Reducing Clinical Waste in a Haemodialysis Clinic, Small Change Big Impact.
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The „Small Change, Big Impact‟ project was implemented in a busy 14 bed haemodialysis unit. The organisation as a whole was looking at ways to reduce waste production throughout the hospital. It was found, by looking at a departmental level that the amount of clinical waste generated by a single haemodialysis treatment was substantial. While this waste production cannot be eliminated, there are measures that can be taken to substantially reduce the majority of this fluid prior to removing the used dialysis circuit from the dialysis machine.
The dialysis machine has a function that enables the safe drainage of the blood contaminated fluid from the dialysis circuit prior to their disposal. This function does not incur any extra financial costs or require additional equipment to perform the task. By carrying out this simple action, it would result in the amount, in weight, of clinical waste leaving the unit reducing dramatically. The change was implemented over an 8 week period. Collaboration with all members of the team was important to maximise the potential for success in the change process. This was achieved by creating an interest and ownership in the change project from its inception. Current practice was observed prior to carrying out the project then 4 weeks after the initial intervention and then a further 4 weeks later. The involvement of the team was integral to the success of the change process. This was achieved through dissemination of instruction leaflets on how to drain the dialysis lines, ward meetings to gain feedback and answer questions and also provide audit results following the initial intervention. The NHS change model was used as an aid to implement the project. The results were highly positive. There was a massive increase from 18.7% to 93.75% in staff compliance with the new practice of draining the dialysis circuits before removing them from the dialysis machine. This led to a weight reduction of approximately 80kg of clinical waste leaving the dialysis unit on a weekly basis. This substantial reduction in waste shows that this was a positive change that can have a significant impact on the organisation as a whole.