Reducing Clinical Waste in a Satellite Dialysis Unit
Berry,S Wittich,L Mogg,L Williams, P.
Heart of England NHS Foundation Trust
Normal practice was that all rubbish accumulated during a patient’s haemodialysis
treatment was disposed of as clinical waste. This accumulated to between 2 – 2.9kg of
clinical waste, per patient, per treatment (6-8.7kg per patient per week). This created
huge additional costs to health care and the removal of refuse, especially as a large
proportion of that rubbish was not actually true clinical waste. This was a problem
which has the potential for huge cost savings, but which required a change in practice
for both staff and patients.
To make changes in how refuse both clinical waste and black bag rubbish is disposed of
in our haemodialysis units. The task was to identify and segregate true clinical waste
from non clinical waste and safely dispose of both separately. This could reduce refuse
Using a satellite unit as a pilot for the scheme, it was found that over 50% of rubbish
disposed of, was discarded as clinical waste when in fact it was found to be containing
paper, packaging, cardboard boxes, plastic dialysis bottles etc. The number of large
clinical waste bins and black bag rubbish (non clinical waste) bins were monitored as to
how many bins were used and the costing. A further option to reduce black bag rubbish
further was considered, to recycle the plastic dialysis bottles and cardboard boxes.
It was found that approximately 1.9kg per patient, per treatment (5.7kg per week), of
domestic waste was unnecessarily discarded as clinical waste. All non clinical waste
rubbish was placed straight into black bags, and only true clinical waste was discarded
of in yellow clinical waste bags. Cardboard and plastic, that had previously been
discarded in either clinical waste bins or black bag rubbish bins, was later crushed,
bailed and removed for free. The weight per week of this cardboard and plastic was
approximately 140kg, which contributed to unnecessary additional waste costs. Taking
into account the running costs of the bailing machine, an overall saving of £7,311 p.a
was still saved on the removal of clinical and black bag rubbish waste.
This was a huge learning curve for everyone, as it taught staff and patients to think
about the waste they were disposing of. All paper, packaging, plastic wrappers, food
stuffs, disposable cups and plates etc are disposed of in black bags. Only true clinical
waste (blood stained items, dialysers, lines and syringes) are disposed of in clinical
waste. All cardboard and plastic dialysis bottles are crushed bailed and removed free
for recycling. Black bag rubbish remains non hazardous, and incinerated.
This change in practice has given the staff a sense of pride, as they feel they have
personally helped towards reducing the disposal of rubbish and are recycling other
wastes to help improve the environment they live and work in.