Topics around sterilization and infection prevention have such primacy in healthcare facilities that it is easy to start looking at them as if they existed in a void, completely independent of the array of connected considerations that weigh upon staff.
In practice, of course, the administrators weighing the many needs of an institution — in terms of budget, supply chain management, efficiency goals, and so much more — don’t have the luxury of concentrating on sterilization alone. They need to figure out how tools and practices will fit into the larger scheme.
So how can hospitals create an environment that establishes and preserves safety, both for patients and for staff? Halyard Health is one of the manufacturers committed to developing an array of options that can add up to meet the needs of different institutions in ways that are both individualized and all-encompassing.
When it comes to the surgical suite, the development of solutions has to start at the very beginning of the process.
Research has shown an alarmingly high number of surgical instruments are being contaminated by bacteria in the journey between the sterile processing room and the OR. Addressing that problem begins with understanding the reasons it might arise.
A recent study published in the American Journal of Infection Control evaluated the effectiveness of certain sterilization packaging systems — used to maintain the sterility of surgical instruments — at preventing bacteria from contaminating their contents post-sterilization. The study evaluated the efficacy of rigid containers compared to sterilization wrap and found that sterilization wrap demonstrated greater protection of their contents than rigid containers. More specifically, after terminal sterilization 87 percent of rigid containers allowed bacteria to enter during transport and handling, while 100 percent of sterilization wrap prevented bacteria from entering.
“What this demonstrates is that somewhere between sterilization, handling, and transport, bacteria is able to penetrate the rigid container,” explains Joe Hannibal, associate marketing director at Halyard Health “This is important information that all CS department and hospitals have a right to know about.”
With a multitude of different offerings in their own line of sterilization wraps alone, Halyard Health is aware that a mere menu with no guidance is little help, leaving healthcare professionals susceptible to making imperfect choices. That’s why the company forges partnerships with users, delivering valuable learning tools.
“We’ve always emphasized education,” Chris Sloan, senior marketing and communications manager says. “We have an education curriculum that we’re constantly refreshing and expanding. We have over 30 courses just for sterilization.”
Patient safety is the top priority, but mindfulness over the well-being of staff is also important, whether they are in the OR or CS department. Instruments that go into the OR clean are going to come back in very different condition, potentially exposing staff in the sterile processing departments to pathogens.
To that end, Halyard recently supplemented their glove line with PURPLE NITRILE* MAX Exam Gloves, meant for those staff members.
“It’s for SPD — sterile processing departments — and it’s a longer glove that has been designed to stay up, so you don’t get water leakage down the gloves as you’re cleaning,” says Greg Metcalf, global director of gloves and apparel at Halyard Health. “People are cleaning trays coming out of the OR area, so they never know exactly what they’re exposed to. We’re trying to figure out a way to keep them protected, but as economically as possible.”
Halyard also ensures safety in the OR with a series of surgical gowns that meet AAMI Level 3 and 4 requirements for protection. AERO SERIES* Gowns are differentiated by color to quickly show clinicians what level of protection they need, taking the guesswork out of gown selection.
“The AERO SERIES is at the forefront of innovation, maximizing effectiveness, safety, and cost savings without sacrificing clinicians’ need for comfort,” said Alex Hodges, vice president and general manager at Halyard Health. “AERO SERIES gives hospitals the ability to simplify gown management and move towards standardization, reducing by up to 40 percent the number of gown codes needed to protect operating room (OR) teams in a full range of surgical procedures.”
The other concern healthcare facilities face after a completed procedure centers on the refuse created. Halyard Health is also trying to help hospitals deal with that problem, especially the leftover sterilization wrap.
Halyard Health created the popular BLUE RENEW* Wrap Recycling Program, which gives hospitals and other healthcare facilities a convenient way to recycle all the used sterilization wrap. After a procedure, hospitals pull together all their clean, used sterilization wrap to be picked up by a waste collector. The material is stored by the waste collector until it can be turned over to a recycler, who then transforms it into pellets that can be used to create a new product.
As with other partnerships, Halyard puts in the effort to make it as easy as possible for the end user.
Halyard partners with facilities to help drive each step of the process, from customizing the program and training staff to locating waste collectors and recyclers and reporting success in terms of recycling pounds of wrap, for example, for facilities’ sustainability reports,” explains Hannibal.
“So far, the BLUE RENEW Wrap Recycling Program has been implemented in over 250 hospitals, which have collectively recycled over four million pounds of Halyard sterilization wrap,” he adds.
In addition to the opportunity to tout green practices, there are some basic monetary benefits for healthcare facilities participating in the program.
“Halyard estimates a potential cost savings of $0.07 for each pound of sterilization wrap recycled,” says Hannibal.
Dignity Health was one of the early adopters of the BLUE RENEW program, and they’ve already notched approximate landfill diversion savings of $17,500 by sending their sterilization wrap to the recycler instead of the waste disposal system.
“Dignity’s success with Halyard’s BLUE RENEW program has been amazing,” says Dan Constant, president of Sustainable Solutions, LLC, who worked with Halyard and the hospital system to implement the program. “It all started with high level corporate support and then a true passion and professionalism from their OR and EVS staff to implement, manage, and maintain the program. To date, Dignity’s BLUE RENEW program has been the largest collector of OR blue wrap waste totaling more than 250,000 lbs. annually.”
At Dignity, they’ve reported the BLUE RENEW program has had a ripple effect, inspiring individuals to seek out similar efficiencies in other aspects of hospital operations. Once a culture of responsibility takes hold, it can spread far and wide in an organization.
“Since implementing the program, our surgical departments have asked what other types of products are available for recycling or reuse,” says Sister Mary Ellen Leciejewski, OP, vice president of corporate responsibility with Dignity Health.
“We are currently looking into what else we could incorporate into our waste stream,” she adds. “And it doesn’t end at the waste stream. The success that staff experience as a result of their sustainability efforts in the OR, ripples out into other aspects of the organization — smarter purchasing, healthy food, safer chemicals, etc. Staff know they can make a difference by their efforts, their questions, and voicing their concern.”
The staff empowerment that Leciejewski sees was part of the strategy for implementing the program, according to Elise Nagowski, product line administrator in perioperative services supply and services resource management at Dignity Health.
“We needed to make sure that workflow issues were addressed from the outset since this would affect the success of the BLUE RENEW program going forward,” Nagowski says. “What we found is that by in-servicing the facilities and planning how the program would flow on the very same day made a huge difference. We were able to incorporate staff concerns and department and facility knowledge into the workflow. Overall, the buy-in for the program that the staff develops is much higher than a program we try to implement in a vacuum.”
Taking the right approach from the beginning contributed to the program’s moment. It’s been widely adopted across Dignity Health’s 39 hospitals, and the amount of wrap recycled at each facility keeps ticking upward.
“The BLUE RENEW initiative is part of our overall mission to promote the health of our patients, community and planet — not just in touchy feely ways but in very practical ways,” Leciejewski says. “The kinds of products we buy, how much we waste, how we dispose of that waste, all reflect our values and complement our existing efforts to define leadership in environmentally responsible healthcare. Without a healthy environment, we will not be healthy.”
That outlook represents the ways in which different parts of a facility’s operations are connected. Limited success will come from single tools implemented without much thought or care for how they fit into the big picture.
Manufacturers like Halyard Health are aware of the need to focus not only on needs, but to examine how they’re interconnected. That mindset is what will keep patients — and healthcare professionals — safe and healthy.