Sustainability projects

Hello Clare, 

I like you idea of a Teams page to share ideas. At our trust we have a whatsap group of Green Champions.

The project I have been working on locally (very slow progress) has been on thinking about how we can use LEAN thinking to improve paediatric respiratory care and reduce its environmental impacts.

I have been discussing with the pharmacist if we can reuse SABAs when they are given via a Spacer as a "trial" in the ED/PAU. I have checked with MRHA and there is no policy that meter dose inhalers are a single patient/single device product- the spacer certainly cannot be reused by the inhaler itself can. In asthma clinics resp nurses have used the same salbutamol inhaler for different patients if given via a spacer to check for reversability. I thought idea might reduce waste/save money but I have to get clearance from infection control first and they are understandably busy at the moment. 

Here are some of the other ideas I have had:

- Using less puffs of their preventer where possible by moving to bigger dose per puff for some inhaler types. 1 puff >= 2 puffs.

-  Considering moving to a dry powder device as a preventer treatment when they reach 12 years.

- Education on knowing how to tell an inhaler is empty (or full).

- Returning empty inhalers (or those that have past their expiry date) to pharmacies.

Interested to have comments/ hear others ideas. 

Kind regards, 

Rosie 

Hello Rosie,

So you may want to look at How to reduce the carbon footprint of Inhaler prescribing - A Guide for healthcare professionals

Also to advise that in England it is now mandatory for all Community Pharmacies to highlight and discuss with inhaler users return of inhalers for correct dispoal to community pharmacies.

Regards,

Lynn

Thanks Lynn.

Its an excellent guide but I think it is aimed at adults (or at least people aged  >12 years) so I was applying this to the acute paediatric care context where the majority of MDIs are used with a spacer in those <12 years. 

In terms of paediatric inhalers the following may interest you:

Reducing the Environmental Impact of Inhalers in Paediatrics at Wexham Park Hospital

In terms of recycling inhalers you may want to point patients to: recycle now page: What to do with inhalers

Regards,

Lynn

I'd love to hear from anyone who has ideas as to how we can make neonates greener... From PPE to single use items it somewhat feels like a battle too big to fight...where to start?

Any suggestions welcome!

You might be interested in this  - PVC medical devices recycling - RecoMed is a PVC take-back scheme currently being implemented at 36 different NHS hospitals across Britain (as of November 2019)[1]. The scheme involves the collection of used PVC medical devices including nasal cannulas; oxygen tubes; anaesthetic masks and oxygen masks. See this article in Anaesthesia_News_June_2016 ( page 24-25)

Other areas to think about would be 

Prevention - i guess you already do a lot of work on this but getting together with Obs to think about any further strategies that coudl be used might be productive. 

Self -Empowerment - I would guess that keeping babies with mum for warmth/ feeding as much as possible, interventions like octopuses and joint incubation for twins could also improve recovery times and reduce energy use. You may well be doing alot of this already. 

Lean Pathways - process mapping your pathways to identify low value resources intensive activities that coudl be reduced / eliminated, esp prescribing. 

Low carbon alternatives - thinking about digital notes, reusable equipment ( esp gowns, masks, caps etc - seeEnvironmentally friendly Masks | Revolution-ZERO and https://drive.google.com/file/d/16WfMzJ1e8JEsmM86YjNm5n1-VbI-z3ir/view?…

Hope some of that  is helpful. have you been on one of our intro courses? Introduction to Sustainable Healthcare | Centre for Sustainable Healthcare

1. [1] https://www.bpf.co.uk/recomed.aspx#:~:text=RecoMed%20is%20a%20PVC%20take,anaesthetic%20masks%20and%20oxygen%20masks.