Essential Elements of a Highly Efficient Fluid Waste System

Three critical questions to get the most out of your facility’s major purchasing decision.

Waste management is a crucial part of any high-volume GI practice. Your staff deserves a system that is safe, efficient, portable and one-hundred percent reliable against unintentional exposures, unsafe spillage and even lost specimens such as polyps.

To ensure your fluid collection solution encompasses all these elements, here are three critical questions you need to ask and answer before purchasing or upgrading your system.

1. What are your primary needs?

For facility leaders at busy centers, this core question ultimately dictates exactly how you should approach waste management. For Nikki Williams, RN, CNOR, executive director of Lakeland (Fla.) Surgical & Diagnostic Center, the answer to this question is a multifaceted one. In addition to the ability to easily transport the equipment, which Ms. Williams stresses is key, leaders should demand a lot more from whatever fluid waste solution in which they decide to invest.

“When it comes to a waste management system, facilities should look for a closed system that will provide adequate protection from bodily fluids,” she says. “It should be a system that can handle large volumes — and safe disposal and accurate measurements — of fluids as well as one that isn’t too bulky or noisy, with safety devices in place to protect the patient.”

If, like Ms. Williams, your facility opts for a closed system — or a direct-to-drain system that essentially removes any risk of fluid exposure and injuries associated with moving filled suction canisters — you must also determine which type is right for you: a mobile or wall-mounted removal system.

• Mobile collection. This system involves mobile units that have large internal reservoirs with the capacity to collect runoff during several fluid-heavy cases. Staff wheel a cart into the OR and attach its ports to arthroscopy pumps, surgical drapes or floor wicking devices. When the cart’s reservoirs are filled, staff roll the cart to a dedicated docking station, which automatically empties the cart’s contents into the sewer system.

• Wall-mounted removal. With this option, fluid canisters are positioned next to the OR table on a mobile cart. Nurses or surgical techs then roll the unit to a wall-mounted disposal system when the canisters are filled, remove them and place canisters in the wall-mounted system, which automatically flushes them.

2. What can you live without?

Many fluid waste management solutions come with an array of extra features, but opting for all the latest bells and whistles that are part of the newest generation of a system isn’t necessarily a value-add if your staff won’t use them. For instance, some mobile fluid collection units come with built-in smoke evacuation systems. For her part, Ms. Williams sees features like an automated IV pole, a smoke evacuation system and “a light in the fluid chamber so you can see volumes when the lights are off in the OR” as nice to have but non-essential. On the other hand, with more states passing smoke-free OR legislation with each passing year, Cheryl “Skeet” Todd, BSN, RN, CNOR, CPAN, CNAMB, RNFA, surgery center director of the Texas Spine and Joint Hospital in Tyler, says it’s worthwhile to look at the amount of surgical-smoke your facility generates and factor that into the decision of whether it’s worth investing in a new mobile unit with an integrated smoke evacuation system.

For Ms. Todd, the ability to raise and lower an IV pole with the push of a button — a nice ancillary benefit for some — was a must-have feature in a mobile system. “This might not sound like a big deal, but when a circulator is hanging four bags from the pole and trying to lift it up and secure it in place, that push-button capability is a difference-maker,” she says.

3. What should you demand of a vendor?

TO AND FRO Mobile fluid collection units should be easy for your staff to transport in and out of ORs and procedure rooms.

When your facility invests in a fluid waste system, you should expect a lot from your vendor partner — and rightfully so. Ms. Williams says it’s imperative to ask pointed questions about disposable costs and safety features — including variable suction rates, alarms and whether there are any risks to the patient when using the system. Above all else, she recommends getting the answer to this key question before continuing the discussion with a potential vendor: “Can the product can be trialed prior to purchasing to allow physicians and other staff to see what it is like?”

If a request for a couple days of demoing the equipment can’t be accommodated, it’s an automatic red flag against the prospective vendor for many leaders. In fact, some believe one week minimum is what any vendor should offer. “When trialing a fluid waste management system, don’t bring it in for a day or two,” says Ms. Todd. “Give your staff at least a week, or ideally two weeks, to figure out the kinks and see how they work with the new technology.”

In addition to seeing how your staff will respond to a new system, a trial is also important to see how the equipment will fit — physically speaking. “While mobile collection units don’t take up a lot of room on their own, you must account for the docking stations,” says Ms. Todd. “For a lot of smaller ASCs, space is tight and not having a dedicated location, such as a janitor closet, for the station can present issues.” When the demo is complete, that’s when your facility can really gauge the service of a potential vendor, as they should be willing and able to tailor requests to your specific needs. “Once you’ve gathered insights from staff, go back to the vendor reps armed with that info and say, ‘This is what we like, this is what we don’t like. Can we change this? Is this a possibility?’” says Ms. Todd. “Sweating the details is a small but crucial part of the purchasing process.”

Your relationship with a vendor should continue long after that initial purchase is made. That’s why it’s so important to factor vendor service and education into your decision. What type of training, education and customer service should your vendor reps provide? Ms. Williams says they should be responsive and able to offer hands-on training and education to staff in a variety of tasks. “Staff needs to see how to operate the machine in a safe manner that doesn’t put patients at risk, how to troubleshoot any potential issues, what to do if the system is alarming and how to perform cleaning procedures,” she says.

Purchasing perspective

There’s no doubt that a closed collection system is the safest and most efficient way to handle fluid waste in your facility. Still, many leaders hesitate due to the initial cost of investment. If that’s the only thing holding you back, remember: Single-use containers cost money to dispose of in regulated medical waste. Factoring this and the time savings of not needing to take extra disposal steps should show you the upfront cost and long-term savings are well worth it in the long run. OSM