STUDENT RESEARCH: biohazard waste?

[Designstudent]

hello everyone!

we are now starting our final semester, which means finalizing our project and building a model to present and the end of the semester.  we have thought of possibly adding an new feature that combines a couple of our already existing concepts.  What we want to do is address the waste issue.  not necessarily the paper waste from random things that you guys might have like food wrappers or kleenex, but the actual medical waste that accumulates from a dialysis session.  the problem is since we couldnt do a visit we dont know how much there is    just from me and tony brainstorming we figured that there would be a seringe, the tubes that transport the blood?, and filters for the dialysis machines?, do these things get changed often or only once a month? i would assume they get changed every time but that is an assumption that i would hope that you all could clarify this for us.  please let us know

alan and tony

[Rerun]

Are "gloves" considered Medical Waste?  They go through a box per shift per person.  Lots of damn gloves.  They use 3 to 4 syringes during my run.  They do reuse some dialysors but only about 25 times.  Some clinics don't reuse at all.  Of course tubing is disposable.

[kitkatz]

Some dialyzers are reused for twenty five to forty times depending on the patient's and staff's demands and clinic policy. There are dialysis hookups to consider with the lines to and from the patient that are hazardous waste, the needles used on the patients, needles from the epo and iron shots and other medication, as well as non reuse dialyzers.  There are also considerations for cleaning the chairs and tables used.  Where do you throw away the bloodied junk, too?

[BigSky]

Here some of us do have the reuse kidneys.  20 times max.   They are capped on all ports and put into a container then taken and cleaned, disinfected and tested, then labeled and put away for the next time person comes in for treatment.

Syringes, needles go into the sharps container.

Tubing and one time kidneys  goes into the medical waste containers.

Gloves go to garbage and sheets and blankets used go to laundry basket.

Chairs and machines are washed between treatments of patients.

[Zach]

No reuse here.  Everything is thrown out in a hazard bin.

[okarol]

I think you should really visit a few different dialysis centers - they vary greatly.
Better yet, do what this woman did: http://ihatedialysis.com/forum/index.php?topic=1931.msg26163#msg26163

[Hawkeye]

There are many things used during a treatment that are considered hazardous waste.  Depending on the type depends on how it is disposed of initially. 

Sharps
All needles, syringes, and glass vials from medication.  Basically anything sharp, anything that may have a needle attached to it, or anything that may be able to be easily broken such as glass medication vials.  Items don't need to have come in contact with the patients blood or dialysate to be discarded in this way.  They just need to have the potential of causing cuts and bleeding.  Larger items such as lightbulbs would not be considered as a sharp since they would not be discarded in a treatment area.  Some clinics have sharps containers mounted on the walls, some on the machines, and some on rolling carts.  All containers vary in size, but a few common rules apply to them all.  Do not shake the container to make more room, and empty the container when it reaches 1/2 to 3/4's full.  All sharps containers I have seen even have a dotted line on their labels showing you when to empty it.  Once it is full to this point close the opening of the bin and discard into one of the larger waste company bins.  Make sure that if you are putting these into an empty bin that you have a bag in the bin first.  You can also add sharps bins into partially full bins from the treatment floor as long as you can still tie the bag and the lid still closes securely.

All Other Medical Waste
All other medical waste is kind of a broad category.  All dialyzers are discarded this way single use or reuse when the have lived out their time.  All bloodlines must be discarded this way.  The rest of it depends on if there is any blood on the item.  Things like gauze, blue chux/underpads, gloves, tape, drape sheets, and so on only need to be put in the Biohazzard bins if they have been "Soiled".  If they appear to be clean they can be put into the regular trash bins.  Regular Biohazzard bins also vary from clinic to clinic, as do the policies on how they are changed.  Some have bins that stay on the floor that look like big red garbage cans that get filled up during change over, once they get full other bins from the waste company get wheeled out and the bins on the floor get transfered into them.  This is how we do it at my clinic.  If going this route it is important to remember to put a bag in the bin from the waste company before transfer the bag from your bins.  Tie the bag closed from your bin put it in the waste companies bin, and tie that one closed too.  This keeps any tears that may have occurred during transfer from making a big mess, plus the waste compnay does not have to take any bins that have not been properly tied and closed.  The other popular route is to just have the bins from the waste company on carts and wheel them out during changeover to be filled.  When changeover is done it can be wheeled back to your waste room to be tied and seeled, or left in the waste room to be filled up the rest of the way during the next changeover.  Some clinics don't like this way because though it may be more convenient, the bins from the waste company are always very beat up and trashy looking.

Proper Packaging
If you do not properly close your sharps containers, discard medical waste loose in the waste company bins, overfill the bins causing the lids not to fit or stay closed, or making the bins too heavy (yes they are supposed to have weight restrictions to keep the waste compnay employees from hurting their backs) the waste company driver can refuse to pick up those bins until you have corrected the problem regardless of if you have the room or not to store them.  The closing of the sharps containers, the tying of the bags and making sure not to over fill the bins are the big ones.  Most drivers will take the bins even if they are heavier then they should be.

Hope I have helped answer your question and maybe given you more info to chew on.  For more info about proper waste handling try going to one of the waste companies such as www.stericycle.com.  This is the company Fresenius uses for their U.S. medical waste company.

[jbeany]

My center doesn't reuse anything.  They treat 40+ hemo patients every week.  (11 chairs, Two full morning shifts, one full afternoon shift, and one partial afternoon shift.)  For each patient, for every session, they use and pitch into a biohazard bin,  the filter and two long tubing lines, two needleless syringes used to start the blood flow from the needled lines in the acess, multiple pairs of gloves, and an assortment of bloody gauze, bandages, etc.  They put the needles in a separate sharps container - and that includes the two they use each time to hook up anyone with a graft or fistula, and the ones they use once each week at the beginning and end of the session to do blood work.  I'm not sure what they use for someone with a cath.  The sharps container also gets needles for all the doses of other meds - at least one each week for most of us, for things like epo, etc.  All the empty saline bags also go into the biohazard bins.

There is a big sharps container next to every chair, maybe 1ftx2ftx 3ft high.  The biohazard bins are even bigger - like big outdoor trash bins, and they have several in random spots around the unit.  Sorry, I don't know how fast they fill up, but given the amount of waste we produce, I doubt it takes more than a day or two to fill them.

[Designstudent]

thans everyone for all the input  and keep it coming if there is anything else to add.  in hindsight this is something we should have addresses much earlier, but it wasnt the main focus of our project so i guess it got put on the back burner, but with this info i think we can definately come to a good solution.  and i will TRY to post a few teaser pages from out presentations on photobucket or something so you guys can get an idea of what we are doing 

alan

[kitkatz]

I think small biohazard containers that could be emptied throughout the day in each cubicle.  Or else with your panel system have them attached to the back of a panel.

[Designstudent]

I think small biohazard containers that could be emptied throughout the day in each cubicle.  Or else with your panel system have them attached to the back of a panel.

you must be a genius kitkatz...    we pretty much are already going down those lines, thats funny. we are trying to implement it into the panels, tony is working on this particular part, i know he has been checking in on the forums so ill make sure he sees that you said that. we also got some good info form that link okarol provided 

kitkatz... did you post some feedback on the pictures thread? i know you gave us alot of info during our research questions..  your obligated!

alan

[tamara]

I was just thinking implement them onto the panels and possibly send them to a chute to be all collected in a larger disposal area, saves time collecting them for staff, and all is required is a disinfection wipe of the area where you insert the waste in the cubicle.