1. Let’s Change the Way We Waste! PAULA PURNAVEL WIDENER UNIVERSITY

2. Types of Waste  infectious waste : waste contaminated with blood and its by-products, cultures and stocks of infectious agents, waste from patients in isolation wards, discarded diagnostic samples containing blood and body fluids, infected animals from laboratories, and contaminated materials (swabs, bandages) and equipment (such as disposable medical devices);  pathological waste : recognizable body parts and contaminated animal carcasses;  sharps : syringes, needles, disposable scalpels and blades, etc.;  chemicals : for example mercury, solvents and disinfectants;  pharmaceuticals : expired, unused, and contaminated drugs; vaccines and sera;  Genotoxic waste : highly hazardous, mutagenic, teratogenic 1 or carcinogenic, such as cytotoxic drugs used in cancer treatment and their metabolites;  radioactive waste : such as glassware contaminated with radioactive diagnostic material or radio therapeutic materials;  heavy metals waste : such as broken mercury thermometers

3. Segregation of Waste

4. Of the total amount of waste generated by health-care activities, about 80% is general waste. The remaining 20% is considered hazardous material that may be infectious, toxic or radioactive.

5. What Should Go in the Red Bag? Most infectious waste streams DO NOT go in red bag Items that do are generally derived from this category: Blood and body fluid contaminated items that are “saturated or dripping” and “those caked with dried blood or dried body fluids.”

6. Safety First! While we’re talking about RMW(Regulated Medical Waste) minimization, NEVER compromise safety and compliance.

7. and what should not belong in red bag trash Unless visibly soiled with blood  Bed Pans  Empty specimen containers  Dressings and gauze  Diapers/Incontinence Pads  Splints  Masks, gowns, gloves  Tapes  cotton  Emesis basins  Urinals  Paper towels  IV bags  Casts and splints  Packaging materials  Foley bags

8. Why Bother Segregate Wastes? Biohazard waste is 10-13 times more costly than regular waste.

9. 10 Steps to Reducing RMW  1. Understand State- specific RMW definitions  2. Identify true waste costs and potential costs savings  3. Create a team to develop goals and an action plan  4. Planning for waste segregation  5. Container placement and signage  6. Worker Training and Education Plans and Policies  7. Sharps Management  8. Problem Identification and Resolution Plan  9. Waste treatment and waste handling  10.Track progress, report successes, and reward staff!

10. Lippitts Theory of Change  Phase 1. Diagnosing the problem. Project management  Phase 2. Assess motivation and capacity for change  Phase 3. Assess the change agent’s motivation  Phase 4. Planning the change  Phase 5. Choose the appropriate role for the change agent  Phase 6. Maintaining the change  Phase 7. Terminating the helping process

11. Economic Impacts Of Waste The average hospital provider spends $72 million/year in supply chain materials. Majority became waste. 7000 tons of waste every day and $10 billion annually in disposal costs

12. Best Waste Practice Hierarchy FACTS: Health care facilities can generate up to 25 pounds of waste per day per patient; For every pound of product manufactured in the United States, 32 pounds of waste are created during the manufacturing process, and transportation also adds to the environmental impact of products a hospital purchases.

13. Why bother to reduce waste?  Waste management initiatives offer tremendous opportunities for a facility to reduce both its environmental footprint and its supply chain and waste disposal expenses.  Estimates of cost savings can be as high as 40–70% of waste disposal outlays, representing $4–7 billion in savings for the industry as a whole.

14. Post signs

15. Location, Location, Location!

16. Staff Education Properly training staff and ensuring adequate procedures like clearly mandating use of correct waste containers is critical to ensuring program success.

17. Tools and Resources  Greenhealth Tracker  Green Guide for Healthcare (GGHC.org)  EPA Waste Wise Program  EPA Waste Reduction Model (WARM)  Zero Waste Alliance  The Story of Stuff

18. References Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management - UK, 20(1), 32-37. Practice Greenhealth. Topics. Waste. Retrieved from https://practicegreenhealth.org/topics/waste Sustainability Roadmap for Hospitals. A Guide to Achieve your sustainability Goals. Topics. Waste. Retrieved from http://www.sustainabilityroadmap.org/topics/waste.shtml#.U0u7xWDD_IU http://www.sustainabilityroadmap.org/topics/waste.shtml#.U0u7xWDD_IU Yeshnowski, M. Minimizing Regulated Medical Waste. Retrieved from http://wsppn.org/pdf/hospital/04_2%20Minimizing%20RMW_AZ.pdf