CHU CLERMONT-FERRAND
At Clermont-Ferrand University Hospital maternity hospital, single use is not systematic
At the Clermont-Ferrand CHU maternity hospital, 3,600 deliveries are carried out each year, and as many single-use sets are thrown away. The hospital decided to switch to reusable medical devices for vaginal delivery packs. It took the team a year to implement the project, following a comparative study based on three pillars: economic, environmental and social.
"At the time when we launched this study, the maternity unit was already very committed to sustainable development, having just been awarded the THQSE gold level label," explains Steffi Calland, Pharmacist in the Territory Sterilization Department at Clermont-Ferrand University Hospital. " In May 2022, our new sterilization department opened, with a sharp increase in production capacity. We reinternalized the sterilization activity on the maternity ward site, which had previously been outsourced to Lyon. The fact that we opened our own sterilization department was an opportunity to ask ourselves the question: couldn't we switch back to reusable medical devices? "
The maternity hospital has defined two comparative scenarios, one for single use, the second designed in conjunction with the maternity hospital's midwives and obstetricians: " It's a reusable instrument tray with everything you need inside for delivery, suturing and episiotomy if required. In this scenario, however, we have kept the single-use drapes and compresses, which cannot be sterilized. At the same time, we tested three reusable delivery trays.
3 times less greenhouse gas emissions for reusables
To compare the two scenarios in terms of environmental impact, the maternity hospital carried out a product life-cycle analysis. The figures speak for themselves: the use of single-use medical devices (SUDs) represents around 38 tonnes ofCO2 per year, compared with 12 tonnes in the reusable scenario. In terms of water consumption, the single-use scenario consumes 1,300m3 per year, compared with 238m3 for the reusable scenario.
" When we collected data from suppliers for the episiotomy pack, we discovered that some materials come from China, Pakistan, Israel and Spain. These products, shipped to Morocco for assembly and sterilization, are then sent to France for storage and distribution to care facilities. The figures confirmed it, but it's still crazy that these medical devices, which have been all over the world, end up in the garbage can pretty quickly! "
Other impacts are also taken into account in the study, such as environmental toxicity, acidification of marine waters, human toxicity and water consumption.
" According to the results of the study, by switching fromsingle-use to reusable over the course of a year, we save in terms of carbon emissions the equivalent of three round-the-world trips by car. In terms of marine ecotoxicity, the death of all fish in an equivalent of 4.5 Pavin lakes, for human toxicity it's the equivalent of 9 million mothballs, for water consumption the equivalent of four municipal swimming pools ".
64 centimes difference per intervention
On the economic side, the maternity hospital made an overall cost comparison, taking into account the cost of purchasing medical devices, waste disposal, the cost of pre-disinfection and the cost of sterilization: " We're at around 87,000 euros over the year for reusables. For single-use, we're at 85,000 euros. This represents a differential of 64 centimes per procedure (€24.22 versus €24.86).
For the social aspect, stress and ease of use questionnaires were offered to all users and healthcare professionals involved in the DM chain.
"So far, so good with our reusable medical devices. We'll be evaluating our circuit for some time to see how satisfied healthcare professionals are with the equipment. A new economic assessment will be necessary, in particular to reassess the cost of sterilization in the light of rising energy prices.