Greening guide

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.

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.

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.

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.

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.

Measuring a patient’s oxygen saturation is an essential part of patient care. Due to their high consumption in hospitals, disposable pulse oximeters have a considerable environmental impact.

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.

Measuring a patient’s blood pressure is an essential part of patient care. Nurses can do this using either disposable or reusable blood pressure cuffs.

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.

Blood samples are an essential part of patient care, but they also generate waste and take time. Nurses play an important role at the start of this process and, together with physicians and nurse specialists, can explore ways to reduce the number of blood samples performed.

Incontinence materials are used for various patient groups in hospitals. By processing incontinence materials as a separate waste stream, resources can be recovered and reused.

Disposable cellulose mats have a significant environmental impact due to the raw materials used in their production. For example, wood is needed to make the pulp that gives the mats their absorbent quality. In addition, cellulose mats are difficult to recycle.

Disposable absorbent mats are designed to absorb large amounts of body fluids from patients. In practice, they are also used for other purposes, such as wiping up spilled liquids on the floor. In many cases, a towel or collection tray will suffice. Because of their high consumption in hospitals, absorbent mats have a significant environmental impact¹.

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.”

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Keeping a stock of linen in the patient room, either by the bed or in the cupboard, is convenient but not always necessary. After discharge, the patient room is cleaned and any unused linen in the room is treated as used laundry and washed again.