Haemodialysis: optimising heat disinfect cycles and use of standby mode

Winning SusQI project completed as part of Leeds Teaching Hospitals NHS FT Green Team Competition from January – March 2022.

Team Members:

• Alison Hardy – Satellite Dialysis Unit Sister
• Peter Jones – Renal Technical Services Manager
• Terence Simpson – Renal Technologist
• Dr V R Latha Gullapudi - Consultant Nephrologist
• Dr Mark Wright- Consultant Nephrologist and Haemodialysis Lead

Setting/Patient Group: Dialysis Unit

Issue to be addressed:

Haemodialysis comes with huge environmental costs, including usage of vast amount of medical consumables, water, and electricity. It is estimated that 3.8 tonnes of carbon-dioxide equivalent emissions are produced by one patient’s dialysis treatment per year.

Intervention:

1. Reducing the number of disinfections of the dialysis machines to once in 24 hrs in staggered manner and replacing the others with rinsing process
2. Once the initial priming process of the dialysis machines is complete, placing them on standby mode whilst waiting to connect patients to the machine
3. Reducing the number of pharmacy deliveries from weekly to biweekly to the satellite dialysis unit

Outcome:

Social

• An improvement in the turnaround of the patients in the dialysis unit
• Saving time by replacement of disinfection (40 minutes) with rinse (9 minutes) of the machine in between patients.
• Reduction in staff workload

Environmental

• Projected annual carbon savings 1,914.4kg CO2e/year (from energy, water, and travel savings).
• Projected to increase to 15,919.2kg CO2e/year if scaled up across all dialysis units
• 114.192 m3 of water savings

Economic

• Annual financial savings of £2,837.05, projected to £33,435.30/ year if scaled up across all dialysis units in Leeds.

Key learning point:

Renal Units can make significant savings by implementing relatively simple changes. Involving team members makes all the difference when integrating changes into everyday practice.