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

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.