Environmentally Sustainable Waste Segregation and Linen Use in a Burn and Polytrauma Intensive Care Unit: A Nurse-Led Quality Improvement Initiative.

IF 2.6 3区医学 Q1 NURSING

Nursing in Critical Care Pub Date : 2025-09-01 DOI:10.1111/nicc.70165

María Ibarra Hernández, Jorge Bonastre Juliá, Roberto González Fernández, Sara González Martín, Saray López Tornero, Eva Martín Morente, Yuliana Monsalve Cárdenas, Javier Remondo Blanco, Raquel Rincón Domínguez, Juana Janet Silva Leiguez, Jesús Díez-Sebastián, Manuel Quintana Díaz

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引用次数: 0

Abstract

Background: The healthcare sector is a significant producer of greenhouse gas emissions, with intensive care units (ICUs) being major contributors. The environmental impact of medical waste largely depends on disposal methods; proper segregation can enhance recycling potential.

Local problem: High variability in waste segregation and excessive linen consumption in the burn and polytrauma ICU.

Methods: This quality improvement initiative in a 10-bed burn and polytrauma Spanish ICU used a pre-post interventional study design to address poor waste segregation and excessive linen use challenges.

Interventions: Following educational workshops, placement of posters and reducing chemical waste container size, the workflow for medical waste segregation was improved. During a 60-day baseline period, packaging waste, chemical waste and linen were measured for burn victims, polytrauma cases and conventional ICU patients. A new intervention focused on packaging and chemical waste segregation practices, classifying plastic or glass containers with less than 10% medication remaining as recyclable. Measurements were repeated during a subsequent 112-day intervention period.

Results: Significant differences were observed during the baseline period: average packaging waste per shift was 251.51 g (range: 62.34-440.68; p = 0.02) and average daily packaging waste was 754.53 g (range: 187.02-1322.02; p = 0.02) for burn victims compared with other groups. When comparing both periods, total chemical waste decreased from 5.34 kg (range: 4.06-6.62) to 2.07 kg (range: 1.76-2.38), with average chemical waste per patient per day dropping from 790 g (range: 582.10-998.20) to 304.70 g (range: 260.50-348.90), both statistically significant (p = 0.001). Linen usage indicated a decrease in variability despite not reaching statistically significant differences (p = 0.154).

Conclusions: This study demonstrated that improving segregation criteria reduced variability in waste management within an ICU setting. Chemical waste was successfully decreased while increasing recyclables, showing that transforming a conventional ICU into a sustainable one is both feasible and effective.

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环境可持续的废物分类和亚麻使用在烧伤和多发创伤重症监护病房：护士主导的质量改进倡议。

背景：医疗保健部门是温室气体排放的重要生产者，重症监护病房（icu）是主要贡献者。医疗废物对环境的影响在很大程度上取决于处置方法；适当的隔离可以提高回收潜力。局部问题：在烧伤和多发创伤ICU中，废物分类的高度可变性和过量的亚麻消耗。方法：在西班牙一家10张床位的烧伤和多发创伤ICU中，采用介入前-后研究设计来解决废物隔离不良和过度使用亚麻的挑战。干预措施：在举办教育讲习班、张贴海报和减少化学废物容器尺寸之后，改进了医疗废物分类工作流程。在60天的基线期内，对烧伤患者、多发创伤患者和常规ICU患者的包装废弃物、化学废弃物和亚麻制品进行了测量。一项新的干预措施侧重于包装和化学废物分类做法，将剩余药物少于10%的塑料或玻璃容器分类为可回收物。在随后的112天干预期内重复测量。结果：在基线期间观察到显著差异：烧伤患者每班平均包装废弃物为251.51 g（范围：62.34-440.68,p = 0.02），平均每日包装废弃物为754.53 g（范围：187.02-1322.02,p = 0.02）与其他组相比。在比较这两个时期时，化学废物总量从5.34公斤（范围：4.06-6.62）下降到2.07公斤（范围：1.76-2.38），每名患者每天平均化学废物从790克（范围：582.10-998.20）下降到304.70克（范围：260.50-348.90），两者均具有统计学意义（p = 0.001）。亚麻的使用表明，尽管没有达到统计学上显著的差异（p = 0.154），但可变性有所下降。结论：本研究表明，改善隔离标准减少了ICU环境中废物管理的可变性。成功地减少了化学废物，同时增加了可回收物，表明将传统ICU转变为可持续发展的ICU是可行和有效的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nursing in Critical Care NURSING-

CiteScore

6.00

自引率

13.30%

发文量

109

审稿时长

>12 weeks

期刊介绍： Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice