Save the Planet: Recycling in the OR
by Kathy Donaldson, RN, CNOR
For most people, the term "medical waste" means infectious waste, including used needles and blood. However, approximately 80% of a medical facility's waste can be classified as general refuse, or municipal solid waste, and therefore is similar to the kinds of waste generated in hotels, restaurants, shopping centers, office buildings, and private residences. 1
In the hospital, a significant portion of waste can be attributed directly to the types of products that are brought on site for facility use. The hospital industry has shifted from a primarily reusable product supply system to a primarily disposable product supply system. The majority of these supplies are sealed in individually wrapped packages. This shift has dramatically increased the waste production of medical facilities. It has been reported that the hospitalized patient generates an average of 15 pounds of hospital waste per day.1
It is estimated that half of medical waste generated from hospitals originates in the operating room2 and that almost 80% of the waste from a single operation is generated before the patient enters the surgical suite. Because everything must be sterile, almost all the supplies, instruments, drapes, and other equipment come sealed in disposable polypropylene wraps, rigid plastic packaging trays, or other packaging material. It is not unusual for such packaging from a single cardiac or other large case to fill three or more large garbage bags. Much of this waste is filling landfills when it could be reused or recycled.
In an effort to reduce the amount of waste deposited into the waste stream and raise the consciousness of the operating room staff regarding recycling, a special project was launched in the operating room at the University of California Davis Medical Center (Sacramento, Calif). Ideas were solicited from the OR staff regarding recycling, reusing, and reducing waste. Staff were encouraged to put their ideas in "Save the Planet" boxes located in the unit. The ideas and tips were collected and presented in an inservice. Prizes were given for the 1) most ideas, 2) most ingenious idea(s), and the 3) most original idea(s). The following are examples of some of the ideas:
- Use instrument tray wraps instead of chux.
- Save and reuse paper instrument tray liners to use to wipe spills or for household cleaning.
- Save plastic sponge containers to hold paints, desk items, or give to schools for art projects.
- Save foam from inside of donut shaped headrests for preschool painting sponge or water toy. Saved foam can be wet with soap and water and used with a razor instead of opening a shave kit.
- Epidural/spinal trays make great toy or hobby organizers.
- Use paper drapes for sewing patterns, sample garments.
- Re-assess the need for each piece of paper that we use.
- Carefully assess the need for egg crates and elbow pads, not really necessary in every case--especially short cases.
- Use papers wrappers as covering for the armboards.
- Change bed linen on gurneys only if necessary. Often it is clean and has only been occupied for a very short time.
- Check items before opening for a case to make sure that you need them.
- Separate clean trash during the case and recycle all plastic.
- Save plastic bags covering sterile supplies and use as covers for foot pedals, patient's belongings, etc.
- Disposable styrofoam and plastic trays can be used for art projects.
- Save empty irrigation bottles for water bottles for hiking, camping, etc.
- Items opened and not used for a case should be sent to the missions or other entities in need of these supplies.
- Use reusable cloth products and basin sets.
The contest winners where announced at the recycling inservice. The winner of the most ingenious idea made a Halloween dress out of the paper instrument tray liners and modeled it for the staff. Another staff member made a beautiful quilt from assorted operating room paper products, winning a prize for the most original idea.
Since this hospital is a teaching facility, supplies opened and not used for a case are used for teaching in the operating room training program. Supplies are also given to an affiliated Veterinary Medical Teaching Hospital. What the Vet Hospital cannot use is given to the missions.
Finding a charitable organization to donate supplies to can be difficult. One organization that facilitates this process is REMEDY (Recovered Medical Equipment for the Developing World). REMEDY (www.remedyinc.org) is a not-for- profit organiztion that will help hospitals and medical personnel to identify organizations, either locally or nationally, who have experience and resources to support effective overseas shipping and distribution. This service is provided free-of-charge.
According to the Association of Operating Room Nurses Recommended Practices for Environmental Responsibility, "Personnel should become ecologically sensitive and advocate changes that reduce the quality of waste generated while maintaining quality patient care and worker safety."3 Operating room nurses have a responsibility as healthcare providers and as inhabitants of this planet always to look for ways to preserve the environment. It is a challenge to provide both safe care for the patient and for the planet.
Kathy Donaldson, CNOR, RN, is a Staff Developer, Operating Room, at the University of California Davis Medical Center (Sacramento, Calif).
1 Leach C, Shaner H. Medcycle offers opportunities as front-line recyclers. Medical Waste. 1992;2:1.
2 French H. Blueprint for reducing, reusing, recycling. AORN J. July 1994.
3 Recommended practices for environmental responsibility. Standards, Recommended Practices & Guidelines. Denver: Association of Operating Room Nurses, Inc., 2000.
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