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真是浪费!手部手术中未使用的外科用品的影响,以及我们如何改进。

What a Waste! The Impact of Unused Surgical Supplies in Hand Surgery and How We Can Improve.

机构信息

NYU Langone Orthopedic Hospital, New York City, NY, USA.

Rothman Orthopaedic Institute, Philadelphia, PA, USA.

出版信息

Hand (N Y). 2023 Oct;18(7):1215-1221. doi: 10.1177/15589447221084011. Epub 2022 Apr 29.

Abstract

BACKGROUND

The US health care system is the second largest contributor of trash. Approximately 20% to 70% of waste is produced by operating rooms, and very few of this waste is recycled. The purpose of this study is to quantify the opened but unused disposable supplies and generate strategies to reduce disposable waste.

METHODS

A single-center prospective study to evaluate the cost of opened but unused single-use operating room supplies was completed by counting the number of wasted disposable products at the end of hand surgery cases. We used χ test, test, Wilcoxon rank-sum test, and simple linear regression to assess the associations between patient and case variables and the total cost of wasted items. Environmentally Extended Input Output Life Cycle Assessment methods were used to convert the dollar spent to kilograms of carbon dioxide equivalent (CO-e), a measure of greenhouse gas emissions.

RESULTS

Surgical and dressing items that were disposed of and not used during each case were recorded. We included 85 consecutive cases in the analysis from a single surgeon's practice. Higher cost from wasted items was associated with shorter operative time ( = .010). On average, 11.5 items were wasted per case (SD: 3.6 items), with a total of 981 items wasted over the 85 cases in the study period. Surgical sponges and blades were 2 of the most unused items. Wasted items amounted to a total of $2193.5 and 441 kg of CO-e during the study period.

CONCLUSIONS

This study highlights the excessive waste of unused disposable products during hand surgery cases and identifies ways of improvement.

摘要

背景

美国的医疗保健系统是垃圾的第二大制造者。大约有 20%到 70%的废物是由手术室产生的,而这些废物很少被回收。本研究的目的是量化已打开但未使用的一次性供应品,并制定减少一次性废物的策略。

方法

通过计算手部手术结束时浪费的一次性产品数量,完成了一项评估已打开但未使用的一次性手术室用品成本的单中心前瞻性研究。我们使用 χ 检验、t 检验、Wilcoxon 秩和检验和简单线性回归来评估患者和病例变量与浪费物品总成本之间的关系。环境扩展投入产出生命周期评估方法被用来将花费的美元转换为二氧化碳当量公斤(CO-e),这是衡量温室气体排放的一种措施。

结果

记录了每个病例中处理和未使用的手术和敷料物品。我们从一名外科医生的实践中分析了 85 例连续病例。浪费物品的成本较高与手术时间较短有关( =.010)。平均每个病例浪费 11.5 个物品(SD:3.6 个物品),在研究期间的 85 个病例中总共浪费了 981 个物品。手术海绵和刀片是最未使用的两种物品。在研究期间,浪费的物品总计 2193.5 美元和 441 公斤的 CO-e。

结论

本研究强调了手部手术病例中未使用的一次性用品的过度浪费,并确定了改进的方法。

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