Wastefulness in healthcare

gettingbsn2msn, MSN, RN · Jun 3, 2019

TREMENDOUS waste in healthcare. I am a nurse practitioner and the amount of paperwork involved is horribly wasteful.

My opinion is that healthcare is a business. The hospitals are making tremendous amounts of revenue.

My husband went for a treadmill test last week. We pay $700.00 plus per month for our policy. His treadmill test (at the hospital) was $8,900.00. We are responsible for 30% of that. My husband is not in healthcare so ASSUMED that it was covered since we pay so much per month.

We both have decent incomes. We will eventually have to file banktrupcy. These are not good times for healthcare.

I could write for hours on this topic. Unfortunately, I just finished my 5 minute lunch.

LikeTheDeadSea, MSN, RN · Jun 3, 2019

I think if big-box stores can create the "e-mail only" option for receipts and such, I think a computer generated PDF of discharge instructions should suffice. A log where the patient signs to state it was received in their e-mail would cut down on paper waste. The pharmacy uses the electronic signature now, if I was somewhere as a patient I'd be happy to do it that way. We almost all have our phones with e-mail capabilities on us all the time anyway, In 20 seconds I could confirm receipt.

**LibraSunCNM, BSN, MSN, CNM** · Jun 3, 2019

This is but a drop in the bucket of healthcare waste, but I’ve always thought it was crazy that we put a man on the moon 50 years ago but can’t figure out how to create a box for disposable gloves that doesn’t dispense half the box when you try to pull just one or two out. I’d estimate at least 10-25% of gloves are wasted just by falling on the floor.

kbrn2002, ADN, RN · Jun 3, 2019

The incredible amount of waste in LTC is appalling. We go through tens of thousands washcloths a year, mostly because many CNA's would rather throw away a soiled one than rinse it out and toss it in the laundry. Incontinent briefs and any personal care items that are put in a resident's room can't be used elsewhere and often are "stockpiled" in a room and need to be thrown away if that resident is discharged or passes away. All manner of nursing supplies are wasted. One of the biggest is dressing supplies. A bunch might be left in the room for convenience, then the order changes and they are all tossed. Some of those dressings are expensive! Those are just a few of the things that we as employees have some control over the waste.

The things on a system wide level that we have no control over though, cripes I could write a book! Just the mountains of redundant paper we shred! Why so much paperwork if everything is supposedly computerized? And we recycle exactly nothing. Everything in the garbage and off to the landfill! Where I live it's mandatory for residential homes to recycle, so why are businesses exempt from this? Well, I take that back, we do recycle something. We have a cardboard dumpster that is only for corrugated cardboard so the boxes that our supplies come in at least go to recycling, but that's it. We even have massive amounts of waste with meds. Somebody will get an order for an off the wall OTC med, so instead of buying a bottle as needed, let's order a case! So of course off to the garbage when the majority of it expires before being used. And that's just nursing. Don't even get me started on the waste in dietary. Just the amount of food that is thrown away every day is astounding.

Gampopa · Jun 4, 2019

Single patient use lift sheets and hover mats! Designed so they cant be cleaned and go right to the landfill.

brownbook · Jun 4, 2019

I'm holding a McKesson Sterile Tongue Depressor. It is in it's original paper wrap, undamaged, no stains or tears, on the wrap, yet it expired 2009/09????

Going to McKesson or other hospital suppliers and requesting they repackage their kits, make more items "Sterile unless package damaged or opened".

winniewoman9060ret · Jun 4, 2019

Tape in rooms. Rolls and rolls of tape. Different flavors for different nurses. And don’t forget Coban too

Emergent, RN · Jun 5, 2019

22 hours ago, brownbook said:
I'm holding a McKesson Sterile Tongue Depressor. It is in it's original paper wrap, undamaged, no stains or tears, on the wrap, yet it expired 2009/09????
Going to McKesson or other hospital suppliers and requesting they repackage their kits, make more items "Sterile unless package damaged or opened".

And, why in the world does a tongue depressor need to be sterile if used on the tongue?

TitaniumPlates · Jun 5, 2019

On 5/30/2019 at 3:54 PM, Emergent said:
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.

Date stickers for IV tubing. I've worked at a place where the sticker is placed for 3-4 days (depending on your facility's IC policy) in the future--and as long as you're using the tubing for the same drug--you reuse it for 3-4 days.

Room set up bags. Get a list of all of the things actually needed for an admit--ekg pads, rainbow tubes, 2 primary setups, suction cannister, 6 alcohol wipes...you get my drift---premake them and keep them in the supply room in their own reusable baggies. Nobody brings into the room what isn't in that bag. Empty the bedside carts of all items. If someone needs something extra--you go get it.

boxes for specific procedures. Chest tube box, a line box...etc. only what is needed for that particular procedure---zip tie the box closed (like a tupperware bin) and use when that procedure is done. Restock items when they are used, don't bring the whole kit into the room---get what the doc asks for out of the box when he/she needs it.

re-usable slings for overhead lifts--wash when dirty or between patients. use backboards for transfers and not these disposable things we do now.

restart the autoclave biz. no more "one use" scissors or pushers. I get it that these tidy little "suture kits" are all so cute---but all you need to suture a damn lac is a pusher, a scissor and some prolene. FFS. even the wrapping is a waste on those stupid things.

no more "pre packaged IV kits". if you don't know what to bring to an IV start...make laminated cards for each nurse to have on their person--or have them in the omnicell room for someone to refer to. the wrapping---again---is ridiculous.

this is all about pharma companies like BD making money. like those stupid "expiration dates".

someone here takes expired meds and supplies to another country and donates them. An expired GAUZE works just the same as an unexpired gauze.

this is about a revenue stream for the hospital too. they can bill for these things if you let them.

BettyGirard, BSN · Jun 8, 2019

Yeah, I suppose those "kits" for IV admin or Foleys or whatever seem like a good idea, but frankly, they are wasteful. First off, there's no reason for the whole thing to be sterile as each component is individually wrapped. Inside are the antibiotic scrub and lube packets. Is the amount provided too little, too much. If too much, it probably goes into the trash after the kit is used. Too little, go scrounge some from elsewhere (another kit?). The gloves in these kits never fit me so I have to add another set and where do the extra-small ones go, in the trash.

It wasn't always that way. I remember when I started in the ER, I'd just grab all the individual components. Sure sometimes at the end of the day I'd have things in my pockets left over, but they hadn't been compromised and usually (OK, a few went home with me by mistake) returned to stock.