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
Nursing practice
Reducing maintenance IV flow rate
A maintenance IV with NaCl 0.9% at a flow rate of 5 ml/hour is often used to keep the IV line open for patients not receiving intravenous medication. Reducing the pump rate to 2 ml/hour lowers NaCl 0.9% use, allowing for smaller infusion bags or less frequent bag replacement. This is more sustainable and reduces material consumption.
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.
