Which sluice solution? Clinical staff preferences

Sluice rooms are primarily used by clinical staff so it crucial that processes are designed with their interests at the forefront.

From our extensive experience, clinical staff prefer systems that are:

Quick
Easy
Clean
Reliable
Non-smelly
Minimal contact with offensive material

One-way macerator systems

Studies have shown that 95% of clinical staff members believed disposable bedpans are cleaner and safer than re-use systems (Delaney 2017). As most macerators use a one-step process, they are generally the fastest and easiest system and have minimal contact with the contaminated pans.

Nursing staff have reported that sluice rooms have very little to no smell when using macerators as human waste is immediately flushed away. Reliability of machines is generally high, although this depends on the manufacturer and staff training.

One-way disposal systems

Clinical staff have reported that one-way systems are clean, quick and easy-to-use. Disposal systems are likely to encounter infection control problems due overfilling bins, insufficient collection or tears in trash bags. Such environmental contamination constitutes an infection risk to hospital staff and patients. Porter staff are particularly at-risk as they often come into direct contact with offensive substances when collecting waste.

Sluice rooms are smellier when using refuse systems as used human waste is left in the room until refuse is collected. Not only is this high-risk for aerosol contamination but also creates an unpleasant working environment.

Re-use washer systems

Washers require more handling by clinical staff to empty waste and load bedpans than one-way alternatives. Research has shown high levels of user error when using bedpan washers, suggesting that practices are complicated or difficult to follow (Delaney 2017). Many clinical staff members are concerned with the safety of re-use bedpans and whether they are sufficiently disinfected in washer cycles.

Clinical staff members have reported that washers can make the sluice room smelly due to the processing steps before the cycle. Machine reliability depends on staff training – one study found that a hospital had over 500 maintenance callouts for machines in a six-month period, of which a significant proportion were attributed to user error (Delaney 2017).

Re-use handwash systems

Handwashing systems are generally the least popular bedpan management process amongst healthcare workers as they require direct contact with contaminated bedpans. Handwashing is criticised by clinical staff as being “dirty”, “ineffective” and “degrading”. Practices are often unsafe as bedpans are left to soak in strong detergents for extended periods of time. Plastic bedpans float and non-submerged areas compromise the effectiveness of disinfection. Smells are also circulated throughout the process, contributing to a hazardous working environment.

Conclusion

Clinical staff have reported a strong preference for single-use systems over re-use alternatives due to cleanliness and efficiency. Clinical staff like how the single-use systems allowed them to spend more time with patients and meant there were less opportunities for contact with contaminated items. The absence of human waste smells when using a macerator is also reported to improve working conditions. We recommend that healthcare facilities open an internal dialogue with nursing staff to establish methods to improve infrastructure.

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