Approved October 10, 2015
Revised January 30, 2017
AST Guidelines for Environmental Practices in the Operating Room
Introduction
The following Guidelines for Best Practices were researched and authored by the AST
Education and Professional Standards Committee, and are AST approved.
AST developed the guidelines to support healthcare delivery organizations (HDO)
reinforce best practices in environmental practices as related to the role and duties of the
Certified Surgical Technologist (CST®), the credential conferred by the National Board of
Surgical Technology and Surgical Assisting (NBSTSA). The purpose of the guidelines is
to provide information OR supervisors, risk management, and surgical team members can
use in the development and implementation of policies and procedures for environmental
practices in the surgery department. The guidelines are presented with the understanding
that it is the responsibility of the HDO to develop, approve, and establish policies and
procedures for the surgery department regarding environmental practices according to
established HDO protocols.
Rationale
The following are Guidelines for Best Practices related to
environmental
or
sustainability
practices
in the surgery department, often referred to as “
going green
”. U.S. HDOs
continue to be responsible for the disposal of over four billion pounds of waste annually
making the healthcare industry the second largest contributor to waste behind the food
industry.
16, 17
Surgery departments are the leader in medical supply usage; they are
estimated to be responsible for approximately 33% of a hospital’s supply costs.
32
OR and
labor and delivery waste account for approximately 30% - 70% of a HDOs waste.
10, 14, 20
The volume of waste in the OR is primarily due to the volume of disposable or “single-
use” products. The reasons for the use of disposable items revolves around issues of
sterility, infection control, ease of use, and most importantly the push by manufacturers
who discovered a method of continuous revenue.
25
The following are the principal
categories of waste typically generated by HDOs:
23, 34
•
Solid waste: General trash that is non-regulated medical waste.
•
Liquid waste: Liquid waste in the OR is comprised of blood and body fluids that
are typically collected in disposable suction canisters. One study found that suction
canisters make-up 25% of regulated medical waste at HDO’s and a second study
estimated that up to 40% of surgical waste consisted of suction canister disposal.
6,
18, 30