ABSTRACT
Aims‘There is so much waste on our unit’, an echo heard throughout departments in the National Health Service (NHS). With increasing waste noted on our paediatric intensive care unit (PICU), exacerbated by the COVID-19 pandemic, and the COP26 momentum, there was a strong desire from PICU staff members, and even parents, to start turning this particular PICU into a sustainable one.A PICU Sustainability working group was set up with 3 core members and over 10 collaborators, known as the ‘sustainability friends’. The group aims to add direction and focus to making this PICU sustainable and a player in the NHS’ commitment to becoming ‘carbon net zero’.As a working group, the ideas were endless and almost impossible to decide where to start. There had been previous sustainability attempts but these quickly tapered out due to lack of interest and eventually ceased with the COVID-19 pandemic. It is well described in literature that interventions are more successful if there is a desire for that specific intervention.1 Knowing this, we sent out questionnaires to find out the top 3 things staff and parents found wasteful on the unit and suggestions on how to tackle these.MethodsAn online questionnaire was designed with three blank space questions and was sent to all staff members on the PICU via electronic mail and posters were put on the unit with a QR code for easy access. Humorous cartoons were used in the questionnaire to encourage responses. These were placed in staff areas as well as the parents’ room to encourage parent involvement. An electronic sustainability diary was uploaded online to document past projects, current projects, future plans and contact details.ResultsThe questionnaire generated 89 suggestions from 35 respondents. The majority of these were from nursing staff (68.5%), as well as doctors (14.3%), domestic services (8.6%), pharmacy team (5.7%) and dietitians (2.9%).Suggestions were categorised into 6 sub-categories: Equipment, PPE, Waste, Drugs, Environment and Patient Bedside. The top 6 desired changes were 1) Re-introduce recycling bins (51%) 2) Reduce unnecessary glove use (22%) 3) Reduce unnecessary apron use (22%), 4) Minimise drug wastage (13%) 5) Reduce unnecessary lights being left on (13%) 6) Reduce the amount of bedside trolley equipment thrown out between new patients (13%).ConclusionThe sustainability working group created a sustainability calendar with monthly themes starting with the most popular suggestion from the survey. This calendar will be displayed in staffing areas and every month an audit will be conducted to assess the intervention. Audit results will be added to this calendar and a monthly Sustainability newsletter. The sustainability diary will facilitate handover for incoming working group members and as a way of reporting to senior managers. In future, we hope we can expand this approach to a trust-wide level to increase the impact on climate change. Listening to staff and acting on what they feel needs to be changed is crucial to make everyday practice sustainable.ReferenceMichie, S. Behaviour change wheel: a new method for characterising and designing behaviour change interventions.