Decreasing single-use plastic within the pneumatic tube system during medication transport

Pneumatic tube systems (PTS) have become a common mechanism for transporting items such as medications, documents, supplies, and lab specimens within large healthcare facilities.Contamination of PTS has been linked to a pseudo-outbreak in a large hospital. 1To mitigate the risk of cross-contamination, our pharmacy initially adopted the universal use of plastic bags as secondary containment.In 2024, this practice prompted a collaboration between Pharmacy and Infection Prevention and Control, which subsequently led to a reduction in plastic bag use while maintaining the safety of the PTS.Our initiative illustrates how clearly defined policy changes developed with Infection Prevention can deliver measurable safety, cost, and environmental benefits.The UK Sustainable Quality Improvement 2 approach calls for QI initiatives to consider the triple bottom line of patient safety and experience, environmental impact, and financial value, integrating sustainability into routine quality work rather than treating it as a separate aim, as demonstrated by this project.About the policy: In 2024, our Pharmacy and Infection Prevention and Control team re-evaluated routine bagging policy within the pneumatic tube carriers.The revised policy (Table 1) specifies when carrier-only transport is allowed and when bagging remains necessary.Carrier-only transport (without a secondary plastic bag) is appropriate when the item is clean; outer packaging is intact, and the item is not a return item.Items must meet the pneumatic tube limits of 2.2 pounds or 1 liter, and carrier must close and latch fully with no protruding paperwork or packaging.For medications, the pharmacist's final verification must be complete before dispatching.Bulk medications in sealed manufacturer or pharmacy packaging and properly capped oral medications do not require plastic bagging.Bulk medications include sealed multidose bottles, blister cards, inhalers, ointments, and creams when the exterior packaging is intact.Properly capped oral medications include pharmacy-dispensed liquid preparations in bottles or oral syringes with secure caps that have been checked for tight closure and an intact seal.These items qualify for carrieronly transport provided they are not on the do-not-tube list, do not exceed weight or volume limits, and show no signs of leakage risk.