Nursing News Case studies Nurses already

8Nursing Times September 2020 / Vol 116 Issue 9 www.nursingtimes.net

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Nursing NewsCase studies

Harriet Dean-Orange helped spearhead a series of projects to reduce plastic, metal and water waste in operating theatres at Brighton and Sussex University Hospitals NHS Trust. In her former role as a sustainability ambassador at the trust, Ms Dean-Orange worked with an organisation called Sharpsmart, which collects sharps materials from hospitals.

The company takes away the sharps containers and re-sterilises them before bringing them back, said Ms Dean-Orange. Her hospital was the second in the country to trial the idea. Previously, it used a box that was “just thrown away” and incinerated, she said.

Ms Dean-Orange asked Sharpsmart if there could also be a way of collecting metal waste. “In the operating theatre, there’s an immense amount of waste [resulting from] single-use items, but they are heavy aluminiums and mixed metals,” she said.

As a result of her request, the team was given a different recycling box so metals could also be extracted and recycled appropriately, instead of incinerated. Ms Dean-Orange noted that “sadly” this initiative had been temporarily stopped because of Covid-19 – however, she stressed that the concept had been proven to be “doable”.

Arguably, she said, the biggest sustainable change made in the operating department was the removal of desflurane – a gas that is used to

anaesthetise patients before an operation. “Desflurane is in a family of really high-intense greenhouse gases”, noted Ms Dean-Orange. She said the decision to remove it was controversial for anaesthetists but “most people got

on board in the end, and I can see it happening across the country

quite a lot now”.Ms Dean-Orange also spent

time with staff looking at how they could reduce water waste

and helped to re-educate them on preparing their hands for

surgery by using “essentially… a hand sanitiser, rather than a running tap constantly”. In addition, her team introduced a waste matrix system that helped to categorise recycling and general and medicines waste, with the aim of preventing all materials from going into a clinical waste stream.

The green agenda and promoting of environmental benefits have helped to encourage a reduction in inappropriate glove use by nursing staff, according to a consultant nurse currently working at a world-famous hospital in London.

In 2018, Great Ormond Street Hospital for Children NHS Foundation Trust started the Gloves Off: Safer in our Hands campaign,

which focused on the overuse of non-

sterile gloves and aimed to educate staff on when they should be

worn for their own protection and

for patient safety. Results from the first

year of the project showed the trust saved more than £90,000 and prevented 18 tonnes of waste being sent to landfill.

The campaign was launched to make sure that – pre-Covid-19 – staff were

only using non-sterile gloves when there was a risk of exposure to blood or other bodily fluids, and that gloves were not used inappropriately during standard care.

Helen Dunn, consultant nurse for infection prevention and control at the trust, told Nursing Times that one of the key reasons staff had engaged with the initiative was because of the green agenda and the difference that glove reduction would make to the environment. Other reasons included the protection and safety of patients and staff.

When staff were “looking for a reason to think about trying something new”, in terms of their use of gloves, thinking about trying to reduce plastic was “something that really resonated with them”, said Ms Dunn.

The coronavirus pandemic had “a large impact” on the campaign, she noted, because national guidance had required an increase in the use of gloves and other protective equipment. But, she said she was hopeful that updated guidelines, issued last month, would give the trust more freedom.

Nurses already leading on the green agendaMany nurses up and down the country are making positive changes in the name of sustainability. Megan Ford has spoken with nurses implementing a range of initiatives to drive forward the green agenda

Desire to be ‘green’ helped glove reduction at major London trust

Nurse championed sustainability in operating theatres

9Nursing Times September 2020 / Vol 116 Issue 9 www.nursingtimes.net

Nursing News

Nurses at North Tees and Hartlepool NHS Foundation Trust have ramped up efforts to recycle waste, following concerns over the volume of single-use personal protective equipment (PPE) that was being thrown away during the Covid-19 crisis.

Urgent care nurse practitioner Emma Francis told Nursing Times the coronavirus pandemic had given staff at the trust a renewed focus on becoming more green friendly and aware. Efforts to recycle had been boosted by the pandemic, she noted, because people had seen there were “a lot more single-use” items, especially PPE, that were being used. But it also went further than that, she said.

A focus on becoming more environmentally aware had

been “picked up more in the past few months”, said Ms Francis. “Especially during the Covid-19 pandemic – we’ve realised there’s been a lot more things that we are throwing away that we shouldn’t be throwing away.”

She said, during the crisis, the trust had launched a new campaign calling on staff, patients and visitors to take pride in the organisation’s buildings. As part of the move, it introduced a series of posters to educate staff and the public on what items could be recycled appropriately. In addition, plastic cups – used frequently during patient medicine rounds – were swapped for a recyclable paper alternative. The trust

said it had recycled more waste than ever before, thanks to the campaign.

Ms Francis, who works at the trust’s University Hospital of North Tees, said she hoped the efforts of staff would “make a huge difference”.

“As nurses, our job is to care, and we are just normally caring for people. But we need to be aware that we have a massive part to play in caring for the environment, such

as the hospital,” she told Nursing Times.

She highlighted the large volume of items that had previously just been “thrown away” during a 12-hour shift.

“If we think of all the stuff that is getting recycled now that wasn’t getting recycled

before, hopefully it will make a huge

difference,” she said.Ms Francis added

that she thought it was also important for nurses to help

remind their patients to be aware

of the environment and encourage them to use the hospital’s recycling facilities correctly. She praised her colleagues, who she said had “really embraced” the move.

The trust has also appointed a group of recycling champions to help lead the green-friendly drive.

Nurses and colleagues at Barts Health NHS Trust have formed a staff-run sustainability and climate action group. Members aspire to ensure their own jobs and work do not contribute to ill health by increasing air pollution and environmental degradation.

The trust’s ‘green team’, which has been running for the past year, works on a range of projects to promote sustainability and highlight climate emergency issues to Barts Health leaders, staff and patients, as well as the public. One of its projects saw members of the group involved in the planning stages of the re-building of Whipps Cross Hospital, which aims to be the UK’s first carbon net-zero hospital.

Nursing Times spoke with Jacqueline Sear, an accident and emergency nurse, who joined the group earlier this year. She said one of the key aims of the group was to “make sustainability more at the forefront” of the trust. As an

example, she said that, from their very first day, new staff would be handed information about the group and told how they could get involved.

Ms Sear, who works at the trust’s Royal London Hospital in Whitechapel, East London, said she had also decided to change the way she travelled to work

– she now cycles in for her shifts instead of getting the tube.

When asked why it was important for nurses to be engaged with the green agenda, she said: “Nurses are uniquely placed because we are the absolute front line; we are the only sort of speciality that is there 24 hours a day, at the bedside, in some capacity.

“So, in terms of advocating for our patients and educating our patients about these sorts of matters, we are, in many ways, the best people to do it,” she said.

Part of her motivation for signing up to the team, she said, was “knowing that the NHS contributes something like 4% to the whole of the UK’s

carbon footprint”.“Obviously we do lots of hard work

for our patients to give them the absolute best care. But we are also – without sometimes knowing it – very much contributing to the huge issue [of climate change] that seems to snowball and that we need to get on top of.”

Coronavirus refocuses recycling efforts and leads to new trust record

London nurses lead sustainability and climate action group