needleless syringe disposal

[MsRehabRN]

I am looking for some input from other nurses's that work in hospitals. Recently our Nurse Manager sent out an e-mail to all employees stating that ALL needleless syringes were to be disposed of in the sharps disposal box. On our unit, this primarily consists of BD posiflush saline flush syringes. The e-mail had no policy attached or rationale behind the statement.

I have been researching medical waste disposal regulations in NYS, including information on the DOH and DEC websites, and cannot locate anything to support the need to dispose of used needless syringes in the sharps container (unless of course it has visible blood on/in it). Staff should assume ALL waste in the regular patient garbage is potentially contaminated and should not be handling it without using standard precautions/gloves.

Our hospital is cutting staff/hours, micromanaging the use of supplies, and has even asked us not to bring in our own cups and not use the hospitals paper cups. I do know that the cost of incinerating sharps containers is calculated by the pound and very expensive. I just hate to see us spend money on something, incinerating needless syringes, out of ignorance and not facts.

Are there any nurses here that work in NYS that have researched this? Not to be mean, but I am not looking for what people "think" or "feel" should be done, but what the regulations require.

Thank anyone in advance for their input!

[P_RN, ADN, RN]

The needless syringes I have seen can still have a needle attached. Paper waste is shredded and burned as are the contents of the sharps containers here. I see a reason here. Who is to say that someone wont put the wrong syringe (a sharp) in the wrong (paper) container? This may be too much micromanaging.

[Penelope_Pitstop, BSN, RN]

My syringes go in the sharps container once used, no matter if there is a needle attached.

Why? I do not allow anyone access to syringes. The new ones are locked up in my drawer, my med cart, or the clean room. I'm not putting a dirty one just anywhere.

Patients do take these and use them to "help themselves" to their IV sites. And guess who's at fault there? Why, the nurse of course!

[morte, LPN, LVN]

if they are needle adaptable, they are still a "controlled" item.....need a safe, secure disposal. As stated above, if in regular trash they are available to the general public.

[GM2RN]

At my hospital, syringes that have been used to draw up medications, as well as the empty med vials, go into the sharps containers so they can be disposed of without residual medication getting into the soil or water supply.

[NurseLoveJoy88, ASN, RN]

I've always seen and have put needless syringes in the sharps container. My nursing instructor drilled that into me.

[mappers]

Yep...You don't want a patient helping themselves to syringes. Put them in the sharps container.

[canesdukegirl, BSN, RN]

Yep. Sharps. Period.

[SlightlyMental_RN]

My syringes go in the sharps container once used, no matter if there is a needle attached.

Why? I do not allow anyone access to syringes. The new ones are locked up in my drawer, my med cart, or the clean room. I'm not putting a dirty one just anywhere.

Patients do take these and use them to "help themselves" to their IV sites. And guess who's at fault there? Why, the nurse of course!

Yep...I've seen patients decide to "IV push" meds that they've brought in off the streets. Definitely put the used the syringes in the sharps containers.

[l-styx]

i'm sure you already found this if you've been looking at the nys doh info, but it's pretty clear: if the syringe has not been grossly contaminated, and is not attached to a needle, it's not supposed to go into a red sharps container. you're right; it's incredibly expensive and not a good use of resources.

managing regulated medical waste

subcategory 4 - sharps

"this waste shall include but not be limited to discarded unused sharps and sharps used in animal or human patient care, medical research, or clinical or pharmaceutical laboratories, hypodermic, intravenous, or other medical needles, hypodermic or intravenous syringes to which a needle or other sharp is still attached, pasteur pipettes, scalpel blades, or blood vials. this waste shall include, but not be limited to, other types of broken or unbroken glass (including slides and cover slips) in contact with infectious agents. this waste shall not include those parts of syringes from which sharps are specifically designed to be easily removed and from which sharps have actually been removed, and which are intended for recycling or other disposal, so long as such syringes have not come in contact with infectious agents."

one point needs to be clarified.

no attempt should be taken to remove the needle from the barrel of the syringe.

to do so would only increase the opportunity for needle stick injury. the total unit should be placed in a sharps container and disposed of as regulated medical waste. in those instances, however, where

only the barrel of the unit is utilized

, as found for example in infusion pump setups, then the barrel can be disposed of as solid waste provided it did not come into contact with infectious agents.

[MsRehabRN]

I was the original OP.

If these saline flush are a controlled substance then we have a bigger problem in our hospital because "unused, new" ones are left out all the time. Extra ones are sometimes at the bedside, on the roll around computer carts, or on top of the Alaris pumps. I am not saying this is good practice, it is just reality at our hospital (and no I am not in management).

Can you give me some examples of what someone could do with an empty syringe without a needle? How would they draw up a med that came from the street? Honestly if this is a seasoned drug user, they are going to find away to get the drug in their system one way or another, with our without a needless syringe.

I did read the information from the DOH website and what I am struggling with is interpreting infectious agent. If it means the tip of the luer lock touching the port of an IV to flush for patency, then according to their regs it does need to go into the sharps container.

I guess what I am struggling with is what is the difference between the minute infectious agent on the tip of the leur lock and the amount on a dressing taken off a patient and placed into the garbage at the patient bedside.

[morte, LPN, LVN]

I was the original OP.

If these saline flush are a controlled substance then we have a bigger problem in our hospital because "unused, new" ones are left out all the time. Extra ones are sometimes at the bedside, on the roll around computer carts, or on top of the Alaris pumps. I am not saying this is good practice, it is just reality at our hospital (and no I am not in management).

Can you give me some examples of what someone could do with an empty syringe without a needle? How would they draw up a med that came from the street? Honestly if this is a seasoned drug user, they are going to find away to get the drug in their system one way or another, with our without a needless syringe.

I did read the information from the DOH website and what I am struggling with is interpreting infectious agent. If it means the tip of the luer lock touching the port of an IV to flush for patency, then according to their regs it does need to go into the sharps container.

I guess what I am struggling with is what is the difference between the minute infectious agent on the tip of the leur lock and the amount on a dressing taken off a patient and placed into the garbage at the patient bedside.

i specifically refrained from saying controlled substance, the syringe itself is the item to which i refer....to get syringes, you need a script.....It would seem to make more sense, economically, to crush them. Can you put forth a plan to collect them separately from the sharps?