Sustainable Solutions for Daily Gloving

The purchasing practices and behavioral changes that make a difference.

Eco-conscious facilities should always strive to practice sustainable health care.

But let’s be clear — sustainability itself isn’t a destination you arrive at simply by selecting the industry’s greenest vendors and crafting perfectly worded policies that staff adhere to without question. It’s a constantly evolving process that repeatedly asks decision-makers to balance the safety, sterility and environmental impact of a product with its performance and cost-effectiveness. That balancing act is especially challenging when it comes to surgical gloves, one of the most common items in surgery.

OR recycling obstacles

“You can create recycling programs for bouffants, booties, gowns and various other PPE because you can recycle those products, but gloves are the most contaminated items in attempted OR recycling programs,” “Recycling gloves isn’t easy, so you need to reach for solutions beyond disposal practices,” says Christopher Bodkin, manager of sustainability innovation for Health Care Without Harm (HCWH), an international organization dedicated to providing resources, knowledge and inspiration for the healthcare sector to help reduce its environmental impact, and Practice Greenhealth, the leading sustainable healthcare organization, delivering environmental solutions to more than 1,700 hospitals and health systems in the U.S. and Canada. Combine the intractable issues inherent in attempting to recycle non-recyclable and often-contaminated materials with the widespread overuse of surgical gloves and you have a sustainability challenge of titanic proportions.

Luckily, experts like Mr. Bodkin have created a simple strategy that facility leaders can use to guide them as they search for sustainable solutions to their daily gloving practices.

Inquire about sustainability criteria

Increasingly, facilities are including sustainability in their purchasing discussions with prospective vendors. One of the most important steps surgical facility leaders and other healthcare decision-makers can take, says Mr. Bodkin, is having sustainability representation to connect their green ideals to the value-analysis process of purchasing products. “When decision-makers are deciding which product to purchase, there’s going to be functionality considerations and, of course, there’s the price,” he says, “but when leaders have information such as the chemical criteria for a certain product, they can be equipped with the right questions to ask prospective vendors about sustainability.”

Sustainability representation is a broad term. While larger health systems have the resources to create formal, full-time positions such as chief sustainability officer, smaller independent surgery centers often must take a DIY or fugazi approach to sustainability initiatives. Mr. Bodkin has seen plenty of successful, impactful programs started by nurse champions or greening-the-OR champions. GPOs also have the clout to create chemical criteria and packaging standards with participating vendors.

There are also plenty of outside resources available for facilities. For instance, Health Care Without Harm’s “New Sustainability Criteria for Examination and Surgical Gloves” is a valuable tool for leaders to have handy for sustainable purchasing discussions. The document breaks down the criteria for suppliers in the areas of supply chain, product specifications and packaging. Individuals with purchasing power should inquire about the materials used to create a vendor’s gloves. “When it comes to the required chemical criteria in the manufacturing of the material, we ask manufacturers to avoid accelerants and antimicrobials, to make sure they’re not treated with antimicrobials like biocidal chemicals,” says Mr. Bodkin.

Factor in the packaging

Packaging is another consideration for environmentally minded facilities. Use the sustainability — or lack thereof — of the product’s packaging as part of the vendor-vetting process. “There are some vast differences in the recyclability of packaging among glove companies,” says Mr. Bodkin.

With all the variability, it’s important to understand what to look for in a gloving vendor’s packaging. HCWH’s sustainable criteria includes seven straightforward items related to glove packaging. According to HCWH, sustainable packaging means the optimally designed packaging was reduced to the greatest extent possible and based on the ease of recycling — and that it doesn’t contain plastics and additives that impede recycling. You also want to make sure the secondary or tertiary packaging is made of Forest Stewardship Council or equivalent material for paper products.

“Recycling gloves isn’t easy, so you need to reach for solutions beyond disposal practices.”
Christopher Bodkin

Although this sounds simple enough in theory, for surgical glove packaging, it’s anything but in practice. The financial ability to recycle non-homogeneous, lightweight product is extremely difficult because of the aggregating, transporting and condensing of the materials when people recycle cardboard, says Mr. Bodkin. “Generally, it’s the large cardboard boxes that are bailed because they can retain some sort of value in recycling and downstream,” he explains. “When it comes to a small glove box that may include plastic liner, most recyclers will not recycle that product under their waste acceptance policies.” Admittedly, the standards of organizations like HCWH are difficult for many facilities to meet — but that’s kind of the point. “These standards are set forth as something for facilities to strive toward,” says Mr. Bodkin.

Enact change through behavior

Sustainability doesn’t stop after surgical leaders purchase green products for their ORs. There are multiple ways OR staff can help the environment and work toward curbing the massive carbon footprint surgical facilities create through their own day-to-day actions — especially with ubiquitous PPE like surgical gloves. “The mentality in healthcare settings often creates this extreme overuse of the products, and to really enact change here, you need to start with behavior,” says Mr. Bodkin. “That’s proper glove-use training, educating surgical techs and other staff entering and exiting on when it’s appropriate to wear gloves and when it’s not. These are the starting points of sustainability when it comes to gloving.”

The needle in health care is slowly but surely moving toward a safe and sustainable standard of care, but change is a slow process — especially when you consider the complexity and magnitude of the OR waste problem. “In health care, there are a lot of things that can be done, but for every positive, there are negatives that need to be carefully considered,” says Mr. Bodkin.

Once the evidence has been presented and the pros and cons have been weighed, it’s up to facilities to act. Sustainable glove purchasing and usage are small but meaningful ways for surgical facilities to make a difference right now.

The criteria for eco-friendly product is readily available. The vendors are out there. The choice is yours. OSM

This three-part article series is supported by Mölnlycke.