JPP PG July 2015 (Vol:04 Issue:03)

Journal of Perioperative Practice

PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 01423 881300 www.afpp.org.uk

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Contents 03

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Welcome to your July 2015 Guide 05 Safety and quality:

13 Product news:

09 “4 x 3 please!” From

15 Product news:

it’s in your hands

hydrophobic raw cotton to absorbent gauze swab

11 Product news:

Schülke detergent

Are you putting your patients at risk?

A helping hand

17-18 Product news:

Vacsax, Peskett

Journal of Perioperative Practice Procurement Guide information In print within the AfPP Journal of Perioperative Practice covering national AfPP members, but also with a dedicated print and e-distribution to supplies and purchasing managers.

Key Sectors: NHS Supply Chain, Independent Hospitals, Higher Education.

Medical Device Companies.

Published 6 times a year we will focus on procurement issues in every edition as well as specialist subjects which for the following year include:

September 2015 Airway Management/Anaesthesia November 2015 Safety/Sharps January 2016 Recovery/Patient Warming

Contact Information: Advertising, Sponsorship & Partner Packages.

Frances Murphy Account Manager Open Box M&C T: 0121 200 7820 E: frances.murphy@ob-mc.co.uk Editorial Chris Wiles Head of Publishing/Editorial AfPP T: 01423 882950 E: chris.wiles@afpp.org.uk

PR & press material.

All press releases welcome and we will feature as many as we can in each issue, all press releases need to be submitted to: Frances Murphy Account Manager Open Box M&C T: 0121 200 7820 E: frances.murphy@ob-mc.co.uk

04

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

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05

Consumables

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Safety and quality: it’s in your hands We practice in a complex clinical environment but what must the public have thought when they read this recent newspaper headline: “New mother claims doctor left his mobile phone inside her after delivering her baby...” (Davies 2015) This never event occurred in an overseas private hospital, was followed by a further recovery operation to remove the phone and the demand for a government to resign. The article finished with a 2012 report of a retained A4-sized surgical mat from operation in a large UK surgical unit!

What?

A recent Association for Perioperative Practice (AfPP) study day included a session entitled ‘We’re all in this together: Never, say never’.

Delegates were picked at random and asked “to reflect upon an incident that occurred in the team you’re a member of in the last two weeks that caused you concern and made you stop and think”.

Using Rolfe et al’s (2001) reflective model based upon Borton’s (1970) developmental model, a simplistic cycle composed of three questions, they were asked to consider: • What - Through this analysis a description of the situation is given which then leads into the scrutiny of the situation - That could have gone better?

• So What - Leads into the construction of knowledge that has been learnt through the experience - Why did that happen?

An anaesthetist mistakenly injected chlorhexidine, a skin-cleansing fluid in place of a pain killing agent into Grace’s spine.

The 33-year-old mother suffered massive nerve damage, endured two brain surgeries and ended up paralysed from the waist down.

• What Next - Ways in which to personally improve and the consequence of one’s response to the experience are reflected on - What on earth is going on today, get me out of here!

In mastermind fashion, a large black chair under a spotlight was provided for delegates’ comfort. The first delegate chosen recounted their ‘cause for concern’: • What - An ophthalmic wrong surgical site preoperative anaesthetic injection • So What - Site marking removed during prep & draping with foreign language issue • What Next - Correct side injection and procedure, early apology and protocol review / practice revised.

The next volunteer’s name was duly pulled out (delegates could refuse to participate), an anaesthetic assistant recounted his story: • What - Prior to major surgery the insertion of a central line arterial device was required; during this intervention a major anaphylactic episode occurred which required treatment.

Surgery was deemed essential so, after emergence from this event, the anaesthetic team continued with arterial access whereupon another anaphylaxis episode occurred!

• So What - Shocked anaesthetic team check device only to find that it is coated in chlorhexidine, an allergy noted in the patients notes! Critical incident reported.

• What Next - Review of all arterial devices especially for latex materials, items were found in stock held by department.

As chair of this session I was shocked by his revelation.

I shared with delegates a conversation with a colleague as we planned this session.

She wanted to share this 2010 dated story (Mandarin News Australia 2013), having worked with the anaesthetist involved in a different facility: • Grace and her husband, Jason Zheng, were looking forward to becoming new parents, but the biggest moment of their lives turned to tragedy when a routine epidural procedure went horribly wrong.

• An anaesthetist mistakenly injected chlorhexidine, a skincleansing fluid in place of a pain killing agent into Grace’s spine.

• The 33-year-old mother suffered massive nerve damage, endured two brain surgeries and ended up paralysed from the waist down.

Planning a study day, you are never quite sure how each speaker’s presentations will fit

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Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

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together: on this occasion a theme of ‘chlorhexidine never events’ emerged.

I intended to, and ended, our reflective session with this YouTube video: • ‘The Human Factor: Learning from Gina’s Story’ is a hard-hitting film by Doncaster and Bassetlaw Hospitals NHS Foundation Trust (2014) that tells the tragic story of how a simple human and procedural mistake caused a tragic incident at the Trust in February 2013.

Key factor: Chlorhexidine preprocedure skin preparation.

The emotional reaction observed in delegates was palpable! So now watch it yourselves, see how you feel! And then please read the rest of this article.

So What?

In a meeting debrief email it was suggested that if we were going to use Gina’s story as part of the ‘issues session’ there needed to be some conclusion to it, again with some learning outcomes for delegates – or a key message at the end.

Here are my own reflective learning outcomes.

Donald Schön’s (1983) three stage reflection model of: • Reflection for action – Knowledge for planning actions and imagination • Reflection in action – Knowledge for acting / doing • Reflection on action – Knowledge of self derived from doing

Aids a reflective cycle of forethought, performance and self reflection to bring context to practice parameters and critical incidents.

We use chlorhexidine in our daily perioperative practice in a range of pharmaceutical preparations and clinical uses; both on ourselves and patients under our care, but what do we know about this chemical that clearly in the wrong place causes harm? For informative data go to Drugs.

Com (2015) and read their Chlorhexadine-GluconateTopical data sheet: http:// www.drugs.com/monograph/ chlorhexidine-gluconatetopical.html#r111

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What Next?

From the three critical incidents exposed and discussed during this study day it is evident that, chlorhexidine used in the wrong anatomomical environment, has a toxic effect on tissues and patients homeostasis; nerve damage, paralysis, anaphylactic shock, pain, disability and loss of limb / life.

The most significant issue however is human factors, a systematic failure of procedural integrity, and a practice error allowing a damaging substance designed for surface use only, being injected / carried in to the patient’s neuro-vascular systems.

The use of gallipots to hold skin preparation disinfectants is

07

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Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

universal for perioperative scrub practitioners (AfPP 2011), for the preparation of surgical sites, prior to establishing surgical field and supported by: AfPP (2011) Standards and Recommendations for Safe Perioperative Practice (Infection Control: Section 5.7 Patient Preparation) • STANDARD: The Risk of postoperative surgical site infection is minimised through the effective management of skin preparation of the surgical site.

(AfPP 2011) This publication is currently being reviewed prior to re-publication this autumn. However, in the context of these never events, I believe these key practice elements need discussion.

1. Only personnel who have been assessed as competent and skilled in skin preparation should prepare the surgical site, this should be a registered scrub practitioner (delegated / supervised assistant theatre practitioner) or member of consultant led extended surgical team, including a surgical first assistant (SFA) or surgical care practitioner (SCP).

2. After intraoperative surgical site preparation and prior to draping, all gallipots containing preparation solutions should be removed from the surgical field and instrument trolleys.

3. Any pharmaceuticals entering the surgical field should be in sterile sealed identifiable packaging. Irrigation fluid should be dispensed in sealed sterile containers.

4. All intraoperative injectable local anaesthetics / catheter pumps, used as part of enhanced recovery protocol, should be dispensed in sealed containers and verbally checked by two members of the surgical team.

5. Skin disinfect solutions required at the end of procedure, should only enter the surgical field after final swab, needle and instrument checks (where possible via sealed sterile containers).

We use chlorhexidine in our daily perioperative practice in a range of pharmaceutical preparations and clinical uses; both on ourselves and patients under our care, but what do we know about this chemical that clearly in the wrong place causes harm?

6. All intra-vascular devices to be checked by two members of anaesthetic team, with particular attention to patient allergy references.

Context – the set of circumstances or facts that surround a particular event, situation (Dictionary.Com 2015) Just prior to the study day, I checked my emails from Nursing Times.net who had just published a report and online discussion describing reaction to: • NHS England (2015) Patient Safety Alert published 26 May 2015: Stage One: Warning - Risk of death or severe harm due to inadvertent injection of skin preparation solution

Alarming report “NHS England has identified three incidents involving inadvertent injection of skin antiseptic solutions since 2012, and one additional near miss.

Two incidents involved severe harm from confusion between 2% Chlorhexidine and x-ray contrast media in circumstances where both substances were in unlabelled gallipots (one during a lower limb angiogram and resulting in leg amputation, and one during a pacemaker insertion resulting in cardiac arrest and resuscitation).

The third incident involved a patient undertaking renal dialysis with assistance from healthcare staff; the line was flushed with Chlorhexidine from a gallipot instead of the intended saline solution and the patient became unwell but apparently recovered.

The near miss also involved Chlorhexidine and x-ray contrast medium, and occurred despite the skin preparation being on a separate trolley.”

(NursingTimes.net – subscription required)

Action points 1. Please take time to watch the Gina’s Story video, inform your colleagues.

2. Read and disseminate the Patient Safety Alert to your colleagues (NHS England 2015).

3. Reflect on your own practice parameters (Knight 2015); engage in a team practice review to ensure patient safety.

To the best of our knowledge, a similar chlorhexidine incident has not yet occurred in a UK operating theatre setting, nor discussed abroad (Markström et al 2015). There are issues with food dye used to colour these preparations (Chow et al 2013), without dye the solution looks like saline.

Martin Bromiley (Smyth 2014) reminds us that “Hospitals are full of error-prone environments and opportunities for things to go wrong”.

Never, Say Never: let us together ensure that your team never makes a newspaper headline.

“The strength of the team is each individual member. The strength of each member is the team.” - Phil Jackson: Nine-time NBA Champion coach (2015) Adrian Jones AfPP Vice President & Orthopaedic Surgical Care Practitioner

References Borton T 1970 Reach, touch, and teach: student concerns and process education New York, McGraw Hill Chow J, Ng J, Pun A 2013 Effects of food colouring added to 2% chlorhexidine gluconate and 70% alcohol for surgical site antisepsis Journal of Perioperative Practice 23 (11) 255-257 >>

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Davies M 2015 New mother claims doctor left his mobile phone inside her after delivering her baby... and she only realised when her stomach began vibrating [Online] MailOnline 13 May 2015 Available from: http://www.dailymail. co.uk/health/article-3080064/ Gynaecologist-left-MOBILEPHONE-inside-woman-deliveringbaby-Jordan-realised-beganVIBRATING-inside-her.html [Accessed May 2015] Dictionary.com 2015 Context definition [Online] Available from: http://dictionary.reference. com/browse/context [Accessed June 2015] Doncaster and Bassetlaw Hospitals NHS Foundation Trust 2014 ‘The Human

Factor: Learning from Gina’s Story’ [Online] Available from: https://www.youtube. com/watch?v=IJfoLvLLoFo [Accessed May 2015] Drugs.Com 2015 ChlorhexadineGluconate-Topical data sheet [Online] Available from: http:// www.drugs.com/monograph/ chlorhexidine-gluconate-topical. html#r111 [Accessed June 2015] Jackson P 2015 Goodreads [Online] Available from: www. goodreads.com/quotes/527132the-strength-of-the-team-iseach-individual-member-the [Accessed June 2015] Knight S 2015 Realising the benefits of reflective practice Nursing Times 111 (23/24) 17-21

Mandarin News Australia 2013 Epidural tragedy mum speaks out [Online] Available from: http://www.sbs.com.au/news/ article/2011/06/29/epiduraltragedy-mum-speaks-out watch this story on YouTube: [Accessed May 2015]

psa-skin-prep-solutions-may15. pdf [Accessed June 2015]

Markström I, Bjerså K 2015 Diversities in perceived knowledge and practice of preoperative skin preparation in Swedish orthopaedic surgery Journal of Perioperative Practice 25 (5) 101-106

Schön D 1983 The Reflective Practitioner, How Professionals Think In Action London, Temple Smith

NHS England 2015 Stage One: Warning Risk of death or severe harm due to inadvertent injection of skin preparation solution [Online] Available from: http://www.england.nhs.uk/ wp-content/uploads/2015/05/

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Rolfe G, Freshwater D, Jasper M 2001 Critical reflection for nursing and the helping professions: a user’s guide New York, Houndmills p26–35

Smyth C 2014 Thousands of patients killed by drugs and equipment errors The Times, London p28, 24 Dec Edition The Association for Perioperative Practice 2011 Standards and Recommendations for Safe Perioperative Practice Harrogate, AfPP

09

Consumables

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

“4 x 3 please!” From hydrophobic raw cotton to absorbent gauze swab Every day in NHS hospitals, thousands of swabs are used in operating theatres to absorb blood. We all know these swabs are made of cotton. But many people are unaware that raw cotton fibre is actually very short (about one inch long) and hydrophobic, which means that its water absorbency is quite limited.

The raw cotton can float on water.

There is a coating of natural waxes outside of cotton fibre that repel water. Raw cotton is unsuitable for use in many products that require absorbency, a trait that is critical in many cotton applications.

If we use a microscope, we can see that a cotton fibre is like a tiny tube formed of six different concentric layers. The inside of the tube is filled with living cells. Once the fibre matures and the cotton boll opens up to reveal its puffy white contents, these cells dry up and the fibre partially collapses, leaving behind a hollow beanshaped canal, or ‘lumen’. And because of the wax and dead cell debris in lumen, the unprocessed cotton fibre may appear yellowish or brownish colour.

The layers of cotton fibre are made of a long chain of connected glucose molecules with slightly negative charges.

As we know, water molecules have slightly positive charge.

Here we have negative charge cell walls that can capture lots of positive charge water molecules; we also have a lumen that potentially can hold water molecules too. This structure gives cotton the capability to absorb water, up to 27 times of the fibres own weight.

The layers of cotton fibre are made of a long chain of connected glucose molecules with slightly negative charges.

As we know, water molecules have slightly positive charge.

Absorbency test: the whiter, the better To reveal its massive capacity, the cotton fibres must be processed, i.e., to remove all wax coating outside of the layers and debris within lumen.

This process is called bleaching.

Ideally, we would like to get rid of all unnecessary but keep the cellulose walls and expose as much lumen space as possible.

After processing, it will reflect light and it will appear white not yellow anymore.

In fact, the better the processing, the whiter the cotton fibre would appear. In Japan, the whiteness must reach 88 degrees (out of 100 as full mark) before the cotton can be approved in the medical industry.

Any remaining cotton wax and dead cell debris could potentially be antigen to human bodies. Therefore the less processed cotton fibre, the more chance it could cause contaminations even if they are sterilized.

The safe bleaching reagent is hydrogen peroxide as the only things it could leave in the lumen after processing are water and oxygen, hardly

toxic in ordinary environment.

Other reagents may have safety issues though.

Fibre linting The one inch-long cotton fibres must be grouped together to form realistic functions. The grouping process is called spinning and weaving. We have yarns coming out of the spinning process and gauze out of the weaving process of yarns. After all these processes, we have gauze swabs. To add traceability, we can either heat adhered X-ray detectable threads which are made of barium sulphate or weave them into gauze.

There is no chemical reactions between each cotton fibre and they are physically pressed to form yarns. From time to time, cotton fibres may become loose and come out of the yarn. This is called linting or fraying. It is impossible to prevent fibre linting.

The only way to minimise the contamination of the cotton fibre to human body is to process fibre as thoroughly as possible, so that minimal wax and debris left in fibres. And only long chain of glucose left in fibres which can be slowly digested by human immune system. >>

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Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Warp and weft and blood loss count As we already know the water absorbency comes from the processed cotton fibre. More processed fibre; the more water can be absorbed. But it is not the more cotton fibre the better.

In UK, the British Pharmacopeia recommends having 19 threads of yarn x 15 threads of yarn per square inch. Depending on the size of swabs, this specification could potentially indicate the blood loss during the operation. However, if warp and weft are not UK spec, same size of swabs has up to three times different absorbency on blood.

Quality Tests Before our products reach you, they have been through a lot of rigid tests. These processes may increase our costs and make ourselves less competitive on price. We just want to make sure our products are SAFER to use.

Learning outcome We are very grateful to Francis Yuan and MeCoBo Company in particular for supporting AfPP’s educational activities.

EN 14079 Performance requirements and test methods for absorbent cotton gauze and absorbent cotton and viscose gauze.

Here Francis has answered a question which you may have always wanted to ask; how did this packet of five sterile 4”x 3” swabs end up in my hands today as part of my pre-surgical swab, instrument and sharps check?

EN 556 Series Sterilization of medical devices.

But what happens if I should leave a “4 x 3” swab in a patient.

EN 10993 Biological evaluation of medical devices.

Please download the following report to reflect upon a series of such incidents: External Review of Never Events in Interventional Procedures,

by Brian Toft. Professor Brian

EN 868 Series Sterilization packaging.

Toft has carried out an external review of ‘Never Events’ in Interventional Procedures co-commissioned by Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield Clinical Commissioning Group.

The report, published on 7th January 2015, discusses many issues, including those around human factors that will be of interest. http://chfg.org/wp-content/ uploads/2015/01/Externalreview-redacted-version-at-therequest-of-patients.pdf Adrian Jones AfPP Vice President Francis Yuan Business Manager MeCoBo: Medical Consumables

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For further information about this product or a service, please contact your local Aspen Medical representative or visit www.aspenmedicaleurope.com.

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11

Product News

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Detergent choice from schülke gigasan® ND from schülke is the latest addition to the extensive range of disinfectants and detergents from schülke, which is designed to offer choice, convenience and cost savings. gigasan is a non-enzymatic neutral detergent for the manual cleaning of medical and surgical instruments, including endoscopes and endoscopy equipment. Because of the ultra- concentrated formulation a 5 litre container of gigasan ND can be diluted into 12,500 litres of in-use solution. This makes gigasan ND a highly cost effective neutral detergent and also saves on storage space.

If an enzymatic detergent is preferred, gigazyme® contains enzymes and surfactants for optimum cleaning performance. gigazyme is available in both 2 litre and 5 litre pack sizes.

gigazyme spray foam includes three different enzymes for cleaning and disinfection and is designed to keep soiled instruments moist for a prolonged period of time. www.schulke.co.uk

Whether gigasan or gigazyme is used, gigazyme® ready-to-use spray foam can be used for the immediate pre-cleaning and disinfection of surgical instruments, including flexible endoscopes.

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Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

12

Product News 13

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Are you putting your patients at risk?

Even mild hypothermia (when the patient’s core temperature drops below 36°C) can increase post-anaesthesia recovery time, blood loss and morbid cardiac outcomes and lengthen hospital stays1.

Maintaining normothermia should include the use of warm irrigation fluid for surgical procedures as part of the holistic approach to keeping the patient warm throughout the procedure.

NICE guidelines state that fluids

should be warmed to 37°C and that all irrigation fluids used intraoperatively should be warmed in a thermostatically controlled cabinet to a temperature of 38–40°C2.

However, how many operating

teams check the temperature of the fluid leaving the warming cabinet and can be sure of the exact temperature of the fluid being used to irrigate the patient? How confident are you that the fluid is the same as the temperature reading on the warming cabinet?

A recent survey carried out

by Ecolab Healthcare at the AfPP conference in York (2014), identified that out of 28 participants, only 12% were able to correctly ‘guess’ the temperature of the warmed irrigation fluid, when using the traditional ‘finger dip’ test.

The tried and tested method of adding some warm or cold water to get to the correct temperature before being used does raise questions. Not knowing the exact temperature of the irrigation fluid at point of use can jeopardise patient safety. Irrigation with hot solutions has resulted in patient injuries3 and we know that fluid temperature drops by 1°C per minute after removal from a warming cabinet.

Do you know the exact temperature of the irrigation fluid that you are using?

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References 1. Association of Perioperative Registered Nurses (AORN) Recommended Practices Committee. Recommended practices for the prevention of unplanned perioperative hypothermia. AORN J. 2007 May;85 (5):972-988 2. National Institute for Health and Care Excellence (NICE).

Inadvertent Perioperative Hypothermia. NICE Clinical Guideline 65. NICE 2008 April, p12.

3. Association of Perioperative Registered Nurses (AORN) Recommended Practices Committee. Recommended practices for the prevention of unplanned perioperative hypothermia. AORN J. 2012

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Product News 15

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

A helping hand Lord Carter of Coles, the man tasked with leading the procurement efficiency charge, has said “we’ll never get £22bn savings by driving down the cost of rubber gloves”. Now he may have a valid point considering the amount the NHS is looking to save. Although we shouldn’t underestimate the impact all changes can amount to.

The NHS spends £25 million per year on sterile surgical gloves alone. HAIKA™ has been able to help its healthcare clients save up to 40 per cent without compromising quality and double digit savings on millions of pounds cannot be balked at.

In fact the NHS, in its ‘Better Procurement, Better Value, Better Care’ report also references the fact that product substitution could generate savings of up to 38 per cent.

Globus, a privately-held British company, a world leader in protecting hands and the organisation behind the HAIKA brand believes that the secret to efficient purchasing lies primarily in education; education which ensures a genuine understanding of the product being procured and its use. Focusing on this belief HAIKA has come to market with an added-value offering, which in addition to

a comprehensive range of sterile surgical and non-sterile examination hand protection products, will provide consultancy and advice to enable more efficient purchasing.

Essentially Globus will provide hospitals with ‘a helping hand’ to source the right products for each task or procedure, whether its intricate surgical procedures, handling chemotherapy drugs, or gloves for ward cleansing.

Globus can also help healthcare staff to better understand their hand protection needs, thereby enabling them to make better choices at the frontline.

Confidence in selecting the ‘right’ glove ensures a more expensive option isn’t selected ‘just in case’. By instilling a more positive approach to hand protection throughout the hospital Globus is confident that hospitals will be able to save money without compromising quality. Essentially

Globus intends to help hospitals choose the gloves which match the task at hand (excuse the pun!).

With education at the core of its offering Globus is a corporate patron of the Association of Surgeons in Great Britain and Ireland and works with the Association to develop an understanding of exactly, what surgeons need from their gloves and how their usage patterns can influence development.

As well as frontline support Globus is also ably positioned to help hospitals manage the process of change to ensure maximum efficiency when moving to a HAIKA solution. As such, Globus also seeks to work in partnership with procurement personnel to conduct feasibility and usage assessments and then to make the subsequent recommendations. Globus will also ensure that hand protection policies are implemented and that staff understand what gloves they are meant to wear for which task.

Gloves are one of the four highest volume items bought by hospital trusts. This highlights just how vital they are in a hospital environment.

Yet despite this importance they are often an item which is downplayed with people balking at the amount spent a year by the NHS. Whilst there are, undoubtedly, opportunities for significant savings, HAIKA is keen to remind people of the fundamental role they play in the healthcare setting.

And why? Because they protect hands - the hands that do the most amazing things in hospitals every day across the UK.

The fight against HAIs has motivated increased hand protection advice but, according to Globus, this advice often falls short of what it needs to be. For example, whilst a hospital knows that gloves should be used when undertaking infection control procedures are they confident they know which gloves are right for the task and for the chemical being exposed to? Have the effects of the chemical exposure from the cleaning fluids which are regularly used been considered?

For nurses and other frontline staff this should be a question of paramount interest.

A partnership approach For healthcare professionals, their hands are their livelihood and it is vital that they have the correct tools with which to protect them.

By offering a comprehensive portfolio HAIKA is able to support all hand protection needs across the healthcare environment; from specialist sterile surgical gloves to examination gloves and everything in between.

In summary, Globus believes that if hospital procurement has access to the right sector and product knowledge that this will facilitate better informed purchasing decisions. Gloves are the interface between patient and healthcare professional and the right, or wrong, choice can directly affect patient outcomes. I bet you didn’t realise gloves were so interesting? www.haikagloves.com

Product News 17

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

VacSax VacSax, UK leaders in the design and manufacture of disposable suction system for use in all Departments within the hospital, has taken the unprecedented step to manufacture all Suction Liner Products with Antimicrobial Protection.

Founded in 1996, the company currently exports to more than 25 countries around the world. The VacSax BactiClear® Antimicrobial system is seen by over 60% of hospital beds across the UK and has been proven to reduce harmful bacteria such as MRSA and E-Coli by up to 99 per cent as independently tested to the ISO 22196:2011 standard.

VacSax BactiClear® Antimicrobial Suction Liner system is the only system where all external surfaces are totally antimicrobial, designed to minimise the risk of cross-infection.

VacSax Bacticlear® Antimicrobial liners are available in 1 litre, 2 litre and 3 litre versions and are PVC-free, producing only carbon dioxide and water upon 100% combustion.

The unique patented designed liner is folded for ease of storage and begins to inflate as soon as the vacuum is attached. VacSax Bacticlear® Antimicrobial canisters fit any bracket within the hospital and are suitable for all clinical areas. www.vacsax.com

JPP_138x188_sharps_BMS_JULY/AUGUST 27/05/2015 09:24 Page 1

safety

in mind first time, everytime In response to the EU Sharps Directive 2010/32/EU Swann-Morton have launched the KLEEN Blade Management system consisting of their standard blade enclosed within a protective cartridge thus supporting safe handling when fitting and removing the blade from your existing surgical handles. Complimented by Retractable Safety Scalpels, single use Blade Removers and “Cygnetic” they can now offer a complete range of compliant safety solutions.

Swann-Morton can offer in house sharps safety training in line with the new Directive so contact us on sharpssafety@ swann-morton.com for more information.

For more information on the complete range of surgical blades, handles, scalpels, disposable, fine and retractable scalpels please go to our website.

All medical devices are CE marked in accordance with the Medical Device Directive (93/42/EEC)

Owlerton Green, Sheffield S6 2BJ Telephone: 0114 2344231, Sales: 0114 2344223, Fax: 0114 2314966 uksales@swann-morton.com, exportsales@swann-morton.com www.swann-morton.com ‘Swann-Morton’ and the ‘Ring Pattern Logo’ are the registered trade marks of Swann-Morton Limited and related companies.

www.swann-morton.com

Product News 18

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

Peskett

Is a lubricant a contaminant or a crucial necessity for maintaining the proper operation of a surgical instrument?

Most instrument manufacturers recommend the use of lubrication to ensure the correct functioning of their surgical instruments and to minimise wear and tear, thus extending the life of the instrument.

Unfortunately, there is a trend away from the use of lubricants on surgical instruments due to the fact that a lubricant is considered a contaminant. This definition does

not apply to a water-soluble lubricant; a residue would be a more precise definition.

You can use a water-soluble lubricant before sterilization; however the use of oil-based lubricant is discouraged. The ideal location for using the lubricant is the packing room before sterilization. However,

if the lubricant dislodges dried contaminates, the instrument will require returning to the decontamination area for reprocessing, which may include soaking in a lubricant bath until all traces of the soil lodged in the joint are removed.

By introducing the following safeguards into your lubricating routine, you will be able to reduce surgical instrument failures and extend their life span. By ensuring that only the minimum amount of lubricant required is used, the level of lubricant residue will be totally harmless. By not using a lubricant we are running a greater risk of the instruments failing in use, than the risk from lubricant residue on the instrument causing contamination of the operation site.

sterilizable and steam penetrable.

• Check the lubricant’s COSHH (SDS) sheet, section 3 -Hazard Identification Signs/Symptoms of Exposure, to ensure that the product will not react with tissue.

• Restrict the use of the lubricant to the area of the instrument requiring lubrication.

• Test the action of the lubricated joint to ensure penetration.

• If the lubricant dislodges dried contaminants from the joint, return to the decontamination/wash area for reprocessing.

• When introducing a lubricant into the department, ensure that the manufacturer of the lubricant supplies a method of residue testing following steam sterilisation.

• Most importantly ensure the manufacturer backs up any claims with independent test results.

• Only use a water-soluble lubricant.

• Ensure the product has been tested to be totally steam

Matthew Peskett Peskett Solutions Ltd www.ruhof.co.uk

Premier

Healthcare Excellence

PREMIER DETECTORS® X-RAY DETECTABLE SWABS

Make Savings Without Compromise Shermond has been supplying medical and surgical swabs for 20 years supporting safer surgery and best patient care.

With patient safety, risk management and ease of use in mind, all Premier Detectors® and Premier swabs and absorbency products are produced to the highest standards guaranteeing absorbency, thread construction and and x-ray detectability.

Shermond also offers a comprehensive range of theatre consumables and infection prevention and control products including headwear and facial protection.

REQUEST SAMPLES Contact us to find out more.

T: 01530 278111 E: sales@shermond.com W: www.shermond.com

Product News 19

Journal of Perioperative Practice PROCUREMENT GUIDE July 2015 Volume 04 Issue 03 www.afpp.org.uk

AfPP’s Theatre access course Who’s it for?

This course has been tailored specifically for medical device representatives but may also be suitable for students wanting to get a ‘taste’ of theatres.

Where is it held?

Either at AfPP HQ in Harrogate or onsite at your offices (a minimum of 10 delegates are required for onsite courses).

What do you get out of it?

- An understanding of theatre etiquette, correct protocol and the roles and responsibilities of those within theatres.

What does it cost?

- £250+VAT for medical device representatives - £150+VAT for students The course can also be ‘tailor made’ to your specifications.

- A certificate and theatre access course ID pass card.

R

To book your place or for further information, please call Kelly Squires on 01423 882969 or visit www.afpp.org.uk/events/theatreaccess

NING LEA C ECESSIN PRO G RE

CEDURE PRO

P

How long does it last?

The course is valid for two years, after which you will be required to complete a refresher module.

Cantel Medical has launched MEDIVATORS ® RAPIDAER ® Endoscope Reprocessor: a flexible solution to suit all sizes of endoscopy department. The RAPIDAER Endoscope Reprocessor is the fastest, most reliable and productive pass-through washer disinfector currently on the market.

EVOLUTIONARY PROCESS REVOLUTIONARY SOLUTION

STOR ENDOSCOPY PROCEDURE • ENDOSCOPY REPROCESSING Cantel Medical (UK) Limited Wolsley House, Staffordshire Technology Park Beaconside, Stafford, Staffordshire, ST18 0GA United Kingdom Tel: +44 (0) 1785 782420 Fax: +44 (0) 1785 782421 Website: www.cantelmedical.com MEDIVATORS ® is a registered trademark of Medivators Inc. RAPIDAER ® is a registered trademark of Cantel Medical (UK) Limited.

AG E

VISIT US AfPP Residential Event University of York

Intersurgical

30 July - 2 August

range Comfortable for the patient Comfortable for the environment Enter the comfort zone at www.intersurgical.co.uk/info/ecolite

lnteract with us

Quality, innovation and choice

www.intersurgical.co.uk