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The NHS accounts for 5.4% of the UK's total carbon footprint, with the perioperative environment being the most resource hungry aspect of the hospital. The aim of this systematic review was to assimilate the published studies concerning the sustainability of the perioperative environment, focussing on the impact of implemented interventions. A systematic review was performed using Pubmed, OVID, Embase, Cochrane database of systematic reviews and Medline. Original manuscripts describing interventions aimed at improving operating theatre environmental sustainability were included. 675 abstracts were screened with 34 manuscripts included. Studies were divided into broad themes; recycling and waste management, waste reduction, reuse, reprocessing or life cycle analysis, energy and resource reduction and anaesthetic gases. This review summarises the interventions identified and their resulting effects on theatre sustainability. This systematic review has identified simple, yet highly effective interventions across a variety of themes that can lead to improved environmental sustainability of surgical operating theatres. Combining these interventions will likely result in a synergistic improvement to the environmental impact of surgery. • Perioperative environments use 3–6 times more energy than the hospital in general. • Paper/cardboard recycling bins in operating areas led to a 50–67% recycling rate. • Reusable items can lead to 70% reduction in waste generation. • Alcohol scrub solutions vs handwashing saves ∼930,000 L/year/hospital of water. • Dispensing propofol in 20 mL bottles instead of 50/100 mL reduces drug wastage by 90%. [ABSTRACT FROM AUTHOR]

This paper reports an investigation intended to obtain some understanding of how the working environment might influence the practice and knowledge of those involved in the management of healthcare waste. The National Health Service (NHS) has a continuing waste problem, and the way it manages waste harms the environment and consumes resources. It has been estimated that the carbon footprint of the NHS in England is approximately 20 million tons of CO2e. It has been suggested that better waste segregation could lead to more effective recycling, saving up to 42,000 tonnes of CO2. This qualitative study employed nonparticipant observation and semi-structured interviews. The interviews were carried out with the key informants within the participating neonatal intensive care unit. Findings from this study indicate that space and the physical arrangement of the environment are significant and influential factors in clinical practice. Where the clinical environment is not supportive, poor infection control and waste management practice is likely to occur. However, proximity of staff caused by a lack of physical space might facilitate situated learning and a collective development of knowledge in practice. The implementation of sustainable waste management practices would be more likely to succeed in an environment that facilitates correct waste segregation. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the possibility of safely and lawfully employing a sustainable reduce, reuse, recycle philosophy in the management of waste within healthcare settings. Climate change presents significant threats to our wellbeing on a global scale and provides a new challenge for healthcare organisations. As the United Kingdom’s biggest public sector employer, the National Health Service has enormous power to mitigate the impact of climate change by implementing sustainable practices. One area in which sustainable practices could be employed is within healthcare waste management. The investigation used a qualitative approach using semi-structured interviews with 20 participants responsible for the safe management of healthcare waste in an English county.Interviews indicated that topics such as knowledge, the environment, finance and legislation influence attitudes and behaviour in healthcare waste management. Participants were clear that from financial and environmental perspectives an aim to reduce, reuse and recycle waste in health care was desirable. Attempts to implement sustainable healthcare waste management practices, informed by a sustainable waste management philosophy are desirable both financially and environmentally. Research is needed to explore behaviour, attitudes, learning, knowledge and the role of the environment in healthcare waste management. [ABSTRACT FROM PUBLISHER]