Wyong Hospital Emergency Department (ED) is reducing hospital waste through the implementation of reusable tourniquets.
The use of disposable tourniquets in Australian hospitals is common, imposing substantial financial and environmental costs on the healthcare system. To reduce waste, some staff choose to re-use these disposable tourniquets. This poses an infection control risk as they are made of elasticated fabric and cannot be cleaned.
In 2024, the Wyong Hospital Emergency Department (ED) used over 55,000 disposable tourniquets, costing $41,408 and sending 2000kg of waste to landfill. To address this, the Wyong ED environmental committee, SustainED, implemented the use of Tristel daisygrip reusable tourniquets, a commercial product available in Australia. This project aimed to save money and reduce waste, reduce the carbon footprint attributed to healthcare and improve staff morale through taking steps to address climate change.
Staff educated on the use of reusable tourniquets
Whilst a single daisygrip tourniquet costs $35 (compared to $0.75 for a disposable tourniquet), the reusable tourniquet becomes cost-equivalent after 46 uses and is designed to be used over 10,000 times. The reusable tourniquet does require cleaning with a disinfectant wipe after each use, however these wipes are inexpensive at $0.05 each. By proving long-term cost effectiveness, our request to order the reusable tourniquets was approved.
We advertised a launch around the ED to launch the new daisygrip tourniquets, which was attended by a Tristel representative. On the day, we allocated each staff member accredited for phlebotomy or cannulation with their own tourniquet and educated them on correct use. We held a second stall after 2pm to capture the evening staff.
We recorded details of of each staff member allocated a tourniquetand labelled each with their name using permanent marker, so that we could track the allocation process and register them via the Tristel website. Over the following weeks, we continued to supply tourniquets to staff, with one of our clinical nurse consultants demonstrating their use.
We also distributed tourniquets during orientation sessions, to help improve the efficiency of the distribution process. Further advertising was unnecessary as word of mouth spread and anyone yet to receive a tourniquet actively sought one out. Rotating junior medical staff were also allocated a tourniquet to continue using when rotating out of the ED.
1.5 tonnes of waste diverted from landfill annually
Following our intervention, we held informal interviews with staff members. Feedback relating to the the use of the reusable tourniquets was universally positive.
- Staff noted that the mechanism of use was different to the old tourniquets but easy to perform with one hand.
- Staff felt that the daisygrip tourniquets were too stiff for use on neonates, however, would be appropriate in all other demographics including bariatric patients.
- Staff felt good about taking steps to tackle climate change.
After the first month, the procurement of the disposable tourniquets dropped to 12% of previous use levels (based on the monthly average). We plan to track this trend serially throughout the year. Assuming a consistent trend, the daisygrip tourniquets will pay for themselves after approximately two -and-a-half months, and save the hospital $23,600 in one year. As the tourniquets can be used at least 10,000 times, the savings will continue to accumulate.
While Tristel does supply the carbon footprint of the daisygrip, published data on the carbon footprint of the disposable tourniquets was unavailable, so we were not able to compare the two calculate the carbon footprint and environmental impact of the initiative. However, when the disposal of the disinfectant wipes is considered, we estimate that around 1.5 tonnes of waste will be diverted from landfill per year.
References
- Nash C, Nelson J. Reusable tourniquets: their impact on patients, planet and public purse. 2024.
