Reducing plastic in single-use central line insertion packs: A mixed methods observational study

Central venous catheter (CVC) line insertion packs contain single-use plastic and metal items that are disposed of after the pack is opened, regardless of whether the item was used. This study aimed to collect data on the experiences and views of Australian clinicians who use CVC line insertion packs in paediatric critical care, elicit possible solutions to reduce waste associated with these packs, and to estimate the potential for financial and carbon footprint savings from a refined pack. This study was performed in two large paediatric tertiary referral hospitals in Sydney, Australia. Clinicians were invited to a survey and an interview to determine if and what items from a CVC line insertion pack could be excluded. Outcome measures included financial costs and embodied carbon emissions (CO_2e). Of approximately 200 eligible clinicians who were invited, 25 (12.5%) completed the survey and 18 (9%) were interviewed (five did both). All survey respondents were willing to use a new pack that had less waste. They identified five items within the existing CVC pack as commonly non-essential. Interview data identified additional strategies for waste minimisation, including use of a trolley that allowed choice of items to use. Many clinicians expressed moral distress concerning healthcare's impact on the environment. We calculated that a refined CVC pack without these five items would save the two participating hospitals approximately A$1400 and 230 kg CO_2e per year. Financial and carbon savings may be achieved through removing items that are infrequently used and/or through use of a trolley.