New system protects staff from pathogens
New system protects staff from pathogens
Kansas hospital lets staff decide which to use
For several years, staff at the University of Kansas Medical Center in Kansas City had considered changing its disposal system for waste from the operating rooms but had never made it a priority.
But as the U.S. Occupational Safety and Health Administration (OSHA) made protecting employees from bloodborne pathogens an issue, they started considering their options more seriously, says Mark Turner, LPN, utilization coordinator for the operating room (OR) at the hospital.
"It’s not that we were having incidents, but we had our staff dumping fluids into the hopper while still in their surgical gear," he explains. "It satisfied all the regulatory requirements, but it made the hopper area dirty, and we thought we could do better."
Three options for waste disposal
There have long been three options to getting rid of OR wastes: using solidifier systems, dumping liquids into the sewer, or capping the substance and red-bagging it.
As of November, OSHA banned pouring the fluids down the toilet without including some engineering control that safely guards employees from exposure to the waste. JD Dunn, RN, vice president of product development at Dornoch Medical Systems in Riverside City, MO, says many hospitals relied on being able to flush waste into the sewers.
The department of transportation also doesn’t want to haul free-flowing wastes. "You can wrap canisters in enough material to sop up any spills, but that can be very expensive," Dunn adds.
There are several disposal systems to choose from, too, says Turner. Two of the systems are one that Dunn invented for Dornoch, which costs about $10,000, and one developed by Bemis Manufacturing Co. in Sheboygan Falls, WI, which costs about $13,000. (For more information, see box, above.)
The Dornoch and Bemis systems both provide the engineering controls that OSHA demands. They confine and contain the fluids before flushing them into the sewer system, eliminating the need for special protective gear that would make dumping into the sewer OSHA-compliant, says Dunn. In both cases, the fluids are put into a canister; a flushing jet adds hot water and bleach; and the waste is disposed of.
To determine what system to use, Turner tried to find out what systems other hospitals use. Information from ECRI, a nonprofit health care consulting company based in Plymouth Meeting, PA, as well as from Turner’s peers in area hospitals, helped to narrow the field.
Then Turner, the nurse manager, and the OR director from the hospital decided which three systems to pilot. They chose Bemis, Dornoch, and the Premicide Isolizer solidification process. The staff who had daily contact with waste disposal processes all participated in the trials and were encouraged to comment on the different processes.
"We knew that each system has its ups and downs," he explains. "The Bemis system has a needle apparatus that wouldn’t tolerate clotting or tissue debris. And you also have to consider what happens if the system goes down. Will the company you buy it from be around to offer service, or will your facility operations staff have to take on that responsibility?"
Price wasn’t much of a factor. The Premicide Isolizer system requires additional waste hauling costs. Dornoch and Bemis require a large, upfront capital investment. "But when you do all the math, you find a pretty negligible difference," Turner says.
The hospital selected the Dornoch system, and for the last eight months has used it with great success. The learning curve was short, and the process change has gone smoothly, says Turner. A subsequent Joint Commission survey even noted that OR processes were good, and the surveyor particularly noted the protection processes provided to staff.
[To get more information about this and other innovations in health care, go to www.best4health.org, the site of The Best Practice Network, an organization devoted to promoting information sharing and experience exchange among nurses, physicians, and other health care professionals. For more information on The Best Practice Network, e-mail: join-us@best4health. org, or call (800) 899-2226.
For more information, contact:
• Mark Turner, LPN, Utilization Coordinator, University of Kansas Medical Center, Kansas City, KS. Telephone: (9130 588-2886.
• JD Dunn, RN, Vice President of Product Development, Dornoch Medical Systems, Riverside, MO. Telephone: (816) 505-2226.] n
For more information on hospital waste disposal systems mentioned in this story, contact:
- OBF Industries Inc. (Premicide Isolizer), Downers Grove, IL. Telephone: (800) 848-5663.
- Dornoch Medical Systems Inc., Riverside City, MO. Telephone: (816) 505-2226.
- Bemis Manufacturing Co., Health Care Products Group, Sheboygan Falls, WI. Telephone: (800) 558-7651
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