Jesvin George

Quality Nurse, Department of Nursing, Kauvery Hospital, Electronic City, Bangalore

*Correspondence: Tel: +91 80950 15040; Email: jesvin.george.86@gmail.com

Background

The aim of this quality improvement project is to reduce the risk of cross infection from wall mounted suction apparatus with minimum cost, manpower and TAT with maximum environmental safety (Green Initiative).

Period of study

15 Oct 2022 to 11 Feb 2023 (120 Days)

Area of study

Emergency Department, Kauvery Hospital, Electronic City

Inclusion Criteria

All wall mounted suction apparatus Emergency Department.

Process to reduce the risk of cross infection

  1. Should be sterilized for every 48hrs when kept open, even if not used.
  2. Should be sterilized after every use.
  3. Gas used for sterilization process – ETO.

About ETO

  1. Ethylene oxide gas is most common sterilization method used for medical devices.
  2. It is carcinogenic.
  3. Misuse and over use is an environmental hazard.
  4. It is a flammable colourless gas.

Pre-implementation Scenario

  1. Oct 15 to Dec 13 (60 days Pre-implementation)
  2. Before the introduction of green initiative, the suction apparatus has been sent to sterilization process 226 times from October 15th to November 13th and 231 times from November 14th to December 13th. Even though it is not utilized for that many times, it has been sterilized 457 times as it has to be sterilized for every 48hrs.So there is more effect on environment and people health due to ETO used in the process of sterilization.

Snapshots of Pre-implementation process analysis

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Process flow Pre-implementation

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Post implementation

December 16th 2022 to February 11th 2023 (60 days post-implementation)

Green initiative has been implemented which reduced the number of times the apparatus needs to be sterilized as it need to be sterilized only after use for patient. Keep In closed pack at each bed side ready to connect, and the package is opened so no need to be sterilized for every 48hrs as of before when not used. Data from December 14th 2022 to January 12th 2023 revealed that the apparatus has only been sent 31 times and 29 times from January 13th 2023to Feb 11th 2023. As a result, the number of times the apparatus needs to be send to sterilization has been reduced and consumption of ETO gas for sterilization is also reduced.

Snapshots of process implementation

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Process flow post implementation

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Analysis of Old process V/s New process for one Apparatus.

Product Process Average Man Hour in minutes Cover use in inches Packing ETO Gas in ml Cost in rupees
Old New Old New Old New Old New Old New
Apparatus 5 min 5 min 30″ 90″ Single Double 7.14 10 143 200

Analysis of Process Pre V/s Post with and interval of 30 days at the Period of study.

Period of  30 Days  Each  Number of Apparatus sent to CSSD Total Man Hour in minutes for process Cover use in inches Packing ETO Gas in ml Cost for ETO in rupees 
       Oct-22 to 13-Nov-22 226 1130 6780 Single 1613.64 32,318
      14-Nov-22 to 13-Dec-22 231 1155 6930 Single 1649.34 33,033
      Dec-22 to 12-Jan-22 31 155 2790 Double 310 6,200
       Jan-22 to 11-Feb-22 29 145 2610 Double 290 5,800
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Benefits of Green initiative

  1. Reduced the risk of cross infection.
  2. ETO consumption is reduced. ETO Gas burden on nature reduced (green initiative)
  3. Reduced cost Burden
  4. TAT is reduced from 60 seconds to 3-5 seconds.
  5. Number of times the apparatus had to be sterilized is reduced
  6. The life of apparatus increased.

Recommendation/ Way forward

The same can be replicated in O2 flow meter.

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Mr. Jesvin George

Quality Nurse

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