SUS TAINABL E HEALTHCARE


the gown. It is crucial that emissions are calculated in this way. A reusable gown may not generate CO2


during disposal compared


to a single-use gown, but if that reusable gown has to be flown across the globe to reach the end-user, the energy cost increases by a significant amount. Additionally, if the gown has to be driven to and from a laundry one hundred times before disposal, a similar problem occurs. If, at the end of its life- cycle, the reusable gown is then placed into landfill, it still generates carbon emissions, albeit reduced compared to one hundred single-use gowns.


At each stage of the product’s life cycle, sustainability has to be an active calculation. NTH Solutions works with UK manufacturers to source its reusable gowns and aprons. These minimise the need for air-freight or shipping in addition to the other benefits in terms of the UK economy, job creation etc. Furthermore, a fleet of electric vehicles handles delivery to further reduce the impact the service has upon the product’s overall energy consumption. Sites are supported in cases where they wish to launder their own gowns, reducing the transport costs even further. This is supported by barcode technology to help sites track the number of uses each gown has had, and instructions for use which guarantee decontamination between uses.


In terms of chemical supply, the same philosophy is applied; a plant on-site at University Hospital Hartlepool produces hypochlorous acid for delivery, but sites with sufficient demand can also lease or purchase their own hypochlorous generator to be installed and maintained on-site to ensure a continuous supply is available. Disposal is a key part of the life-cycle of any product, so NTH Solutions covers this also. Hypochlorous acid is depleted through use, but the gowns are collected and returned to NTH Solutions for recycling. After one hundred uses, the gowns can no longer function as suitable PPE, but it can still be decontaminated and shredded, with the raw materials being repurposed for a range of other products such as pet bedding, punch- bag filling and others. Even the hypochlorous acid is provided in spray bottles made from recycled plastic.


In order to deliver sustainable solutions for any sector, there has to be an understanding of the relationship between user confidence, product quality and service delivery and how interdependent these three factors are. These are challenges, but they are also drivers for innovation. The need to match or outperform their disposable counterparts can act as a catalyst for change in manufacture and development of new products with smaller carbon footprints. Addressing potential issues in service delivery before they appear allows


All garments comply with the UK MAKE strategy, produced by a British manufacturer to reduce carbon cost associated with air-freight and avoid any possible supply issues


The garments are branded to a client’s specification and delivered via a fleet of electric vehicles


The garments are worn, then collected, laundered or sterilised, and returned


Bar-code (RFID) technology is used to enable full traceability and maximise the use of each garment


When the garments eventually reach end of service, they are collected. Working with sustainably responsible partners, these are sterilised and shredded, ready for recycling


The reusable PPE is now recycled into a wide range of new and useful products, from bedding to punch bags


Figure 1: The lifecycle, above, provides a more sustainable approach to PPE usage.


companies to offer customers sustainable solutions with no hidden cost or burden of labour. Finally, and most importantly, research and education not only give momentum to the sustainability agenda in terms of emerging ideas and projects, it empowers end users to make informed decisions about which products and services they choose to access. The NHS may produce 5% of the UK’s carbon footprint, but the journey towards a carbon neutral economy in the fight against climate change is going to involve society as a whole. The reliance on disposable PPE has been exacerbated by COVID-19 but it is symptomatic of a deeper misperception of sustainable options. Providers need to offer superior products, backed by managed delivery systems and a robust education programme, in order to achieve lasting success for the sustainability agenda.


CSJ


References 1 Way C. Healthcare is still hooked on single-use plastic PPE, but there are more sustainable options. The Conversation 2020. https://theconver- sation.com/healthcare-is-still-hooked-on-single- use-plastic-ppe-but-there-are-more-sustainable- options-143940


2 Growing plastic pollution in wake of COVID-19: How trade policy can help, UNCTAD, 27 July 2020, accessed at: https://unctad.org/news/growing-plas- tic-pollution-wake-covid-19-how-trade-policy-can- help


3 Government confirms 400,000 Turkish gowns are useless for NHS, Coronavirus, The Guardian, 7 May 2020, accessed at: https://www.theguardian.com/ world/2020/may/07/government-confirms-400000- turkish-gowns-are-useless-for-nhs


4 Why a billion items of PPE is not enough - BBC News


34 l WWW.CLINICALSERVICESJOURNAL.COM


5 Fadare OO, Okoffo ED. Covid-19 face masks: a potential source of microplastic fib- ers in the environment. Sci Total Environ, 2020;737:140279. doi:10.1016/j.scito- tenv.2020.140279 pmid:325631


6 Coronavirus face masks ‘could have a devas- tating effect on the environment’, Energy Live News, 17 Mar 2020, accessed at: https://www. energylivenews.com/2020/03/17/coronavi- rus-face-masks-could-have-a-devastating-ef- fect-on-the-environment/


7 Fletcher C. What happens to waste PPE during the coronavirus pandemic? The Conversa- tion, 2020. https://theconversation.com/what-hap- pens-to-waste-ppe-during-the-coronavirus-pan- demic-137632


8 The Scourge of Hygiene Theater, The Atlantic, 27 Jul 2020, accessed at: https://www.theatlantic.com/ ideas/archive/2020/07/scourge-hygiene-theat- er/614599/


9 Meakin et al, “Comparison of Cleaning Efficacy between in-use disinfectant and electrolysed water in an English residential care home” Journal of Hospital Infection 80 (2012) 122-127


10 The Textile Services Association, The Case for Reusable Gowns, accessed at: https://tsa-uk. org/wp-content/uploads/The-Case-for-Reusable- Gowns-2.pdf


11 Vozzola et al, AORN Journal March 2020 Vol. 111 No.3.


About the author


Dan Sullivan is the lead trainer for NTH Solutions and is responsible for the devel- opment and delivery of classroom-based and online educational content. He is also a qualified teacher with over five years’ experience working in various NHS departments.


JANUARY 2022


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