By introducing reusable ambulatory infusion pumps for intravenous antibiotics, our project improved outcomes for patients of Hospital in the Home (HiTH) at Central Coast Local Health District (CCLHD), as well as producing environmental benefits.
Throughout the pilot project, we found that switching from single use to reusable pumps improved dosing accuracy, leading to better infection control and expected reduced risks of antimicrobial resistance.
Patients experienced faster discharge times and fewer disruptions, with many able to receive treatment for cellulitis through once-daily visits that previously required twice daily visits.
The pilot successfully:
- enhanced patient satisfaction
- freed up hospital beds more quickly
- increased HiTH capacity.
In addition to the clinical benefits, the project addressed environmental and financial concerns associated with traditional single-use elastomeric infusers—ambulatory pumps used to administer 24-hour continuous intravenous infusions of antibiotics to HiTH patients.
By switching to reusable pumps, we have eliminated thousands of disposable devices, reducing plastic waste and greenhouse gas emissions. The initiative also resulted in substantial cost savings, demonstrating a safe, effective and sustainable alternative for continuous intravenous therapy in the home setting.
Addressing the need for a reliable infusion method
We initiated this project to improve patient safety and clinical outcomes for HiTH patients receiving intravenous antibiotics. Traditional elastomeric infusers often failed to deliver full doses, particularly with higher-concentration antibiotic solutions, leading to suboptimal treatment and increased risk of antimicrobial resistance. These dosing inconsistencies compromised infection control and patient recovery, highlighting the need for a more reliable infusion method.
In addition to clinical concerns, the use of single-use elastomeric devices generated significant environmental waste and financial burden. Over 5,000 units were disposed of annually, also requiring incineration, which added to greenhouse gas emissions. We trialled reusable pumps (CADD Solis) to address these issues, aiming to enhance patient care, reduce environmental impact, and achieve cost savings—all while maintaining safety and efficacy in home-based intravenous therapy.
Embedding green practices into routine care
We began this project in October 2024, using pumps borrowed from Cancer Care and later buying additional pumps to expand the project. A clinical nurse educator provided training, supported by senior nurses, doctors and pharmacists. Nurses implemented the pumps gradually, starting with a small patient group before scaling up to broader use. The reusable pumps were used to deliver antibiotics such as cefazolin, piperacillin/tazobactam and vancomycin for 203 patients over 1,803 treatment days
Challenges included increased nursing time to prepare antibiotic solutions and occasional pump alarms. We managed these challenges by providing training, patient education and troubleshooting protocols. Despite the learning curve, HiTH staff increasingly embraced the pumps as 'business as usual'.
By replacing single-use infusion devices with reusable pumps, we have have made a meaningful shift towards more sustainable and cost-effective care in CCLHD. Over the course of the project, from April 2024 to May 2025, 9 single-use infusion pumps were used to treat 203 patients across 1,803 treatment days. That meant 1,803 disposable devices were no longer needed, avoiding over 423kg of plastic waste and saving 1,368kg of greenhouse gas emissions. This equates to roughly the same emissions from a round-trip drive between Sydney and Perth in a medium-sized car.
The financial impact was equally impressive. Traditional elastomeric infusors are expensive not just to buy, but also to deliver, refrigerate and dispose of. For example, using elastomeric infusors to administer piperacillin/tazobactam costs over $340,000 per year. In contrast, delivering the same treatment with reusable pumps costs just over $9,000.
Even after accounting for the upfront cost of the pumps themselves, the project saved between $197,000 and $358,000 over 2 years. This equals an estimated $98,000 in annual savings, which CCLHD can reinvest into patient care. These results show that small changes in how we deliver treatment can lead to big wins for patients, the environment, and for the health system’s bottom line.
