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At least 73 records · Page 4Linked to original sources
PubMed1995

An outbreak of needlestick injuries in hospital employees due to needles piercing infectious waste containers.

OBJECTIVES: To investigate the cause of an outbreak of needlestick injuries (NSIs) in hospital employees. SETTING: A 700-bed university hospital. DESIGN: Outbreak investigation, laboratory evaluation of a medical waste disposal device, cost analysis. METHODS: Employee health department records were reviewed of workers suffering sticks from needles piercing fiberboard-contaminated material containers (CMCs). A laboratory evaluation of needle-puncture resistance properties of the CMCs was performed using a testing apparatus. The cost of a hospital waste disposal program using fiberboard CMCs was compared with the cost of a program using rigid plastic (polypropylene) boxes. RESULTS: During 40 months of surveillance in 1986 and from 1989 to 1991, only one NSI had occurred from a needle piercing a CMC. During 9 months in 1993, 13 NSIs occurred due to needles piercing CMCs (P < .001). No clinical illness resulted from the NSIs. The outbreak was halted by a temporary change to plastic (polypropylene) boxes for sharps disposal ($4.92 to $23.33/cu ft) until receipt of a box with a newly designed solid fiberboard liner ($1.25/cu ft). CMC liners used during the epidemic had a mean needle puncture resistance of 527 g, as compared with 660 g for liners used before the outbreak (P < .001). The new solid fiberboard liner has a mean puncture resistance of 1,765 g. A program of waste disposal using fiberboard CMCs was found to cost approximately one-seventh the cost of a program using plastic boxes for disposal of infectious waste. CONCLUSION: A program for infectious waste disposal using fiberboard CMCs can be safe and cost-effective if appropriate standards for puncture resistance are met.

Containment of Biohazards↗
PubMed1990

Environment, cost concerns spur new interest in reusables.

Disposable linens have blanketed the hospital market since the 1970s, but reusable products are attracting renewed interest. Sparking the reassessment are elevated costs of medical-waste disposal, innovations in recycled linens and blossoming environmental concerns.

Bedding and Linens↗
PubMed2006

Turkish nurses' information about, and administration of, chemotherapeutic drugs.

AIM: The aim of this study was to determine both the level of information that nurses possessed and the method of administration nurses used during chemotherapeutic drug preparation and administration. BACKGROUND: While compliance with the regulations related to chemotherapeutic drug preparation and administration seems to be very difficult, it is at the same time vital. METHODS: This descriptive study was conducted between 1 May 2002 and 1 May 2003 in the chemotherapy administration units of all hospitals in Eskisehir, west Turkey. The sample consisted of 121 nurses. Data were obtained first via questionnaire forms developed by the researchers to learn the level of awareness concerning exposure to chemotherapy. This was then followed up by the completion of observation forms during drug administrations. RESULTS: The average score for information levels pertaining to nurses' protection of the environment was 7.82 +/- 0.38 of a total of 14 points, and that of self-protection was 7.94 +/- 0.24 of a total of 11 points. Nurses showed that their actual administration method was insufficient according to their level of information, with average administration evaluations of 5.46 for protection of the environment and 6.59 for self-protection. The ratio for nurses' usage of the safety cabinet during the preparation of chemotherapeutic drugs was very low at 14.2%. Only 7.4% of nurses had received in-service education about chemotherapeutics. CONCLUSION: In order to ensure the taking of sufficient preventive precautions during the preparation and administration of chemotherapeutic agents, hospitals should be required to provide sufficient equipment and to give this precedence in hospital politics. RELEVANCE TO CLINICAL PRACTICE: Healthcare workers who prepare and administer chemotherapeutic drugs may experience the cytotoxic effects of the drugs through direct skin contact, respiratory and digestive system exposure, and these effects are vital to human life. Thus, it has been recognized that nurses' information and administrations during preparation and administration of chemotherapeutic drugs are of utmost vital importance in removing the harmful effects of chemotherapeutic agents.

Adult↗
PubMed1994

Measurement of insulin wastage in five Ontario hospitals.

This study was designed to determine the extent of insulin wastage and the extrapolated cost of wastage for Ontario hospitals. The five hospitals in the study were chosen to include differences in patient mix and drug distribution systems. Beginning and ending inventories of all insulin types were taken spanning a six-week period. The quantity of insulin dispensed and wasted during this time period was recorded. Partial vials were measured using a calibrated scale. Wastage was calculated as insulin discarded divided by the amount of insulin used in the time period. Insulin wastage averaged 34.1%. This was equivalent to up to $8,000 a year for the largest hospital surveyed and translates to an estimated cost of $360,000 a year in all Ontario hospitals. Therefore, hospitals should estimate their insulin wastage and seek ways to reduce it. The pharmaceutical industry should be encouraged to develop cost-effective insulin delivery systems.

Data Collection↗
PubMed1995

Planning equipment acquisitions.

As the mire of healthcare reform continues to grow, many providers are developing an insatiable appetite for alternatives to the way they currently do business. For some, solutions come in the form of repackaging the same old stuff. Others have jumped recklessly into every managed, capitated, or reformed idea that has come along. Old-school thinkers are still awaiting government direction. Providers of quality healthcare face increasing demands on their shrinking capital funds. An aging population, indigent care, AIDS patients, medical waste disposal, nursing shortages, declining reimbursement, increasing labor costs, and the federal healthcare reform threat have negatively affected cash flow. Though previous cost-plus reimbursement encouraged wasteful spending, the threat of healthcare reform has already caused providers and suppliers alike to work together to cut costs even without government mandates. The impact has been the closure of over 600 facilities nationwide in the past ten years. More than 70,000 acute care hospital beds have been lost from the US healthcare system. Many healthcare facilities have merged into managed care systems, integrated delivery networks, and regional alliances whose costs can be consolidated and controlled. At the same time, new services and profit centers are also being created to increase revenue. A healthcare moves into alternative care environments--home care, ambulatory care, diagnostic testing--these providers need more capital equipment to serve an increased patient load. Coupled with an aging installed base of technology in the acute care environment, healthcare managers face an ever-growing need for capital equipment and creative financing programs to meet longer payment options.(ABSTRACT TRUNCATED AT 250 WORDS)

Capital Expenditures↗
PubMed1997

Negotiating a sound physician office lease.

Physician group practices that lease office space should consider several issues before signing a lease. These issues include whether to hire a broker to assist in the search for office space, negotiating lease provisions that pertain to compliance with the Americans with Disabilities Act; confidentiality of patient records; proper disposal of medical waste and other hazardous materials; compliance with occupational safety standards; quiet enjoyment; and utility use. In addition, physician group practices that lease office space from other healthcare providers must ensure that the lease terms conform with antifraud and abuse safe harbor regulations.

Air Conditioning↗
PubMed1996

Outpatient wound care.

As patients are discharged from the acute care setting to the home care setting at a much earlier time in their recovery, surgical wound care will be delivered by patients, family members, and home health care providers rather than by the hospital nurse in a traditional in-patient setting. This trend, which began in the mid-1980s, is expanding to include not just surgical wounds but also surgical complications such as wound dehiscence and traumatic wounds healing by secondary intention. Intensive care nurses are involved in discharge planning from the time the patient is admitted to the ICU. Early planning and teaching regarding wound care, universal precautions, and medical waste disposal have become a vital component of preparing the patient for optimal continuity of care as the transition is made into the community.

Ambulatory Care↗
PubMed2002

Medical waste production and disposal arising from renal replacement therapy.

The treatment of end stage renal disease (ESRD) makes extensive use of pre-sterilised disposable items that are contaminated by blood or other body fluids following use. Commonly these items are incinerated. Because they contain substantial amounts of polyvinylchloride (PVC), their incineration releases polychlorinated dibenzo p dioxins (PCDD) and polychlorinated di benzo p furans (PCF), as well as heavy metals. A consequence of the release of these substances has been the introduction of legislation controlling waste disposal. These issues are likely to impact on the management of waste at the healthcare facility level. In parallel, new PVC-free materials for use in renal replacement therapies have been developed whose incineration is less controversial environmentally.

Environmental Pollutants↗
PubMed1994

Handling and disposal of contaminated waste and pathology specimens in general practice.

Medical practitioners have a legal obligation to dispose of surgery waste in a way that does not endanger staff, patients, or the general public. The practitioner has a responsibility to self and to family to minimise personal risk from infection. Contaminated waste must be segregated as soon as it is generated. It must be stored safely and appropriate precautions taken for sharps. Laboratory specimens must be transported safely. The methods of disposal must conform to State legal requirements.

Family Practice↗
PubMed1992

The medical waste audit. A framework for hospitals to appraise options and financial implications.

The generation, handling, and disposal of medical wastes involve virtually every department in the hospital. To enhance coordination, managers must comprehensively describe the total system and specify the roles of key functions and individuals. Hospitals produce about 77 percent of the approximately 500,000 tons of regulated medical waste produced annually in the United States. The amount produced by different hospitals varies, primarily because of differences in "waste-management practices." The Environmental Protection Agency is trying to develop a greater understanding of the types of medical wastes that are infectious, methods of transmission, and the likelihood of transmission in the handling and disposal of waste within the hospital environment. To ensure that medical waste is being handled and treated in the most cost-effective manner and with the least health risk to employees and the community, hospital administrators must undertake a comprehensive appraisal of the activities associated with the generation, handling, and disposal processes. A "medical waste audit" requires the following steps: Generation profile to identify origination points, categories or types of waste, and associated generation rates. Inventory of handling practices, including existing regulations, procedures and protocols, training programs, definitions regarding waste segregation, and documentation. Review of current disposal practices and existing and developing alternatives. Cost analysis

Accounting↗
PubMed2005

Medical waste management in Korea.

The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past medical waste was often mixed with municipal solid waste and disposed of in residential waste landfills or improper treatment facilities (e.g. inadequately controlled incinerators) in Korea. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better manage the waste from healthcare facilities. This paper presents an overview of the current management practices of medical waste in Korea. Information regarding generation, composition, segregation, transportation, and disposal of medical wastes is provided and discussed. Medical waste incineration is identified as the most preferred disposal method and will be the only available treatment option in late 2005. Faced with increased regulations over toxic air emissions (e.g. dioxins and furans), all existing small incineration facilities that do not have air pollution control devices will cease operation in the next few years. Large-scale medical waste incinerators would be responsible for the treatment of medical waste generated by most healthcare facilities in Korea. It is important to point out that there is a great potential to emit air toxic pollutants from such incinerators if improperly operated and managed, because medical waste typically contains a variety of plastic materials such as polyvinyl chloride (PVC). Waste minimization and recycling, control of toxic air emissions at medical waste incinerators, and alternative treatment methods to incineration are regarded to be the major challenges in the future.

Air Pollutants↗
PubMedDate not supplied

Disposal options for infectious medical waste generated during home-based dental care.

The number of dentists providing mobile care is increasing. One of the challenges the mobile dentist faces is proper handling and disposal of infectious medical waste generated during patient care. Mobile dentists must concern themselves with meeting Federal, state, and local regulations. Federal agencies that have jurisdiction over this issue are the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA). EPA guidelines are summarized and clarified with respect to pre-transportation and transportation issues. Compliance with OSHA standards are addressed through presentation of a sample protocol for handling infectious medical waste. It is beyond the scope of this paper to discuss in detail the policies of each municipality, and practitioners are advised to consult with state and local authorities regarding proper handling and transportation of this material. Using the information presented in this paper, the mobile dentist can approach this complex issue in an organized manner.

Aged↗
PubMed2000

[Measures for the disposal of non-regulated alternative medical wastes--cloned DNA of amplified DNA as waste materials].

Cloned DNA of amplified DNA, synthesized oligomer DNA and peptide nucleic acid is a candidate for hazardous medical waste material. The numerous identical base sequence of DNA has a risk associated with its handling in a laboratory and medical waste. To avoid the risk SD box, NaOCl, filtered chip of micropipette and a clean-bench are recommended for waste management.

Animals↗
PubMed2000

[Measures for the disposal of non-regulated alternative medical wastes--prion protein-polluted medical waste].

Transmissible spongiform encephalopathy (TSE), sometimes known as prion diseases, are fatal degenerative brain diseases. From epidemiological evidence and many investigations of data, the risk that TSE agents will be transmitted from TSE patients to other humans, is very low, but TSE agents comprise one of the very severe bio-medical hazards. Although government agencies, world organization and other institutions have distributed some guidances for safe working and prevention of infection, these guidances are not compulsory and no globally harmonized guidelines is present to date. Therefore, medical staff particularly in hospitals individually take countermeasures for safety against TSE agents by using these guidelines, and both the level and method differ in each hospital. In this chapter, transmission of TSE and related parts of guidelines from the Advisory Committee on Dangerous Pathogens and Spongiform Encephalopathy Advisory Committee in the United Kingdom recommending relatively strict standards are described.

Animals↗
PubMed2000

[Measures for the disposal of non-regulated alternative medical wastes--effects of disinfectants on activated sludges].

Effects on activated sludges of several disinfectants with strong and wide antimicrobial ability, were investigated using an oxygen up-take method. As a results, at the maximal non-reactive concentration of disinfectants, hexachlorophene has estimated value of 6 mg/l and shows the highest toxicity against activated sludges. At the lethal concentration of 50%, the toxicity of triclosan is the strongest disinfectant.

Bacteria, Aerobic↗
PubMed2000

[Measures for the disposal of non-regulated alternative medical wastes--safe handling of cytotoxic drugs].

It is easy to come into contact with cytotoxic drugs, by touching or inhaling small quantities of the drug-containing aerosols or dusts. Contact with cytotoxic drugs can cause immediate problems, such as dermatitis, dizziness, nausea, and headache. Studies suggest that repeated exposure to small amounts of the drugs many cause organ or chromosome damage, impaired fertility, and even cancer. The evidence is not conclusive, but an approach that will minimize the possible risks is needed.

Aerosols↗