Reducing waste from single-use procedure packs in hospitals: A scoping review

Single-use items in pre-packaged procedure packs are disposed of after opening, regardless of whether they were used. We aimed to synthesise published evidence on evaluations of hospital-relevant interventions or comparisons targeting waste from procedure packs. We included intervention and aetiological observational studies, excluding purely descriptive studies, secondary studies and conference abstracts. We searched MEDLINE, Embase, CINAHL and Scopus from inception to 7 May 2024 and undertook forward and backward citation searches of included records. Of 1074 records retrieved, 14 studies met inclusion criteria. Eight were before-after quality improvement studies, five were comparative life cycle assessments and one was an audit. Studies reported on reductions in items in the pack (n = 8), change from single-use to reusable items (n = 3) and comparisons between different packs (n = 2) or individually packed items and packs (n = 1). Twelve studies reported on financial and waste impacts, six on environmental impacts and three on staff/patient impacts. Studies reported financial savings up to US$49.43 for reduced item packs and up to £7.22 for reusable packs versus single-use packs. Pack size and weight can often be much reduced, leading to less resource use and up to 2042g reduction in waste/pack and up to 860g less CO₂ equivalent (CO₂e) emissions. Switching instruments in packs from single-use to reusable reduced emissions by up to 90% where local energy was not predominantly from fossil fuels. No negative impacts on staff or patient outcomes were reported. Initiatives to reduce waste from single-use procedure packs may result in significant financial, resource use and CO₂e emissions savings.