McGain Forbes, Moore Graham, Black Jim
Departments of Anaesthesia and Intensive Care, Western Health, Footscray Hospital, Australia
Melbourne School of Engineering, University of Melbourne, Australia.
J Health Serv Res Policy. 2016 Jul;21(3):166-71. doi: 10.1177/1355819615625698. Epub 2016 Jan 13.
Steam sterilization in hospitals is an energy and water intensive process. Our aim was to identify opportunities to improve electricity and water use. The objectives were to find: the time sterilizers spent active, idle and off; the variability in sterilizer use with the time of day and day of the week; and opportunities to switch off sterilizers instead of idling when no loads were waiting, and the resultant electricity and water savings.
Analyses of routine data for one year of the activity of the four steam sterilizers in one hospital in Melbourne, Australia. We examined active sterilizer cycles, routine sterilizer switch-offs, and when sterilizers were active, idle and off. Several switch-off strategies were examined to identify electricity and water savings: switch off idle sterilizers when no loads are waiting and switch off one sterilizer after 10:00 h and a second sterilizer after midnight on all days.
Sterilizers were active for 13,430 (38%) sterilizer-hours, off for 4822 (14%) sterilizer-hours, and idle for 16,788 (48%) sterilizer-hours. All four sterilizers were simultaneously active 9% of the time, and two or more sterilizers were idle for 69% of the time. A sterilizer was idle for two hours or less 13% of the time and idle for more than 2 h 87% of the time. A strategy to switch off idle sterilizers would reduce electricity use by 66 MWh and water use by 1004 kl per year, saving 26% electricity use and 13% of water use, resulting in financial savings of AUD$13,867 (UK£6,517) and a reduction in 79 tonnes of CO2 emissions per year. An alternative switch-off strategy of one sterilizer from 10:00 h onwards and a second from midnight would have saved 30 MWh and 456 kl of water.
The methodology used of how hospital sterilizer use could be improved could be applied to all hospitals and more broadly to other equipment used in hospitals.
医院中的蒸汽灭菌是一个能源和水资源密集型过程。我们的目标是找出改善电力和水使用的机会。具体目标包括：确定灭菌器处于运行、闲置和关闭状态的时间；了解灭菌器使用随一天中的时间和一周中的日期的变化情况；找出在没有待处理负载时关闭灭菌器而非使其闲置的机会，以及由此产生的电力和水的节省量。
对澳大利亚墨尔本一家医院的四台蒸汽灭菌器一年的日常活动数据进行分析。我们检查了灭菌器的运行周期、常规关闭情况，以及灭菌器处于运行、闲置和关闭状态的时间。研究了几种关闭策略以确定电力和水的节省情况：当没有待处理负载时关闭闲置的灭菌器，以及在所有日子的10:00之后关闭一台灭菌器，午夜之后关闭第二台灭菌器。
灭菌器运行时长为13430（38%）灭菌器小时，关闭时长为4822（14%）灭菌器小时，闲置时长为16788（48%）灭菌器小时。四台灭菌器同时运行的时间占9%，两台或更多灭菌器闲置的时间占69%。一台灭菌器闲置两小时或更短时间的情况占13%，闲置超过2小时的情况占87%。关闭闲置灭菌器的策略每年可减少66兆瓦时的电力使用和1004立方米的水使用，节省26%的电力使用和13%的水使用，节省资金13867澳元（6517英镑），每年减少79吨二氧化碳排放。另一种关闭策略是从10:00起关闭一台灭菌器，午夜起关闭第二台灭菌器，可节省30兆瓦时电力和456立方米水。
所采用的关于如何改善医院灭菌器使用的方法可应用于所有医院，并更广泛地应用于医院使用的其他设备。
