Renal unit reducing waste weight

Dan Goodhind's picture

Good morning, I have heard about a renal unit possibly in Kingston(?) who are somehow reducing the weight of their renal waste considerably, presumably by emptying all the fluid out of the bags by some process. I am interested in learning about this and was wondering whether you have any contact or further leads about this please? Many thanks, Dan Goohdind

Comments

renal unit reducing waste weight

Tara Collidge's picture

Hi Dan,

in Glasgow we've reduced waste by diverting it into the non-clinical waste stream and reviewing our processes and removing anything we really don't need to use.

See http://map.greenerhealthcare.org/nhs-greater-glasgow-and-clyde/waste-management-renal-dialysis-unit-case-study-how-guide

If you go to the 'mapping' link there are other good case studies along similar lines.

If you need specifics email me at tara.collidge@nhs.net

good luck!

Tara

like0

Reducing waste

James Dixon's picture

Hi Dan,

I'd echo Tara and Frances' comments. Our Renal Unit at Newcastle were very keen to reduce the amount of waste they were generating. When the unit initially opened there was confusion over the classification of the acid bottles and they were going into orange bags (£340pt). We swiftly changed this to ensure at least they were going into black bags (£60pt) whilst we investigated the feasibility of a baler to start recycling them.

Our case study on crushing and baling all cardboard and plastic from our renal sessions can be found here: http://map.greenerhealthcare.org/newcastle-upon-tyne-hospitals-nhs-foundation-trust/baling-and-recycling-bottles-cardboard. This was the winning entry in the recent Green Nephrology Awards.

Moving on from this we are in discussions with Fresenius to switch from 5L HDPE bottles of acid to 4.7L LDPE "SmartBags" of acid. It's early days but this might have the potential of reducing our weight of plastic waste by 75% (from 12 tonnes a year to just 3 tonnes).

We'd love to go even further and eliminate this waste, like Bradford, but the confines of our existing unit negate the possibility of large storage tanks and piped delivery.

Good luck,

James

like0

Good morning and thanks for

Dan Goodhind's picture

Good morning and thanks for your comments. I'm actually wondering about reducing the weight of the dialysis circuits that we dispose of in offensive waste - a driver for one of our contractors mentioned he'd seen a renal unit doing this by emptying the bags of the saline fluid before putting into the offensive waste bin and I was interested in how this was being done, or whether the message may have gotten mixed up. 

We are currently recycling our acid bottles and have just taken delivery of a baler to see how that works for us. 

Also, has anyone been able to recycle the plastic cups that hold bi-carb in them? 

Thanks very much,

Dan

like0

baling plastic bottles

Dan Goodhind's picture

Hi James, 

First of all, thanks for your response - our Renal unit are quite receptive to saving money (who isn't) and we're trying to make things cheaper and less impact on the environment.

I'm just wondering how your baling of the plastic bottles is going? We've currently got a baler on loan - it's a CK151 - 

Single Chamber Baler

Motor 1.1kW

single phase

Electrical connection 3 pin plugtop

4 x bale strapping

Compaction force 10 tonne

How does this compare to what you were using? We seem to be having some problems with the bottles being compacted, then when the compaction plate is lifted, the bottles reform to fill most of the void, making it quite a slow process (baling 2 - 3 bottles at a time is not the idea of this!). The porters aren't very keen to spend so long baling these itmes. 

Did you have any similar issues please? 

I like the talk of the 'smartbags' and will look into that myself. If you have any more info on this please can you send through? 

Many thanks

Dan 

like0

baling plastic bottles

Dan Goodhind's picture

Hi James, 

First of all, thanks for your response - our Renal unit are quite receptive to saving money (who isn't) and we're trying to make things cheaper and less impact on the environment.

I'm just wondering how your baling of the plastic bottles is going? We've currently got a baler on loan - it's a CK151 - 

Single Chamber Baler

Motor 1.1kW

single phase

Electrical connection 3 pin plugtop

4 x bale strapping

Compaction force 10 tonne

How does this compare to what you were using? We seem to be having some problems with the bottles being compacted, then when the compaction plate is lifted, the bottles reform to fill most of the void, making it quite a slow process (baling 2 - 3 bottles at a time is not the idea of this!). The porters aren't very keen to spend so long baling these itmes. 

Did you have any similar issues please? 

I like the talk of the 'smartbags' and will look into that myself. If you have any more info on this please can you send through? 

Many thanks

Dan 

like0

Hi Dan,connected with Tara's

Frances Mortimer's picture

Hi Dan,

connected with Tara's reply about waste reduction in Glasgow (and there's a similar case study from Fife), you might want to look at the dialysis equipment inventory tool here: http://www.sustainablehealthcare.org.uk/green-nephrology/resources/2012/01/how-guide-reduce-dialysis-waste-equipment-inventory

Reducing use of non-essential equipment is ideal because then you don't have to buy it in the first place.

In Bradford they have switched to central delivery of acid concentrate into bulk tanks instead of individual plastic cannisters - this cuts out over 4 tonnes of plastic waste each year: http://map.greenerhealthcare.org/bradford-teaching-hospitals-nhs-foundation-trust/central-delivery-acid-haemodialysis

like0

Hi Dan, We do encourage our

James Dixon's picture

Hi Dan,

We do encourage our staff to drain off excess saline to a non-handwashing sink and then dispose of the giving set/circuit in the clinical waste (we are still struglling to implement offensive waste/tiger bags over here - one of my many battles).

I wasn't aware that anyone was sending bags still containing saline away for disposal. From a effluent water discharge point of view, flushing to foul water is permitted as it is just clean salty water.

This does have fantastic potential for reducing the weight of your offensive waste.

James

like0

In Fife we reduced the weight

Mary Thomson's picture

In Fife we reduced the weight of our clinical waste from 1.9kg per treatment to 1kg. This was achieved by removing the saline bags from the treatment and using the online facility available on the newer models of our dialysis machines or draining the saline bags and recycling the infusion bags on the older machines. We also removed the bicarb from the clinical waste stream and disposed of it in domestic stream.  We could recycle the plastic container holding the bicarb but as yet have not found a suitable and safe procedure to store and dispose of the bicarbonate. Recently we have started using 600g bicarbs instead of 900g bags and this has reduced the weight of the domestic waste by a further 0.3kg. In Fife all our paper, plastic, aluminium, foil is recycled at ward level. We reduced our yearly Clinical Waste by 69% and when recycling was introduced the domestic waste was reduced by 82%. This is carried out by our local authority. Hope this is of interest to you.

Mary Thomson

Contact: 07903861339

like0

Disposal of bicarbonate

Frances Mortimer's picture

Hi Dan & al,

there is a bit of guidance for disposal of bicarbonate in this summary of a previous forum thread:

http://sustainablehealthcare.org.uk/green-nephrology/blog/2012/06/recycling-concentrate-bottles-summary

Essentially, it should be ok to put it down the drain as long as it is rinsed with plenty of water.

Frances

like0

Baling plastic bottles

James Dixon's picture

Hi Dan,

We use a MACFAB Compact 75 twin chamber that we have on a two year lease (11 months left). It is also single phase (normal 3-pin plug), 1.5kw motor (less power than a kettle), with a pressing force of 3.5t.

We chose a twin chamber model because we generate a lot of bottles (150x 5L bottles each day, six days a week) and we knew there would be an issue of plastic bottle "memory" where it springs back up after initial compaction. Two chambers allows us to fill one side with bottles then drop the platten and keep it there to take out the "memory" of the bottles whilst we fill the other side with bottles and vice versa. This allows us to crush up to 75x 200g bottles per bale (15kg bale) and two full bales a day.

Re: SmartBags - our current renal acid supplier Fresenius is trialling them to see if we would be willing to switch to them (we're one of their biggest customers). They are currently produced in Germany, meaning they aren't cost effective or as green an alternative at present, but they are looking to see if they can justify their production in the UK as well, if there is enough demand - somthing we are keen on.

Feel free to email me directly on james.dixon@nuth.nhs.uk if you would like more detail on this.

Regards,

James

like0

44:1 acid concentrate

Frances Mortimer's picture

The Kent units have recently switched from 34:1 to 44:1 acid concentrate for dialysis, which reduces the volume and weight for transport as well as the amount of packaging waste. (See http://map.greenerhealthcare.org/east-kent-hospitals-university-nhs-foundation-trust/441-haemodialysis-concentrate-solution).

What concentration comes in the Fresenius SmartBags? Small volumes in bags rather than cannisters might be best option for places which cannot accommodate central delivery.  Maybe we could campaign for this to become standard from all suppliers in time for NHS Sustainability Day?!

like0

Register or log in to join our networks!