This week, we continue to showcase some of the excellent work presented at IP2025. This edition focuses on the critical intersection between IPC and sustainability. Selected posters explore how innovative environmental design and resource-conscious solutions; from reusable PPE and eco-efficient eye drop use to water safety and economic modelling, can strengthen infection prevention and control while reducing our environmental footprint.
- Promoting Hand Hygiene and Responsible Glove Use with Point-of-Use Educational Stickers
Inappropriate use of gloves reduces hand hygiene compliance and contributes to environmental waste. Behavioural science and human factors research highlight that to be effective, information must be visible and accessible at the moment of decision-making. This initiative aimed to improve glove-use behaviour and hand hygiene compliance through targeted visual prompts placed at the point of use.
Methods: To support real-time decision-making, point-of-use visual reminder stickers were developed and placed on PPE dispensers. The stickers delivered three key messages: when gloves are required and not required, the need for hand hygiene before and after glove use, and the environmental impact of overuse. The intervention was designed with principles from human factors theory—similar to how airline safety instructions are placed directly in view—to prompt correct actions in context. Hand hygiene and glove-use audits were conducted before and after implementation. Results: Baseline audits showed poor compliance with hand hygiene related to glove use, frequent unnecessary glove use, and lack of awareness of the environmental impact of glove overuse. Following sticker implementation, compliance with hand hygiene improved by 30%, and appropriate glove use increased by 20%. Staff feedback indicated increased awareness of the Environmental impact of glove overuse and the benefit of prompts at the point of use. Conclusion: Hand hygiene is critical, regardless of glove use. Point-of-use prompts are an effective, low-cost intervention that promote behaviour change, improve compliance, reduce waste, and support safer, more sustainable PPE practice.
Authors: Davitt J, Murray V , Maczynska A , Hayes L , Lemass H , Johnson T , McGuinness J, (HSE West North West, Ireland, Galway, Ireland)
- Investigating the role of the healthcare water sources in healthcare-associated Gram-negative bloodstream infections
Healthcare-associated Gram-negative bloodstream infections (GN-BSIs) caused by Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa are increasing across England, yet many cases lack an identifiable source. Environmental reservoirs, particularly hospital water systems, have been proposed as potential contributors. This study investigated the role of water outlets in hospital-onset GN-BSIs at a large tertiary hospital in southern England between March 2024 and January 2025.
Seventy-four hospital-onset GN-BSIs were identified, with water sampling performed for 57 (77%). In total, 154 swabs were collected from incoming water in patient- and non-patient-facing taps and showers located near the patients at the time of blood culture collection. No swabs yielded E. coli or Klebsiella species. Only two cases (3.5%), both involving P. aeruginosa, had matching isolates in clinical and environmental samples. These were recovered from patient showers—one on a medical ward and one on a surgical ward. Whole-genome sequencing demonstrated close genetic relatedness (0–14 SNPs), consistent with recent transmission.
Overall, hospital water outlets appeared to be an infrequent source of GN-BSIs. While P. aeruginosa transmission between water and patients can occur, the direction of transmission—whether from outlet to patient or vice versa—remains uncertain and warrants further investigation. Broader surveillance is needed to clarify these pathways and inform prevention strategies.
Author: Lena Hassan – Clinical Fellow in Medicine (University Hospitals Sussex NHS Foundation Trust)
- The benefits of using multi – use Tropicamide 1% dilating eye drops versus single use dilating eye drops on the environment and cost
Ophthalmology’s high volume of activity and its reliance on single use disposable items has a significant impact on the environmental footprint. One of the most significant factors that contribute to global greenhouse gas emissions and have huge cost implications is the extensive use of single use eye drops. As part of the Trust’s green plan initiative and a wider commitment to sustainability and cost effectiveness, the use of single use tropicamide 1% dilating eye drops which are required in most ophthalmology outpatient clinics and all medical retina clinics for the adequate visualisation and examination of the internal structures was reviewed and a pilot to replace the single use drops with multi-use bottles of tropicamide 1% in the Medical Retina Diagnostic Hub was undertaken.
Over a three-week period, 953 patients participated in the pilot. Multi-use drop bottles were used for 938 (98.4%) while single use drops were used for 15 patients due to symptoms of a red eye, preservative allergies, when the no-touch technique was unsuitable or when a patient refused the multi-use drops. A total of 84 multi-use bottles were used.
The pilot demonstrated that plastic waste reduced from 953 grams to 603 grams (36.7% reduction), the CO₂ emissions reduced from 2.0013 kg to 1.2663 kg (36.7% reduction) and the cost reduced from £594.20 to £142.75 (75.8% reduction). There were no cases of conjunctivitis, or any other adverse effects reported by patients or identified from an audit undertaken in the Accident and Emergency Department where 300 consecutive patients were followed up.
As this pilot has demonstrated a significant reduction in cost, plastic waste and carbon emissions and is aligned with the NHS green plan, the plan is for single use 1% Tropicamide drops to be replaced with multi use bottles in all clinics. Additionally, a broader review will be undertaken to assess the feasibility of replacing other single-use eye drops with multi-use alternatives.
Author: Amita Sharma, Lead Infection Control Nurse (Moorfields Eye Hospital NHS Foundation Trust)
- Economic analysis of desk-based personal-responsibility hygiene intervention of respiratory infections on healthcare systems.
Hot-desking has become a common practice in workplaces since the Covid-19 pandemic. This increases the risk of individuals acquiring common respiratory infections (RIs), because of germ transfer on shared surfaces. These infections place a burden on employers and healthcare systems.
Promoting targeted hygiene practices that are the personal responsibility (PR) of employees (such as the use of hand sanitiser and/or surface wipes) can reduce the risk of workplace-acquired RIs, thus economically benefitting employers and healthcare systems. To assess the impact, a five-year economic analysis was conducted to estimate the financial impact of the PR intervention in reducing RIs in shared-desk offices from a UK perspective.
This analysis estimated a reduction in GP visits, hospitalisations and antibiotic prescriptions of 22.2%, 33.3% and 23.5%, respectively. Representing a saving of £1,979 from a small office (100 shared desks with 100% daily occupancy and 232 office days per year (to account for weekends and statutory holiday entitlement)) over a five-year time horizon. For employers, PR reduced lost workdays and productivity losses by 132 days, saving £13,484. This is a total economic saving of £14,129, over a five-year time horizon.
This study demonstrates PR can play an important part in breaking the chain of infection in shared office spaces, therefore reducing the burden of work-place-acquired RIs for healthcare systems and employers.
Authors: Newman J¹, Aluko P¹, Malik S¹, Gent L¹, Buckley C¹, Sexton J², Dymond A³, Garrett M³, Vale L⁴, Reynolds K².
1.Medical Sciences – Germ Protection & New Growth Platforms, Reckitt
2.Community, Environment, and Policy, Mel & Enid Zuckerman College of Public Health, University of Arizona
3.York Health Economics Consortium, University of York
4.Global Health Economics Centre, London School of Hygiene and Tropical Medicine
- Sustainability, Equality and Inclusivity Benefits from Transparent Medical Masks Reusable (TMMR) and Transparent Reusable Respirators
Aim: Covid-19 identified transparent masks and respirators were needed for equality and inclusivity when 100% of staff were masked. Companies developed single-use transparent masks, none were procured; there still is a need for them.
Method: Extensive testing and development identified an anti-fogging material for a reusable alternative to the single-use TIIR masks, and reusable P3 respirators, not single-use FFP3s. NHS uses 750m TIIR masks, (1.4bn in the pandemic) and 13m FFP3s, (50m in the pandemic), with very poor, or no fit-test scores. Transparent respirators target smaller, slimmer faces, not heavy industry. Results: Innovative, reusable products, from Wales. TMMR tested for 100 reuses, now to test against EN14683-2025.The P3 Connect respirator, reprocessed at the point of use, has the highest fit-test scores, 5-year life, producing net savings of £133m. The masks, respirators and ani-fogging eye protection reduce plastic waste by 4,000 tonnes. Save £1.5m waste and £6.7m storage costs. 15,000 tonnes CO2(e) reduction, 1,000 fewer lorries.
Conclusion: Removes barriers to communication, ensures staff and patient protection, delivers environmental benefits, saves money with on, or near shore production.
Next steps, on-site trials and pandemic planning.
Author: Paul Chivers (Innovation & Sustainability Lead) – PCC Sustainable Solutions Ltd
