Waste reduction on nursing units

meanmaryjean, DNP, RN · Dec 28, 2017

We did a HUGE project in the PICU I used to work in several years ago, and eliminated about 1/3 of what we kept in patient rooms. It was a lengthy process, and involved inventories to see what was really being used vs. what was just stocked because someone, sometime thought it would be handy. We also ended up locking up a LOT more stuff than we previously had as we discovered items being stolen by families.

I truly don't know how much it saved, but we did eliminate a lot of items from our inventory that were seldom used before expiration dates.

JKL33 · Dec 29, 2017

Hmm. According to your research, what items do your nurses waste the most? Perhaps if you tell us what is being wasted we might have some ideas.

KelRN215, BSN, RN · Dec 29, 2017

When I worked in the hospital, there was some initiative like this to save money. They asked us staff nurses for our ideas and promised us something in return if they used our ideas. Let me tell you, more than once they used my idea for some money saving initiative and I never go anything in return.

Some things we did-

Eliminate the tiny pink emesis basins that aren't big enough to vomit in anyway and were mostly used for holding toothbrushes (not my idea)

Eliminate digital/disposable thermometers that cost something like $8 each. We had expensive thermometers mounted on the walls at every bedside but people frequently complained that they "weren't working" and then just went and grabbed a disposable one. Some patients ended up with multiple of these thermometers at their bedside which would then be thrown away at discharge. It didn't take much effort to figure out that the issue with the wall mounted ones was that the person in charge of replacing their batteries wasn't doing that. I created a log sheet that was kept at the front desk for people to record when there were issues with these thermometers and then our supply guy could check that daily and know which batteries he had to change. (Thermometers were locked in their wall mounts so you needed a key to change the battery and, of course, nurses didn't have access to said key.) I also arranged for a couple extra of these thermometers to be on the floor on wheels so that they could be used if there was an issue with the bedside thermometer without having to waste one that would be thrown away.

Eliminate disposable stethoscopes. Everyone had their own and these frequently ended up at bedsides but were rarely used and then thrown away at discharge. Out of habit, people put these in the rooms of anyone on precautions but when we actually looked up the infection control policy, it said "dedicate equipment OR disinfect after use." There was no reason to have these things as long as people could be diligent about disinfecting their equipment.

Another money saving idea of mine (unrelated to supplies) they used and never gave me credit for was eliminating our weekend on call program. It was a program where they paid people minimum wage to be on-call and then paid them overtime if they were called in. This could only be used in the event of a call out and was a last resort- they'd go to the registry, try to get a float from another floor or try to find someone who wanted to come in in exchange for another shift off before they called in the on-call person since said person had to be paid extra- and was rarely used so basically they were just paying people to be on-call knowing that these people would never be called in. We were a normal floor that had to have staff 24 hrs/day, not an OR or Radiology that didn't regularly do cases at night and needed an on-call team. And our census usually dropped on the weekends anyway.