AST Guideline - Environmental Practices in the Operating Room

7 (1) Containers for red bags must be covered to prevent cross- contamination in the event a bag is unknowingly compromised and to prevent solid waste carelessly tossed into the container. (2) Often solid waste containers must be larger in size as compared to RMW containers and should be placed next to the RMW containers. (3) Educate surgery personnel in the segregation of paper-based products. The surgery department is a significant source of cardboard packaging (e.g., glove boxes, equipment boxes, supplies such as back table packs that are delivered in manufacturer’s boxes). Surgery personnel should be aware that paper and cardboard cannot be recycled if it becomes wet; therefore, the paper and cardboard must be kept separate from wet items such as saline bottles. 14, 38 (4) Use as small of a container as possible based upon the waste generation reports in order to decrease costs. (5) Use containers that can be quickly opened by using a foot pedal and are wheeled for easy movement that prevents personnel injuries due to lifting heavy containers. (6) All containers for solid waste, RMW, SUDs for reprocessing, and donations should be color coded. The colors should be easily distinguishable from each other and their use standardized throughout the HDO. 14, 38 (7) The biohazard label should be displayed on all RMW containers. (8) Signage should be posted directly above the containers as well as on the lids of the containers. The signage should be large enough to be easily read and if necessary, use multiple languages to optimize communication. The signage should be consistent in wording, symbols, color and size. 14 (9) Solid waste containers should be frequently emptied to prevent overfilling that could result in the improper use of the red bag container. (10) All containers must be leak proof. 15 2. Surgery personnel should know the five categories of medical waste that require different disposal procedures based on federal guidelines: general waste (eg, paper and unsoiled linens), infectious and pathologic (eg, tissues and body fluids), pharmaceuticals, radioactive waste and sharps. 3. CSTs must properly segregate waste in the OR during every surgical procedure. A. The CST should know the criteria for separating waste into clear bags (noninfectious waste) and red bags (infectious waste). 15 Additionally, the CST should know the criteria for separating reusable textiles, such as gowns, back table and Mayo stand covers, from disposable items. (1) Approximately 90% of red-bag waste is improperly placed, most likely due to not knowing and/or understanding the segregation criteria. 16, 17 Only those items that are visibly soiled with blood or bodily fluids should be disposed of in red bags. For example, a