AST Guideline - Environmental Practices in the Operating Room

13 canister is still considered RMW that adds the weight of the canister to the RMW disposal costs. 23 A. Solidifiers can be added to the suction canister and disposed of in red bags; however, this can still predispose surgical and environmental personnel to splashing and spills of potentially infectious material. B. It is recommended that surgery departments install an automatic fluid management system (FMS) that flushes blood and body fluids directly to the sanitary sewer to increase safety for the staff, decrease the amount of RMW and offer other long-term cost-savings such as a reduction in the transportation costs of RMW. 23, 32 (1) FMS are stationary and connected directly into the sanitary sewer of the HDO or situated on a portable cart that allows for automated drainage to the sanitary sewer. 23 However, depending on the system purchased by the HDO there are three types of canisters that are recommended for use by the OR. 23 (a) Some FMS require the use of a reusable canister that is disinfected between uses. (b) An integrated canister system is one that is completely enclosed. (c) Some FMS still utilize disposable canisters that can be placed in the regular trash after disinfecting with an enzymatic cleaner. However, this system still contributes to purchasing and disposal costs, and the canisters are not calibrated in order to measure patient fluid loss. C. The CDC’s publication The Guidelines for Environmental Infection Control in Healthcare Facilities , 2003, states that sanitary sewers may be used for safe disposal of blood and suctioned fluids, as long as the HDO meets local sewage discharge requirements, and the state has approved of the disposal method. (1) It is recommended the HDO receives the approval by local and state water officials for the disposal of blood and body fluids into the sanitary sewer prior to purchasing a FMS. 23 Guideline IX The surgery department should utilize water and energy conservation technologies. 1. Due to the surgery department being a significant source of water usage, it should be targeted for installing water conserving methods. A. Low-flow fixtures should be installed in urinals, toilets and showers. B. Motion-sensing devices should be used at the scrub sinks. 14 C. Technology for reclaiming water should be installed in the department as long as the reclamation of water does not interfere with infection control, patient safety and sterilization methods. 14