Abstract

IIn hospitals and long-term care facilities, nurses are involved daily in decisions and patient management related to Incontinence Underpads (IUP). There are reusable and single-use options, but with some interesting variations. This paper provides evidence-based information on annual costs and the supply chains with environmental footprints, available to assist nurses in lowering hospital annual costs and reducing environmental impact when managing these clinical devices for patients. With the four-layer underpad architecture, the absorbent zone materials are typically rayon-polyester or cellulose, while the protective barrier for beds is available in Polyurethane (PU) or Polyvinyl Chloride (PVC). Data from 148 health care facilities show that nurses and administrative personnel have teamed up with Centers for Disease Control and Prevention-certified laundries to collect and determine that the typically reusable IUP achieve 29 cycles with reliable performance. All incontinence underpads are laundered on a set schedule, but interestingly, from a direct field evaluation at multiple locations, 75% were unsoiled, 25% wet, and only 5% feces soiled. Another important nursing decision is that, because of the lighter, smaller size, it is not uncommon to use about 2 single-use incontinence underpads rather than 1 reusable underpads. For the approximate actual use rate of 2.1 disposable:1 reusable incontinence underpad, reusables with laundry processing are 80% lower in annual cost, resulting in significant cost savings. Even at a ratio of 1 disposable:1 reusable, the reusables are 64% lower in annual cost. Said differently, the selection by nurses or their hospital Group Purchasing Organization (GPO) of disposable incontinence underpads leads to a 510% higher hospital cost for the approximate actual usage of 2.1:1; while, for equal uses (1:1 ratio), the disposable incontinence underpads annual cost is still 280% higher. If we calculate the financial impact of all 6,129 U.S. hospitals switching to reusable incontinence underpads, the U.S healthcare system will save about $340 million each year. Thus, the annual cost savings of reusables are very significant, and as published separately, reusables also have much lower supply chain and environmental impacts.

This study was not required to be registered since no patient data were involved.

Keywords: Reusable incontinence underpads; Life cycle analysis; Environmental Genome Initiative; Disposable incontinence underpads; Laundry; Hygienically clean