Wastefulness in healthcare

[Emergent]

I'm pushing to start a program to reduce wastefulness where I work. Not only is it expensive but it's environmentally deleterious.

I'd love to hear ideas from you all.

[Davey Do]

Sutures.

Back when I worked in OR, I would keep the suture packets that were dropped on the sterile field and not used.

They came in handy one time I laid open the web between my thumb and index finger and had to sew myself up.

I figured if Rambo could do it, so could I!

[Leader25, ASN, BSN, RN]

thermometer covers, they use a new one every 3 hours,when one for same patient would be ok. They are only used under the arm.

too numerous to list....

[NormaSaline]

One of the fastest ways to draw negativity toward myself and fight with others is to suggest a return to non-disposable syringes. I do it anyway. There has got to be a way to throw away the needle only. Human ingenuity truly knows no bounds. I believe we can do it.

NS

[MelEpiRN]

I once saw a facility that used paper washbasins instead of plastic. I thought that was cool (except having never used one I don't know how they hold up in practice).

But yeah, I think a lot of the waste comes from infection prevention practice.

[guest974915]

I'm with Davey Do on charting-a big time waster that seems like it could somehow be better streamlined. What also comes to my mind, are facilities that cheap out and utilize a bare bones approaching for staff-i.e. no or minimal ancillary staff. Not that I am above assisting a patient with ADLs or the near constant answering of telephones/call lights, but is that perhaps not the most efficient use of professional staff?

[Daisy4RN]

Along with what others have stated regarding the waste because of infection prevention (or perceived risk) I think that there is much waste because patients believe that they are entitled to superfluous demands/supplies (did I use that word correctly @Davey Do, I have to admit I had to look it up LOL), or because of the facility going overboard r/t risk of litigation.

That said I agree with what others have stated re: waste of medical supplies. @Emergent there are charity organizations that hospitals/clinics can donate extra supplies that will be use internationally in poorer countries. Some will even accept expired supplies. You can search for these in your area and try to see if your hospital will donate.

Start at Charity Navigator, or try these, Samaritans Purse or Project C.U.R.E.

One of the hospitals I worked at did this, it was nice to see those supplies (that for some reason we deem unworthy, hello regulations!) used for people that otherwise would not have them.

I have also tried to cut down on waste on the unit but to no avail. Good luck!

[JadedCPN, BSN, RN]

At my current hospital, our scheduled medications are dispensed and delivered from pharmacy to the bedside drawer in the most wasteful way I have ever seen in my career.

If a patient is ordered for gabapentin pills, for example, they will place the three pills into a very small zip lock type bag with the appropriate pharmacy label on it. That baggie is THEN placed into a big paper envelope, with another pharmacy label on the front of it. Repeat that for every single individual medication that is ordered for the patient. Such a waste.

[NutmeggeRN, BSN]

I would like to see prescription bottles reused. Label removed, cleaned and sent back to the pharmacy.

[amoLucia]

Anything that comes in a pre-filled/assembled KIT becomes fodder for the Waste Police. Esp wasteful is the opening of SUTURE SETS (so someone can cannibalize the scissors). Staple removal sets also count. As does foley/straight catheter trays (somebody wanted the KY lubricant). What surprises me is that someone will open a perfectly sterile setup, remove a piece and then leave the remainder setup there on the shelf. Like will anyone of YOU use a setup where the sterility may have been compromised?? I know I won't use it.

What about glucometer strips bottles that have the coded calibrating chip ... someone will open a new bottle of strips but DOES NOT check that the calibration chip MATCHES the bottle's code number. Then next someone comes along, notes the discrepancy, and has to remedy the situation which is usually the disposal of the remaining gluco strips. Then a NEW bottle is opened. I can't assure that the prior readings are really TRUE readings that have NOT been compromised by the inaccurate chip. Better still, I wonder if pts have been treated based on those WRONG chips. Ya think?!?

Another favorite of mine is the sterile IV drsg kits that will be opened only to remove the clear biofilm/opsite date drsg because the original first one got all sticky-ed up and a new film is needed.

Nurses will open IV flush syringes but not use them and they leave them for someone else to go ahead and use. Like oh yeah ... let me use a syringe whose sterility I can't ensure or that the substance hasn't been replaced!!!

Now I retired from LTC. These 'wasteful' items are mostly NURSE wastes. Wastes by CNAs are numerous also. Sometimes I would try to start simple programs designed to slow down wastes but with little effect.

Sometimes I think the only way to impact those wastes would be to require that no access to supply areas that necessitated staff to have to sign out supplies.

I could continue on and on.

[Orca, ADN, ASN, RN]

8 hours ago, MelEpiRN said:

I once saw a facility that used paper washbasins instead of plastic. I thought that was cool (except having never used one I don't know how they hold up in practice).

I wonder if they use the same kind of coating that is used on the inside of fast food restaurant drink cups to keep the water from soaking in. If so, this renders them unrecyclable and it greatly reduces their utility. The plastic ones can at least be recycled.

[Leader25, ASN, BSN, RN]

8 hours ago, MelEpiRN said:

I once saw a facility that used paper washbasins instead of plastic. I thought that was cool (except having never used one I don't know how they hold up in practice).

This reminds me ,many decades ago they used paper undershirts in the nursery,so soft,felt like cloth,the ends even folded over to make a mitt.

[beekindRN, ASN, RN]

We have a program where we can donate unused items for overseas. Not sure the name but I work tomorrow night -- I'll try to find out for you. We can donate anything that wasn't "contaminated," like from an isolation room or with bodily fluids. But unopened oral care kits are a heavily donated item; we do q2h oral care kits and often patients won't need all of them.