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.
Specializes in Nurse Leader specializing in Labor & Delivery.
As someone else said, putting it in the sharps or biohazard containers is a huge waste of resources. Unless it has blood on it, I remove the needle, throw the needle in the sharps, and throw the syringe in the regular trash.
Specializes in Nurse Leader specializing in Labor & Delivery.
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.
IMO there is no difference. In OB, we deal with a lot of blood on an ongoing basis. Every time the woman goes to the bathroom, she throws a bloody pad in the trash. Meanwhile, the nurse changes the bloody chux that's on her bed. It too goes in the regular trash. Unless it's absolutely saturated, we don't put it in a red bin. We keep red bins in the L&D rooms for throwing everything away immediately after delivery (lots of blood, placenta, fluids, etc). We don't keep red bins in the postpartum rooms.
Specializes in Nurse Leader specializing in Labor & Delivery.
No you don't. I used to buy syringes all the time (from a vet supply company, no scrip needed) for my business.[/quote
lol, i was wondering how long that was going to take.....i didnt mention it on purpose!....but to go to the pharm. and buy them, yup. you do.
I guess I'm missing your point, then. I thought the point you were making is that syringes themselves are "controlled" and the general public doesn't have access to them, and I'm saying no, they're not "controlled". Anybody can legally buy syringes *somewhere*, no scrip needed.
We take off dressings, 2X2's with blood from drawing blood, empty used urinals/bedpans and place them in the garbage at the bedside. In fact this is consistent regardless of the type of isolation room the patient is in. The regulated waste requirement according states it has to be "saturated" to be placed in the regulated waste disposal system. This means when you pick it up, the fluid has an opportunity to leak or drip from the item.
I guess what I am saying is to me, placing these saline flush syringes without needles into the red box just does not make common sense. It is almost as if it is being done because emotionally it "feels right". People look at these and because they are visually similar to syringes with needles, they want them in the sharps.
I really believe strongly in evidenced based practice. Until someone can show me real evidence that these are any more hazardous than dirty dressings, chux, used emesis basins, urinals etc., it just doesn't make sense to me.
From the above I am excluding needleless syringes that have gross blood on/in them, have any gross medication in them, or have a needle attached. Having said that, whatever my facility decides I will follow. I just wouldn't do it if it was my money paying to expensively dispose of them. Unfortunately the type of facility I work at, we are all paying for it in our taxes.
This is a NEW policy? I can not believe this was not already standard. I use to work for a needle exchange program, you do not know what people will do for a needle OR syringe...it needs to go into the sharps container; needle or not!
So what you are saying is that this is an "access" issue not an infection control issue?
I am being completely serious. So we are paying all this money for disposal to prevent the VERY VERY small percentage of patients from picking through the trash and grabbing a needleless syringe?
I am not familiar with drug addicts and their deceptive behaviors. What exactly can they do with a syringe without a needle. Well I guess the more I think about it, I suppose they could but their drug in water and submerge the luer lock tip of the syringe into to it and draw it up and inject into their IV. But honestly I feel that if they are going to go to that extent for a high, they will find a way with our without our discarded syringe. Maybe the cost/benefit would be met on a drug rehab unit or psych, but I don't see it on my unit.
Also for the rest of you, can you honestly say that ALL unused saline flush syringes in your facility are under lock and key? None are in the rooms or on med carts? If we are the only facility that is not doing so, then maybe that is a problem we need to address as well.
If you're in NYS it is legal for anyone (over the age of 18) to obtain syringes AND needles through the Expanded Syringe Access Program (ESAP).
I completely agree- most people who are unnecessarily and inappropriately putting every single syringe into Sharps containers are doing so because they 'feel' like they should, or because that's what they were taught to do. It's not EBM, it's emotion and tradition. And it's a waste of resources (money).
Put the trash where it's supposed to go and give people access to clean syringes and needles via the appropriate channels.
Thanks for bringing this up. It happens to be a pet peeve of mine :-)
What The Law Says
Licensed pharmacies, health care facilities, and health care practitioners who can otherwise prescribe hypodermic needles or syringes may register with the New York State Department of Health to sell or furnish up to 10 hypodermic needles or syringes to persons 18 years of age or older.
Persons who are age 18 years or older may legally obtain and possess hypodermic needles and syringes through ESAP- without a medical prescription.
Specializes in Nurse Leader specializing in Labor & Delivery.
Also for the rest of you, can you honestly say that ALL unused saline flush syringes in your facility are under lock and key? None are in the rooms or on med carts? If we are the only facility that is not doing so, then maybe that is a problem we need to address as well.
Saline flushes are often kept in the room, resting on the pump, etc. In addition, at the facility I used to work at as well as the one I work at now, many common supplies, including syringes of various sizes, were kept in unlocked cupboards in every L&D room.
If the concern is simply access to syringes, it doesn't make sense to throw them in a sharps or biohazard container (which is very expensive to dispose of, and the facilities are charged by weight). The facility should just have a policy to not throw them away in pt rooms, but rather throw them out in the pyxis room.
It may have more to do with housekeeping seeing a syringe in the trash and not being able to tell if there is or isn't a needle attached. They may not want anyone to get used to putting any type of syringe in there at all.
A sharps container is exactly that... a SHARPS container. needless syringes ARE NOT supposed to go into them. The hospital can actually get fined by OSHA per peice of non sharps material in the container. They are meant to dispose of needles and ampules, scalples and suture needles. I have plenty of experience with this in my business of biohazard cleanup and the regs around it.
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klone, MSN, RN
14,857 Posts
As someone else said, putting it in the sharps or biohazard containers is a huge waste of resources. Unless it has blood on it, I remove the needle, throw the needle in the sharps, and throw the syringe in the regular trash.