consume more energy in manufacture and have very different material properties. Also, a wide variety of sterile and non-
sterile plastic consumable products are used. Our stance has followed the advice of independent and our own Infection Prevention and Control Microbiologists and our Infection Prevention and Control
team that asked for assurance that the use of the PiP was not different in terms of microbiological safety to a sterile plastic pot.
investigation of urine suggest that the specimen vessel used should minimise the risk of contamination and other nursing and clinical guidelines advocate for the use of a wide- necked sterile vessel. One of our sustainability objectives outlined within our Green Care Action Plan has been to reduce the use of individual use plastic items. The introduction of the PiP has achieved that. Our estimations suggest that widespread use of the PiP could save the NHS three tonnes of carbon annually in terms of reduced carbon emissions. The reduction in our previous MSU collection and processing pathways based on a life cycle carbon analysis suggest a carbon saving of between 78- 87%. That saving will differ between providers. Non-compliant practice: We note that many alternative practices exist across providers of
Evidence of social value measured As with any innovation, acceptability in terms of its use, design and ease of use and packaging is important. Our anti-nesting feature was modified based upon early feedback from clinical teams and the shape of the PiP designed to allow for decant out of excess urine but with sufficient volume to allow for a clean catch specimen. Education of healthcare professionals and patients is important to ensure they hold the PiP from underneath or placed within a commode liner, where a patient has mobility issues to collect the MSU specimen. We have measured patient feedback and
feedback from HCAs who were involved in assisting patients in MSU specimen collection and that has been very positive and is reported on our website:
www.peeinpot.com Further feedback from IPC teams led to
us including the instructions for use on the external packaging to the individual cartons of the PiPs (25 per carton) and the design of those instructions, to ensure they are easy to follow and relevant.
Lessons learned Auditing MSU collection procedures across various care settings reveals process variability. It is helpful to complete this pre-analytic step with input from procurement, sustainability and Infection Prevention and Control (IPC) teams. It is helpful to have a project lead from relevant clinical stakeholders. Care settings such as your Emergency Department, Care of the Elderly Ward or Acute Frailty Unit, Urology Surgery Pre- Operative Assessment Clinic, Ante-natal Clinic are suggested areas to audit and engage with. Engage your pathology laboratory early in the discussions so that there is an understanding of how MSU samples are currently received by the laboratory whether from secondary care
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