AST Guideline - Environmental Practices in the Operating Room

8 CST is setting up the sterile back table and Mayo stand but the case is cancelled; the disposable gown, gloves, back table cover, etc. can be thrown away in the clear bag (or donated – see Standard of Practice IV). (2) By following the criteria the CST can contribute to significant savings. For example, it is estimated that 40% of RMW from ORs is packaging material that should be placed in a clear bag. 8 If the amount of packaging material placed in red bags was reduced, the volume of RMW could decrease by approximately 15%. 16 B. The Surgery Department should implement a simple system to ensure the waste is properly segregated in each OR. Most recyclable waste is generated pre-incision when items are opened and prepared before the procedure begins. 25, 30 The following recommendations help to decrease the volume and expense of waste. (1) One method is to line the waste hamper with a clear bag as the OR is being set up and prior to the patient being transported into the OR, remove and close the clear bag to prevent the entrance of infectious contaminants, and replace with a red bag. 14, 20, 38 However, the clear bag must remain in the OR until the procedure is completed. (2) Second method is to line the waste hamper with a red bag and place a clear bag within the red bag; prior to the patient being brought into the OR, remove and close the clear bag, and set aside in the OR. 25 (3) The two methods described above allow the surgery team to have a red bag readily accessible for the disposal of RMW that is generated during the surgical procedure. 30 Guideline IV Surgery departments should implement the use of reusable textiles and basins to lower the amount of RMW that is generated and the associated costs of purchasing and disposal of single-use items. 1. Reusable textiles have been improved over the years; they are technologically advanced textiles that are lab tested and required to meet strict barrier performance standards. HDOs are taking several factors under consideration when making the decision to switch to reusable textiles including feedback from surgeons and CSTs who are increasingly expressing a preference for reusable gowns due to improved thermal comfort, barrier performance and ease of donning and removing versus disposables. 12 2. Surgery departments should complete a comparative analysis of the cost of disposables versus the cost of reusable surgical gowns, surgical textiles, and basins. 26 A. The analysis of the cost should include the following variables: (1) In-house inspection and repair of reusable textiles. (2) Reprocessing costs including laundering in-house or contracting with a vendor. The most important factor the HDO should take