计算碳排放：量化医院环境中吸入器剂量浪费的财务和环境影响。
Counting the Carbon: Quantifying Financial and Environmental Implications of Wasted Inhaler Doses in the Hospital Setting.
作者信息
Bentley Alison, Culley Celia L, Stoynova Valeria
机构信息
, PharmD, ACPR, is with The University of British Columbia, Vancouver, British Columbia, and Island Health, Victoria, British Columbia.
, BSP, ACPR, PharmD, is with The University of British Columbia, Vancouver, British Columbia, and Island Health, Victoria, British Columbia.
出版信息
Can J Hosp Pharm. 2025 Apr 9;78(2):e3606. doi: 10.4212/cjhp.3606. eCollection 2025.
BACKGROUND
Inhalers contribute to health care-related environmental impacts, particularly through greenhouse gas emissions. They are dispensed in multidose formats, which leads to waste, yet little is known about the environmental impact of inhaler waste in the hospital setting.
OBJECTIVES
The primary objective was to quantify wasted inhaler actuations on adult medicine and respiratory wards at a community and a tertiary hospital. Secondary objectives were to quantify the cost and carbon footprint of wasted doses, to determine the rate of duplicate inhaler dispensing, and to quantify the prevalence of dispensed inhalers remaining unused.
METHODS
For this multicentre, retrospective chart review, the pharmacy informatics team generated a report of adult inpatients for whom one or more inhalers were dispensed from the pharmacy to the respiratory and general medicine wards at a 500-bed tertiary hospital or to the medicine-surgery ward at a 48-bed community hospital over 3 nonconsecutive months (during fiscal year 2021/22). The number of inhalers dispensed was compared with the number of doses documented on patients' medication administration records.
RESULTS
In this study, 23 031 actuations (211 inhalers) were dispensed for 132 patients. Of these, 81.9% were wasted, at a total cost of $6172.82 over the 3 months of the study. For 22 patients (16.7%), at least one inhaler was dispensed, yet no doses were administered; for 16 (12.1%), a duplicate inhaler was dispensed. The carbon footprint of the wasted doses was 1 226 342 g carbon dioxide equivalent, equivalent to driving 5951 km by car.
CONCLUSIONS
This study showed significant inhaler waste in the hospital setting, which contributes to the health care-related carbon footprint without contributing to patient care. These results raise important questions about how to continue providing high-quality patient care while minimizing carbon footprint and health care costs.
背景
吸入器会对医疗相关的环境产生影响，尤其是通过温室气体排放。它们以多剂量形式分发，这会导致浪费，但对于医院环境中吸入器废物的环境影响知之甚少。
目的
主要目的是量化社区医院和三级医院成人内科和呼吸科病房中浪费的吸入器按压次数。次要目的是量化浪费剂量的成本和碳足迹，确定重复分发吸入器的比率，并量化分发的吸入器未使用的患病率。
方法
对于这项多中心回顾性病历审查，药房信息学团队生成了一份成年住院患者报告，在一家拥有500张床位的三级医院的呼吸科和普通内科病房或一家拥有48张床位的社区医院的内科 - 外科病房，在2021/22财年的3个非连续月份中，有一名或多名患者从药房获得了一个或多个吸入器。将分发的吸入器数量与患者用药记录中记录的剂量数量进行比较。
结果
在本研究中，为132名患者分发了23031次按压（211个吸入器）。其中，81.9%被浪费，在研究的3个月内总成本为6172.82美元。对于22名患者（16.7%），至少分发了一个吸入器，但未给药；对于16名患者（12.1%），分发了重复的吸入器。浪费剂量的碳足迹为1226342克二氧化碳当量，相当于汽车行驶5951公里。
结论
这项研究表明医院环境中存在大量吸入器浪费，这增加了医疗相关的碳足迹，但对患者护理没有帮助。这些结果引发了关于如何在最小化碳足迹和医疗成本的同时继续提供高质量患者护理的重要问题。
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