Disposing of human waste safely and hygienically

Advances in bedpan washer-disinfector technology are helping hospitals to improve infection prevention procedures and make sluice rooms more sustainable. Trusts can cut costs, reduce carbon emissions, and help clinicians to save time — enabling them to dedicate more time to delivering hands-on care.

Traditionally, hospitals have tended to favour medical pulp macerators over bedpan washer-disinfectors. Macerators shred medical pulp bedpans into tiny pieces and flush them directly into the sewerage system. Once the macerator lid is closed, those single-use bedpans will never be seen again. It’s a ‘flush and forget’ system. The ‘downside’, however, is that hospitals need to purchase and store large amounts of medical pulp. This is why care homes tend to invest in bedpan washer-disinfectors rather than macerators. Care homes simply don’t have the kind of space that hospitals do (although the latter would argue that they too have capacity constraints).

Thermal disinfection

Bedpan washer-disinfectors employ thermal disinfection processes that involve high-temperature steam, ensuring the destruction of bacteria, viruses, and other potentially harmful microorganisms. This thorough disinfection is critical in preventing the transmission of infections through contaminated reusable items.

Many bedpan washer-disinfectors are equipped with advanced tracking and monitoring systems. These features provide hospitals and care homes with valuable data on cleaning cycles, temperatures, and disinfection processes. This enables comprehensive traceability, and ensures compliance with infection-control standards.

So, bedpan washer-disinfectors very much have a place in hospitals, even though NHS Trusts tend to prefer macerators. Like care homes, hospitals can benefit from the sustainability benefits offered by reuseable bedpans, commode pots, and urine bottles — and the new technology in the latest bedpan washers is making them more popular.

Hospitals that have traditionally eschewed bedpan washer-disinfectors in favour of macerators would be wise to give them a second look and compare their benefits in more detail. After all, both types of machines enable healthcare providers to dispose of human waste safely, hygienically, effectively, and efficiently — helping to stop the transmission of bacteria, viruses, and fungi, between patients, staff, and hospital visitors.

This is especially crucial in the context of contagious diseases. Timely and effective infection control measures can prevent small outbreaks from becoming large-scale epidemics within healthcare and care home facilities.

Today’s new generation of bedpan washer-disinfectors has been designed very much with sustainability in mind, while building on the infection prevention and control dependability of previous models. It is vital that hospitals should never have to compromise: they should never have to sacrifice infection prevention in favour of sustainability — or vice versa. They should expect and get both.

Bedpan washer-disinfectors such as DDC Dolphin’s four newly updated Panamatic models (Midi, Maxi, Optima 2, Optima 3) have been designed to save energy and water while delivering improved infection prevention and control. This has been achieved through a series of design enhancements. On the inside, the new Midi now has 25% more capacity, accommodating two pans and two bottles in a single cycle. This means that more bedpans and bottles can be disinfected in fewer cycles — making the updated Midi 33% more energy- and water-efficient than its predecessor. Clinicians will spend less time filling, emptying, and refilling the machine, enabling them to spend more time delivering care at the bedside.

Larger antimicrobial touch area

Meanwhile, on the outside, the new Midi and Optima 2 both have a much larger antimicrobial touch area. It is 2.5 times the size of that on the previous models. Antimicrobial protection has also been added to the Maxi and the Optima 3. This antimicrobial protection uses silver to kill bacteria and destroy viruses. Physicians have known of the infection control properties of silver for thousands of years. It was documented in the 17th and 18th centuries, but dates as far back as 4,000 BC. In the case of the Panamatic range, silver ion protection is moulded into the plastic on various surfaces. Silver ion antimicrobial powder reduces the growth of Campylobacter, E.coli, Listeria, MRSA, Pseudomonas, and Salmonella, by up to 99.99%. It is tested to ISO 22196:2011.

Other external improvements include a new lid-opening mechanism that builds on the hands-free technology that has long been a feature of some bedpan washer-disinfectors. The less that clinicians can touch a bedpan washer-disinfector the better, so in the past machines had foot-operated lid opening. However, even this can be improved upon. Previously, machines such as the Midi and Optima 2 had a foot cup for opening the lid (while the Maxi and Optima 3 had a footplate). Now, all four machines have an ultrasonic sensor instead. It is still foot operated, but each machine now has a flat front — eliminating the risk of a possible dirt trap, and making it quicker and easier to clean.

Enhancements to the Panamatic range also include updated decals with clear, easy-to-understand symbols for ‘in cycle’ and ‘cycle complete’. It is important that sluice machines should always be as simple and as intuitive to use as possible. This helps to stop inexperienced users from inadvertently misusing and breaking the machine. Never forget that sluice room equipment downtime is more than an inconvenience — it can lead to the spread of infections, with dangerous and costly consequences for patients, clinicians, hospital visitors, and the wider community. The stainless steel side panels on the Panamatic Midi and Optima 2 now cover the water tank on each machine. This makes the machines even stronger, further enhances their aesthetics, and makes cleaning easier. In turn, this results in superior infection control — because simpler cleaning encourages better cleaning.

Key questions when specifying bedpan washer-disinfectors

Specifying the most effective, reliable, and energy-efficient bedpan washers or macerators will have a significant positive impact on a Trust — not least because of the sheer number of sluice machines that each hospital uses. Given that all these machines will be used 24/7/365, daily savings will soon add up and be reflected in monthly and annual running costs — especially when you consider that each bedpan washer (or macerator) should last for at least 10 years when properly maintained. So, it is vital to consider the whole-of-life cost of acquiring, operating, maintaining, and disposing of each machine.

These are some of the key questions that you should be asking when specifying bedpan washer-disinfectors:

Is the machine right for the size of ward? Will it cope with demand at peak times? How efficient is the bedpan washer disinfection process? What is the cycle time? Can the machine deal quickly with large numbers of bedpans?
Does the bedpan washer meet all the relevant industry standards and regulations? What are its certifications? Will the machine comply with infection control guidelines?
How easy is the bedpan washer to use? Does it have any automated features that make it simpler and more user-friendly to operate? How much training will the staff need?
What are the recommended service intervals? How easy is it to clean, disinfect, and service the machine? Does the supplier offer any technical support or service agreements that will help to reduce operating costs and make them more predictable? How can the supplier help to reduce administration time and costs?
How much water and energy does the equipment consume per cycle? What eco-friendly features does the machine have? Can its software be customised to make it run more efficiently in different medical settings?
Is the machine compatible with various types of bedpans, commode pots, and urine bottles? Can it handle different sizes and materials?
What safety features are there to protect users and patients? How does the machine deal with infectious waste without risking cross-contamination?
How much space will each machine take up? What are its utility requirements? Is any special plumbing or electrical work needed?
What is the overall cost of purchasing and installing each machine? How much will it cost to operate, service and maintain? Are there any long-term cost savings or efficiencies that will benefit the user organisation?

Then there is the matter of repairs. A good manufacturer should be able to service and maintain all makes of machines — not just their own. This reduces the number of engineer call-outs, ensuring that non-functioning machines are fixed faster, and at lower cost.

Cutting the cost of repairs

Many sluice machine breakdowns are caused by misuse or lack of servicing. A bedpan washer-disinfector’s biggest enemy is limescale. It only takes 1 mm of limescale to increase the energy usage of a bedpan washer disinfector by 11%. NHS Trusts that are serious about saving money and meeting their Net Zero targets should tackle limescale as a priority.

Multiply that 11% rise in energy costs by the number of bedpan washers being used, and suddenly the power bills can start to look very troubling. Think about it: for every nine limescale-affected bedpan washers a hospital operates, it is effectively paying for the energy of a tenth machine that is not there — with all the associated negative impact on the Trust’s carbon footprint; all at a time when Net Zero is the target.

Aside from the high energy costs, limescale can also result in some big repair bills. The true cost of a machine breakdown averages £633 (assuming there is no service contract in place). This average cost is based on:

A call-out charge of £217.
Labour at £116/hour.
Parts: £300.

However, planned preventative maintenance delivered through a pre-agreed service contract can cut the cost of the average breakdown to just £347, a 45% reduction in cost. Importantly, the machine will be fixed faster — within 24 rather than 72 hours. That’s a crucial consideration because it means the machine can be returned to infection prevention duties sooner — safeguarding everyone in the hospital from the risk of healthcare-associated infections (HCAIs).

Choose a sluice room equipment manufacturer that has the expertise and experience to work on all brands of machines — you will save on call-out charges and spend less time waiting for the right engineer to arrive. Establish a baseline — get your sluice machines audited by a specialist so you know precisely what needs servicing, repairing, or replacing, and when. Choose a supplier with an online portal so that you can assess the condition and requirements of all your bedpan washer-disinfectors and medical pulp macerators quickly and easily, ’24/7′, from any location with good broadband or a reliable mobile phone signal.

Always think about the full lifetime cost of running each machine. Use of scale inhibitor and proper servicing/maintenance will extend the operational life of the machine and result in savings on energy, repairs, and replacement (compared with a badly maintained machine).

Ensure that your machines are covered by a service plan — proper planned preventative maintenance means better performance, fewer breakdowns, optimal uptime, lower energy bills, and faster (and less costly) repairs. The savings are easily quantifiable, and the peace of mind is priceless. Consider signing up to a chemical plan. This will reduce the cost of consumables such as wash and scale inhibitor (for bedpan washer-disinfectors) and disinfectant (for medical pulp macerators) by up to 15%. Chemicals will be delivered when needed — either monthly, quarterly, or yearly. This ensures security of supply, eliminating another worry. Using a manufacturer with a proven track record also helps to ensure they will supply the right quality chemicals. Seemingly cheaper alternatives can be a false economy, because you may need to use more. Worse still — using unapproved chemicals or an incorrect dosage can damage the machine and/or reduce its operational lifespan.

Infection prevention: depth of defence

Bedpan washer-disinfectors and medical pulp macerators are at the heart of any good sluice room, but they are by no means the full story. There is much more to consider — and again, advances in technology are pushing forward the boundaries of infection prevention and control.

Key components

A well-equipped sluice room should also include:

Stainless steel furniture that can withstand strong cleaning agents. Smooth surfaces and clean welds minimise the risk of dirt traps. Sluice room furniture in UK hospitals must comply with the requirements of Health Technical Memorandum (HTM) 64, a set of guidelines and standards developed by the Department of Health Estates and Facilities Division. HTM 64 focuses on the design and installation of healthcare furniture, including sluice room equipment and sanitary assemblies. It provides guidance on the design, manufacture, and installation of sanitary assemblies in healthcare facilities, with the goal of ensuring safety, hygiene, and efficiency. The document covers various aspects of healthcare furniture, including materials, construction, and infection control measures. It is particularly relevant to areas where sanitation and hygiene are critical. Two grades of stainless steel are used for sluice room furniture:

304 is the world’s most popular type of stainless steel, notably because it is the one used for cutlery.

316 is marine grade stainless steel. It offers even greater protection against corrosion, because the alloy contains molybdenum.
UVC water trap disinfectors that use ultraviolet light to kill off biofilm-forming bacteria in water traps, one of the most contaminated areas of a hospital or care home. Sink water traps are a breeding ground for lethal multidrug-resistant (MDR) bacteria that can infect patients, clinicians, and hospital visitors. Infection risks occur when water used for staff handwashing, patient hygiene, and washing devices, becomes contaminated, and is then drained through the sinks. If the water flow is restricted, biofilm-forming bacteria may create stable reservoirs in waste pipes and semi-horizontal drainpipes. Bacteria that form in one water trap or wastepipe can easily spread to other nearby sinks. A good UVC water trap disinfector should eliminate multi-drug resistant Carbapenemase-producing organisms (CPO), Vancomycin-resistant enterococci (VRE), and bacteria that produce Extended-spectrum beta-lactamases (ESBL).
UV air purification technology that draws in polluted air and treats it using UV light and photocatalytic oxidation. UVMATIC air purifiers combine three technologies — photoplasma, ozone, and negative ions — to destroy viruses such as influenza, as well as E.coli, Salmonella and similar bacteria. UV air purifiers are highly effective at removing unpleasant smells. They kill the bacteria that cause malodours — improving hygiene, and leaving rooms smelling fresh and clean.
Tough medical-grade flooring that is resistant to liquids and stains, is easy to clean, has anti-slip properties, and low emissions of volatile organic compounds (improving air quality).
Tiled or aseptic laminate wallcoverings that are robust, stain-resistant, and easy to clean/disinfect.

Consider also how waste will be collected and stored if it is to be disposed of by third-party contractors. This waste must be stored safely prior to disposal if it is not to become an infection hazard. Machines such as Vacumatic enable staff to collect waste safely by vacuum compacting, sanitising, and hermetically sealing, waste bags. Vacumatic is a 100% hygienic and odourless waste disposal system — and because it compacts the waste, it can help hospitals and care homes save money if they pay for disposal on a ‘per collection’ basis, rather than by weight.