MACERATORS VS.
WASHER-DISINFECTORS
Multi-use or single-use solutions? This is a question for all areas of hospital management. Even when buying bedpans and urine bottles . And it has consequences for the disposal and cleaning systems used, too.
Driven by the need for sustainability, the costs involved and the limits imposed by hygiene, the answer can only be as follows: opt for reusable solutions - with reusable care utensils and washer-disinfectors from MEIKO.
We tell you why disposable care utensils, which is shredded together with its contents in macerators and discharged via the waste water system, is not only bad for the environment, but can also become a real hygiene and cost trap.
ENVIRONMENT
STUDY: ‘DISPOSABLE AND REUSABLE DISPOSABLE SYSTEMS FOR PATIENTS' EXCRETA’, INSTITUTE OF ENVIRONMENTAL MEDICINE AND HOSPITAL EPIDEMIOLOGY (IUK) AT FREIBURG UNIVERSITY HOSPITAL (2004)
‘Disposing of patients' excreta using single-use, disposable systems is a clear case of injecting refuse into the sewage system,’ states Martin Scherrer, Dipl. Ing. in Hospital Operations Technology. Disposable bedpans made from pulp (cellulose) are unquestionably a form of refuse according to the IUK’s study report, regardless of whether they are produced from recycled materials.
WORK REPORT BY THE DWA (GERMAN ASSOCIATION FOR WATER MANAGEMENT, WASTE WATER AND WASTE), WORKING GROUP ON HOSPITAL WASTE WATER
‘Introducing macerated cellulose containers into the waste water puts a greater strain on the sewage system than disposing of excreta with reusable systems.’ The independent DWA found that each litre of sewage from a disposable system contained settleable solids in the region of 600 to 900 millilitres per litre – at least at the point in which the material is released into the sewers.
THE BRITISH LOBBY ORGANISATION WATER UK: MACERATORS - THE IMPACT ON SEWERS (2009)
Macerators significantly increasethe risk of sewer blockages, overflows, environmental pollution, odour nuisance and also the infestation of rats and other rodents. In view of the fact that macerators do not support efforts to achieve sustainable waste management, as stated in the report, the aim is to influence legislators to forbid their use.
CONCLUSION FOR THE ENVIRONMENT:
HANDLING
WORK REPORT BY THE DWA (GERMAN ASSOCIATION FOR WATER MANAGEMENT, WASTE WATER AND WASTE), WORKING GROUP ON HOSPITAL WASTE WATER
Pulp cellulose containers cannot be set aside or stored for any length of time once they have been used because of the risk of softening and leakage. That means that they are far more heavily dependent upon the uninterrupted availability of the disposal appliance than is the case with reusable care utensils. According to the DWA, a cost-benefit analysis reveals that there are not even any advantages in terms of the time required to dispose of pulp containers in comparison to the time required to treat stainless steel containers in reusable systems: ‘Comparing the appliances based on the current state of the art does not reveal any time benefits for the alternative [disposable] system.’
NIZAM DAMANI: MANUAL OF INFECTION PREVENTION AND CONTROL, 3RD EDITION, P. 89, PUBLISHED BY OXFORD UNIVERSITY PRESS (2012)
‘Carriers used with disposable bedpans should be washed in bedpan washer or cleaned after each use with detergent, disinfect with hypochlorite 1000 ppm av Cl2 solution.’
DR HEINZ-MICHAEL JUST, MEMBER OF THE HOSPITAL HYGIENE AND INFECTION CONTROL COMMISSION AT THE ROBERT KOCH INSTITUTE (RKI)
‘Although a stainless steel bedpan may feel slightly cold at first, it is stable and gives the patient the reassurance that nothing is going to soak through or bend out of shape.’
COSTS
VEIT FLÖSER, SPOKESPERSON FOR THE DWA (GERMAN ASSOCIATION FOR WATER MANAGEMENT, WASTE WATER AND WASTE), WORKING GROUP ON HOSPITAL WASTE WATER
‘Even if pulp cellulose has been macerated, it can still cause problems when it settles if the waste water flow rate is low. In this case there is a very real risk of blocking up the waste water system.’
CHRISTINE LOBÈ: COMPARATIVE ANALYSIS OF BEDPAN PROCESSING EQUIPMENT (2009)
In the Health Department of Western Australia, the responsible water authority decided to introduce an annual charge per appliance for clinics that use macerators if they discharge the waste water from them into the public water system.
EXAMPLE: NUH SINGAPORE (NATIONAL UNIVERSITY HOSPITAL)
Cost of purchase Macerator:
| Number of units | ||
|---|---|---|
| 47 | ||
| Buying cost macerator total | Costs per unit | |
| 500.000 SGD / 344.841 € | 10.638 SGD / 7.336 € |
Running expenses for disposable items with Macerators:
| Number of wards | ||
|---|---|---|
| 45 | ||
| Cost 1 ward / month | Cost 45 wards / month | |
| 2.500 SGD / 1.725 € | 112.500 SGD / 77.612 € | |
| Cost 1 ward / year | Cost 45 wards / year | |
| 30.000 SGD / 20.696 € | 1.350.000 SGD / 931.340 € |
- These running costs for disposable items are eliminated with a bedpan washer.
- The example of NUH Singapore (National University Hospital) shows:
- After just one year the running costs add up to such an amount that the higher purchase costs and the higher water and electricity costs of a bedpan washer would generally be covered.
- And that's not all! These costs are incurred every year. Calculated over several years, the savings potential of a bedpan washer is enormous compared to a macerator.
(Source: The Straits Times Singapore)
PUBLISHED JAN 20, 2014, 7:40 AM SGT
https://www.straitstimes.com/singapore/nuh-switching-to-disposable-bedpans-for-all-patients
CONCLUSION FOR COSTS:
‘Using disposable systems has more of an adverse affect on waste water than using reusable systems does. In contrast, reusable systems use more water and energy than disposable ones. In terms of costs, the reusable system requires a greater initial outlay, but the higher operating costs of the disposable system mean that this advantage is lost after just one year.’ (Kümmerer et al. 2004)
Study: ‘Disposable and reusable disposal systems for patients' excreta’, Institute of Environmental Medicine and Hospital Epidemiology (IUK) at Freiburg University Hospital
HYGIENE
THE CONCLUSION OF THE STUDY:
Disposable system appliances are not recommended for the disposal of patients' excreta. Bedpans and urine bottles combined with a suitable washer-disinfector are far superior to disposable systems in all the parameters studied.
This statement is reinforced by Dr Klaus Kümmerer, Armin König and Martin Scherrer, Dipl. Ing. in terms of the environmental and financial impact. And as far as hygiene and medical requirements are concerned, the researchers expressed a clear opinion on the thermal disinfection of reusable systems: ‘This process is safe, familiar, and easy to use, as well as state of the art!’
Study: ‘Disposable and reusable disposal systems for patients' excreta’, Institute of Environmental Medicine and Hospital Epidemiology (IUK) at Freiburg University Hospital (2004)
