The Top Three Challenges Facing Hospitals Today: Infection Control, Sustainability & Costs.

Research shows that 80% of hospital infections are spread through ‘CONTACT’1. Feedback from nurses revealed that the disposal of bags of plastic waste from ‘used’ thermometer covers represented a significant infection risk as thousands are used with routine devices in hospitals every day.

Nurses also reported finding ‘used’ plastics in patients’ beds, food trays and other hazards, such as dementia patients swallowing them, which could be fatal.

Plastic consumables don’t only impose a high infection risk, they also cost hospitals millions to dispose of, and in some hospitals they create the need for infrastructure to recycle consumables; leading to additional costs to maintain them.

Whilst working in hospitals, TriMedika Ltd recognised an opportunity to reduce hospital infections by eliminating single use plastics for thermometry. The first device to market is TRITEMP™, a non-contact, and non-waste generating medical grade thermometer. TriMedika is passionate about developing smart, innovative medical devices, that use new technologies that challenge the current hospital workflows and deliver savings on time and cost whilst eliminating infection spread and plastic waste.

Feedback from hospitals suggest that the top three challenges they face are infection control, sustainability, and costs.

1. Infection Control:

Reports indicate that at any one time, more than 1.4 million people worldwide are estimated to suffer from Hospital Acquired Infections (HAIs). Due to an increase in invasive procedures and a growing resistance to antibiotics, HAIs have increased by 36% in the last 20 years and are consuming more healthcare resources each year2.

WHO estimates that 7% of all patients admitted into healthcare facilities will acquire at least one HAI3.

Impacts of HAI’s include:

  • Longer hospital stays for affected patients
  • More pressure on nursing staff
  • Increased costs to healthcare systems
  • Patients more likely to be readmitted to hospital
  • An increase in deaths – in American hospitals alone, the Centre for Disease Control (CDC) estimates that hospital-acquired infections (HAIs) account for an estimated 1.7 million infections and 99,000 associated deaths each year4.

Controlling the spread of infection is an ongoing challenge. However, there are steps hospitals and healthcare facilities can take to reduce infection and minimise risk. Every hospital will have a set of standard infection control procedures which are the minimum infection prevention practices that apply to all patient care, regardless of the suspected or confirmed infection status of the patient.

IPC teams work tirelessly to keep infections at bay, however the challenge of infection spread is ongoing and was tested to the limit during COVID-19.

The cleaning of routine medical devices, used on many patients every day, is a key focus for many infection prevention teams in hospitals. Despite the enforcement of standard infection control procedures between 2015 and 2017, one NHS Trust, had a total of 70 ICU patients who were found to have contracted Candida Auris, a potentially deadly fungal pathogen.

Following a DNA sequencing programme, the source of the outbreak was traced back to the disposable probe covers used on the axilla contact thermometer on the ward. Despite implementing increased cleaning measures, the infection continued to spread until the axilla thermometers were removed5. Since 80% of HAIs are caused by contact, the ICU have switched to non-contact thermometers.

Adopting non-contact infrared thermometers such as TRITEMP™ over traditional thermometers like tympanic thermometers is an innovative way to reduce contact, giving less opportunity for infection to spread.

2. Sustainability

4.4% of global plastic waste is generated by hospitals, according to Practice Greenhealth6. The thinking on single-use plastic is changing and in fact it is now recognised to be detrimental to the environment and expensive due to the costs and disposal. Hospitals face a challenge when it comes to sustainability as they need to find solutions whilst delivering optimal care and outcomes for the patient.

Single-use plastics pose a threat to the environment, and with only 7% of plastic waste from healthcare being recycled in the UK7, reducing plastic waste within healthcare is essential to becoming net-zero.

Plastic-wrapped or consumable dependent medical equipment is used in healthcare because it provides a high standard of hygiene for patients.

However, there are many other alternatives that are better for the environment whilst still providing optimal patient care.

Reducing plastic medical waste is a significant undertaking as it requires a holistic approach and changes across the board, to achieve a net-zero health system that will positively benefit the environment.

2.1 Responsible Procurement

The Royal College of Physicians outlines 12 principles to reduce waste8. Within their guidance they highlight the importance of selecting products for use in the healthcare setting that provide positive environmental impact. In fact, where possible they recommend environmentally friendly products should be used over more harmful alternatives.

Adopting an approach which incorporates sustainability into the procurement process, where environmental impacts are considered up front, will help healthcare  systems  to  reduce  unnecessary  single-use  plastic. One area where plastic waste could be easily reduced is thermometry. Traditional contact thermometers require a plastic probe cover for every temperature reading. A 900-bed hospital takes around 2-3 million temperature readings per year, that’s 2-3 million plastic probe covers for disposal.

TRITEMP™ is a medical grade non-contact thermometer which provides a more sustainable option as it requires no consumables.

2.2 Recycle Where Possible

Recycling in a hospital setting can help hospitals reduce plastic waste for medical plastics that are not contaminated.

The NHS creates 133,000 tonnes of plastic annually with only 5% of it being recyclable9.

2.3 Advocate And Collaborate

Healthcare systems need dedicated leadership, incentives and direction to help reduce waste. In 2008 the UK Climate Change Act legislated for an 80% reduction in CO₂ emissions by 2050 and formed the Sustainable Development Unit – a national body charged with reducing CO₂ emissions in healthcare. By 2017 there was an 11% reduction in CO₂ emissions10, despite an 18% increase in UK healthcare related activity. Devices are placed in hospitals on a “consumable model” where the device is free of charge, however, they are then tied down to a contract that commits the hospital to be charged for plastic consumables.

A total cost of ownership approach to reducing waste must be adopted by the healthcare industry to reverse the effects of climate change and positively impact our planet.

3. Costs

When you consider facilities, wages, supplies and administrative costs, hospital expenditure is significant in any healthcare system, which can put a strain on services as they try to manage their ever-shrinking budget which can impact patient care.

Health-related quality of life (HRQOL) is a multi-dimensional concept that considers several aspects such as physical, mental and emotional wellbeing and social functioning. It goes beyond direct measures of population health, life expectancy, and causes of death, and focuses on the impact that health status has on quality of life. Therefore, improving healthcare is essential.

Striking a balance between improved patient care and budget cuts is extremely difficult. The NHS England budget fell from £148 billion in 2021 to £139 billion in 202211, meaning budgets will have to be stretched to achieve the same level of care.

The United States spends nearly $4 trillion on healthcare, making it the most expensive system in the world12. Over the past decade, the public health workforce in the US has shrunk by approximately 56,000 positions primarily due to funding issues. Similar trends across the globe highlight the need for healthcare systems to find innovative means to reduce cost whilst maintaining quality of care.

A study at a UK hospital showed just 4 wards spent close to £14,000 on consumables across 2 years13. The disposal of this contaminated plastic waste incurs additional financial costs to hospitals.

Plastic consumables account for 97% of some device budgets, so eliminating this cost eases pressures on budgets, without compromising on quality as TRITEMP™ is a medically graded, CE marked thermometer manufactured by an ISO13485 accredited company, TriMedika that requires no consumables.

Many hospitals don’t realise the hidden costs associated with traditional contact thermometers and the significant impact that this recurring cost has in draining hospital budgets of much needed cash.

Internal research carried out by TriMedika shows that up to 10 contact thermometers are being disposed of in hospitals due to breakages every week, this equates to 520 devices per year.

Consequently, hospitals unnecessarily replace multiple devices when there are more efficient and robust alternatives reducing breakages, saving time and money.

TriMedika Ltd continues to lead the way in cost effective, sustainable, and accurate medical device manufacturing. With early trials for their ‘connected’ thermometer, which is a paperless solution for temperature data capture, TriMedika’s new connected thermometer will enable the automatic transfer of data into the patient electronic record. Connected health solutions will benefit not just hospitals, but people at home who’ll be able to monitor their conditions without the upheaval of going to hospital.

For more information contact www.trimedika.com

1. Infection Prevention Head Nurse in Northern Ireland – Colin Clarke

2. https://pubmed.ncbi.nlm.nih.gov/21677524/

3. https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf

4. https://patientcarelink.org/improving-patient-care/healthcare-acquired-infections-hais/

5. https://www.nejm.org/doi/10.1056/NEJMoa1714373

6. https://www.nationalgeographic.co.uk/environment-and-conservation/2019/10/can-medical-care-exist-without-plastic

7. https://returntowellness.co.uk/2019/06/13/is-the-nhs-wasting-money/

8. https://www.rcplondon.ac.uk/projects/outputs/less-waste-more-health- health-professionals-guide-reducing-waste

9. https://blogs.bmj.com/bmj/2020/12/08/the-plastic-pandemic-could-the- environmental-impact-of-the-nhs-response-to-covid-19-be- reduced/#:~:text=The%20NHS%20disposes%20of%20around,of%20England ’s%20total%20carbon%20footprint

10. https://theconversation.com/five-ways-hospitals-can-reduce-their- environmental-footprint-90390

11. https://www.hsj.co.uk/finance-and-efficiency/nhs-budget-to-fall-by-9bn-next-year-as-covid-funding-is-scaled- back/7029612.article?utm_content=178964299&utm_medium=social&utm_   source=facebook&hss_channel=fbp-100485091733477

12. https://www.tampabay.com/news/health/2021/12/23/american-health- care-is-broken-and-expensive-floridians-say/

13. https://trimedika.com/wpcontent/uploads/2022/02/EvaluationofThermometerStudy2018-FINALTRIMEDIKA.pdf

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