Sustainability interventions in nursing wards
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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.
Intervention
Clean bladder catheterization with the no-touch technique instead of sterile bladder catheterization.
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.
Environmental impact
Measured in CO2-emissions due to less use of (environmentally harmful) materials during bladder catheterization. Want to know more about the environmental impact? See the bottom of this page for more information.
Current situation
Sterile catheterization with 2 sterile gloves, 2 sterile gauzes, 100 ml sterile water from a 500 ml bottle, cellular mat
- 1 sterile catheterization = 0.4 kg CO2-eq
New situation
Clean catheterization with 2 non-sterile gloves, 2 non-sterile gauzes, 100 ml tap water, towel
- 1 clean catheterization = 0.2 kg CO2-eq
-46% CO2
The impact of sterile bladder catheterisation depends on how often the 500ml bottle is used. Do you throw away the bottle after 1 time? Then this provides 0.9 kg of CO2-eq and saves up to 80% compared to clean bladder catheterization!
Performing 100 bladder catheterizations cleanly instead of sterile saves at least
20
kg CO2-eq
and is equivalent to driving 103 km
When is it implemented?
This intervention is implemented when each nursing unit in the hospital uses the clean catheterization guideline and the kg of CO2-equivalent has been calculated.
How is this measured?
Determine the number of bladder catheterizations per year using purchasing data for insertion sets or individual catheters (when sets are not used). Analyze the purchasing data from the previous year and calculate how many insertion sets or catheters were purchased over the course of a year for the nursing units. Fill in the environmental impact calculation tool. This tool can be found in the MS Teams channel if your hospital participates in the Greening healthcare together program.
If not all nursing units have adopted the new method, follow the "measuring intervention with purchasing data" procedure.
Resources
click here for the Radboudumc infographic where they implemented this intervention and saved 2151 kg of waste per year.
click here for a display from the Green OR about the difference in materials between clean catheterization and sterile catheterization.
click here for an information poster published by V&VN.
click here for the bladder catheterization guideline, module 2 insertion.
Footnotes
- Samenwerkingsverband Richtlijnen Infectiepreventie. (Juli 2024). Richtlijn Blaaskatheterisatie.
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 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.
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.”
