A Better Way to Handle Fluid Waste

Bodily fluid overflow is common during notoriously messy joint procedures. Your staff can stem the tide by attempting to sop it up, but closed mobile collection units are the no muss, no fuss solution to keeping OR floors dry. In my mind they're no-brainers for busy orthopedic centers. Here's why.

• Major time-savings. Our old fluid-collection method involved four canisters on a wheeled surgical tree. We had to put a solidifier in full canisters, which exposed staff to biohazardous spillage and splashback. Nurses or techs then had to carry filled 3-liter canisters to a dirty utility room to dispose of the fluid waste, putting them at risk of injury from the repeated heavy lifting.

Our facility purchased 11 mobile fluid waste collection systems last year — one for each operating and procedure room. Mobile systems can be rolled into and out of the OR and positioned in a variety of ways that makes it easy to collect fluid without obstructing staff during surgery. For fluid-producing arthroscopy cases, the transition meant we went from lugging and bagging heavy fluid-filled canisters throughout the facility to rolling one of the new devices to a docking station.

The old process was as time-consuming as it was aggravating. You had to double-bag the canisters and take them to the utility room after each procedure. The larger reservoirs in the mobile units make it extremely rare for us to have to empty the system after each case, even during procedures that produce high volumes of fluid.

Even if you bagged the canisters as you went during the procedure, you weren't able to fully concentrate on the case, which led to other inefficiencies. We're definitely able to schedule more cases because we've reduced our turnover times now that we're not dealing with more than a dozen canisters during each surgery.

• Improved staff safety. The new closed systems feature large internal reservoirs that hold 20 liters of fluid, so they don't need to be moved as much. When they are moved, they're detached from arthroscopy pumps, surgical drapes or floor wicking devices and pushed to the docking station, hooked up and emptied into the sanitary sewer system. Staff never touch any of the fluids, so they're not exposed to dangerous bloodborne pathogens. The machine's daily cleaning is automatic, overseen by OR techs, as is the weekly deep cleaning. The techs simply wipe down the outside of the machine after each use. Our techs even devised a simple system, so staff know which machines are ready to go and which ones need to be cleaned (osmag.net/FJX4zo). Of course, keeping fluids off the floor also prevents slipping hazards.
• Eco-friendliness. The new closed systems have also reduced our facility's environmental footprint because we're reducing the amount of regulated medical waste generated. We've also eliminated the use of thousands of the single-use canisters and the chemicals in the solidifiers that are classified as red bag waste. We're sending less nonhazardous refuse to the landfill as well.

"Fluid waste management systems can save facilities an average of $51,000 per year."

The closed fluid collection systems have a dual role: They also serve as smoke evacuators. The suction is attached to a cautery pencil and the smoke gets sucked in as the surgeon is using it. Its filter is changed periodically throughout the year to help remove as many burning carcinogens in the room as possible.

• Return on investment. We expect the collection systems — which cost $10,000 to $15,000 apiece — to be worth the investment. In 2018, our last year using the old collection system, we purchased 4,228 3-liter canisters. Last year we bought 500, which we stopped using once we put our mobile units into service, for a savings of $4,972. Our facility also spends less on solidifying agents and on red bag waste disposal. The OR staff spends less time prepping, transporting and emptying the closed system, and less time cleaning messy OR floors. Practice Greenhealth, an environmental healthcare group, says fluid waste management systems can save facilities an average of $51,000 per year and provide a return on upfront investments in as little as one to three years.

If the upfront expense is a potential deal-breaker, ask the system's rep if creative financing is available. Many vendors will work with you on pricing. Also, ask about available service contracts and be sure to pay the extra cash to get one of them. Once you make a purchase, have the vendor take the time to introduce the machines to your staff and educate them on how to use them.

Smaller surgery centers that don't do a lot of high-volume orthopedic cases could consider wall-mounted removal systems. When canisters are filled, nurses or techs roll them to the wall-mounted disposal system, take the canisters off the cart and insert them into the system, which automatically flushes the contents.

Nurses at our facility are less aggravated now that they aren't always carrying heavy canisters full of dangerous fluids out of the OR. Surgeons are no longer annoyed by how long it takes to turn over rooms between cases.

OR staff members are happier walking on dry floors without having to worry about slipping and falling during messy ortho cases.

Overall, the transition to the closed fluid collection systems has had a positive impact on the entire OR team as well as the planet — which is priceless. OSM