SUS TAINABL E HEALTHCARE
some have dubbed as “hygiene theatre” – where staff in non-clinical settings such as bars or cafes don PPE in situations that don’t strictly require PPE, and so the PPE ends up being a prop to reassure the public that high standards of cleanliness are at work.8
If
the global community temporarily accepted that disposable PPE was a necessary evil in an acute moment of crisis, the challenge becomes that of convincing everyone that such moments are relatively short-lived, and that this temporary solution has to be scaled back significantly.
NTH Solutions provides a range of
support services to its parent Trust and a wide range of healthcare and community providers across the country and many of its key products are designed to replace environmentally intensive products with greener options. A prime example would be the company’s championing of hypochlorous acid for use in domestic cleaning; the chemical has had proven success in care home settings9
and is currently being trialled
in a controlled study at University Hospital of North Tees.
Known as electrolysed water in America, and used globally in wound treatment, food preparation and other industries, hypochlorous acid is a chemical produced by our own immune system, which is a natural disinfectant, proven to kill 99% of known or tested pathogens, including enveloped viruses such as coronavirus. The chemical breaks down into salt and water after 30-60 days and is so gentle to humans that is has no COSHH implications attached to it, all while being highly powerful.
The challenge associated with hypochlorous acid is its short shelf-life, which is why NTH Solutions manages a delivery service supplying its own brand of the solution to its customers, with revenue generated being reinvested back into NHS Trusts to improve frontline services. Similarly, NTH Solutions provides a fully-managed reusable gown service, using gowns made from polyester woven through with carbon fibre. These gowns meet EU regulations as a Class One medical device, with each gown
fit for up to one hundred uses, and recycling at end-of-life, which eliminates the need for landfill or incineration (see fig. 1). The challenging of misconceptions is fundamental to the introduction of any new idea or product. Hypochlorous acid for example is colourless and only produces a faint chlorine scent when activated. It lacks the bright colour and strong smell of bleach, even if these are just placebos to convince us of how powerful it is. This means that when I go into a school or care home for example, and present the evidence in a side-by-side comparison, there is usually an acceptance that bleach is harmful to the environment, but it is trusted to ‘get the job done’ and the benefit therefore outweighs the risk.
This is why NTH Solutions have made additional efforts to make the case for hypochlorous acid, investing in research in collaboration with an independent lab and the Trust, and building an educational programme that goes into the community and presents the case for the product as well as teaching people how to enhance the efficacy of their cleaning techniques in face- to-face training sessions. Reusable gowns face a similar misconception – namely the idea that a soiled gown cannot be decontaminated. We have already identified that incineration is an effective method of disposal – this is because high temperatures kill viruses. In fact, a wash temperature of 60 Degrees Celsius will disinfect a gown in ten minutes. The laundry and the incinerator are performing similar functions in this respect, with the difference being that the laundry allows the gown to be used up to one hundred times before disposal. The UK Textiles Association estimates that switching from disposable gowns to reusable would save the UK £1.2 billion annually,10
and a
research study published by the Association of Perioperative Registered Nurses calculated the switch would reduce carbon emissions from the PPE life-cycle by 66%.11
The idea
that reusable products entail an infection risk is a myth, and the correlation between
chemical toxicity and effectiveness is a false one, provided the product in question is being sterilised correctly. These are the perceptions that need to be broken down if sustainable services are to become a trusted norm for the healthcare sector, and they can only be broken down by investment in education and outreach training across all public spheres.
The second challenge is the requirement that reusable products be equal or superior to their alternatives in terms of performance and effectiveness. If anything, the public perception of risk posed by sustainable products is a catalyst for innovation in these products. Disposable aprons are, quite honestly, annoying to wear – they are difficult to peel open, they stick to themselves through static charge, they do not accommodate different body sizes, and are hot to wear for any length of time. Reusable aprons can afford to be produced with quality-of-life features such as these in mind. Basic features such as a range of sizes and colours can be catered to, and investment in static resistant qualities, anti-ligature press-studs and lightweight, breathable materials are made possible by knowing that each apron will see one hundred uses.
EU standards mandate levels of protection against microbial penetration, but the additional investment in quality features elevates the reusable PPE in relation to several other metrics not governed by regulation, such as user comfort. These benefits only come into consideration once the user’s misconceptions have been overcome, but they are instrumental in breaking down those misconceptions, so the two challenges have to be overcome concurrently. Once these have been addressed, the final challenge lies in service delivery, and how to ensure that sustainable products don’t entail hidden costs to the environment or the user.
When the AORN published its study on reusable gowns and calculated the 66% carbon reduction, they took into account energy costs over the entire life-cycle of
JANUARY 2022
WWW.CLINICALSERVICESJOURNAL.COM l 33
▲
©Kat Ka -
stock.adobe.com
©boyloso -
stock.adobe.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
