139 - Reducing Red Bag Waste in the Operating Room
Description: Reducing Red Bag Waste in the Operating Room Elisha Rines RN and Jordan Guinto RN Description of Team Two Operating Room (OR) staff nurses enrolled in the Nurse Residency program identified excessive Red Bag waste was being generated in the OR secondary to staff’s lack of knowledge regarding appropriate waste disposal. Preparation and Planning The two new-to-practice nurses discussed their concerns with the department manager, director, and clinical educator. Additional meetings included the directors of Environmental Services (EVS) and Infection Control departments. Requirements for items to be discarded in Red Bags and standards for regular waste disposal were reviewed. Discussion included safety standards, processes involved, and costs for Red Bag waste management. Assessment As new nurses to the OR, we noticed that many staff were non-compliant with requirements for Red Bag waste and that non-red bagged items are being placed in a red bag trash receptacle throughout many cases. Most of these improperly discarded items were not bloody or soiled contaminants, therefore, did not require to be discarded into red bags. The need to educate staff on this excessive cost to the environment and our organization became clear. A three-day trial was completed in order to establish a baseline of Red Bag waste volume. Implementation We developed a program of education in coordination with the OR management team, the department educator, and the directors of infection prevention and EVS based on our assessment. The aim was to positively impact institutional costs and the environment by increasing staff knowledge and awareness. Outcomes After staff education we re-evaluated red bag waste for a three-day period mirroring the initial three-day baseline assessment. Prior to the education intervention, Red Bag waste for day one was over 880 lbs., day two 1040 lbs. and day three 1,040 lbs. Post intervention, Red Bag waste was measured at 800 lbs., 640 lbs. and 160 lbs. respectively. Reminders about Red Bag waste were incorporated into daily huddles. We found that daily reminders were effective in increasing staff compliance. After six months we re-evaluated and results indicated that staff remained compliant with waste disposal standards. Implications for Perioperative Nursing The education intervention resulted in great improvement to our department processes. We were able to dramatically reduce total Red Bag waste with significant savings to our organization and the environment. With the department’s teamwork we were successful in achieving this goal. Continuing education is ongoing with all involved. New staff are in-serviced to ensure they understand the requirements and standards so they can maintain compliance. This quality improvement project demonstrates that new-to-practice nurses can make significant improvements to the organization when given the support of a Nurse Residency program.