Environmental Stewardship

FLUID WASTE Joyce Stengel, MSN, RN, CNOR, disposes of a reusable suction canister.

Environmental stewardship is nice, but Joyce Stengel, MSN, RN, CNOR, nurse manager of the 8-OR SurgiCentre at the Hospital of the University of Pennsylvania in Philadelphia, happily discovered that going green carries with it the added reward of real savings. As it turns out, going green saves green, the ultimate win-win.

“You always want to be environmentally responsible, but it’s turned out to be an excellent cost-savings initiative for us,” says Ms. Stengel. For the environmentally responsible and economically sound example she’s set, Ms. Stengel is the winner of the OR Excellence Award for Environmental Stewardship.

Saving money and reducing the landfill
Let’s start with the reprocessing device program. A Harmonic scalpel buyback program has produced the most dramatic, significant savings: in 1 year alone, $40,000 in instrument and waste-removal savings. After the Harmonic scalpel has been used, a nurse or a tech will place the device into a specially designated green bin. Weekly, a vendor rep collects the bin and leaves an empty one behind. The vendor then reprocesses the devices and sells them back to the surgery center for reuse, sharpened, cleaned and tested. “It’s almost like a perfect instrument when it gets back to you,” says Ms. Stengel.

Before the buyback program started 2 years ago, OR staff would throw the Harmonic scalpels into a red sharps container, along with syringes, suture and glass vials. The key was educating staff to segregate the devices to be reprocessed into the green bins. Compliance has been outstanding. From August of last year to this year, Ms. Stengel calculates that the reprocessing program has saved her facility $37,000 in instrument purchasing and an additional $1,900 in landfill costs. “That’s not pocket change,” says Ms. Stengel.

They also recycle and reuse pneumatic compression stockings. Ms. Stengel plans to broaden the reprocessing program by including other instruments.

“We also constantly educate staff. They have to be conscious of what they’re doing.”

— Joyce Stengel, MSN, RN, CNOR

Fluid waste disposal
The ASC reuses and recycles its fluid waste containers. The reprocessing staff store the filled containers in a large, gray, square container. Once the container is full — it can hold 8 or so containers — it’s secured and sent to the trash room, and then shipped to a vendor that empties the contents, cleans and sterilizes the containers, and returns them to the facility.

The ASC also saves on red-bag waste. By simply relocating the red trash bag to the other side of the room, Ms. Stengel says staff are less likely to place wrappers and prep sponges — sponges go in a bucket lined with a clear trash bag — into the red bag, especially while they’re opening a case. “Because the red bag is on the other side of the room, people aren’t tempted to put trash in there while they’re setting up,” says Ms. Stengel. “We also constantly educate staff. They have to be conscious of what they’re doing.” That includes nursing assistants on the turnover team who might think it’s okay to throw their gloves into the red bag after they’ve transported a patient. “They’re not bloody or soiled, but you automatically think red trash,” says Ms. Stengel. “You don’t need to do that.”

— Dan O’Connor