Sustainability interventions in nursing wards
Nursing practice
Wound care irrigation with tapwater
For acute wounds (traumatic or surgical), irrigation using a female catheter filled with lukewarm tap water is recommended instead of NaCl 0.9%. This increases patient comfort and reduces material use, as a new sterile NaCl 0.9% bottle or sterile collection tray is no longer needed every 24 hours.
Intervention
Use tap water for cleaning traumatic and/or surgical wounds instead of NaCl 0.9%.
Exclusions:
- Shower rinsing and rinsing using a vacuum system, as these are different applications from wound irrigation using a female catheter.
- Wound treatments excluded in consultation with the hospital's wound care specialist, such as open fascial wounds or wounds where depth and structure are unclear, and where rinsing fluid may not drain properly.
Environmental impact
Measured in CO₂ emissions, based on the reduced use of environmentally harmful materials in wound care.
Implementation approach
Look at the approach for implementing a different method in nursing practice and consult the step-by-step guide for more information on setting goals, implementation, and evaluation.
When is it implemented?
This intervention is considered implemented when rinsing with tap water becomes the standard option for wound care on nursing units, unless this is not possible.
How is this measured?
The effect of this intervention on a hospital level cannot be reliably established based on the variation in purchasing data, such as the number of NaCl 0.9% 500ml bottles.
Analyze existing wound care protocols to assess the implementation at the hospital level. Check if rinsing with tap water is listed as the standard. Keep in mind that protocols do not always reflect the daily practices of wound care; clinical experience and expertise also play an important role.
At the department level, the number of wound rinses can be estimated based on protocols and practices for specific patient groups. This can help estimate the consumption of containers and NaCl bottles. The environmental impact of this can be calculated using the environmental impact tool*.
Resources
- V&VN (May 2023). 'Beter Doen' recommendations (n = 369) | Hospital list
Resultaten
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Nursing practice
Containers made from recycled plastic for specific hospital waste
Nursing units produce large amounts of waste, including specific hospital waste (SHW). Nurses collect this waste in separate SHW containers, also known as WIVA containers, identifiable by their blue bins with yellow lids. A more sustainable alternative made from recycled plastic has been developed, recognisable by its grey colour.
Verpleegkundig handelen
Non-sterile bladder catheter insertion
Since July 2024, bladder catheterisation may be performed using the new ‘no-touch technique’. In this method, non-sterile gloves are used, and the genital area is cleaned with tap water. This more sustainable approach requires fewer sterile materials and saves time, as the procedure can be performed by a single nurse. With this intervention, nurses put the new guideline into practice.
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.
