Perioperative nurses can incorporate the various Operating Room procedures to minimize the risk of patient harm. A discussion regarding the literature detailing medical waste and perioperative nursing is not complete without a discussion involving the clinical impact of medical waste.
In Volko's 2002 article "Contact with Hospital Syringes containing bodily fluids; Implications for Medical Waste management regulation," detailed the results of a study wherein the use of syringes was examined in their conjunction with medical waste. The objective of the study was to determine the amount and body fluids of these syringes (Volko, 2002). Syringe use was surveyed at a tertiary care center or a period not exceeding seven (7) days. Syringe use was categorized into four different components. These components included: (1) Contained Blood at the time of use; (2) Contained other bodily fluids; (3) Used exclusively for drug dilution and application and (4) Intramuscular; Subcutaneous and Intradermal IV's (Volko, 2002).
As a result of the study, approximately 17% contained blood during use; 4.8% had other bodily fluids within; 73% were used exclusively for drug dilution and .5% were used during injections (Volko, 2002). The study concludes there is an urgent need for a review of the management of medical waste. Updating the process and standards will improve the management of medical waste and reduce the probability of environmental damage (Volko, 2002). The Volko study serves to express what has been a looming theme in perioperative research in relation to medical waste.
Ultimately, Nurses and other hospital staff are at the mercy of the Hospital Administrator in terms of budget allocation. Incorporating enhanced standards for the maintenance of medical waste requires increases in training, possibly staff and improvements in the facilities that store and collect the medical waste. This requires the hospital to expend resources, in times when resources are stretched thin this necessity may fall by the way-side as other more pressing matters...
Each individual or group has a vested interest in improving the handling and storage of medical waste. From a purely economic perspective, the cost-benefit analysis of medical waste would afford the Hospital Administrator to enhance cost effectiveness by allowing for the improvement of procedures that ultimate will reduce waste and therefore costs.
The Board would be in favor of improved processes in that it would reduce the possibility of a patient securing an infection due to tainted or toxic instruments being used in a procedure. Physicians would logically be in favor of improved Perioperative procedures in that their patient would have a faster recovery time and it would avoid unnecessary complications. The one barrier to implementing effective change is that all effective change requires a staff with the appropriate level of training to carry out these changes and if the cost of increasing staff or increasing the required training outweighs the benefits then it will remain difficult for the Perioperative nurse to convince the main stakeholders who control the purse strings to allocate scare resources to improve medical waste management practices.
References
"Nurses can make a difference: Environmentally responsive health care," the Nightingale Institute for Health and the Environment, http://www.nihe.org (accessed 6 January 2011).
Melamed, a (2003). "Environmental Accountability in Perioperative Settings" AORN, 77(6), 1157-1168
Owens, PJ (2005) "Challenges of International Disaster Relief" Disaster Management and Response, Spring 2005
Anderson, LG (1992). "Medical Waste Management: Implications for Plastic Surgery Offices and Surgicenters" Plastic Surgical Nursing, 12(1): 7-12
Volko,…
