Achieving cost and carbon savings in neonatal practice: A review of the literature on sustainable waste management

Beyond the incubator: applying a "one health" approach in the NICU

A "one health" approach recognises that human health, animal health and planetary health are closely interlinked and that a transdisciplinary approach is required to fully understand and maintain global health. While, by necessity, Neonatal Intensive Care has traditionally focused on the acutely unwell newborn, the avoidance of long-term harm is core to many management decisions. The COVID 19 pandemic and climate crisis have brought into sharp relief the importance of a "one health" approach as part of long-term health promotion in the holistic care of neonates, who may survive to experience the burden of future environmental crises. This narrative review seeks to integrate what we know about "one health" issues in the neonatal intensive care unit, notably antimicrobial resistance and climate change, and suggest "everyday changes" which can be utilised by practitioners to minimise the impact of neonatal intensive care on these global health issues. Many of the changes suggested not only represent important improvements for planetary health but are also core to good neonatal practice. IMPACT: Neonatal patients are likely to bear the burden of future environmental crises including pandemics and climate related disasters. While the focus of intensive care practitioners is acute illness, awareness of "one health" problems are important for our smallest patients as part of preventing long-term harm. High quality neonatal care can benefit both the planet and our patients.

Determining a conceptual framework for safe and sustainable health-care waste management (SSHCWM) implementation in health-care facilities

Purpose

This paper aims to explore current sustainable facilities management knowledge and practice, focussing specifically on sustainable waste management implementation in health-care facilities with an aim to conceptualize a framework for assessing performance and impact of successful implementation of safe and sustainable health-care waste management on health-care provision.

Design/methodology/approach

This paper used a review of existing literature in relation to health-care waste management in the context of sustainable facilities management and facilities management performance and forms a basis for further research.

Findings

The growing significance of the strategic role of facilities management is established. Building on this recognition, a conceptual framework for assessing both implementation of sustainable facilities management practice in the context of waste management in health-care facilities and its impact on health-care provision is proposed.

Originality/value

This paper conceptualizes a framework for optimizing safe and sustainable waste management implementation in health-care facilities and assessing its impact on the bottom-line of health-care provision.

Costs associated with the management of waste from healthcare facilities: An analysis at national and site level

Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings. At the site level, waste generation and type were linked to department type and clinical performance, with the top three highest generating departments of hazardous healthcare waste being anaesthetics (5.96 kg day^-1 bed^-1), paediatric and intensive care (3.37 kg day^-1 bed^-1) and gastroenterology-digestive endoscopy (3.09 kg day^-1 bed^-1). Annual overall waste management costs were $US5,079,191, or approximately $US2.36 kg^-1, with the management of the hazardous fraction of the waste being highest at $US3,707,939. In Italy, reduction in both waste arisings and the associated costs could be realised through various means, including improved waste segregation, and linking the TARI tax to waste generation.

Developing awareness of sustainability in nursing and midwifery using a scenario-based approach: Evidence from a pre and post educational intervention study

BACKGROUND

The delivery of healthcare has an impact on the environment and contributes to climate change. As a consequence, the way in which nurses and midwives use and dispose of natural resources in clinical practice, and the subsequent impact on the environment, should be integral component of nursing and midwifery education. Opportunities need to be found to embed such issues into nursing curricula; thus bringing sustainability issues 'closer to home' and making them more relevant for clinical practice.

OBJECTIVES

The study was designed to measure the impact of a sustainability-focussed, scenario-based learning educational intervention on the attitudes and knowledge of student nurses and midwives.

DESIGN

Pre test/Post test intervention study using scenario-based learning as the educational intervention. The Sustainability Attitudes in Nursing Survey (SANS_2) was used as the outcome measure.

SETTINGS

Clinical skills session in a UK University School of Nursing and Midwifery.

PARTICIPANTS

676 second year undergraduate nursing and midwifery students.

METHODS

The 7-point scale SANS survey was completed before and after the teaching session; standard non-parametric analysis compared pre and post intervention scores.

RESULTS

Changes were observed in attitude towards climate change and sustainability and to the inclusion of these topics within the nursing curricula (p=0.000). Participants demonstrated greater knowledge of natural resource use and the cost of waste disposal following the session (p=0.000). Participants also reported that sessions were realistic, and levels of agreement with statements supporting the value of the session and the interactive nature of delivery were higher following the session.

CONCLUSIONS

Using a scenario-based learning approach with nursing and midwifery students can change attitudes and knowledge towards sustainability and climate change. Embedding this approach in the context of clinical skills provides a novel and engaging approach that is both educationally sound and clinically relevant.