Reducing the environmental impact of gloves used in the Intensive Care Unit

Abstract

Background
The healthcare sector is one of the most polluting sectors in the Netherlands. To limit the environmental impact of the medical sector, Erasmus MC collaborated with Metabolic to conduct a Material Flow Analysis (MFA) and Impact Assessment for the Intensive Care Unit (ICU). The research revealed the hotspots of the ICU, contributing to this polluting sector. Based on the hotspots The Convergence, a cooperation between the Erasmus University, Erasmus MC, and TU Delft have set up the first three design projects.
Project aim
This graduation project aimed to make a start towards greener ICUs. In the ICU care is delivered to critically ill patients. The number of gloves used is high because of the intensity of care and high standards. Due to its resource-intensive production and frequency of use, the use of nitrile disposable gloves was found as a hotspot. The question to be answered was; How could the environmental impact of gloves in the ICU be reduced, while remaining quality of care? Research
Extensive research is done with different focuses; product-centred, human-centred and material centred. Furthermore, the waste from the PICU was analysed for one week. The research revealed the importance of the procurement department and the Unit Infection Prevention.
Design direction
Together with the nursing staff, it was decided to go for the design direction of reducing the number of unused gloves. The scope was set to the current situation in the ICU and the idea should be implementable in the short term. The research resulted in five building blocks for the design that need to be incorporated; (1) infection prevention, (2) zero-risk, (3) ease of use, (4) efficiency and (5) technology.
Ideation
Ideation was done by involving people in creative sessions. Restrictions were excluded in the creative sessions, to come up with a wide range of ideas. Three ideas were chosen based on their short-term implementation possibility and incorporation of the building blocks. The ideas were presented to the Green Team of the ICU and it was decided to go on with an addition of the current box and applying a different way of dispensing gloves.
Prototyping and testing
Prototypes were made to quickly verify the functioning of the ideas. While testing the prototypes, iterations were applied. A user evaluation was performed and resulted in a preference for the vertical dispensing design.
Final design
The final design is GloVe, a vertical dispense system. By incorporating the five building blocks, the design can provide benefits for multiple stakeholders. It reduces the environmental impact of gloves in the ICU by dispensing one glove at a time. Furthermore, the gloves are dispensed at the cuff, which comes in little contact with the patient. The vertical movement is pleasant to the user. The use of colour for different sizes makes it clear to the care assistant which box should go in which holder. Also, nurses will see at a glance, which size gloves they are dispensing. The small V-shaped opening makes the undesirable behaviour, of placing gloves back, almost impossible.
Transformation towards greener ICUs The design thinking approach has yielded a design, insights, and recommendations for subsequent projects. Furthermore, the project has drawn a lot of attention to making healthcare more sustainable. The project has been a necessary start towards more sustainable ICUs.