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REGULATED MEDICAL WASTE REDUCTION

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Title: REGULATED MEDICAL WASTE REDUCTION


1
REGULATED MEDICAL WASTE REDUCTION
  • EASTERN SHORE HOSPITAL CENTER
  • Elizabeth Jackson, RN, ADN
  • Director of Infection Control

Environmental Excellence in Healthcare
Conference November 12, 2008
2
OBJECTIVES
  • The participant will be able to
  • (1)   Identify 2 methods utilized by ESHC
  • to reduce medical waste
  • (2)   Identify the financial savings seen
  • (3) Identify the amount of waste
  • stream reduced

3
EASTERN SHORE HOSPITAL CENTER
CAMBRIDGE, MARYLAND
4
Description
  • 80 BED Dept. of Health Mental Hygiene
  • PSYCHIATRIC INPATIENT HOSPITAL
  • 4 UNITS named after four rivers in our area
  • NANTICOKE
  • CHOPTANK
  • WICOMICO
  • MANOKIN
  • where our medically fragile population is
    cared for and where the majority of our Regulated
    Medical Waste is generated.

5
PROBLEM IDENTIFIED
  • IN OCTOBER 2005 MAINTENANCE STAFF ASKED ME TO
    MEET THEM AT OUR MEDICAL WASTE STORAGE SHED

6
STORAGE SHED
  • WHAT I USUALLY SEE

7
WHAT I SAW
8
CURRENT UNIT PROCESS
9
WHAT WENT WRONG?
  • OUR MEDICAL WASTE CONTRACTOR HAD RECENTLY
    REPLACED OUR CARDBOARD CONTAINERS WITH SQUARE
    PLASTIC BINS

10
  • MAINTENANCE PROVIDED EACH UNIT WITH A CONTAINER
    AND LID ON A ROLLING BASE

11
  • MAINTENANCE STAFF STATED THEY HAD TOLD THE NURSE
    IN CHARGE ON EACH OF THE FOUR UNITS WHEN THEY
    DELIVERED THE NEW SYSTEM HOW IT WAS TO BE USED
  • THERE ARE 109 NURSING STAFF EMPLOYED AT ESHC

12
  • WHAT WE HAVE HERE IS A FAILURE TO COMMUNICATE

13
INITIAL CORRECTIVE ACTION
  • WE POSTED INSTRUCTIONS OVER THE CONTAINERS IN
    EACH SOILED UTILITY AND TREATMENT ROOM
  • EMAILED THE INSTRUCTIONS ON THE NEXT 3 SLIDES TO
    ALL NURSING STAFF AND ASKED THE UNIT SUPERVISORS
    TO INCLUDE THIS INFORMATION IN UNIT PERSONNEL
    MEETINGS FOR THE NEXT COUPLE OF MONTHS

14
  • Instructions for New Biohazard Containers
  • Black square lightweight plastic bins with
    Biohazard labels and folding locking tops are
    provided by our contractor and stored in the
    locked Biohazard Trash Shed on the Loading Dock.
    Staff unit keys unlock the shed
  • A square wheeled base and removable covered trash
    lid have been provided to each unit and are to
    remain assembled until full
  • Items saturated with blood infectious body
    fluids, and Filled, Sealed SHARP CONTAINERS
    should be placed in the Red Bags Bin

15
  • When the Red Bag is full, tie it off
  • Leave it in the square bin
  • Remove the trash lid
  • Fold the doors up from the sides of the bin and
    snap them closed to lock securely
  • Transport the closed locked bin on the provided
    dolly to the Biohazard Trash Shed on the loading
    dock

16
  • Remove the full locked bin and place it in the
    right side of the Biohazard Trash Shed
  • Obtain a new unlocked empty bin and Red Bag from
    the shed, placing it on the dolly return it to
    the designated place on the unit
  • AT NO TIME SHOULD RED BAG TRASH BE TRANSPORTED
    THROUGH THE HOSPITAL, OR PLACED IN THE BIOHAZARD
    SHED IN ANY OTHER MANNER

17
PROGRESS
  • I FOLLOWED UP WITH MAINTENANCE STAFF MONTHLY
    THROUGHOUT FY 2006
  • AND THEY REPORTED NO FURTHER PROBLEMS WITH
    PROPER STORAGE

18
  • PROBLEM SOLVED
  • OR
  • WAS IT?

19
FY 2007 REVEALED A BIGGER ISSUE
  • I REALLY LIKED THE CONTAINERS USED AT ESHC AND
    WANTED TO GET THEM FOR OUR SISTER FACILITY.
  • I ASKED ESHC MAINTENANCE STAFF FOR ASSISTANCE

20
  • A CALL TO OUR MEDICAL WASTE CONTRACTOR REVEALED
    THAT ESHC HAD BEEN PROVIDED THESE CONTAINERS DUE
    TO THE LARGE VOLUME OF MEDICAL WASTE
    GENERATED.THEY ADDED
  • ESHC GENERATED MORE MEDICAL WASTE THAN MOST OF
    THE LOCAL NURSING HOMES!!!
  • A REVIEW OUR MEDICAL WASTE RECORDS FOR FY 2006
    REVEALED THE FOLLOWING INFORMATION

21
INVESTIGATION IN FY 2006 ESHC GENERATED
921 CONTAINERS OF MEDICAL WASTE
AT A COST 14,653
THATS A LOT OF TRASH!
22
UNIT ROUNDS LED TO THE DISCOVERY THAT MANOKIN
UNIT WAS DISPOSING ALL DIAPERS AND BLUE
PADS IN RED BAGS
23
MANOKIN TUB ROOM
24
REGROUPING
  • THE RED BAGS ON THE MANOKIN UNIT WERE REMOVED
    FROM ALL AREAS EXCEPT THE TREATMENT ROOM
    SOILED UTILITY ROOM
  • THIS CHANGE WAS COMMUNICATED TO ALL UNIT STAFF
    HOUSEKEEPING BY EMAIL AND THROUGH PERSONNEL
    MEETINGS
  • MET FACE TO FACE WITH DIRECT CARE STAFF AND
    HOUSEKEEPERS

25
THE REAL WORK BEGINS
  • FY 2007 HOSPITAL GOAL OBJECTIVE
  • RED BAG WASTE WILL BE REDUCED 20
  • EMAIL EDUCATION quizzes word searches
  • 36 employees returned quiz word search to
    be eligible for one of two 10 Mc Donald gift
    cards.
  • Sent out correct answers key to word search
    to all staff.
  • KNOW WHERE to THROW Poster, Biohazard sticker,
    Waste Disposal Table were emailed and posted on
    the units

26
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29
MONITORING EVALUATION
  • THE AMOUNT OF MEDICAL WASTE PICKED UP BY OUR
    CONTRATOR WAS TRACKED MONTHLY and communicated
    to all staff
  • MONTHLY UNIT ROUNDS SPORADIC SPOT CHECKS OF
    UNITS negative positive findings were
    communicated to staff
  • FACE TO FACE MEETINGS WITH UNIT STAFF AND
    HOUSEKEEPERS to discuss issues or concerns

30

31
CONTAINERS OF WASTE GENERATED BY ESHC
32
RESULTS OF INITIATIVE
  • FY 2007 6,642 SAVED
  • FY 2008 6,212 SAVED
  • 2 YEAR SAVINGS 12,854
  • FINANCIAL SAVINGS 88

33
  • REDUCED
  • MEDICAL WASTE STREAM
  • 86

34
MANOKIN UNIT OUR SHINING STAR
35
MANOKIN TUB ROOM
36
FINISHED?Choptank, Nanticoke
WicomicoTreatment Rooms
37
WICOMICO UNIT
38
CHOPTANK
39
NANTICOKE
40
  • QUESTIONS?

41
RESOURCES
  • COMAR 10.06.06
  • COMMUNICABLE DISEASE PREVENTION
  • Handling, Treatment, and Disposal of Special
    Medical Waste ,
  • Brenda Roup, RN, PhD- Maryland DHMH EDCP
  • CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD
  • - Posters and Signs
  • HEALTHCARE WITHOUT HARM
  • - Waste Minimization Segregation and
    Recycling Hospitals
  • - 10 Ways to Reduce Regulated Medical Wastes
  • HOSPITALS for a HEALTHY ENVIRONMENT
  • - H2E Self-Assessment Guide
  • -Regulated Medical Waste reduction
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