Natural rubber latex or NRL allergy has profound impacts on professional dental facilities, and our organization is not an exception. Based on current research, due to prolonged exposure to NRL-containing supplies, dental professionals face tremendous risks of developing immediate and delayed skin and respiratory system reactions in the workplace (Lajolo et al., 2019). For both professionals and patients, contact with non-NRL-free supplies can be fraught with skin reactions, mild-to-moderate-severity conditions affecting the ear, nose, and throat system, and even life-threatening consequences, such as anaphylaxis. From the financial and organizational perspectives, imperfect allergy prevention measures can generate extra recruiting and induction training expenses due to job-leaving behaviors and negative changes to the volume of provided services. Current allergy risk evaluation measures have flawed nature since patient-reported information may be incomplete or inaccurate. It creates the threat of exposing allergic patients to NRL and dealing with subsequent medical malpractice claims, which is destructive to the facility’s reputation.
The facility can be recommended to develop and switch to a new procurement strategy that would involve purchasing only NRL-free supplies for treatment and care activities. In the preliminary solution comparison activities, this option outperformed the other two opportunities. It has the highest anticipated allergy prevention effectiveness due to relying on ubiquitous allergen avoidance in clinical procedures rather than selecting between low-protein and NRL-free gloves based on individual risk assessments. As the slide demonstrates, many scholars with degrees in occupational safety and dentistry/dental hygiene favor the latex-free environment strategy.
Basically, the solution is a four-step process that will not require external advisors’ engagement. The team led by the dental office manager will be formed to review the existing procurement plan and the purchasing list. Then, the team will identify all NRL-containing items, find hypoallergic alternatives for all items which might require new contracts with equipment distributors, and make changes to the dental equipment procurement plan.
The involved expenses are related to the workforce and dental supply replacement. Firstly, all clinical staff members will be paid 1.5 of their standard hourly wage for every hour of work in the process improvement team. The monetary reward for the team leader will be assigned depending on the presence of extra working hours or the need to work from home after the shift. Secondly, the product replacement costs will vary depending on the final selection of NRL-free products to be purchased. The author’s preliminary findings from an online price comparison suggest that purchasing only nitrile gloves will not create considerable extra expenses. At the same time, NRL-free alternatives to currently purchased dental dams and rubber stops can generate moderate expenses.
Effort and Timeline
In total, the anticipated effort for the project will not exceed 74 hours of work. For the first and the second steps, the sequence of activities will involve team establishment, team meetings, and group-based procurement list analysis to define items to be excluded. This preparatory stage will not take more than two weeks, with about one hour of each member’s work daily. Due to suppliers’ and the market’s unpredictability, effort estimates for steps three and four are less precise, and the work may take between four and eight weeks. The timeline includes the sequence of four tasks with unknown duration. Product analysis and selection will be conducted by the entire team, and the remaining tasks will not require clinical staff participation.
Challenges to Implementation
The solution will involve two barriers to implementation associated with the inability to find trustworthy medical equipment suppliers to collaborate with and staff members’ resistance to change. The first challenge is a series of financial and reputational risks, including purchasing low-quality or overpriced dental supplies. Worse still, the problem is that the labels can be misleading, so there are some risks of purchasing products that are marketed as NRL-free but can still induce allergic reactions. As for employees’ responses to the latex-free initiative, they may criticize the project’s viability due to having no known reactions to NRL and following all current anti-allergy precautions in clinical interventions. In the worst scenario, this could result in individual or organized attempts to oppose the new practices.
Strategies for Overcoming Challenges
There are easy-to-implement strategies to reduce the challenges’ impact on creating a latex-free clinical environment. The first challenge can be resolved by choosing well-established suppliers based on other facilities’ recommendations and supplier rating and evaluation information from diverse professional sources. In particular, the evaluation team can review the list of the Health Industry Distributors Association (HIDA) member organizations. The fact of active membership proves the distributing organization’s awareness of the most recent medical product safety standards and best practices in manufacturer evaluation (HIDA, 2021). The second challenge would require staff education events to demonstrate the project’s feasibility in clinical contexts. Specifically, staff members should be educated on cases in which NRL-sensitive patients’ failure to report accurate information results in health complications and legal responsibility for acting without due analysis. The issue is that patients are not always capable of recalling and offering detailed information on their risk factors for NRL allergies. For instance, food allergies to bananas, chestnuts, and other products sometimes predict NRL hypersensitivity, but dental patients may fail to recognize and mention the facts of irritation after food consumption (Vandenplas & Raulf, 2017). Thus, it should be made explicit to the staff that the elimination of exposure to NRL is the most optimal strategy.
The project is associated with two critical risks, one of which contributes to the aforementioned barriers to implementation. The risk of agreements with disreputable suppliers and subsequent service quality complaints from patients cannot be fully excluded since the project may require entering new business relationships. As for exclusively financial risks, hypoallergic products can become even more expensive compared to their low-protein latex alternatives due to the ongoing COVID-19 pandemic and its impacts on the demand for medical supplies.
There are two dependencies or activities that can be started only when the implementation decision is approved. Firstly, searching for new suppliers will be initiated after the project approval, team formation, and procurement list assessment stages. Secondly, after revising and confirming new supply contracts, it will be possible to start the gradual removal of potentially unsafe supplies.
Implementing the solution will result in a series of organizational benefits aside from allergy prevention. Success in creating a latex-free environment will translate into reputational gains and staff members’ and patients’ positive attitudes to the organization and its health promotion strategies. Also, no exposure to NRL will reduce the need for NRL-focused pre-intervention patient interviews and medical history reviews, which could slightly increase the speed of service provision. Finally, the initiative will eliminate the cases of suddenly emerging NRL hypersensitivity among staff members and related medical expenses.
In summary, despite some risks and the need for extra financial resources, the proposed solution is a viable course of action for addressing the issue of latex allergy. With effective team meetings and responsibility distribution practices, the implementation will not take much time or involve huge medical product expenses. In the longer term, the facility will enjoy multiple benefits, including better service reviews, a reputation as a customer-centered service, safety, reduced financial risks, and faster service provision.
Critchley, E., & Pemberton, M. N. (2020). Latex and synthetic rubber glove usage in UK general dental practice: Changing trends. Heliyon, 6(5), e03889. Web.
Health Industry Distributors Association. (2021). Product safety and quality are critical for new PPE manufacturers’ success. Web.
Lajolo, C., Leso, V., Gioco, G., Patini, R., Fedele, M., Giuliani, M., & Iavicoli, I. (2019). Chemical hazard for dental hygienists: A systematic review. European Review for Medical and Pharmacological Sciences, 23(18), 7713-7721. Web.
Raulf, M. (2020). Current state of occupational latex allergy. Current Opinion in Allergy and Clinical Immunology, 20(2), 112-116. Web.
Tabary, M., Araghi, F., Nasiri, S., & Dadkhahfar, S. (2021). Dealing with skin reactions to gloves during the COVID-19 pandemic. Infection Control & Hospital Epidemiology, 42(2), 247-248. Web.
Vandenplas, O., & Raulf, M. (2017). Occupational latex allergy: The current state of affairs. Current Allergy and Asthma Reports, 17(3), 1-11. Web.