Environmentally Sustainable Waste Segregation and Linen Use in a Burn and Polytrauma Intensive Care Unit: A Nurse-Led Quality Improvement Initiative

Abstract

Background The healthcare sector is a significant producer of greenhouse gas emissions, with intensive care units (ICUs) being major contributors. The environmental impact of medical waste largely depends on disposal methods; proper segregation can enhance recycling potential.

Local Problem High variability in waste segregation and excessive linen consumption in the burn and polytrauma ICU.

Methods This quality improvement initiative in a 10-bed burn and polytrauma Spanish ICU used a pre–post interventional study design to address poor waste segregation and excessive linen use challenges.

Interventions Following educational workshops, placement of posters and reducing chemical waste container size, the workflow for medical waste segregation was improved. During a 60-day baseline period, packaging waste, chemical waste and linen were measured for burn victims, polytrauma cases and conventional ICU patients. A new intervention focused on packaging and chemical waste segregation practices, classifying plastic or glass containers with less than 10% medication remaining as recyclable. Measurements were repeated during a subsequent 112-day intervention period.

Results Significant differences were observed during the baseline period: average packaging waste per shift was 251.51 g (range: 62.34–440.68; p = 0.02) and average daily packaging waste was 754.53 g (range: 187.02–1322.02; p = 0.02) for burn victims compared with other groups. When comparing both periods, total chemical waste decreased from 5.34 kg (range: 4.06–6.62) to 2.07 kg (range: 1.76–2.38), with average chemical waste per patient per day dropping from 790 g (range: 582.10–998.20) to 304.70 g (range: 260.50–348.90), both statistically significant (p = 0.001). Linen usage indicated a decrease in variability despite not reaching statistically significant differences (p = 0.154).

Conclusions This study demonstrated that improving segregation criteria reduced variability in waste management within an ICU setting. Chemical waste was successfully decreased while increasing recyclables, showing that transforming a conventional ICU into a sustainable one is both feasible and effective.