Dr. David Swann from Huddersfield University discovered that 55% of nurses' medical bags that have been used to deliver community care in the UK for the past 150 years are never cleaned and only 6% are cleaned once a week.
Swann's study revealed that around one third of medical bags carry the MRSA bug, which prompted him to design a new medical bag that is set to change medical bags around the globe.
Swann will be commercializing his award winning '21st century' nursing bag next year, which could result in a dramatic reduction of the MRSA infection risk in communities around the world.
Due to the non-existence of any official cleaning specifications for nurses' medical bags outside the hospital, the problem has worsened drastically. Swann urged healthcare commissioners to introduce a cleanliness standard to minimize the risk of infection, given that more and more hospital treatments are now performed in patients' homes rather than in hospital due because of the dramatic increase in costs and demand.
An analysis of community nurses diaries has demonstrated that nurses in the UK visit up to 17 patients a day, with the majority of visits consisting of wound care.
"The design of the traditional nursing bag used by mobile clinicians throughout the world is outdated and unsafe. It is an unfortunate case of 21st century professionals using 19th century kit. The aim of my design is to reinvent community healthcare and deliver a world-class patient experience in non-hospital settings."
The bags community nurses use for home visits are often simple rucksacks made from absorbent textiles. The pockets and folds in the material are difficult to clean and can harbor harmful bacteria. The design of Swann's new medical bag has recently been awarded highly commended status in the NHS Innovation Challenge, and was designed to standardize medical bags that are used for delivering treatment in the community with the aim of improving patient safety.
The bag, made from non-permeable polypropylene white plastic, is easy to clean and a has hard surface that can be transformed into a hygienic lay-down treatment area for clinical tools. At the moment, healthcare workers are forced to improvise during home visits using the floor, a table or a chair as their work surface.
The bag has no fasteners, zips and pockets that cannot be cleaned or harbor bacteria and the color alone, being white, makes frequent cleaning a necessity.
In a nurses trial, Swann's design was given an average score of 80% for functionality, usability and appearance, with one nurse commenting that using the bag made her feel like a 'proper nurse'.
According to the World Health Organization, over 1 billion people receive medical care outside hospital settings around the world. The risk of patients contracting MRSA in hospital is one in then people says the World Patient Safety Alliance, yet the risk outside the hospital can increase to one in four due to the rise in contamination of medical devices that healthcare workers use and therefore help spreading the disease.
"At a time when health services are turning increasingly to care in the community to save money, the 21st century nursing bag is an attempt to inspire a paradigm shift in home healthcare that guarantees patient safety, nurse productivity and service quality."
He continues saying that he used innovative design techniques as an alternative to traditional approaches to healthcare design for his bag, to create products that are functional and can control the infection risk.
By applying ultraviolet-sensitive gel to the bag's surfaces to analyze the bags efficacy in terms of cleaning, any missed areas became visible by shining a UV torch onto the bag's surfaces. Swann also held workshops for nurses and specialists using Lego Serious Play to simulate daily use and to improve the design. In the workshops, participants worked through imaginary scenarios using 3-D Lego brick models.
He hopes that the fact that his bag's innovative design to control rates of infections will attract the health policymakers attention for the need to introduce a standard of cleanliness that controls doctors' and nurses' medical bags who work in the community, given that the only standard currently in force is to control medical bags from paramedics.
He declares: "We must take all available measures to preserve patient safety. Without clear guidelines on medical bags we are letting communities down."
The design is part of a research collaboration between Huddersfield University and NHS East Riding of Yorkshire (NHS ERY), named NHS at Home. NHS ERY first introduced the first Neighborhood Care Teams (NCT) in 2008, which enables patients to be treated at home who suffer from long-term illnesses. At present, NCTs provide services to more than 450,000 patients annually.
Dr Kate Ireland, NHS ERY's Director of Quality and Professional Services commented: "Neighborhood Care Teams are our flagship service. The new nursing bag design offers the prospect of enhancing quality of care through the provision of an improved treatment space for patients whatever the patients' environment."
NHS ERY's Director of Innovation and Design, Jo Gaunt declared: "This exciting and innovative initiative has the potential for rapid spread and adoption across East Riding and beyond."
The nursing bag received the Department of Health's NHS Innovation Challenges prize in June and has also earned global recognition, winning the Helen Hamlyn Design Award for Creativity, where Swann was a finalist in the Conran Foundation Design Award at the Royal College of Art and a finalist in the Industrial Designers Society of America's International Design Excellence Awards. He also received a nomination for Index's prestigious Design to Improve Life Awards. Due to worldwide interest in the product, which is supported by Innovation RCA and Second Mile, the 21st century nursing bag is due to be commercially available as off January 2013.
Written by Petra Rattue