Green Nursing Challenge: From Single-Use to Re-usable Kidney Dishes

Project completed as part of the National 2025 Green Nursing Challenge by the Sheffield Teaching Hospitals NHS FT team.

Team members

• Rebecca Palmer, Nurse Lead for Governance Quality Improvement
• Cheryl Odams, Senior Sister. Progressive Care Unit
• Rachel Cottam, Strategy & Planning Manager
• Rachel Morris- Head of Sustainability
• Sarah Morris - Clinical Support Worker, Progressive Care Unit
• Salome Nganga- Sister/ Clinical Educator, Progressive Care Unit
• Janice Bryne- Nurse Consultant Infection Prevention and Control
• Prasanth Joy- Site lead IPC Nurse Specialist.  
• Michaela Fairest- Clinical Procurement specialist (Registered Nurse)
• Steve Newsome-Supplies Officer

Issue

The team acknowledged the global climate emergency and the role that the NHS plays as a significant contributor to carbon emissions. The project was to pilot the replacement of single-use pulp kidney dishes with a clinically suitable reusable plastic alternative.  The team aimed to demonstrate a safe, cost effective, reuseable alternative and develop a process for rapid scale-up across a large NHS organisation.

The Progressive Care Unit is a 6-beded unit that cares for Level 2 (enhanced care) cardiothoracic patients. It is a high-consumption area for single-use items such as kidney dishes, up to 54 per day (approx. 19,760/year).  Single use kidney dishes were used with a variety of functions such as administration of medication, blood gas samples, clinical equipment to support patient interventions and storage of personal cares for patients. They were currently disposed of via macerators or clinical waste, adding to carbon emissions, maintenance burdens on estates, and costs.

Intervention

This opportunity to switch to reuse was highlighted by the PCU’s clinical support worker. The team decided to use PCU as a pilot/test area to replace single use kidney dishes with reusable alternatives through collaboration with procurement, IPC and clinical colleagues with the long-term aim of scaling up this change as a trust wide roll-out across other wards and departments.  They wanted to understand the challenges and risks of scaling up a SUSQI product change at pace across a large organisation

Procurement staff had nursing backgrounds which helped to break down barriers between products and clinical requests. The selected product needed to be available via NHS supply chain with an existing contract or framework. The team engaged with the external supplier who demonstrated their product range to staff. The team, in collaboration with procurement, then selected suitable products.  

Infection Prevention and Control staff outlined a cleaning protocol to ensure the reusable kidney dishes were cleaned to a defined standard the Aseptic Non-Touch Technique.Awareness of the proposals was raised among the nursing team and patients via surveys and engagement boards (to understand perceived impact on patient care, dish quality, and acceptability of reuse by patients).

An Implementation Strategy featured

• Collaborative stakeholders - of ward staff, procurement, IPC team and supplies officer.
• Iterative feedback, further engagement and adaptation- to ensure the change was less carbon intensive.
• ANTT training- completed by IPC team and ward link workers
• Visible prompts- for the initial engagement and to drive safe use of the plastic trays.
• A Standard Operating Procedure
• To support the trust wide roll out of this project, the team considered
• Prior learning
• Further engagement to ensure standardisation
• Leadership Engagement to align with strategic aims
• A separate team - to support roll out.  
• Data to track progress and impact
• Oversight to support delivery trust-wide

Outcome

Clinical

With the use of reusable dishes, there was the potential to improve patient safety and reduce HCAI and promote anti-microbial stewardship

Environmental

Initially the team planned to use two clinell wipes for cleaning however, this would lead to a carbon increase. After collaboration with IPC, they changed to Tristel fuse & a cloth.  

The annual savings were projected to be 202.7 kgCO2e, equivalent to driving 596 miles in an average car. When scaled trustwide environmental savings of 14,873 kgCO2e could be achieved, equivalent to driving 43,757 miles in an average car.

Economic

projected saving were £708.95 per year - but if scaled trust-wide, £41, 271 per year.

Social

Staff feedback on the transition to reusable kidney dishes was collated. Positive comments included  staff liking them, reducing waste, look neater, more substantial and durable.

Key Learning:

Nurse-led sustainability initiatives are both feasible and impactful within complex clinical environments when supported by strong cross-disciplinary collaboration. The project highlighted the importance of early stakeholder engagement, clear governance, and embedding sustainability into routine practice to overcome operational challenges and drive scalable change aligned with NHS Net Zero goals.