Introduction to The Blueprint Purpose of this quick presentation

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Introduction to The BlueprintPurpose of this
quick presentation

• Simple introduction to a pharmaceutical waste
  management tool
• use it to implement a pharmaceutical waste
  management system!
• http//www.h2e-online.org/docs/h2epharmablueprint4
  1506.pdf

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• Managing Pharmaceutical Waste A 10-Step
  Blueprint for Health Care Facilities in the
  United States
• The Blueprint is an H2E document that was funded
  by a grant from EPA. It was written by Eydie
  Pines and Charlotte Smith.

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Quick Review of the 10 Steps

• Step 1 Getting Started
• Support from Senior Management
• Develop a Committee
• Plan for opportunities, challenges and financial
  implications to making changes, improvements in
  your facility.

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• Step 2 Understanding the Regulations
• Defining Hazardous Wastes
• Listed (F, K, P and U)
• Characteristic
• Ignitability
• Corrosivity
• Reactivity
• Toxicity
• If a waste isnt a listed waste or doesnt
  exhibit characteristics of a hazardous waste, it
  is considered a solid waste
• Generators status depends on types and amounts
  of waste generated
• Treatment Disposal Options

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• Step 3 Consider Best Management Practices (BMPs)
  for Non-Regulated Pharmaceutical Wastes
• RCRA waste regulations not updated in pace with
  development of drugs
• Recommendations made for how to manage
  pharmaceutical waste to protect water bodies,
  aquatic species, human health.
• Incineration (endocrine disruptors, carcinogenic
  drugs, Formulations w/listed active ingredient
  that is not the sole active ingredient, etc.)
• Eliminate drain disposal
• Avoid Landfilling
• Use non PVC IV Sets

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• Step 4 Perform a Review of Your Drug Inventory
• Gather Drug-Specific Data national drug code,
  brand name, generic name, Mfr, strength, dosage
  form, package size
• Consider Compounded Items Reformulations
• Obtain purchasing data from Your Drug Wholesaler

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• Step 5 Minimizing Pharmaceutical Waste
• Consider lifecycle Impacts in Purchasing Process?
• Maximize Use of Opened Chemotherapy Vials
• Implement Samples Policy
• Labeling Drugs for Home Use
• Priming Flushing IV lines w/Saline Solution
• Examine Size of Containers Relative to Use

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• Step 5 Minimizing Pharmaceutical Waste (contd)
• Replace Prepackaged Unit Dose Liquids
  w/Patient-Specific Oral Syringes
• Try to eliminate generation of controlled
  substances that are also hazardous wastes
• Use hard plastic buckets for delivery of
  chemotherapy drugs to hospital floors not brown
  paper bags
• Monitor dating on emergency syringes
• Review inventory controls to minimize outdates?

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• Step 6 Assess Current Practices
• Conduct Department Reviews
• Conduct Analyses Frequently
• Confirm your Generator Status

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• Step 7 Taking On Communication/Labeling Challenge
• Automating the Labeling Process
• Manually Labeling in the Pharmacy
• Providing Guidance on the Floor
• Selecting a Message for the Label
• Labeling Drugs further up the food chain

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• Step 8 Consider Management Options
• Segregation at the Point of Generation
• Centralizing Segregation
• Managing all drug waste as hazardous

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• Step 9 Getting Ready for Implementation
• Locating Your Satellite Accumulation Areas
• Evaluating Your Storage Accumulation Area
• Selecting the Right Vendors
• Conducting Pilots
• Putting it all together Policies Procedures
• Preparing for Spills

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• Step 10 Launch the Program
• Educate Train Staff
• Staging the Roll-out
• Paperwork Requirements Filling Out Required
  Forms
• Hazardous Waste Manifests
• Land Disposal Restrictions
• Tracking, Measuring Recording Progress

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Use the Blueprint

• Some copies are here and available to you
• You can download the Blueprint at
• http//www.h2e-online.org/docs/h2epharmablueprint
  41506.pdf
• Mary Dever-Putnam 617-918-1717
• Dever.mary_at_epa.gov