Sustainability interventions in nursing wards
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.
Intervention
Replace sterile disposable suture removal kits with clean, reusable materials.
Implementation approach
- Look at the approach for implementing a (reusable) product.
- Involve the Central Sterilisation Department (CSA) at an early stage and discuss the possibilities for cleaning and disinfection processes for the materials.
- Consult the step-by-step guide for more information on setting goals, implementation, and evaluation.
Environmental impact
Measured in CO2-emissions due to less use of disposable materials in suture removal kits and reuse of non-sterile materials for suture removal. Want to know more about the environmental impact? See the bottom of this page for more information.
Current situation
Remove stitches once with a combination of disposable sterile materials
- Steel scissors or stitch cutter
- Steel tweezers or plastic tweezers
Lowest and highest impact disposable combination
- Stitch cutter and plastic tweezers = 0.106 kg CO2-eq
- Steel scissors and tweezers = 0.421 kg CO2-eq
New situation
Remove stitches once with a combination of reusable non-sterile steel scissors and steel tweezers = 0.231 kg CO2-eq
The reusable combination is always more sustainable than a disposable version with steel scissors. The reusable combination will also be more sustainable than a stitch cutter if the CSA works with green energy. Green energy mainly comes from wind, sun, and bioenergy, and not from fossil fuels.
Removing stitches 100 times with reusable scissors and tweezers instead of disposable steel scissors and tweezers saves at least
19
kg CO2-eq
and is equivalent to driving 97 km
When is it implemented?
This intervention is considered implemented when the nursing units in the hospital have switched to reusable non-sterile tweezers and scissors for removing sutures, and the difference in CO₂-equivalent (kg) has been calculated.
How is this measured?
The environmental impact of this intervention can be determined using purchasing data for the number of suture removal materials, see the procedure for measuring an intervention using purchasing data.
Resources
Click here for the position statement from the GreenTeam Infection Prevention of the Dutch Association for Hygiene and Infection Prevention in Healthcare (VHIG), where the intervention is explained.
View our other interventions
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.
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 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.
