With an estimated 300,000 related deaths in the UK each year, healthcare acquired infections (HCAIs) continue to threaten patient health and recovery speeds1,2 Despite healthcare workers’ best efforts in infection prevention, MRSA, Clostridium difficile, Norovirus and seasonal influenza are still transmitted to patients with weak immune systems caused by ill-health or medical procedure.
Healthcare worker’s hands are the most common indirect vehicle for cross-contamination, accounting for up to 90% of microorganisms’ transmission. It is appropriate therefore, that hand cleanliness is highest on the list of interventions. But even after surgical scrub techniques, the microbial population under the fingernails is above acceptable levels, with studies revealing 3.0 x 103 colony-forming units per mm2. Therefore, for appropriate examination procedures, gloves offer an additional barrier.3
But while every other object in hospital wards — from door handles to sinks — has been scrutinised and developed to reduce bacterial surface transmission, tissue box-style glove dispensers remain a hotspot for microorganisms. Because examination gloves are a highly commoditised product, their dispensing system has been overlooked and not updated since the 1970s. Today, traditional glove boxes risk the communication of HCAIs in three ways:
1. In countries without strict hand hygiene guidelines, companies employ factory workers to manually peel gloves from their ceramic formers and pack them by hand into cardboard dispensers. Therefore, even before leaving the factory, these infection control devices risk contamination.
2. To save on storage space and maximise capacity, the boxes are packed so tightly that it is almost impossible to remove one glove at a time. As a result, an estimated 10% of gloves spill onto the floor. Now contaminated, these are either pushed back into the box or are discarded, creating unnecessary waste.
3. Because gloves are presented randomly from the dispenser, users removing a glove cannot avoid touching their critical surfaces — the fingers and palm.
A 21st-century solution to these problems is through uniform glove presentation as provided by SafeDon. An independent 2009 study by Swann & Morton found that SafeDon’s dispensing mechanism effectively reduces cross-contamination by up to 96%.4
By automating the packing process, these gloves are packed using robot technology, which speeds the process and reduces both labour costs and any risk of contamination of gloves by factory staff.
It also allows for packing with an interleaving fold. With this method, gloves are presented uniformly: one at a time and always cuff-first. To don a new glove, healthcare workers need only touch the exterior cuff, rather than any critical surfaces. Since all gloves within each dispenser are presented the same way, they do not spill. Polyco Healthline says that compared to traditional dispensers, this alternative lasts around 10% longer and creates zero waste.
Like interleaved hand towels, the gloves dispense from an underside aperture to discourage users from touching the surface of the wall mount.
Jason Prichard, Polyco Healthline’s Director of Business Development, says the system “provides an effective infection control solution for use in environments where hygiene is essential.” From the first to the last glove, the quality of delivery and the maintenance of cleanliness is assured, he adds.
Among the products in the SafeDon range, the GX894 is a powder-free, blue nitrile examination glove that takes advantage of this new technology. Available in five sizes, its dual-aperture dispenser retains a traditional glove box’s dimensions. The product will fit into any standard wall mount, but with the benefits of cuff-first dispensing.
The GX994 and GX978 powder-free nitrile gloves, meanwhile, are packed in recycled polythene, in stacks of 100 or 250 gloves respectively to further reduce waste. These are boxed in a spring-loaded holder (the GE/SLG), which fits inside common healthcare wall mounts. It can be sterilised or autoclaved and offers multi-size dispensing and a fast refill mechanism.
Savings through innovation
Influenced by raw material costs and currency fluctuations, glove suppliers are constantly engaged in an incremental price war on this low-margin commodity item. So where does the new glove dispensing technology fit within such a highly competitive market?
Polyco Healthline says the innovation goes beyond its infection prevention, saving money and having environmental benefits. It says, despite being stuffed as tightly as possible, traditional glove dispensers still contain 50% air. By folding the gloves and make use of all available space within the packaging — where a standard shipping container transports 2.2m disposable gloves, the same container can hold 3.5m SafeDon gloves. Fewer containers result in reduced transport costs and fewer carbon miles impacting the environment.
That space-saving also means more gloves can fit on a warehouse pallet and in a healthcare provider’s stockroom. While they may be marginal, these savings stack up over time.
Reduced waste disposal costs
Less marginal is the number of gloves unnecessarily discarded through accidental spillage. Because examination gloves are medical devices in direct contact with the patient, they must be disposed of in clinical waste bins labelled for incineration. In the UK, this disposal method carries a hefty premium of around £800 per tonne. When roughly 25 spilled gloves from every box of 250 are discarded unused, this avoidable cost adds up.
According to Michael Knight, Polyco Healthline Sales Manager to the NHS, there is unnecessary waste in the UK’s infection prevention wards; the sheer number of spilled gloves being thrown away is “frightening” he says, and the effect is compounded where, in some hospitals, instead of having three separately marked bins in the sluice rooms, there is only one for clinical waste. This not only costs a fortune, it also has a negative impact on the environment, says Knight.
With SafeDon’s predictable cuff-first dispensing system, healthcare workers no longer take time to deal with glove spillage. Only ever touching non-critical surfaces, they can don gloves quickly and efficiently. Infection prevention nurses who have trialled the product report that this increases their confidence and productivity while reducing the risk of cross-contamination.
Prichard says: “SafeDon brings examination gloves back to a real infection control medical device, rather than just a commodity product.”
The company has partnered with Colchester Hospital Trust to trial the SafeDon dispensing system. The Trust’s Clinical Evaluation team assesses everyday clinical products that support quality, safety and value in the NHS.
References
1. https://www.nice.org.uk/guidance/qs61/ chapter/introduction
2. https://www.gov.uk/government/uploads/ system/uploads/attachment_data/file/644432/QEC_September_2017.pdf
3. https://www.ncbi.nlm.nih.gov/pubmed/474884
4. http://onesafesystem.com/foodservice/gurus/ uploads/2014/02/Swann-Morton-Studies-2009-2010-Exec-summary-with-note.pdf
N.B. oneSAFE is marketed as SafeDon in Europe