Sustainability interventions in nursing wards
Nursing interventions
Using tap water for wound care
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
Refer to 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 this is 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
%
%
%
View our other interventions
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.
Nursing interventions
Reusable non-sterile suture removal set
A suture removal set contains 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.
Monitoring parameters
Reusable transport bag for laboratory samples
Nurses collect various samples for diagnostic testing. For transport to the laboratory, different single-use containers such as cups, bags, or kidney trays are currently used and then discarded. A reusable transport container is a more sustainable alternative.
Nursing interventions
Replacing IV lines every seven days
IV lines, the part of the infusion system that remains outside the body and connects to the intravenous catheter, are currently replaced every four days to prevent infections. Research shows that replacing IV systems every seven days does not increase the risk of infection. This saves materials and time for nurses.
