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With 4 billion pounds of waste generated by healthcare facilities annually, nurses are protecting the environment by implementing eco-friendly initiatives to reduce, reuse, reprocess and recycle.
The operating room is often the largest waste generating department in a hospital, responsible for 20-33 percent, according to Practice Greenhealth, a nonprofit organization in Arlington, VA, which recently launched the "Greening the OR Initiative" to reduce the environmental impact of the OR.1
OR nurses, as frontline healthcare professionals, are responding and painting a greener landscape in hospitals throughout America.
'Cultural Norm'
Much of the plastic waste generated in healthcare facilities is "clean" (uncontaminated).
Best Practices in Nursing
Therefore, the potential for recycling plastics generated by hospitals appears significant.2
Approximately 85 percent of general hospital waste is noninfectious, according to the Association of periOperative Nurses (AORN).3
One of Practice Greenhealth's initiatives is to reprocess single-use device (SUD) disposable medical products used in the OR. Reprocessing requires no up-front investment and results in cost-savings, waste reduction and savings in energy/water/emissions.2
One facility early to embrace a greener path is Banner Gateway Medical Center in Phoenix, which has been recognized for reducing environmental harm and improving overall hospital quality through medical device remanufacturing and reprocessing.
Penny Boone, MSN-L, RN, CNOR, director of perioperative services, said recycling and reprocessing has become a "cultural norm."
In 2004, Boone said, Banner entered into single-use device reprocessing with an FDA-approved third party reprocessing company, saving more than $34,000 and 1,000 lbs of waste the first year, with numbers increasing yearly. In 2009, the facility saved more than $250,000 in cost and nearly 9,200 lbs of waste.
"Banner has 8 acute care facilities in the Phoenix metro area, which represents many ORs with lots and lots of clean trash."
But change didn't come easy.
"The 2004 reprocessing initiative was seen as suspect until in-depth education was completed," Boone explained, adding effective, long-term change requires facility-wide acceptance and understanding through education.
Nursing staff education included tours of the local reprocessing facility contracted by Banner.
"Educating our staff was the catalyst that sparked a paradigm shift resulting in their conviction that these products were safe and effective for patients," Boone said.
"This shift combined with the environmental passion [held by the OR nurses] planted the seeds for change and acceptance," she said. "The OR's passion created a culture that expects reprocessing and recycling to occur."
Leaving a greener footprint for future generations is the facility's ultimate goal.
"We will look for opportunities to grow our reprocessing and recycling efforts that are safe and cost efficient for patients," Boone shared. "We hope to impact the Banner system at large by sharing our lessons learned with our sister facilities as they take these initiatives on."
Green Idea for Blue Wrappers
A No. 5 polypropylene plastic used to wrap instrument kits prior to sterilization and delivery to the surgery suite typically is a significant portion of a hospital's waste stream. When an instrument kit is opened the sterile blue wrap is discarded, creating approximately 19 percent of the waste generated in surgical services.4
For example, a total knee replacement pack generates an entire trash bag of blue wrap, said Jennifer Ogden, BSN, RN, CNOR, educator, OR, Shawnee Mission Medical Center, Shawnee Mission, KS, a suburb of Kansas City, KS.
Shawnee Mission became the first facility in Kansas to implement an OR recycling/reprocessing of blue wrap program in 2008.
"We heard the same concern from nurses over and over again about what to do with the volume of blue wrap," Ogden said.
Identifying a recycling company and a reprocessing company were the first steps to green the blue wrap in the OR.
"After we secured a recycling company, the challenge was figuring out whether the processor company bails or compacts the blue wrap," Ogden said. We are currently using a recycling company that bails our wrap."
Although it pays to be a pioneer, Ogden added, there were challenges initially.
"The means of collecting at the point-of-use and locating a storage area until the blue wrap is taken to the processor were the two primary challenges," she explained. The 16-OR facility recycles and reprocesses about 8,000-10,000 lbs. of blue wrap annually.
But the program's positives seem to outweigh the long-term maintenance issues.
"When we introduced this program, everybody in our entire facility was on board," said Ogden. "Nobody balked."
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