Save the Planet: Recycling in the OR

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 generalrefuse, or municipal solid waste, and therefore is similar to the kinds of waste generatedin hotels, restaurants, shopping centers, office buildings, and private residences. 1

In the hospital, a significant portion of waste can be attributed directly to the typesof products that are brought on site for facility use. The hospital industry has shiftedfrom a primarily reusable product supply system to a primarily disposable product supplysystem. The majority of these supplies are sealed in individually wrapped packages. Thisshift has dramatically increased the waste production of medical facilities. It has beenreported that the hospitalized patient generates an average of 15 pounds of hospital wasteper day.1

It is estimated that half of medical waste generated from hospitals originates in theoperating room2 and that almost 80% of the waste from a single operation isgenerated before the patient enters the surgical suite. Because everything must besterile, almost all the supplies, instruments, drapes, and other equipment come sealed indisposable polypropylene wraps, rigid plastic packaging trays, or other packagingmaterial. It is not unusual for such packaging from a single cardiac or other large caseto fill three or more large garbage bags. Much of this waste is filling landfills when itcould be reused or recycled.

In an effort to reduce the amount of waste deposited into the waste stream and raisethe consciousness of the operating room staff regarding recycling, a special project waslaunched 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 thePlanet" boxes located in the unit. The ideas and tips were collected and presented inan inservice. Prizes were given for the 1) most ideas, 2) most ingenious idea(s), and the3) 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 mostingenious idea made a Halloween dress out of the paper instrument tray liners and modeledit for the staff. Another staff member made a beautiful quilt from assorted operating roompaper products, winning a prize for the most original idea.

Since this hospital is a teaching facility, supplies opened and not used for a case areused for teaching in the operating room training program. Supplies are also given to anaffiliated Veterinary Medical Teaching Hospital. What the Vet Hospital cannot use is givento the missions.

Finding a charitable organization to donate supplies to can be difficult. Oneorganization that facilitates this process is REMEDY (Recovered Medical Equipment for theDeveloping World). REMEDY ( is a not-for- profit organiztion that willhelp hospitals and medical personnel to identify organizations, either locally ornationally, who have experience and resources to support effective overseas shipping anddistribution. This service is provided free-of-charge.

According to the Association of Operating Room Nurses Recommended Practices forEnvironmental Responsibility, "Personnel should become ecologically sensitive andadvocate changes that reduce the quality of waste generated while maintaining qualitypatient care and worker safety."3 Operating room nurses have aresponsibility as healthcare providers and as inhabitants of this planet always to lookfor ways to preserve the environment. It is a challenge to provide both safe care for thepatient and for the planet.

Kathy Donaldson, CNOR, RN, is a Staff Developer, Operating Room, at the Universityof 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.

For a complete list of references click here