Environmental sustainability of nutrition support in a hospital setting: An observational study of waste reduction and management.

AIMS: Healthcare systems contribute significantly to the global environmental footprint, and hospital food services have been identified as having a significant impact. However, existing sustainability studies auditing the food supply chain in the hospital setting have excluded nutrition support. This study aims to quantify the waste associated with oral, enteral, and parenteral nutrition support in a major tertiary-referral hospital and to identify ways to improve waste management. METHODS: This observational audit investigated the types of waste and waste disposal methods associated with nutrition support, to quantify the amount of waste and the cost of waste disposal and associated emissions, and to identify barriers to improved waste management practices. A draft audit checklist was developed as a tool to assist hospitals in nutrition support waste management quality improvement. Calculations and descriptive statistics were used to identify total waste weights, disposal costs and carbon dioxide equivalent emissions for nutrition support products used on the audit day. RESULTS: Nutrition support generated 45.89 kg of waste per day or median 0.19 kg per patient, approximately half of which was discarded formula. Other than the cardboard cartons, a negligible proportion of the waste was recycled; the cost of disposal was approximately $7400 per year. Improving waste management could save $900 per year and reduce total hospital emissions by 7 tonnes of carbon dioxide equivalents. CONCLUSION: Patients receiving nutrition support in hospital generate waste from packaging, containers and discarded formula and this is commonly sent to landfill. Improvements in waste management could benefit environmental sustainability and reduce costs in the healthcare system.