Reducing Waste in the Dialysis Unit

Key learning point:  Reducing the burden of waste and improving its segregation into appropriate streams for disposal has positive environmental impacts as well as cost savings.

Setting/Patient Group: Dialysis Unit

Issue to be addressed:  

For every dialysis session, a one litre bag of normal saline was used to re-infuse the patient’s blood at the end of the treatment. This bag would be opened and attached to a giving set at the start of the treatment (ready for use should the patient suffer a hypotensive episode during their dialysis treatment), despite the fact that the newer haemodiafiltration machines were able to prepare ultrapure sterile substitution fluid directly from the dialysate by directing it through an ultrafilter.

When it came to re-infusing the patients’ blood at the end of the treatment, only 200mls of the one litre bag was required. The remaining saline and consumables were then disposed in clinical waste.

Intervention:

Reduction 1.

Change in clinical practice – stop hanging ‘in case of emergency’ saline bags, in favour of using the online facilities for emergencies and re-infusion

Reduction 2.

Redirect bicarbonate bags into domestic waste stream after each treatment rather than clinical waste

Outcomes:

Social

• Not documented

Environmental

• 26.847 tonnes CO2e / year (Estimated)
• Reduced clinical waste, 21.5 tonnes per year

Economic

• £14907.10 (Actual)