ROANOKE, Va. — History and some opportunities have a way of repeating themselves. Today we are facing a similar problem to what hospitals faced back in 2009 with the H1N1 virus.
Several people have asked me to resubmit an earlier article I wrote about reusable isolation gowns. It is still a very timely topic and can be used as a blueprint to assist others in developing their own programs.
In December 2009 I published an article about an opportunity to use reusable barrier isolation gowns in all the hospitals that comprise the Carilion Clinic in Roanoke, Virginia. It was an opportunity created by the H1N1 virus and advocated for by environmentally conscious nurses. The ability to start such a program was rewarding after having tried and failed to get approval over the previous seven years.
My first experience with reusable barrier gowns came in Milwaukee when I worked at Aurora Healthcare. The start of that program was a direct result of the then new OSHA bloodborne pathogen guidelines.
That program was extremely successful, and we were able to develop a special wash formula for the product with the use of a Sutter hydrostatic tester. We knew that the wash formula would need to be different than any other product we washed because the barrier gowns did not sequester any of the chemicals that were placed in the washer. They all stayed in solution and were available to react with any soil present.
We also knew that any residual surfactant left on the gown would reduce its barrier properties. It was very much a case of using less to achieve more. Our search for the perfect formula was aided by the Sutter hydrostatic tester because it gave us immediate feedback on how the wash formula was working and provided easily repeatable results.
We had tried sending samples of linen out to be tested at an outside laboratory, but the results often took seven to 10 days to get back to us. If there was a problem, we wanted to know about it now, not several weeks down the road.
When I became the director of linen services at the Carilion Clinic, I had a number of problems to solve during my first year of employment. One of my goals was to introduce reusable barrier isolation gowns to the system to help save the hospitals money and increase the value of the laundry.
I approached the infection control department at our largest facility about the idea and was told that they could not support such a program. They had a number of reasons why it was not a good idea:
- Staff would try and wear a reusable isolation gown multiple times during a day.
- Staff would wear them outside to smoke in (visually not a good thing).
- The laundry would not be able to keep up with the volume.
- The laundry staff would have increased exposure to infectious diseases.
- The distribution system would be difficult to manage.
- Quality control concerns.
I tried laying out my best counter arguments to each of these points but simply could not make any headway. I knew from my previous experience that eventually outside events would provide me with an opportunity to provide this type of product.
The opportunity presented itself as a direct result of the H1N1 virus. The use of disposable isolation gowns worldwide went through the roof and most users were put on a quota system based on previous orders.
This supply-chain problem, combined with a number of nurses who were appalled at the amount of trash they were generating every day in disposable barrier isolation gowns, created the opportunity to make another pitch for the program.
The reusable barrier isolation gown project had been proposed by an outside supply chain consulting company during the previous year, but the proposal had not been given serious consideration.
My goal, and the goal of nursing, was to establish a pilot study for the gowns on a few select high-use areas to see if the product and the proposed packaging system was workable. We wanted to test the reaction of the end users to the product versus the disposables.
Check back Tuesday to read about packaging, distribution and quality control methods.