Sustainability interventions in nursing wards
ADL
Reducing linen use
Linen is used for many different purposes. Reducing linen use is not only better for the environment but also benefits patients by helping to prevent pressure ulcers. The do-not-do recommendations1 advises: “Avoid or limit unnecessary layers underneath the patient, such as linen, positioning materials, cellulose mats, incontinence materials, clothing, and bedding.”
Intervention
Reduce the use of linen by using or changing linen only when necessary.
Implementation approach
- Look at the approach for reducing the use of a product.
- In the implementation plan, describe alternatives, such as situations where smaller linen items are sufficient (for example, using a washcloth instead of a towel).
- Evaluate how often beds are changed and whether this can be reduced. The current recommendation is to change bed linen daily for bedridden patients and weekly for non-bedridden patients.² Include this in the implementation plan.
- Consult the step-by-step guide for more information on setting goals, implementation, and evaluation.
Environmental impact
Lower environmental impact (measured in CO2 emissions) by reducing the number of kilograms of linen that are washed. Want to know more about the environmental impact? See the bottom of this page for more information.
The environmental impact has been calculated for 1 kg of dry linen*
Use and wash 1 kg of linen once = 0.45 kg CO2-eq
The example was made with the weights in the linen template. 1.8 kg of linen is needed to change one bed: one pillowcase and two fitted sheets (one for the mattress and one as a top sheet).
* This includes production, transport, washing and waste treatment. It has been assumed that the linen will be washed 100 times and will then be replaced due to wear and tear.
Change one bed once a week for a year instead of saving daily
225
kg CO2-eq
and is equivalent to driving 1,306 km
When is it implemented?
This intervention is considered implemented when the set goal is achieved, where less linen is used compared to before the implementation, and the difference in CO₂-equivalent (kg) has been calculated.
How is this measured?
- Determine the number of linen items based on the linen order overview. Linen items can include: sheets, pillowcases, blankets, flat sheets, towels, washcloths, patient gowns/pyjamas, and any other items applicable to the hospital.
- Use the linen input tool to calculate the total weight of the linen items and fill in the environmental impact calculation tool. These can be found in the MS Teams channel if your hospital participates in the Greening healthcare together program.
- Note: Other interventions may affect the results of this one. If the "Reducing washing of unused (clean) linen" intervention is implemented simultaneously, it may enhance the calculated environmental impact. If the "Reducing the use of cellulose mats" intervention is implemented simultaneously, it may reduce the calculated environmental impact due to increased use of linen. Implement the interventions "Reducing unused linen washing" and "Reducing the use of cellulose mats" at different times to accurately measure the effect of this intervention.
Resources
There are no inspirational resources available yet. Has your hospital already implemented this intervention and would you like to share your experience? Please contact the Together for greener healthcare programme.
Footnotes
- V&VN (Mei 2023). ‘Beter Laten’ aanbevelingen (n = 64) | Ziekenhuis
- Werkgroep Infectie Preventie (2014). Richtlijn Linnengoed.
View our other interventions
Nursing practice
Containers made from recycled plastic for specific hospital waste
Nursing wards produce a lot of waste, including specific hospital waste (SZA). Nurses collect this waste in separate SZA tanks, also known as Wiva barrels, recognisable by the blue barrel with a yellow lid. A more sustainable alternative made from recycled plastic, recognisable by its grey colour, has been developed.
General resources
Paper medication cup
Medication is often administered several times a day in plastic cups, which generates a large amount of waste. Paper medication cups suitable for liquids (containing less than 5% plastic) offer a more sustainable alternative. In some cases, however, a plastic cup remains necessary, for example when crushing medication.
General resources
Reducing glove use
Nurses use large quantities of non-sterile gloves during patient care. There are three situations where gloves are required: 1) when caring for patients in isolation 2) when there is a risk of contact with mucous membranes or bodily fluids 3) when preparing certain medications. Wearing gloves as a standard practice is not recommended1. Due to the high consumption rates in hospitals, gloves have a considerable environmental impact2.
Nursing practice
Reusable non-sterile suture removal set
Sutures can be removed with sterile disposable materials such as gauze, cotton swabs, tweezers, and scissors or a stitch cutter. The tweezers and scissors do not need to be sterile and can be replaced by clean, reusable ones that are cleaned and disinfected. This means the final sterilisation step is omitted after cleaning and disinfection. Mechanical cleaning (thermal disinfection) is preferred over manual cleaning.
