TOTAL TEAM EFFORT The staff of Seaford Endoscopy Center participate in recycling.

Pamela Borello-Barnett, RN, BS, CNOR, is serious about recycling. From rinsing and reusing plastic bags in her kitchen at home to using reprocessed single-use devices in her operating rooms at St. John Oakland Hospital in Madison Heights, Mich., Ms. Barnett has made it her personal and professional crusade to go green.

EASE OF USE A hands-free receptacle with a foot lever makes it easy for staff to discard contaminated waste.

"I hate looking at landfills when driving down the highway," says Ms. Barnett, the clinical nurse manager of surgical services at St. John Oakland. "I'm not a fanatic about it, but I'd like to do things that are good for the environment and to save money."

St. John Oakland has done its part to go green. By using such reprocessed devices as trocars and ortho shavers, the hospital's ORs have diverted 4,360 devices and 976 pounds from landfills and saved $488 in waste disposal costs in the last 12 months alone, stats provided by the vendor from which the hospital has purchased its reprocessed devices for the last 5 years for about half the cost of new. "It makes me feel good when I see the numbers," says Ms. Barnett. "It might not sound like much, but it adds up."

Reprocessing compression stockings, blood pressure cuffs, pulse oximeters, clamps, scissors and staplers is just one way to save on waste disposal. Here are a few more green practices in the OR you can implement that are as good for the environment as they are for your bottom line.

1. Recycle. Surgicare Crosspointe in Evansville, Ind., has cut its waste disposal costs in half by recycling the many non-hazardous materials that accumulate when you open a case, including wrappers, peel packs, suture packets, IV bags and saline bottles, says OR Manager Angie Field, RN.

You'll find recycling bins inside and outside the Seaford (Del.) Endoscopy Center. Inside, there's a trash can dedicated to recycling magazines, juice and soda cans, plastic wrap from patient gowns and plastic bags, says Nurse Manager Joyce Mackler, RN, MSN. Outside the center, staff place shredding and shipping cartons in 2 large recycling containers. That's not all. The endo center also recycles batteries and fluorescent light bulbs by taking them to the local recycling center, says Ms. Mackler. Even the staff lounge is a green haven: Staff don't use paper or plastic plates and cups. "Instead, we use regular dishes and silver that we wash and reuse," says Ms. Mackler.

West Virginia University Hospitals in Morgantown, W.Va., keeps most of its blue wrap out of the landfill by collecting it in separate containers and making it available to hospital employees who want it. "You'd be surprised how many people want that wrap for things like painting projects at home, packing to move, donating to their vet or a variety of other projects," says Mary Wilson, RN, BSN, CNOR, WVUH's clinical preceptor/educator.

2. Train staff to dispose of waste in the right receptacle. A recycling program is only as good as your frontline staff's commitment to the program. An often-overlooked element of success is training your staff to place waste in the proper receptacle. Don't assume that your staff knows what is and isn't red bag waste. They'll often throw waste into the closest trash receptacle. Teach and constantly remind your staff. They're not thinking about walking a few feet further to put waste in the correct bag. A simple rule to follow: If you can sling it, fling it or wring it, it goes in the red bag. "We provide specific training to all staff about what items go in the red bags," says Debbie Ralph, RN, assistant head nurse at Salinas Valley Memorial Hospital in Salinas, Calif. "We review this periodically and the charge nurse is very good about reinforcing this."

The OR at the Plastic Surgical Center of Rapid City (S.D.) has 2 open receptacles for waste disposal, one with a heavy-duty garbage bag and one with a red garbage bag for contaminated waste. But guess what? Staff were routinely discarding uncontaminated garbage (Bovie grounding pad outer wraps, for example) in the red garbage container. Colette Klein, RN, the ASC's director, purchased a covered waste container for contaminated garbage. The hands-free receptacle is hard to miss and easy to use — staff simply step on a foot lever to open the lid and discard contaminated garbage. The ASC now pays considerably less for waste disposal: $318 per month compared to $480, says Ms. Klein.

You know those stapling devices that normally fill up large sharps containers? A reprocessing company hauls them away at no charge from Martin Health System in Stuart, Fla., and recycles them for companies that use the plastics for park benches, says Val Ruby, BSN, RN, MBA, CNOR, the assistant vice president of perioperative services.

3. Fluid disposal. No-touch, direct-to-drain fluid disposal systems are environmentally friendly. Besides eliminating red bag waste, they also save you indirectly. One, they reduce the risk that staff will injure their backs slipping on wet floors or carrying heavy canisters of fluid waste to the hopper. Two, they help prevent infection, as staff won't get splashed by infectious fluid waste while pouring it down a drain.

4. Save on anesthesia, too. Imagine having to change only the mask and the filter between general anesthesia cases rather than throwing out the mask and the entire anesthesia circuit. Now you can, when you use a breathing filter that protects the anesthesia circuit from contamination by the patient, and the patient from contamination by the circuit and other anesthetic equipment. "Changing the entire filter costs $7.50. With the $2.78 filter, you only have to change the mask, which costs us $1.83," says Carol Cappella, RN, MSN, CNOR, the clinical director of the Delray Beach (Fla.) Surgery Center. "It really makes room turnover easy," Gary Hindin, MD, of Greater Florida Anesthesiologists brought the idea to Ms. Cappella. "You can leave the circuit on the machine and just change the filter and the mask. It's especially useful when you're hosting multiple general cases in the same room."