Greening the operating room, one procedure at a time - 06/12/21
, Rachel Smith-Steinert, CRNA b, ⁎
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Highlights |
• | The healthcare delivery system is often wasteful and can cause significant environmental pollution. The operating room alone is responsible for contributing 20-30% of hospital waste. More than one-third of the carbon footprint stemming from an average operating room comes from anesthetic agents. |
• | The environmental impact of each vapor can be determined by weighing the 100-year global warming potential (GWP) and the atmospheric lifetime. The GWP and atmospheric lifetime of sevoflurane is 130 and 1.4 years, while desflurane is 2540 and 14 years. Desflurane is also almost double the cost per milliliter compared to sevoflurane. |
• | Sustainability education and desflurane restriction were combined to reduce the carbon footprint of one healthcare system's operative service. |
• | Desflurane usage fell from 8.3% to 0.3%, decreasing the production of metric tons of carbon dioxide equivalent from 1681 to 10 over three fiscal years, and saving the health system $200,000. |
Abstract |
Background/Purpose |
There is growing interest within the anesthesia community regarding sustainability practices. A quality improvement initiative at a large, urban, academic medical center provided anesthesia practitioners education to promote change in practice to reduce our overall carbon footprint in the operating room. This endeavor provided cost-savings to the healthcare system and positioned the anesthesia department as environmental advocates.
Methods |
Institutional Review Board approval was granted for non-human subject research. A retrospective chart review was completed examining inhalational agent usage and fresh gas flow rate over thirty days (n = 304). Next, an education on sustainability practices with an overview of inhaled anesthetics and their impact on the environment, based on global warming potential, was delivered during department grand rounds. Afterwards, data was collected for 30 days with the same sampling technique (n = 285). Six weeks later, desflurane vaporizers were removed from anesthesia machines. After removal, data was collected once again to determine desflurane usage (n = 289).
Results |
A retrospective chart review of 878 patients undergoing general anesthesia showed an average baseline usage of desflurane at 8.3%. A reduction to 3% was noted after implementation of sustainability education. Desflurane usage further decreased to 0.3% after desflurane vaporizer removal.
Discussion |
This quality improvement initiative resulted in cost savings and provided a significant environmental impact while providing the tools for a conscious, deliberate decision in care based on current literature to decrease global warming impact while preserving the practitioners right to choose an inhalational agent.
Le texte complet de cet article est disponible en PDF.Keywords : Sustainability, Inhalational agent, Global warming potential, Greenhouse gas, Carbon footprint
Plan
Vol 2
Article 100014- mai 2021 Retour au numéro
Article précédent
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Bienvenue sur EM-consulte, la référence des professionnels de santé.