Blood and Body Fluid Spill Kit in Use: a Staff and Patient Evaluation: Final Report

Abstract

The COVID-19 pandemic has highlighted the importance of cleaning and disinfection, as part of a range of infection control interventions, with the aim of preventing the spread of infection. Standard precautions apply for the safe practice and handling of blood, and other bodily fluids such as urine, faecal matter, vomit, and sputum in a healthcare environment. Disinfecting and dealing with biological spills is integral to reducing the risk of exposure to patients and health care workers. Management of these spills should adhere to national guidance and policy and instructions should be clear within each area/care setting. Decontamination of the spill depends on the nature and size of the spill, the pathogens, the type of surface and the location of the spill. [1] It is important, therefore, to have the right spill management measures in place to protect those individuals at risk. [2] In the UK, biological spill kits generally include polyacrylate granules (which absorb water but not any form of solids or fats often found in bodily fluids), with a chlorine releasing agent and/or biocidal wipes and single use plastic scoops and scrapers. [4] There is currently no incumbent spill kit which is recommended for all biological spills. Instead, healthcare professionals must choose the correct spill kit for different spills. It is against this backdrop that we undertook a comparative analysis of two standard biological spill kit systems currently used in NHS and healthcare environments against BIOPERL+ (a new to market, wide-spectrum biocidal absorbent based on a natural mineral with disposable cardboard dustpan and scraper).

The aim of the study was to investigate the useability of the kits in scenarios that matched real clinical settings as much as possible. Simulated spills such as faeces, urine, blood, and vomit were used. Videos and semi-structured interviews were conducted using a purposive sample of 12 healthcar professionals/students with ‘observing’ patients. Participants were asked to clean up various simulated body fluid spills using the spill kits provided (including following the manufacturers' instructions for use). The kits differed in their component parts, assembly, and their use. Data analysis followed the Framework
Method of Analysis[5].
Kits
• Incumbent Kit 1 (Polyacrylate based, recommended for urine and vomit)
• Incumbent Kit 2 (Polyacrylate based, recommended for biological spills except urine and vomit)
• BIOPERL+ (Natural mineral based, recommended for all biological spills)

Main Findings
Respondents found the instructions for BIOPERL+ were easier to follow with clear, identifiable diagrams. Respondents felt it was helpful that BIOPERL+ is a ‘one size fits all’ kit suitable for all biological spills. Conversely, the incumbent kits’ instructions were more detailed and lengthier meaning that, in some instances, respondents were less clear about which incumbent kit to use for which type of spill. Other respondents found the multiple components in the incumbent kits to be confusing. These challenges were observed and appeared to contribute to hesitancy and potentially impacted on the decision-making process; for example, one participant used the wrong incumbent kit for the presented spill. BIOPERL+ was perceived by both observing patients and healthcare professionals to have increased absorption compared to the incumbent kits and healthcare professionals felt it allowed them to deal with spillages more quickly leading to perceived less psychological discomfort for the patient. Measurement of the total time taken to clear up the spill verified BIOPERL+ as the quickest of the options. The incumbent spill kits were considered to be less efficient, but opinions varied regarding how well the polyacrylate powder absorbed the spill – possibly because polyacrylate absorbs only the H2O element. It was felt that BIOPERL+ left less residual powder while excess polyacrylate granules from the incumbent kit were harder to remove from the floor. None of the participants noted that BIOPERL+ left a dry floor at the end of the process, while the incumbent kits left a damp surface which may have needed to be dried to avoid potential slip hazard. Nonetheless, this could be an important factor in a healthcare setting. The plastic scoop and scraper provided with the incumbent spill kits came pre-formed, ready for use which was seen as simpler. However, the scoop was too small to clear up the spills effectively. The larger, cardboard dustpan and scraper provided with BIOPERL+ was felt to work well and cleared the spill more effectively. Some respondents did find constructing the BIOPERL+ cardboard dustpan challenging, but these respondents had built the scoop outside the scope of the manufacturer’s instructions, which still appeared to be fit for purpose. On the whole respondents reported little or no odour when using the spill kits but a bleach odour was perceived from all three kits by a minority.
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Conclusions
The aim of this study was to compare the useability of a new approach to the clearing up of biological spills in a healthcare environment with current practice to see if there were any additional benefits relevant to infection control. BIOPERL+ potentially represents a simpler, quicker and more effective method of cleaning up biological spills in a healthcare setting. For current incumbent spill kits, the user first has to make a decision about which kit is the correct one for the spill, then utilise multiple components and processes to complete the task. The BIOPERL+ kit can be used on all biological spills and is a more straightforward process with fewer components in the kit. BIOPERL+ was found to be quicker and more effective than the incumbent kits based on polyacrylate granules.

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https://research-portal.uws.ac.uk/en/publications/blood-and-body-fluid-spill-kit-in-use-a-staff-and-patient-evaluat