D SENEVIRATNE EPA1, K BARRACLOUGH1, A WHITE1
1The Royal Melbourne Hospital, Parkville, Australia
Aim: The aim of this study was to audit and compare waste generation and disposal practices and costs within two haemodialysis units in Melbourne.
Background: Dialysis has among the highest recurrent, per capita resource consumption and waste generation profile of any healthcare sector. The environmental and financial costs are high and unsustainable. Research into dialysis waste management in the Australian setting is scarce.
Methods: Three haemodialysis treatment sessions were observed within each haemodialysis unit (units A and B). All waste items generated were identified and weighed. Segregation into general, recycling and clinical waste streams was directly observed. The cost implications of current versus ideal waste practice were calculated.
Results: The average weight of waste generated from a single haemodialysis session at units A and B were 3.9kg and 2.1kg respectively; the excess for unit A was due to non-drainage of left-over fluid prior to container disposal. Clinical waste accounted for 61.5% of unit A’s total waste, compared with 49.4% for unit B. This difference was due to optimal and superior waste segregation at unit B. Because of the increased cost of clinical compared to other waste disposal, the total cost of waste disposal per treatment was $2.23 AUD at unit A compared with $1.55 AUD at unit B, despite the per kg general waste disposal cost at unit B being three times that of unit A. If waste management were to be optimized at unit A, yearly savings of AUD 9064 would accrue.
Conclusions: Optimal dialysis waste practice creates potential for environmental and financial savings. All dialysis units should consider auditing waste management and instituting measures to improve waste management.
Dan Seneviratne Epa is a second year Nephrology Advanced Trainee, undertaking training at The Royal Melbourne Hospital and Box Hill Hospital in Victoria.He has a keen interest in research and continuous quality improvement. This project was undertaken in an effort to boost financial and environmental sustainability in the practice of haemodialysis.