Search

Introduction: The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods: This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results: The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion: Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to a surge in medical waste generation, posing hazards to both the environment and global health. The impacts of the COVID-19 pandemic's medical waste hazard may persist long after the pandemic itself subsides. Improper disposal of medical waste can contaminate environment, posing risks to ecosystems and public health. Discarded medical rubber gloves, for example, can become a source of infection, improper disposal of these gloves can escalate the spread of infectious diseases and increase the risk of transmission of the virus to the general public. This study proposes an innovative and sustainable method to reinforce cement mortar by adding recycled glove rubber as an additive to cement mortar to increase its resistance to impact loads. This study conducted uniaxial compression tests, separating hopkinson pressure bar (SHPB) experiments and SEM observations to evaluate the quasi-static compressive strength and dynamic stress of recycled rubber fiber mortar (RRFM) with varying recycled rubber fiber (RRF) contents (0, 1%, 2%, 3%). Strain curves, dynamic increase factor (DIF), energy absorption rules, failure modes, and microstructure of RRFM mixtures. The experimental results demonstrate that with the addition of RRF, the dynamic stress-strain curve flattens and the peak strain gradually increases. The RRFM sample shows stronger toughness. In comparison to regular cement mortar (NM), RRFM has a higher DIF and specific absorbed energy, a faster increase in dynamic compressive strength, and the ability to absorb more energy per unit volume. Under the same impact load, RRFM has fewer and smaller cracks than NM. Scanning electron microscopy (SEM) testing also observed that RRF formed a strong connection pattern with the cement mortar matrix. [ABSTRACT FROM AUTHOR]

Taiwan has been an active participant in waste recycling for a long period of time due to the need for resource sustainability. The country believes it can one day eventually achieve the goal of zero waste through the effective use of strategies such as source reduction, resource recovery, reuse, and recycling. Despite Taiwan's long‐standing commitment to waste recycling for purposes of resource sustainability, achieving the goal of zero waste remains an immense challenge. Therefore, putting into effect the previously mentioned strategies will obviously be necessary in order to realize this goal. However, the effective implementation of these strategies requires both comprehensive planning and coordination, particularly in large medical institutions. Here, we have aimed to promote waste reduction throughout the entire hospital system in Taiwan using 3 strategies: (1) standardizing the colors of garbage bags, marking patterns of waste, and reviewing and establishing an internal audit mechanism on a regular basis; (2) the systematic monitoring of individual departments with regard to on waste consumption, brands, and materials while linking departments to the procurement source management team. In addition, any related hardware has been upgraded, precisely controlled, and automatically uploaded to the cloud system for an improved intelligent management system. In addition, the Department of Nutrition has adjusted the handling of ingredients and consumption patterns of hospital employees in order to reduce food waste; and (3) with regard to the disposal of medical waste, medical centers will be consolidating and advancing the knowledge and ability of all hospital personnel through education and training programs established for them. After the implementation of this program to promote awareness, the ratio of biological waste percentage in regard to total hospital waste dropped from 37.3% in 2018 to 33.6% in 2022, with a 49% decrease being seen in food waste, and a 99.32% increase being realized in green designated procurement items. Such an efficient management of medical waste has no doubt been extremely beneficial to the hospital. [ABSTRACT FROM AUTHOR]

Objective: Most intravenous anticancer drugs are administered in a dose per unit area or body weight, if not promptly administered to another patient cytotoxic leftover would be destroyed. To contain wastage, low-cost measures are highly desirable to contain and reduce expenditures without impairing the quality of care. The objective of the study is to evaluate the cost saved through the use of the two cytotoxic waste management techniques implemented in National Institute of Oncology's centralized chemotherapy preparation unit, vial sharing and dose rounding. Method: A 6-month prospective single centre study from 1 February to 1 August 2023 at the National Institute of Oncology of Rabat in Morocco. The number of prepared preparations and amount of drug saved by both vial sharing and dose rounding was collected using the centralized chemotherapy preparation unit's 'leftover tracking file', the corresponding cost saved were calculated and then compared for each technique and with 2018 results. Results: In total, 18,218 preparations were considered in the 6-month study. With the vial sharing technique 636,524.5 mg were saved corresponding to 246,031.4 (USD) saved cost, against 212,838.4 mg by dose rounding corresponding to 75,598.5 (USD) saved cost. This saving corresponded to a total of 321,629.4 (USD). Compared to the 2018 results leftovers costs saved by vial sharing corresponded to 289,972.05 (USD) by vial sharing technique for 1-year extrapolated period, and this study shows a saved cost of 321,629.9 (USD) by both vial sharing and dose rounding techniques. Conclusion: Dose rounding technique combined with vial sharing allowed National Institute of Oncology's centralized chemotherapy preparation unit to limit expensive cytotoxic cost wastage, highlighting these technique benefits. [ABSTRACT FROM AUTHOR]

Human-generated waste, including infectious healthcare waste, poses significant risks to public health and the environment. The COVID-19 pandemic has increased the global production of infectious waste, emphasizing the need for safe and sustainable waste management practices. While autoclaves are commonly used for on-site disposal, alternative methods like ozone gas and UV-C radiation offer environmentally friendly options that effectively eliminate pathogens without leaving toxic residues. Inadequate waste management can contribute to disease transmission, while open burning releases harmful pollutants. This study investigated the effectiveness of different disinfection agents – ozone gas and UV-C radiation – on infectious solid waste contaminated with bacteria. The bacterial indicators examined were Staphylococcus aureus, Bacillus subtilis, and Pseudomonas aeruginosa. The experimental methods included operating each ozone and UV-C radiation individually and simultaneously using ozone gas and UV-C radiation. The study also investigated exposure times and various concentrations of ozone gas. The findings demonstrated that the simultaneous application of ozone gas and UV-C radiation was the most effective method for decontaminating infectious solid waste and targeting the selected bacteria. The concentration of ozone gas ranged from 165 to 5000 ppm, depending on generation time and treatment chamber volume, while exposure times varied from 1 to 180 minutes. In applying UV-C rays, complete elimination of S. aureus was observed after 60 minutes up to 6-log, while the reduction of B. subtilis and P. aeruginosa were 2-log and 3-log, respectively. Ozone gas had the ability to inactivate all strains, but when ozone gas and UV-C rays were used simultaneously, this process was accelerated and improved. The total reduction in the bacterial load was 8-log. Considering the increase in population and the subsequent increase in waste generation, adopting an environmentally friendly waste management method can be very advantageous. Implications: This study highlights the effectiveness of simultaneously applying ozone gas and UV-C radiation for decontaminating infectious solid waste, offering an environmentally friendly alternative to traditional thermal treatments like autoclave and incineration. By optimizing ozone concentrations and exposure times, this method reduces disease transmission risks and minimizes environmental impact. These findings are crucial, especially during outbreaks such as the COVID-19 pandemic, providing scalable, sustainable waste management solutions for healthcare facilities. Implementing these techniques can protect public health and the environment, setting a new standard for safe infectious waste disposal worldwide, mitigating hazardous pollutants, and reduce the exposure risk of bio-hazardous residues. [ABSTRACT FROM AUTHOR]

• The effect of temperature on plasma gasification of CPMW is explored experimentally. • A temperature of 1800 °C provides the optimum performance for air-CPMW gasification. • The volume fraction of H 2 and CO increases with the increased reactor temperature. Plasma gasification melting (PGM) provides reliable disposal of toxic medical waste with a low heating value, which is capable of converting waste into energy. This study investigates the performance of experiments on plasma gasification for the treatment of chemical-pharmaceutical medical waste (CPMW) with an air medium. A comparative analysis is performed for gasification characteristics at three reactor temperatures (1000, 1400, and 1800 °C). Moreover, a thermodynamic equilibrium model is developed to assess performance features such as syngas yield, high heating value, and cold gas efficiency in the gasification temperature range of 1000–1800 °C. A comparison of the experiment and computational outcomes shows a good agreement. The results show that the quality of syngas and heating value is improved by increasing the temperature of the plasma gasifier so that at 1800 °C, H 2 , CO, and higher heating value (HHV) are obtained as 41 %, 37 %, and 10 MJ/Nm3, respectively. The obtained syngas is a clean fuel with low sulfur-containing and nitrogen-containing. The experimental results provide an extensive comprehension of CPMW gasification in a plasma reactor and consider a possibility for hydrogen and energy production. [ABSTRACT FROM AUTHOR]

Traditional waste incineration generates a large amount of exhaust gas, resulting in adverse environmental impacts. Therefore, we developed an organic and intelligent photochemical processing system that utilizes high-energy lasers for incineration, thereby reducing the production of exhaust gas. A large-scale laser machine was set up, incorporating low-cost 2D Light Detection and Ranging (LiDAR) technology for system sensing, which performs angle range and threshold filtering, as well as multispectral laser allocation, integrated with the laser ablation machine system. After testing, the error was <5 mm (<8%), achieving precise object scanning and ranging and solving the problem of manual laser positioning. Experimental results showed that CO2 lasers can effectively process organic materials and medical waste of different sizes. This innovative research will have profound implications for the future development of environmental protection and incineration technologies. In the future, it has widespread application prospects in areas such as pet waste disposal and medical waste treatment. [ABSTRACT FROM AUTHOR]

This research explored the life cycle analysis and environmental cost-benefit assessment of converting ash waste from hospital medical waste incineration into environmentally safe paving block raw materials. The growing concerns about medical waste disposal and its environmental impact necessitate innovative solutions for sustainable waste management. This research aimed to evaluate the feasibility and environmental implications of reusing hospital waste into raw materials for paving block mixtures. This research, a comprehensive life cycle analysis, examined the environmental impacts of medical waste collection for the production and use of paving blocks. Additionally, we conducted an environmental cost-benefit assessment to ascertain the economic feasibility and potential environmental impact forecasts of this recycling approach. The research results show that converting hospital medical waste ash into mixed raw materials for paving blocks not only immobilizes heavy metals but also provides a sustainable alternative for non-building materials. These findings highlight the potential for significant environmental and economic benefits, making this approach a promising strategy for waste management and sustainable construction practices. The cost of preventing environmental damage (eco-cost) in the process of converting ash from the incineration of medical waste into a mixture of raw materials for paving blocks is IDR 600,180.9 per cycle. [ABSTRACT FROM AUTHOR]

Within the scope of this research, the fuzzy‐analytical hierarchy process (F‐AHP) method is applied to assess the waste management approaches adopted by various hospitals in the city of Gwalior, India. Fuzzy‐AHP, as an alternative to traditional AHP, accommodates uncertainty and imprecision, offering a decision‐making method that is more adaptable and realistic. The F‐AHP methodology, delineated in a seven‐step process, incorporates pairwise comparisons, fuzzy mathematics, and linguistic variables to compute fuzzy weights for waste management criteria, encompassing physical, biological, social, and economic aspects. Hospital 1, with a weight value of 0.406 and strict adherence to the Bio‐medical Waste Management (Amendment), 2018 rules and regulations of the Government of India, emerges as the most promising sustainability hospital based on the F‐AHP analysis findings. Conversely, Hospital 5 exhibits the poorest waste management practices among the surveyed hospitals, earning the lowest possible ranking. While the proposed F‐AHP method provides valuable insights, the study is limited to a specific geographic area (Gwalior) and potential variations based on environmental factors. Additionally, the practical implications extend beyond the general emphasis on continuous monitoring to include specific actions for hospitals to enhance their waste management systems. [ABSTRACT FROM AUTHOR]

Abstract Introduction The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings.

Addressing the pollution problems caused by improper disposal of effluents and wastes from pharmaceutical companies and medical facilities are important for the safety of humans and animals. This work highlights the challenges and developments in medical and pharmaceutical waste management practices across the world as well as their potential for bio-energy production. It involves the study of these waste properties, their impacts on the ecosystem and treatment or recycling methods. Various studies have shown that successes have been recorded in converting some antibiotic contaminated wastewater to biogas in advance anaerobic digesters. Moreover, not all medical wastes are degradable, the use of placentas, hospital cotton waste, human urine, waste blood and surgery waste has been used in biogas plants built at close proximity to hospitals, in some cases. However, such plants are few and are only located in Tanzania, India and Philippines, among others to generate biogas to power hospitals, boil hot water needed by patients and for cooking. This is because the level of awareness as regards the dangers associated with indiscriminate disposal of medical and pharmaceutical waste is low and hence the development of waste disposal policy by countries is often overlooked. The implication of this is the spread of diseases in affected areas which can results in epidemics. It is therefore necessary to formulate policies that allow the harnessing of these wastes to biogas/ bioenergy or the creation of better waste management practices that is environmentally safe. [ABSTRACT FROM AUTHOR]

Aim: To identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally. Design: Integrative review. Methods: The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal Tool. A deductive content analysis based on Elo and Kyngäs' methodology was employed. Data Sources: CINAHL, MEDLINE, EMBASE, Web of Science, British Education Index, GreenFILE and Scopus were searched up to the 8th November 2022. Results: Thirty‐two studies were included in the review. Two studies included nursing educators in their samples, the rest focused solely on students. Findings suggest that whilst some students were aware of sustainability issues and felt that nurses have a responsibility to mitigate climate change, others showed limited awareness and believed that nurses have more important priorities. A global interest was seen among students for increased curricular content related to sustainability and climate change. Waste management and education of others were suggested actions students can take; however, barriers included lack of confidence and limited power. Conclusion: There is a need for sustainability education within nursing curricula, accompanied by student support. Implications for the Profession: The review acts as a starting point to make sustainable healthcare and climate change mitigation integral aspects of nursing. Impact: Sustainability education within nursing curricula can positively impact on sustainable healthcare and climate change mitigation. More research is needed on the perspectives of nursing educators. Reporting Method: The review is reported according to the PRISMA guidelines. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: One half of Norwegians die in nursing homes, where death certificates (DCs) are completed by two types of physicians: in-house physicians or physicians on call. The aims of this study were to examine differences in the quality of DCs due to type of physician and to uncover possible implications of errors for the public statistics. Methods: DCs from the year 2013 from nursing homes in the catchment area of Akershus University Hospital were examined with regard to logical deficiencies, garbage code diagnoses and type of certifying physician. In one third of cases, the registered causes of death were compared to information in the medical records. Results: A total of 873 DCs from 24 nursing homes were evaluated. Physicians on call certified 46% of all deaths. Logical deficiencies were found in 34% of all DCs and were more common in DCs from physicians on call. Garbage code diagnoses were used in every third DC, with 'sudden death' or 'cause of death unknown' preferred by physicians on call and 'unspecified pneumonia' preferred by in-house physicians. Comparisons against medical records uncovered missing information in 49% and 35% of DCs from physicians on call and in-house physicians, respectively. A dementia diagnosis was frequently overlooked by both physician types. Garbage code diagnoses were more common in DCs with missing information from medical records. Conclusions: Error rates in DCs in nursing homes in Norway are high. The results raise concerns about the validity of public cause of death statistics. [ABSTRACT FROM AUTHOR]

Medical waste bins are a potential source of microbial contamination in the hospital environment, while there is no clear guidance for the management of them. We aimed to assess the impact of medical waste bins on patient's environment. This experimental study simulated microbial contamination by performing medical procedures on a patient model with fluorescent lotion. The waste bin was set as initially empty or two-thirds filled with waste, open or with a lid. The percentage of fluorescent-contaminated area in designated patient's environments was analyzed by 2 independent observers. Among a total of 120 experiments, the sides of the bins were more contaminated in open-occupied bins compared to open-empty bins and in open-occupied bins compared to lid-occupied bins (median 1.9175% vs 0.0916% [ P =.001] and 1.9175% vs 0.0899% [ P =.003], respectively). The top of the bedside equipment trolley for preparing medical procedures was more contaminated in lid-occupied bins than open-occupied bins (median 0.0080% vs 0.0040%, P =.013). In addition to reducing contamination of the bin itself, the manually operated lid had a potential risk of contributing to microbial transmission by contaminating the equipment trolley. Medical waste bins should be kept no more than two-thirds full, and caution should be taken when using the manually operated lid, to avoid cross-contamination. • The guidance on medical waste bins, potential source of pathogen, is needed. • Two-thirds filled waste bins were more contaminated than empty bins. • Open waste bins were more contaminated than lidded bins. • Equipment trolley was more contaminated in bins with manually operated lids. • Occupied waste bin and manually operated lid may be sources of contact transmission. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Pathology is the property of Canadian Association of Pathologists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to assess the prevalence of leftover medicatio10ns and the disposal practices of unused medications among patients visiting public health facilities in northwestern Ethiopia. Subject and methods: A multi-center cross-sectional study was conducted among 354 participants in the public health facilities of the south Gondar zone, Amhara region, Ethiopia, from June 1 to 30, 2021. Face-to-face interviews using structured questionnaires were conducted to collect data. The data were analyzed using the statistical package for social sciences (SPSS) version 25 software. Results: Of the 354 respondents, 267 (75.4%) had taken medication prior to this study. Of the 267 respondents who had taken medication before, 88 (32.9%) of them had leftover medications. The most common reason for having leftover medications was an improvement in disease condition 37 (42.0%). Even though most of the participants (43.8%) were informed about the negative effects of improper disposal of unneeded medicine, 34 (38.6%) of them threw it into the trash. The majority of participants (53.4%) selected the approved disposal technique suggested by the Food and Drug Administration. Conclusion: According to the current study, it is very common to keep drugs at home, and the majority of disposal techniques are not recommended. Additionally, the majority of respondents stated that they did not receive any advice from medical professionals regarding how to dispose of leftover medications. Therefore, it is critical to properly inform and direct patients on how to dispose of unused prescriptions. [ABSTRACT FROM AUTHOR]

Due to the growing population and advancing economy, medical waste accumulation has come to the attention of all facets of society. Although the issue of medical waste management planning has been addressed in developed nations, it still exists in several developing nations. This paper examines the effects of barriers under the Organization action, work handling, and Human Resource Practices section on the healthcare waste management (HCWM) sector in a developing country India. In this study, three hypotheses were constructed and tested using Structural equation modeling. The questionnaire was distributed among 200 health professionals to collect their responses. Ninety-seven responses were received, and 15 barriers were identified affecting the healthcare waste management sector. The results show that all three barriers (i.e., Organizational, Waste handling, and Human resources) hinder the Healthcare waste management sector. Organizational Barriers are the most significant among other barriers. So, the hospitals have to take appropriate actions to overcome these barriers. This paper helps to complete the research gap by providing the different characteristics of barriers. The development of a model for the analysis of barriers influencing HCWM is the Author's original contribution. [ABSTRACT FROM AUTHOR]

Background: Improvements in standard precaution related to infection prevention and control (IPC) at the national and local-level health facilities (HFs) are critical to ensuring patient's safety, preventing healthcare-associated infections (HAIs), mitigating Antimicrobial Resistance (AMR), protecting health workers, and improving trust in HFs. This study aimed to assess HF's readiness to implement standard precautions for IPC in Nepal. Methods: This study conducted a secondary analysis of the nationally-representative Nepal Health Facility Survey (NHFS) 2021 data and used the Service Availability and Readiness Assessment (SARA) Manual from the World Health Organization (WHO) to examine the HF's readiness to implement standard precautions for IPC. The readiness score for IPC was calculated for eight service delivery domains based on the availability of eight tracer items: guidelines for standard precautions, latex gloves, soap and running water or alcohol-based hand rub, single use of standard disposal or auto-disable syringes, disinfectant, safe final disposal of sharps, safe final disposal of infectious wastes, and appropriate storage of infectious waste. We used simple and multiple linear regression and quantile regression models to examine the association of HF's readiness with their characteristics. Results were presented as beta (β) coefficients and 95% confidence interval (95% CI). Results: The overall readiness scores of all HFs, federal/provincial hospitals, local HFs, and private hospitals were 59.9±15.6, 67.1±14.4, 59.6±15.6, and 62.6±15.5, respectively. Across all eight health service delivery domains, the HFs' readiness for tuberculosis services was the lowest (57.8±20.0) and highest for delivery and newborn care services (67.1±15.6). The HFs performing quality assurance activities (β = 3.68; 95%CI: 1.84, 5.51), reviewing clients' opinions (β = 6.66; 95%CI: 2.54, 10.77), and HFs with a monthly meeting (β = 3.28; 95%CI: 1.08, 5.49) had higher readiness scores. The HFs from Bagmati, Gandaki, Lumbini, Karnali and Sudurpaschim had readiness scores higher by 7.80 (95%CI: 5.24, 10.36), 7.73 (95%CI: 4.83, 10.62), 4.76 (95%CI: 2.00, 7.52), 9.40 (95%CI: 6.11, 12.68), and 3.77 (95%CI: 0.81, 6.74) compared to Koshi. Conclusion: The readiness of HFs to implement standard precautions was higher in HFs with quality assurance activities, monthly HF meetings, and mechanisms for reviewing clients' opinions. Emphasizing quality assurance activities, implementing client feedback mechanisms, and promoting effective management practices in HFs with poor readiness can help to enhance IPC efforts. [ABSTRACT FROM AUTHOR]

Introduction: Central Venous Lines (CVL) are an important part of patient care, allowing the administration of intravenous fluids, blood, drugs and parenteral solutions. Their use is a cause of infections due to micro-organisms colonizing the skin at the entry point or the catheter or other point along it or the fluids administered by the Intensive Care Unit (ICU). Central line-associated bloodstream infections (CLABSI's) in children's ICUs are an important factor that negatively affects the course of the disease, causing complications, perhaps irreversible. Aim: The aim of this study was to investigate the interventions for the management of CLABSI's in neonatal and pediatric ICUs. Methodology: Published research articles in the years 2016-2021 in valid scientific journals referring to children with CVL hospitalized in neonatal and pediatric ICUs were studied. A systematic search of the literature was performed in digital scientific databases (Medline, PubMed Scopus, Embase, Cochrane Library) using keywords. The PICOS (Population, Interventions, Controls, Outcome, Study design) procedure was used as a criterion for the inclusion of an article in the present study. The evaluation of the articles of the bibliographic search were evaluated using the PRISMA method. Results: Interventions for the management of CLABSI's included the use of chlorhexidine-soaked pads, implementation of measures to prevent CLABSI's, use of a pre-filled disposable syringe for flushing, implementation of an infection surveillance system, use of new methods/measures for introduction of the catheter, use and management of CVL, use of ethanol lock, use of antibiotic-impregnated catheter and multidimensional approaches. Conclusions: As it was seen from the results of the study, there are several research evidence regarding the effectiveness of nursing interventions to limit CLABSI's in neonatal and children's ICUs. Nevertheless, it seems that prevention measures for CLABSI's and hand hygiene guidelines have a decisive role in limiting CLABSI's in neonatal and pediatric ICUs. [ABSTRACT FROM AUTHOR]

This document provides concise summaries of research studies presented at a medical conference on digestive endoscopy. The studies explore various topics, such as the effectiveness of different procedures for treating gastric conditions and the use of artificial intelligence in diagnosing gastrointestinal diseases. While the studies offer valuable insights into the safety and potential benefits of these interventions, further research is needed to validate their findings and assess their impact on patient care. The document also includes studies on endoscopic procedures for other gastrointestinal conditions, contributing to the understanding and improvement of endoscopic techniques and interventions. [Extracted from the article]

'Good health and well-being" (SDG3) is one of the 17 integrated sustainable development goals (SDG) adopted by the United Nations in 2015. When it comes to health and well-being, pharmaceuticals play a vital role. Pharmaceutical waste and contaminants of emerging concern (CEC) produced during the manufacturing, supply, usage and disposal of drugs, chemicals and personal care products can significantly affect the environment. Some serious global problems have been attributed, at least partly, to the prevalent practices in this sector. With increased awareness, regulations and corporate environmental responsibility, the pharmaceutical industry is making efforts toward sustainability through measures like green production, green technology, improved supply chains, collaborations and strategic partnerships. However, the need is still felt for additional measures to be incorporated into the practice like a circular economy, based on the 4Rs (reduce, recycle, reuse, recover); Artificial Intelligence (AI) can be used to recognise the best way to obtain maximum yield with minimum cost from available resources in an environment-friendly manner for the benefit of society; encouraging the use of renewable energy and promoting research focused on environmental supportive and profitable measures. The journey towards sustainable pharma is complex and requires collaboration across the entire value chain from all the stakeholders, but the benefits to society, the environment and the industry are profound and far-reaching. [ABSTRACT FROM AUTHOR]

Community concerns surrounding syringe waste are a common barrier to syringe services program (SSP) implementation. In Kanawha County, West Virginia, community opposition to SSPs resulted in the closure of needs-based SSPs prior to and during an HIV outbreak among persons who inject drugs (PWID). This qualitative analysis examines views of PWID and community partners on syringe waste and disposal associated with needs-based SSPs. Qualitative interviews with 26 PWID and 45 community partners (medical and social service providers, law enforcement personnel, policymakers, and religious leaders) were conducted. Interviews were recorded, transcribed, and coded. Code summaries described participants' views on syringe waste and disposal and needs-based SSPs. Community partners and PWID who favored needs-based SSPs reported that needs-based SSPs had not affected or reduced syringe waste. Conversely, community partners who favored one-to-one exchange models and/or barcoded syringes described needs-based SSPs increasing syringe waste. Community partners often cited pervasive community beliefs that SSPs increased syringe waste, risk of needlesticks, drug use, and crime. Community partners were unsure how to address syringe waste concerns and emphasized that contradictory views on syringe waste posed barriers to discussing and implementing SSPs. Participants' views on whether syringe waste was associated with needs-based SSPs often aligned with their support or opposition for needs-based SSPs. These differing views resulted in challenges finding common ground to discuss SSP operations amid an HIV outbreak among PWID. SSPs might consider addressing syringe waste concerns by expanding syringe disposal efforts and implementing community engagement and stigma reduction activities. [ABSTRACT FROM AUTHOR]

Background: Medications including unused ones, might lead to financial and environmental costs. Not only they could have economic impact but also, harm the population safety. However, the nature and extent of leftover and unused medications in Saudi families and its economic impact remain unknown. Objectives: The aim of this study is to assess the potential economic cost of the unused medications in Saudi households. Method : A cross-sectional, observational study was conducted using a snowball method for recruiting the families. Descriptive data were collected face to face using a structured questionnaire. Result: A total of 116 family included in the study, 536 unused medications were found in their houses during the study period (December 2021- April 2022). Approximately, 42 % (227) of unused medications were stopped due to symptoms improvement. A total of 56 types of unused medications with different dosage forms were found at houses because of receiving excess medication in the packet (17%, 90) and purchased for emergency (14% 78) use. The total cost was SR 26249. ($ 6995.60) for the unused medications which found at 116 households. Of the total 41(34%) of the total households with unused medication have unused medication range between 1-99SR. The stoke of left over medication worth of above 500 SR for around six (5%) of the families. Conclusion: A significant number of unused medications were found at family's. The study also identified that there were different reasons for unused medications that can be prevented. The unused medications result in relatively high economic impact. Educational interventions are highly needed for families on unused medications. [ABSTRACT FROM AUTHOR]

Objective Unsafe opioid-related practices can lead to abuse, diversion, and accidental overdoses. In this study, we aimed to describe the patterns and beliefs regarding the storage, disposal, and use of opioids among Chinese patients with cancer in their home settings, which remain unclear. Methods A multicenter cross-sectional survey was conducted in Hubei Province from October 2022 to June 2023. We collected information on the storage, disposal, and use of opioids among cancer pain inpatients in the oncology department. Logistic regression was used to estimate the factors associated with unsafe disposal and use of opioids. Results The survey included 221 patients with a median age of 62 years. Only 3.2% stored their opioids under lock and key, and 49.8% were unaware of proper disposal methods. Nearly one-fifth (19.5%) reported having received information on the safe storage (14.0%) and/or disposal (10.0%) of opioids. A total of 44.3% reported unsafe use by sharing (1.8%), losing (4.1%), or taking opioids at a higher dose than prescribed (42.5%). Patients who did not receive information on the safe disposal of opioids (OR = 4.57, P  = .0423), had a history of alcohol use (OR = 1.91, P  = .0399), and used opioids other than morphine (OR = 2.31, P  = .0461) had higher odds of unsafe disposal practices. Individuals with an associate degree/bachelor's degree or above were less likely to dispose of (OR = 0.36, P  = .0261) and use (OR = 0.31, P  = .0127) opioids unsafely. Conclusion A significant proportion of Chinese patients with cancer exhibit unsafe practices in the storage, disposal, and use of opioids. The study highlights an urgent need for implementing routine education programs and drug "take-back" initiatives to improve opioid-related practices. [ABSTRACT FROM AUTHOR]

Medical wastes include the wastes created by biomedical research institutes, medical labs, and hospitals. Through exposure to infectious pathogens, improper waste treatment causes substantial hazards of disease transmission to waste workers, waste pickers, patients, health workers, and the population in general. Poor waste management releases dangerous and detrimental constituents into society. However, due of the volumes of wastes generated and its infectious nature, contamination of highly contagious agents such as the sudden pandemic has created huge instability in medical waste treatments and consequent recycling. Several nations have implemented safety procedures to counteract this pollution and manage medical wastes; nevertheless, these efforts are inadequate and vary depending on the nation. Moreover, worldwide organizations have recognized recommendations for the handling of medical wastes. Those rules are aiding in the management of highly infectious medical wastes generated by all-medical centers. Instead of sending things to landfills, proper medical wastes management may make available value by limiting disease transmission and enhancing recyclability. Disinfecting and classifying medical wastes enables for more sustainable management and reuse of important resources. This paper addresses the various medical solid wastes environmental impacts, management and disposal techniques used in various nations, the issues encountered throughout these strategies, and potential solutions to these challenges. [ABSTRACT FROM AUTHOR]

Indiscriminate dumping of infectious and toxic medical wastes generated from the hospital as well as open burning of these wastes are becoming prevalent in recent times. This usually result in several health and environmental problems. The objective of this study was to determine the soil elemental compositions in hospital waste disposal sites in Uyo metropolis. The study areas, included Uniuyo Teaching Hospital, St. Luke's Hospital, Uniuyo Medical Centre and Children Hospital. Underlying soil samples in the waste disposal sites were collected in a cellophane bag and tied properly to prevent air ingress. Atomic absorption spectrophotometer was employed to determine trace metals present in the waste disposal sites which were compared to World Health Organization Standards. The results were analyzed using statistical analysis, ANOVA. Results obtained from the atomic absorption spectrophotometer revealed that each of the samples contained one of the following elements such Pb, Ni, Cr, As, Cd, Al. The ANOVA results showed that mean values of the heavy metals were within WHO permissible limit, like lead Pb (1.302) at the children hospital site, Nickel Ni (0.448) at Uniuyo Teaching Hospital site, Aluminum Ai (0.486333) at the Uniuyo Medical Centre site, Arsenic As (0.239333) at the control site. Except chromium Cr (0.343667) at the children hospital site that was above the WHO standard. From the result of the statistical analysis, it was observed that medical wastes had a significant effect on the environment of Uyo metropolis. Based on the findings, it is recommended that effective method of waste segregation and disposal should be implemented, and designated sites should be used as dump sites. [ABSTRACT FROM AUTHOR]

In the last several decades, Iran's ecosystem has suffered due to the careless usage of natural resources. Cities have grown in an uneven and non-normative way, and poor project management has been a major issue, particularly in large cities. An even greater number of environmental factors and engineering regulations are not relevant to projects. Because of this, in order to ascertain a project's environmental impact, an environmental impact assessment (EIA), is required. Using the rapid impact assessment matrix (RIAM) is one method of applying it to EIA. Reducing subjectivity brings objectivity and transparency. During the COVID-19 pandemic, a thorough EIA was carried out for the Tehran project utilizing the RIAM and other possibilities. This research is the first to combine the methodology that was discussed during the incident. Through the use of the RIAM technique, the environmental impact of COVID-19 was to be quantified in this inquiry. The research examined lockdown procedures and the COVID-19 pandemic to create an EIA indicator. In a real-world case study conducted in Tehran, Iran, the impact of the initiative was evaluated using the RIAM methodology during the COVID-19 epidemic. The results demonstrated that COVID-19 had both beneficial and harmful effects. Decision-makers were effectively informed about the COVID-19 pandemic's environmental consequences on people and the environment, as well as how to minimize negative effects, according to the EIA technique that used RIAM. This is the first research to integrate the EIA during a crisis, such as the COVID-19 pandemic, with the RIAM approach. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to enhance medication management efficiency by introducing a systematic approach to redistributing medications to high-utilization zones, thereby mitigating the volume and expenses associated with non-returnable expired medications. Methods: This quality improvement initiative encompassed 2 key phases. Initially, a standardized workflow for managing expiring medications was implemented across 2 satellite pharmacy areas. Subsequently, the impact of these interventions was assessed by comparing pre-implementation and post-implementation data on the quantity and monetary value of expired medications. Baseline data were derived from expired medication records spanning January 1, 2022, to December 31, 2022. The new workflow was established in December 2022, and post-implementation data were collected from January 1, 2023, to March 31, 2023. The process rollout involved devising workflow protocols, creating supportive documentation, and delivering training to pharmacy personnel. Data collection encompassed medication identifiers, stock locations, date medications were received, expiration dates, along with wholesale acquisition cost for each item. Descriptive statistical methods were employed for analysis. Results: Comparative analysis of pre-implementation and post-implementation data revealed substantial reductions in the annual estimated quantity of expired medications (284 fewer items, representing a 13.6% decrease) and corresponding wholesale acquisition costs ($5075 USD reduction, translating to a 19.7% decrease) within the satellite areas during the study period. Moreover, a comparison of post-implementation quarter one data with the corresponding data from the previous year highlighted even more significant reductions in the quantity of expired medications (203 fewer items, reflecting a 31.1% decrease) and associated wholesale acquisition costs ($2548 USD reduction, signifying a 33.0% decrease) within the satellite areas. Conclusions: This study underscores the potential advantages of employing a standardized process to proactively reallocate medications prior to their expiration, thereby enabling their utilization in other hospital sections. Future endeavors could concentrate on the wider implementation of similar workflows throughout different hospital locations and the broader enterprise. [ABSTRACT FROM AUTHOR]

Purpose This project aimed to determine whether a supportive calculator that automates the vial selection process might offer a practical and efficient method of reducing pharmaceutical expenditures through minimizing preventable drug waste in outpatient pharmacy settings. Summary Drug waste is a substantial target of cost-saving efforts in the areas of oncology and autoimmune therapy, which involve use of a vast number of high-cost medications packaged in single-dose vials of varying strength. To facilitate selection of the optimal combination of medication vials and thereby minimize preventable drug waste, a Microsoft Excel–based calculator was developed for use by staff of a large oncology pharmacy network. Twenty-three high-cost chemotherapy and monoclonal antibody medications were identified as initial targets for the drug waste prevention initiative. After dissemination and implementation of the calculator and provision of monthly pharmacy staff education, the dollar value of preventable drug waste and the number of suboptimal vial combination selections were reduced by 51% ($412,300) and 54% (315 selections), respectively, in fiscal year 2022 and further reduced by 46% ($183,400) and 27% (71 selections), respectively, in fiscal year 2023. Conclusion After implementation of an automated vial selection tool, preventable drug waste and the quantity of suboptimal vial combination selections were markedly reduced across 11 outpatient compounding pharmacies. [ABSTRACT FROM AUTHOR]

This column discusses the Anatomy Act 1977 (NSW) and its regulatory environment. The column begins with examining the history of anatomy regulation in the United Kingdom and Australia. It then goes on to analyse the history of the current anatomy regulation in New South Wales, pointing out areas for reform. [ABSTRACT FROM AUTHOR]

Government of India has provided Indian Public Health Standards to improve rural health care services and health status, but still rural laboratory is a cause of concern. This study is performed to understand the laboratory facility-level gaps that need to be addressed to improve the public primary health centres (PHCs) present in rural areas. The laboratory assessment is performed for governance, financing, resources and services, and results are validated with the PHC laboratory performance. The current assessment shows critical gaps in the facilities regarding governance, services, resources and financing required for the laboratory services at the rural primary health care level. Governance and services need to be strengthened the most, followed with sustained availability of resources and financing. Poor health status in rural areas necessitates public health response based on health systems. Therefore, health system preparedness in the form of laboratory services is essential in primary health care facilities. [ABSTRACT FROM AUTHOR]

Increased waste in health care is a widespread problem. Currently, modern clinical practices favour single-use products and pre-packaged supply kits. Many of these consist of various types of plastics. By weight, up to 25 per cent of total hospital waste is plastics. Common plastics used are polyethylene terephthalate, polypropylene, polyethylene, polyvinylchloride and polyurethane. Polyethylene terephthalate represents the highest volume, and accounts for 40 per cent of the plastics used in operating rooms. Health care has an enormous ecological footprint. Around the world, health care waste management strategies and clinician activities are starting to address how health care affects our planet and public health. Recovery of valuable waste, or product stewardship, is one of these strategies. In many countries, product stewardship in health care is still non-existent or unregulated. Clinicians and health service organisations must make product stewardship in health care an integral part of sustainable procurement and health care business activities. In addition, sustainable solutions require the engagement of suppliers of plastic packaging who can contribute to reducing waste in health care and minimising the impact of plastics on the environment and public health. [ABSTRACT FROM AUTHOR]

Effective planning and managing medical waste necessitate a crucial focus on both the public and private healthcare sectors. This study uses machine learning techniques to estimate medical waste generation and identify associated factors in a representative private and a governmental hospital in Bahrain. Monthly data spanning from 2018 to 2022 for the private hospital and from 2019 to February 2023 for the governmental hospital was utilized. The ensemble voting regressor was determined as the best model for both datasets. The model of the governmental hospital is robust and successful in explaining 90.4% of the total variance. Similarly, for the private hospital, the model variables are able to explain 91.7% of the total variance. For the governmental hospital, the significant features in predicting medical waste generation were found to be the number of inpatients, population, surgeries, and outpatients, in descending order of importance. In the case of the private hospital, the order of feature importance was the number of inpatients, deliveries, personal income, surgeries, and outpatients. These findings provide insights into the factors influencing medical waste generation in the studied hospitals and highlight the effectiveness of the ensemble voting regressor model in predicting medical waste quantities. [ABSTRACT FROM AUTHOR]

Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices. [ABSTRACT FROM AUTHOR]

Introduction: Special and infectious wastes are the most significant wastes generated in hospitals, health centers, and similar facilities. Reducing and recycling such wastes at the source pose significant challenges to waste management. Therefore, this study assesses the components of healthcare waste in terms of their recyclability, emphasizing different types of plastic. Materials and Methods: Data collection involved sampling normal and infectious waste in selected hospitals over three months using monthly checklists. The total waste generated in these hospitals was analyzed on a daily basis. Moreover, the average microbial load of infectious waste was determined through microbial strip tests and biological tests following patient companion. Tests were performed with the acceptable performance of safe hospital devices with the destruction of microorganisms. Results: Average waste composition in the selected hospitals included 65-70% general waste and 30-35% infectious waste. The most common generated infectious waste was polyethylene (PE) sets (800 kg/month), while the predominant general waste was nylon bags for polyethylene terephthalate (PETE) packaging (520 kg/month). Hospital 1 had the highest per capita production of recyclable waste, generating 7,900 kg and 2,550 kg of normal and infectious waste per month, respectively. The total revenue generated from selling normal and infectious plastic waste was 1.4 and 0.2, respectively. Conclusion: The mixing of waste can be prevented by properly segregating normal and infectious waste and adequate staff training. Given the escalating disposal costs of health-care waste (HCW) and the shrinking space in landfills, efforts to minimize waste generation are crucial for effective recycling and reuse processes.

This article discusses the issue of biomedical waste management in the healthcare sector and its impact on sustainability. It emphasizes the need for awareness among hospital staff and the general population to ensure proper disposal and management of biomedical waste. The article highlights the potential implications of inadequate waste management on public health and the environment. It also provides an overview of the different types of healthcare waste and the methods used for treatment and disposal. The article concludes that effective waste management strategies are necessary to mitigate the adverse effects of healthcare waste and protect human health and the environment. Additionally, the article presents the findings of a study conducted in South Delhi hospitals, which revealed a lack of knowledge and adherence to safe practices among healthcare staff, particularly nurses. The low percentage of staff vaccinated against Hepatitis B is also highlighted as a concern for preventing needle stick injuries. The article concludes by suggesting strategies to improve biomedical waste management and reduce its impact on the environment. The given document is a list of references to various articles and studies related to biomedical waste management in the healthcare industry, providing valuable information for library patrons conducting research on the topic. [Extracted from the article]

Background: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses' environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices. Aim: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment. Methods: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain. Results: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses' environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved. Conclusions: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research. [ABSTRACT FROM AUTHOR]

Introduction: To ensure the efficient use of chemotherapy drugs, chemotherapy wastage is an area that can be investigated. This study aims to quantify current parenteral chemotherapy wastage and estimate parenteral chemotherapy wastage when dose banding is executed, using a chemotherapy wastage calculator in an ambulatory cancer centre. The study also examines the variables that significantly predict the total cost of chemotherapy wastage, investigates the reasons for wastage, and explores opportunities to reduce wastage. Methods: Data were collected from the pharmacy in National Cancer Centre Singapore over 9 months retrospectively. Chemotherapy wastage is the sum of wastage in the preparation phase and potential wastage in the administration phase. The calculator was created using Microsoft Excel and generated chemotherapy wastage in terms of cost and amount (mg) and analysed the reasons for potential wastage. Results: The calculator reported a total of 2.22 million mg of chemotherapy wastage generated over 9 months, amounting to $2.05 million (Singapore Dollars, SGD). Regression analysis found that the cost of drug was the only independent variable that significantly predicted the total cost of chemotherapy wastage (P = 0.004). The study also identified low blood count (625 [29.06%]) as the top reason for potential wastage and no-show ($128,715.94 [15.97%]) as the reason that incurred the highest cost of potential wastage. Conclusion: The pharmacy has generated a considerable amount of chemotherapy wastage over 9 months. Interventions in both the preparation and administration phases are required to reduce chemotherapy wastage. The use of the chemotherapy wastage calculator in pharmacy operations could guide efforts to reduce chemotherapy wastage. [ABSTRACT FROM AUTHOR]

Introduction: Increasing use of expensive oral anticancer medicines comes with the downside of a financial and environmental burden, partially caused by unused medication. Returned oral anticancer medicine to the pharmacy could be considered for redispensing providing guaranteed quality. This study aimed to identify and implement quality aspects and criteria for redispensing oral anticancer medicine in daily pharmacy practice. Methods: A systematic analysis was conducted to determine the eligibility of oral anticancer medicine for redispensing. Over a one-year period, the number of returned oral anticancer medicine accepted for redispensing was quantified, and the reduction in financial waste and environmental burden calculated based on this assessment. Results: Four categories of quality aspects were identified for determining the eligibility of oral anticancer medicine for redispensing: Product presentation suitability (stability characteristics, storage requirements), physical condition (unopened or opened secondary or primary packaging, visual appearance), authentication (Falsified Medicines Directive, confirmation of initial dispense, recall), and additional aspects (remaining shelf life, period of storage in uncontrolled conditions). A standardized procedure for redispensing was implemented in daily pharmacy practice. During the study period, 10,415 oral anticancer medicine dose units out of 13,210 returns (79%) were accepted for redispensing. The total value of oral anticancer medicine accepted for redispensing was €483,301, accounting for 0.9% of the total value dispensed during this period. Furthermore, the potential reduction in environmental burden was estimated at 1132.1 g of potent active pharmaceutical ingredient. Conclusions: By implementing strict procedures considering all relevant quality aspects, redispensing of oral anticancer medicine can be successfully implemented into daily pharmacy practice, resulting in a significant reduction in financial waste and environmental burden. [ABSTRACT FROM AUTHOR]

Raising public awareness about the relevance of supporting sustainable practices is required owing to the phenomena of global warming caused by the rising production of greenhouse gases. The healthcare sector generates a relevant proportion of the total carbon emissions in developed countries, and radiology is estimated to be a major contributor to this carbon footprint. Neuroradiology markedly contributes to this negative environmental effect, as this radiological subspecialty generates a high proportion of diagnostic and interventional imaging procedures, the majority of them requiring high energy-intensive equipment. Therefore, neuroradiologists and neuroradiological departments are especially responsible for implementing decisions and initiatives able to reduce the unfavourable environmental effects of their activities, by focusing on four strategic pillars—reducing energy, water, and helium use; properly recycling and/or disposing of waste and residues (including contrast media); encouraging environmentally friendly behaviour; and reducing the effects of ionizing radiation on the environment. The purpose of this article is to alert neuroradiologists about their environmental responsibilities and to analyse the most productive strategic axes, goals, and lines of action that contribute to reducing the environmental impact associated with their professional activities. [ABSTRACT FROM AUTHOR]

Objective: The National Health Service (NHS) recognised the risk to public health brought by climate change by launching the Greener NHS National Programme in 2020. These organisational changes aim to attain net zero direct carbon emissions. This article reviews the literature on initiatives aimed at mitigating the environmental impact of ENT practice. Method: Systematic review of the literature using scientific, healthcare and general interest (public domain) databases. Results: The initiatives reviewed can be broken down into strategies for mitigating the carbon footprint of long patient stay, use of operative theatres and healthcare travel. The carbon footprint of in-patient stay can be mitigated by a shift towards day-case surgery. The ENT community is currently focused on the reduction of theatre waste and the use of disposable instruments. Furthermore, supply chains and healthcare delivery models are being redesigned to reduce travel. Conclusion: Future areas of development include designing waterless theatre scrubs, waste-trapping technologies for anaesthetic gases and a continuing investment in virtual healthcare. [ABSTRACT FROM AUTHOR]

Copyright of University of Health Sciences Journal of Nursing is the property of Saglik Bilimleri Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)