Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study
Aims: Arthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste,...
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The British Editorial Society of Bone & Joint Surgery
2024-12-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0167.R1 |
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| author | Rohan Prakash Ahmed Nasser Akshat Sharma Deborah Eastwood Mike Reed Yuvraj Agrawal |
| author_facet | Rohan Prakash Ahmed Nasser Akshat Sharma Deborah Eastwood Mike Reed Yuvraj Agrawal |
| author_sort | Rohan Prakash |
| collection | DOAJ |
| description | Aims: Arthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste, and previous studies have shown that over 90% of waste in the infectious stream is misallocated. We assessed the effect of real-time waste segregation by an unscrubbed team member on waste generation in knee and hip arthroplasty cases, and compared this with a simple educational intervention during the ‘team brief’ at the start of the operating list across two sites. Methods: Waste was categorized into five categories: infectious, general, recycling, sharps, and linens. Each category was weighed at the end of each case using a digital weighing scale. At Site A (a tertiary orthopaedic hospital), pre-intervention data were collected for 16 total knee arthroplasy (TKA) and 15 total hip arthroplasty (THA) cases. Subsequently, for ten TKA and ten THA cases, an unscrubbed team member actively segregated waste in real-time into the correct streams. At Site B (a district general hospital), both pre- and post-intervention groups included ten TKA and ten THA cases. The intervention included reminding staff during the ‘team brief’ to segregate waste correctly. Results: Active real-time waste segregation reduced infectious waste by a mean of 2.51 kg (95% CI 1.492 to 3.542) in TKA, and 1.83 kg in THA cases (p = 0.004). Educational intervention reduced infectious waste by a mean of 3.52 kg in TKA and 2.09 kg in THA cases (p = 0.026). Total waste was significantly reduced in both groups post-intervention for TKA cases. Conclusion: Simple educational measures alone can significantly reduce the amount of infectious waste. Extrapolated nationally, our results would yield a reduction of approximately 315,004 kg to 594,577 kg of CO2 annually, which equates to 70 to 132 gasoline-powered passenger vehicles driven for a year. Cite this article: Bone Jt Open 2024;5(12):1119–1124. |
| format | Article |
| id | doaj-art-99adb19e708d4cd8b78fadc3e98d5cf2 |
| institution | Kabale University |
| issn | 2633-1462 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-99adb19e708d4cd8b78fadc3e98d5cf22025-01-28T05:38:30ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622024-12-015121119112410.1302/2633-1462.512.BJO-2024-0167.R1Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre studyRohan Prakash0Ahmed Nasser1https://orcid.org/0000-0001-6787-5715Akshat Sharma2Deborah Eastwood3https://orcid.org/0000-0002-6191-4768Mike Reed4Yuvraj Agrawal5Department of Trauma & Orthopaedics, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UKDepartment of Trauma & Orthopaedics, The Royal Wolverhampton NHS Foundation Trust, Wolverhampton, UKDepartment of Trauma & Orthopaedics, The Royal Wolverhampton NHS Foundation Trust, Wolverhampton, UKDepartment of Orthopaedics, Royal National Orthopaedic Hospital NHS Trust, London, UKNorthumbria Healthcare NHS Trust, Ashington, UKDepartment of Trauma & Orthopaedics, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UKAims: Arthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste, and previous studies have shown that over 90% of waste in the infectious stream is misallocated. We assessed the effect of real-time waste segregation by an unscrubbed team member on waste generation in knee and hip arthroplasty cases, and compared this with a simple educational intervention during the ‘team brief’ at the start of the operating list across two sites. Methods: Waste was categorized into five categories: infectious, general, recycling, sharps, and linens. Each category was weighed at the end of each case using a digital weighing scale. At Site A (a tertiary orthopaedic hospital), pre-intervention data were collected for 16 total knee arthroplasy (TKA) and 15 total hip arthroplasty (THA) cases. Subsequently, for ten TKA and ten THA cases, an unscrubbed team member actively segregated waste in real-time into the correct streams. At Site B (a district general hospital), both pre- and post-intervention groups included ten TKA and ten THA cases. The intervention included reminding staff during the ‘team brief’ to segregate waste correctly. Results: Active real-time waste segregation reduced infectious waste by a mean of 2.51 kg (95% CI 1.492 to 3.542) in TKA, and 1.83 kg in THA cases (p = 0.004). Educational intervention reduced infectious waste by a mean of 3.52 kg in TKA and 2.09 kg in THA cases (p = 0.026). Total waste was significantly reduced in both groups post-intervention for TKA cases. Conclusion: Simple educational measures alone can significantly reduce the amount of infectious waste. Extrapolated nationally, our results would yield a reduction of approximately 315,004 kg to 594,577 kg of CO2 annually, which equates to 70 to 132 gasoline-powered passenger vehicles driven for a year. Cite this article: Bone Jt Open 2024;5(12):1119–1124.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0167.R1arthroplastysustainabilityrecyclingenvironmenthip and knee arthroplastieship and knee arthroplastiestotal knee arthroplasty (tka)kneetotal hip arthroplasty (tha)carbont-testanaestheticmethicillin-resistant staphylococcus aureus (mrsa)national joint registry |
| spellingShingle | Rohan Prakash Ahmed Nasser Akshat Sharma Deborah Eastwood Mike Reed Yuvraj Agrawal Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study Bone & Joint Open arthroplasty sustainability recycling environment hip and knee arthroplasties hip and knee arthroplasties total knee arthroplasty (tka) knee total hip arthroplasty (tha) carbon t-test anaesthetic methicillin-resistant staphylococcus aureus (mrsa) national joint registry |
| title | Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study |
| title_full | Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study |
| title_fullStr | Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study |
| title_full_unstemmed | Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study |
| title_short | Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty: a multicentre study |
| title_sort | staff education compared with active real time waste segregation to reduce the environmental impact of hip and knee arthroplasty a multicentre study |
| topic | arthroplasty sustainability recycling environment hip and knee arthroplasties hip and knee arthroplasties total knee arthroplasty (tka) knee total hip arthroplasty (tha) carbon t-test anaesthetic methicillin-resistant staphylococcus aureus (mrsa) national joint registry |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0167.R1 |
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