Reusable tourniquets for sustainable phlebotomy, South Yorkshire Regional Services (SYRS)

Project completed as part of the 2023-4 Sheffield Teaching Hospitals Green Team Competition.

Team members

• Rebecca Palmer Nurse Lead for Governance Quality Improvement
• Lea Lindley Senior Sister, Cardiology/Vascular Outpatients
• Tony Ward Senior Charge Nurse, Renal Outpatients
• Nina Coggins Sister, Cardiology/Vascular Outpatients
• Joanne Vaines Clinical Support Worker, Key phlebotomy Trainer
• Steve Newsome Logistics Manager, SYRS
• Paul Cattell Senior Charge Nurse Cardiac Catheter Suite

Setting / patent group:

Phlebotomy testing for Cardiology, Cardiac Surgery, Thoracic Surgery, Vascular and Renal services

Issue:

The single-use tourniquets used by SYRS were poor quality and provided a poor experience for both patients and staff. The high volume of tourniquet required also contributed a lot of clinical waste.

Intervention:

A reusable tourniquet (Daisygrip) was trailed and has been implemented across the SRYS service via implementation of a communication and education strategy.

Outcomes

Within our trial of SYRS, we have projected annual savings of £6,632 and 1,057.7 kgCO2e, equivalent to driving 3,123.7 miles in an average car. We will monitor our procurement data to confirm in one year if our estimated savings are correct or under/overestimated.

We plan to promote the scale of this change Trust wide. Based on procurement data of single use items, this change could bring savings of £35,868 and 24,885 kgCO2e, equivalent to driving 73,493.7 miles in an average car.

Staff commented that they had concerns the single use tourniquet could harm patients and agreed they wanted a better option, e.g.

“Removing it [single use tourniquet] is difficult and causes further discomfort as we wrestle with it. And trying to remove it while the needle is still in the arm and the last bottle being drawn can cause trauma in the vein while you're wrestling with it.”

“We need a better-quality tourniquet to help us do our job well. Preserving our patients' veins is really important for their future as renal patients. Poor quality of single use can make patient experience stressful and poor. I feel this when I’m trying to take their blood”.

Following the trial, there was agreement the reusable tourniquet is a better option for patients and staff. 94% staff said it was important to them that the reusable tourniquet would help to reduce waste and carbon emissions in the department. 100% of patients surveyed agreed they liked the reusable option, reporting it does not pinch or mark their skin or cause any pain.

Key learning point

The key elements that contributed to the success and learning in this project were the importance of keeping the weekly meetings going over the 10 weeks. We were extremely focused when it came to driving actions and tracking key milestones and risks. We learnt when things didn't go so well. Particularly around education, communication and stock ordering. This helped focus our priorities which were patient and staff engagement, and listening to what mattered to them. We learned that staff education, product distribution and stock control are important and need to continue beyond the project timeline. Involving the right people from the start and inviting colleagues in response to any issues as they arise. With the support from our Nurse Director, Operations Directors and the Infection Prevention and Control team we were able to make our changes happen.