Two new studies outline how Canadian kidney care providers feel about the environmental impacts of kidney care, and ways in which they could lower the amount of associated greenhouse gas emissions and waste.
Kidney replacement therapies are essential for tens of thousands of patients across the country, but dialysis options are associated with large amounts of carbon emissions and plastic waste. The delivery of dialysis across the country creates more than 11.5 million kilograms of waste each year, and in totality, Canada’s health-care system contributes nearly 5% of the country’s greenhouse gas emissions.
Survey of Canadian kidney care networks
Dr. Caroline Stigant is a member of the Canadian Society of Nephrology-Sustainable Nephrology Action Planning (SNAP) committee that is striving to implement strategies for sustainable kidney care. To lay the foundations of their work, they surveyed established Canadian networks of kidney care providers on their knowledge, attitudes, and professional practice toward climate change. There were almost 500 respondents of which nurses made up the vast majority.
The results, published in the Canadian Journal of Kidney Health and Disease, show the topic is of huge concern to health-care providers, 71 percent of whom said climate change was “very” or “extremely” important to them. Even more respondents – at 94 percent – expressed moderate, high or very high levels of concern about the amount of waste they are seeing in the workplace.
Stigant says these results indicate that many peers share the same concerns: “We want to provide quality kidney care, but we want to be able to do so with better systems that aren’t harmful to the environment, and the results of this study really speak to our community’s values and willingness to do so.”
The survey also collected data on existing practices in the workplace, covering a wide range of areas where emissions, waste, consumables and energy use could potentially be reduced. Stigant says the SNAP committee plans to publish these details in a second, pending study, which could point to “low-hanging fruit” solutions to sustainability.
Examples include simple things, such as printing less, making sure equipment is powered down when appropriate (including lights or even reverse osmosis machines), and ensuring waste bins are in easily accessible places.
Nurses making a difference
Along these lines, another study published in the Canadian Journal of Kidney Health and Disease outlines a wealth of different ways in which nurses can help implement sustainable kidney care practices.
The paper is co-authored by Sarah Thomas, a former hemodialysis nurse who now works with BC Renal helping to plan and coordinate province-wide strategies for optimal kidney care. She emphasizes that nurses are key point-of-care contacts with patients throughout much of their journey, and have many opportunities to implement sustainable kidney care practices.
A primary way is by promoting disease prevention strategies and higher transplantation rates – anything that reduces the need for dialysis in the first place. This may include, for example, promoting health literacy and healthy lifestyles, medication adherence, and transplantation opportunities with patients.
Reducing hemodialysis waste
To help reduce waste, Thomas and her colleagues recommend nurses order, use and rotate health-care supplies in ways that reduces waste and the number of expired products thrown out.
“As a hemodialysis nurse, the amount of waste I would see in our dialysis units was pretty eye-opening,” says Thomas. “Nurses are best suited to make changes in the dialysis unit because they see the amount of waste and where small changes could be made.”
In their paper, Thomas and her colleagues - which included a partnership with the Canadian Association of Nurses for the Environment - highlight a small but impactful case study to reduce waste.
Drawing from and adapting a SNAP committee model, staff at a dialysis unit held an informal discussion among themselves to promote better sorting between biohazardous and non-hazardous waste, and rearranged waste bins to be easily accessible. The dialysis unit was able to substantially reduce the amount of biohazard waste that was being shipped out of the clinic – yielding more than $2,000 in savings over a one-year period.
“It’s a really easy solution to a fairly big problem,” Thomas says, noting that these small changes could make a huge impact when scaled up. “The amount of money we could save as a health-care system, and carbon emissions we could save, would be amazing.”
