Introduction The NHS has committed to achieve ‘net zero’ carbon emissions by 2040. Nationally endoscopy is the third highest carbon emitting hospital department; driven in part by high single-use instrument turnover currently incinerated in S32 sharps bins. Sharpsmart MR64 Clinismart sharps bins (figure 1) have lower carbon emissions than traditional S32 bins as they are sterilised, recycled and reused. Our green endoscopy working-group (GEW) aimed to reduce endoscopy’s carbon emissions through piloting MR64-bins’ and assessing their impact on staff practices and cost compared to S32-bins. Newcastle Hospital’s Freeman Endoscopy Unit is a three-room endoscopy unit including advanced hepato-pancreato-biliary (HPB) therapeutics.
Method We monitored sharps bin usage, hiring costs and disposal costs over a baseline 4-week period using traditional S32 bins and a pilot 4-week period with MR64-bins within our unit. We assessed staff practice through focus group discussion a questionnaire to endoscopy nursing and decontamination staff with Likert scale on acceptability of arising comments and free-text responses. The quality improvement pilot was registered with the local audit department.
Results During baseline (3rd–31st October 2022), 21 S32-bins were used. Hire costs were £258.93 and incineration costs £89.88. During the pilot (1st-30th November 2022), 3 MR64-bins were used. Hire costs were £50.13, recycling and disposal costs £8.40. Over 4 weeks this reduced costs by £290.28; we therefore estimate a saving of £3774 over a year.
13 endoscopy staff completed a survey, all rated the M64 sharps bins as more or much more acceptable than S32 bins. Focus group comments highlighted the ‘larger volume’ of MR64-bins allowing ‘equipment fit in easier’ (12/1, 92% agreed), it was ‘easy to see contents’ (10/13, 77% agreed) and they perceived ‘less of a risk of needle stick injury’ (7/13, 54% agreed). One comment appreciated that ‘metal components can be recycled’.
Conclusion This MR64 sharps bins pilot reduced our incineration carbon footprint; their larger volume allowed more efficient storage of wire waste and are estimated to reduce costs by £3774 annually. Although a small-scale pilot, we have demonstrated the larger bins are more acceptable to our nursing and decontamination endoscopy staff and they were perceived as being safer and more efficient. Future work should calculate the formal emissions factors for incineration and recycline over a longer period to quantity impacts on endoscopy’s carbon footprint.
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