Quality improvement project to reduce the risk of cross infection from wall mounted suction apparatus

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

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

About ETO

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

Pre-implementation Scenario

Oct 15 to Dec 13 (60 days Pre-implementation)
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

Process flow Pre-implementation

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

Process flow post implementation

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