A surgery center nurse assessed her facility’s biomedical waste to look for ways to cut costs. She found many items that could have been disposed of in a generic garbage bag with the regular trash.

“I just looked in the bag and saw all of these bottles that didn’t need to be in there,” says Joyce Kaine, RN, director of nursing and former quality coordinator for Surgery Center of Fairfield County, a part of Surgical Care Affiliates, in Connecticut.

The work began as a quality improvement project, approved by the surgery center’s quality committee. Kaine handled the physical work of going through biomedical trash and used tools to prevent injury. “I didn’t involve other staff members because I didn’t want to expose anybody else to sharps,” she notes.

The biggest proportion of waste that should not have been put in the biomedical bag involved intact medication bottles. “If the bottles were broken, they’d have to go in the sharps container, but an empty, intact bottle could go into the trash,” Kaine explains. Paper products that were not contaminated with fluid also were loaded into the biomedical waste bag unnecessarily.

Before separating biomedical waste from the regular trash, Kaine reviewed OSHA and state regulations on what constituted medical waste, along with other guidance from pharmacy websites and biohazardous bags.

Kaine collected three months of biomedical and sharps waste data from the disposal company. She also went through the sharps container and a biomedical waste bag, removing the unnecessary waste from each, and found the difference in what should have been the biomedical waste weight and what the actual weight was.

“It was almost a five-pound weight difference when we did our audit,” Kaine says. This proved the surgery center was spending more money on biomedical waste than it needed to.

Kaine presented what she learned to staff to help them understand what they could throw away in the sharps container and the hazardous drug box. They also learned what could be dumped down the sink or thrown in the regular trash.

The facility purchased the Drug Buster Drug Disposal System, a solution that dissolves medications and pills. “You dump any residual medications you have into the intact, empty bottle to render it non-retrievable before you put it in the trash,” Kaine explains. “These large jugs are installed in operating rooms and have a charcoal solution that renders it non-retrievable.”

Habits changed quickly. In one month, the facility recorded a 43% reduction in sharps and biomedical waste. “After that, we were able to renegotiate our contract with the biomedical waste company, and we now save $1,200 a month,” Kaine reports.

For her work, Kaine won the 2019-2020 Bernard A. Kershner Surgical/Procedural Care Award from the Accreditation Association for Ambulatory Health Care.