The BC Cancer Planetary Health Nursing Internship Program, part of the Department of Nursing and Allied Health Research and Knowledge Translation, integrates planetary health principles into nursing practice. Nurses have undertaken innovative research, exploring the vital connections between environmental sustainability, patient care, and community health. Their efforts highlight the critical role of nurses in promoting a healthier, more sustainable future.

2024 Cohort #1

Project# 1

WASTE SEGREGATION - Improving Waste Management Practices in Systemic Therapy: Effective Segregation Strategies at BC Cancer Surrey - Infographic

Project Lead: Nisha Mattu (BC Cancer Surrey)

Background: All packaging and waste in systemic therapy is disposed of in the garbage, ultimately ending up in the landfills. This causes high waste management costs and landfill waste emits harmful greenhouse gas emissions that pose a risk to human and environmental health. 

Project Aim: To increase recycling bins in the clinical setting by 80% in 4 weeks.

Outcome & Environmental Impact: 49% of waste generated in systemic therapy is now recycled, reduced from 100% over a few weeks. This has resulted in reducing the demand on landfill space and waste treatment technologies, reducing the release of pollutants that harm human health, and lowering the amount of micro-plastics entering the environment. 

Project# 2

Be Rad Avoid The Pad Project  - Infographic

Project Lead: Brighdie Davey (BC Cancer Prince George)

Background: Prior to project launch on May 6, 2024, approximately 2500 disposable blue pads per year were used for IV prewarming hotpacks resulting in a carbon footprint (measured in Global Warming Potential, or GWP) of 1,037.5 kg C02 eq or equivalent to 442 L gasoline consumed from just the Chemo Room. BC Cancer Prince George treats 75% less patients than some other larger centers meaning there is great potential of this project to have a significant impact if expanded provincially.

Project Aim: Decrease the use of disposable plastic absorbent pads for moist heat warming prior to peripheral intravenous cannulation at BC Cancer Prince George by 80% by August 2024.

Outcome & Environmental Impact: This project reduced overall use or disposable pads in the chemo room by 85%, a monthly overall average of 86 kg CO2 in blue pads reduced to 13 kg C02.

Project# 3

Recycling and Waste Reduction at BC Cancer Abbotsford in ACU - Infographic

Project Lead: Paulina Batke (BC Cancer Abbotsford)

Background: The ACU clinics at BC Cancer Abbotsford had three rooms that did not have any recycling bins in place, including two nursing task rooms and the supply/medication room. These areas produce waste including hard plastic, paper & boxboard items. These items contribute to our greenhouse gas (GHG) emissions when biodegrading in the landfill and producing methane.

Project Aim: To reduce the amount of recyclable material going into the landfill. 

Outcome & Environmental Impact: Recycling bins were added to ACU, posters were created as a visual aid and staff received education about recycling. 5 days after the bins were placed, there was an 80% decrease of recyclable items in the garbage, sustained over 4 weeks with an overall decrease of 83%. 

Project# 4

Medical Waste Diversion: Recycling of Non-Contaminated, Single use Gloves At BC Cancer Vancouver - Infographic

Project Lead: Nancy (Surya) Absolon (BC Cancer Vancouver)

Background: The health care sector is a significant contributor to industrial waste in Canada. This has serious implications for human health, green house gas emissions, and even the psychological wellbeing of health care workers. Single-use, non contaminated gloves are a high contributor to medical waste . A single nitrile glove (~3.2g) has a carbon footprint of 26g CO2e, and may take over 100 years to decompose in a landfill.

Project Aim: Introduce a purpose-built recycling box for non-contaminated single-use gloves to decrease the proportion of gloves sent to landfill. 

Outcome & Environmental Impact: The majority of gloves used in the BC Cancer Vancouver Centre units were non-contaminated and eligible to be recycled (over 90%). Over the duration of the project, 247 gloves were diverted from landfill. The uptake in practice change by staff who are willing to disrupt the production of medical waste indicates that the recycling boxes may be successful if expanded to other areas of Vancouver Centre. 

2024 Cohort #2

Project #1

Ditch the Blue Pad: A Planetary Health Initiative  - Infographic

Project Lead: Claire Liem (BC Cancer Surrey) 

Background: All patients requiring peripheral IV insertions at BC Cancer Surrey (systemic therapy department) are wrapped in a warm moist towel which is covered in a plastic disposable blue pad. Disposable blue pads contain microplastics (specifically polypropylene), which breakdown in landfills and can contaminate our water supplies, with data showing that microplastics found in drinking water may be linked to an increased risk of cancer.  

Project Aim: Decrease disposable blue pad use for warm moist peripheral IV starts by 80% at BC Cancer Surrey Systemic Therapy department by August 15, 2024.  

Outcome & Environmental Impact: Blue pad use for peripheral IV insertions decreased by 90-95%, saved ~320 blue pads during trial period, and potential to keep 15,379 disposables blue pads out of landfill per year. Alternatively, dry heat methods were used for peripheral IV starts, which do not require disposable blue pads.  

Project #2

Forgo the Blue, Please Reuse - Infographic

Project Lead: Letecia Hayes (BC Cancer Kelowna) 

Background: Pelvic Exams are commonly completed in RT ACU with an average of 1 blue pad used per exam. These disposable blue pads contain polypropylene plastic. Some studies show microplastics may cause chronic lung inflammation and increase risk of lung cancer and inflammation to GI tract, as well as being major contributors to environmental degradation.  

Project Aim: Decrease blue pad use from pelvic exams in RT ACU department by 80% by Aug 26, 2024, transition to reusable pads. 

Outcome & Environmental Impact: This project saw a 100% reduction in disposable blue pad use during pelvic exams. The alternative product, reusable linen pads, have a considerably smaller environmental impact without compromising patient care. Reusable pads require significantly less use of non-renewable energy and water during the product lifetime. They also produce 60% less C02e emissions than disposable pads.  

Project #3

Does it Belong in Here? - Infographic

Project Lead: Linden Pon (BC Cancer Prince George) 

Background: Reusable cytotoxic sharps bins are primarily used to dispose of cytotoxic waste from systemic therapy administration. Cytotoxic waste is incinerated, one of the most environmentally impactful methods of processing medical waste, generating 30-50x more emissions compared to other forms of waste processing. Inappropriate items, or contaminants, were being put into the cytotoxic bins, leading to unnecessary greenhouse gas emissions. 

Project Aim: Decrease reusable cytotoxic sharps containers contaminants by 80% in BC Cancer Prince George Systemic Therapy by August 30, 2024. 

Outcomes  & Environmental Impact: 50% reduction achieved; an average of 2.6 contaminants per bin per day. 9kg of non-sharp waste diverted over 4 weeks overall, with the potential to divert 5kg of plastic and paper in IV packaging alone from incineration annually. This reduction in cytotoxic waste contaminants will decrease the emissions of incinerated cytotoxic waste produced by BC Cancer Prince George.   

Project #4

Rolling Away from the Blue Pad - Infographic

Project Leader: Sarena Kataria (BC Cancer Abbotsford) 

Background: Disposable blue pads were used as an organizational tool to roll up the supplies needed for the Infusor Disconnect procedure; the blue pads were not essential to the procedure.  

Project Aim: To decrease the use of single use disposable blue pads by 90% during the Infusor Disconnect procedure at BC Cancer Abbotsford Task Clinic by August 2024.  

Outcomes & Environmental Impact: 100% decrease in the use of blue pads for Infusor Disconnect procedures in Task Clinic. The benefits of eliminating the blue pad for this procedure include cost savings on supplies, enhanced infection control, reduced cytotoxic waste, reduced nursing set up time, and safer medication practice.  

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