Kettering Medical Center, Dayton, Ohio, Duke University School of Nursing, Durham, North Carolina (Drs Plezia, Sabol, and Simmons); and Duke Raleigh, Raleigh, North Carolina (Dr Nelson).
Qual Manag Health Care. 2024;33(1):44-51. doi: 10.1097/QMH.0000000000000416. Epub 2023 Jun 2.
Operating rooms (ORs) disproportionally contribute 20% to 33% of hospital waste nationwide and therefore have a major impact on hospital waste management. Seventy percent of general OR waste is incorrectly eliminated as clinical waste, which compounds unnecessary financial burden and produces negative environmental impact. The primary purpose of this quality improvement (QI) project was to evaluate the effectiveness of waste segregation education for OR anesthesia staff on improving waste segregation compliance in the OR.
A waste segregation QI project was implemented at a 19-OR hospital. Sharps bins in each OR were monitored for weight in pounds and 6 ORs were monitored for percent compliance both pre- and post-institution of a waste segregation education. In addition, a waste segregation knowledge assessment, waste segregation barriers assessment, and a demographic survey were administered to anesthesia staff. Twenty-two certified registered nurse anesthetists (CRNAs), 13 anesthesiologists, and 4 anesthesia technicians responded to the initial surveys and assessments while 30 of these original 39 participants (77%) responded following the educational intervention. A cost analysis was calculated pre- and post-implementation by multiplying total weight of the sharps bins by the price per pound of sharps.
Twenty-three percent of participants reported having formal waste segregation training. Survey responses revealed that the greatest barrier to waste segregation involved bin location (56.4%), followed by lack of time to segregate (25.6%), lack of knowledge of what content goes in the bin (25.6%), and lack of incentive (25.6%). A waste segregation knowledge assessment showed improvement from pre- ( M = 9.18, SD = 1.66) to post-implementation ( M = 9.90, SD = 1.64). Pre-implementation sharps bin compliance was 50.70% while post-implementation bin compliance improved to 58.44%. A 27.64% decrease in sharps disposal cost occurred following implementation, which is estimated to produce a $2964 cost savings per year.
Waste segregation education for anesthesia staff increased their waste management knowledge, improved sharps waste bin compliance, and produced an overall cost savings.
手术室(OR)在全国医院废物中占比高达 20%至 33%,因此对医院废物管理有重大影响。70%的普通 OR 废物被错误地归类为临床废物,这不仅增加了不必要的财务负担,还产生了负面的环境影响。本质量改进(QI)项目的主要目的是评估对 OR 麻醉师进行废物分类教育对提高 OR 废物分类依从性的效果。
在一家拥有 19 间手术室的医院实施了废物分类 QI 项目。在实施废物分类教育之前和之后,对每个手术室的利器箱进行磅重监测,并对 6 间手术室进行百分比合规性监测。此外,对麻醉师进行了废物分类知识评估、废物分类障碍评估和人口统计调查。22 名认证注册护士麻醉师(CRNA)、13 名麻醉师和 4 名麻醉技术员对初始调查和评估做出了回应,而在接受教育干预后,其中 30 名(77%)原始 39 名参与者做出了回应。通过将利器箱的总重量乘以每磅利器的价格,在实施前后进行了成本分析。
23%的参与者报告接受过正式的废物分类培训。调查结果显示,废物分类的最大障碍涉及垃圾桶位置(56.4%),其次是缺乏分类时间(25.6%)、缺乏垃圾桶内容物知识(25.6%)和缺乏激励措施(25.6%)。废物分类知识评估显示,从实施前(M=9.18,SD=1.66)到实施后(M=9.90,SD=1.64)有所提高。实施前利器箱的合规性为 50.70%,而实施后提高到 58.44%。实施后,利器处置成本降低了 27.64%,估计每年可节省 2964 美元。
对麻醉师进行废物分类教育提高了他们的废物管理知识,提高了利器废物箱的合规性,并产生了总体成本节约。