Dornoch Evac Unit

How is your facility disposing of infectious fluid and waste? Chris Hosler, vice president of marketing, Dornoch Medical Systems Inc, Riverside, MO, summed it up this way: "If you ask those who are still pouring, they’ll say ‘you don’t want to know!’ Until the Occupational Safety and Health Administration (OSHA)’s Bloodborne Pathogens Standard [effective March 1992], for the most part, people didn’t recognize splash and spatter as an issue. Since then, there’s been a dramatic change in how people view the risks of fluid medical-waste disposal. Today, people realize the safety issues and can’t ignore them."

Dornoch makes the Transposal Fluid Waste Management System, which Hosler described as "the only reusable suction-canister system in the marketplace. It’s the only system that terminally disinfects reusable components in accordance with OSHA regulations and AORN standards," he said. The Transposal system’s "reusable canisters hold 1800 cc or 2800 cc, used for most general surgical procedures and for placement at the head of every patient bed. Optional 24- and 48-liter—capacity High Fluid Carts simplify fluid collection during arthroscopy and cysto cases."

Here’s how the system works, according to Hosler. After use, fluid-collection devices are transported to Transposal processing equipment in decontamination or central sterile processing areas. Sealed canisters are securely placed on closed instrument carts or in one of several specially designed transport carts. Transposal empties, cleans, and disinfects all fluid-collection equipment. Reusable suction canisters are processed using the Safety Station. High Fluid Carts are processed with the Cart Evac Unit. The optional Safety Station Plus serves double duty, processing fluids from both reusable canisters and High Fluid Carts. "Typically, a hospital will purchase one Safety Station Plus, two 48-liter High Fluid Carts, and a 3-day supply of reusable suction canisters," he said.

Hosler emphasized the versatility of Dornoch’s system: "It can be used house-wide (operating room, emergency department, labor and delivery, patient rooms, etc.); it completely isolates employees from potentially infectious-fluid waste during disposal; it eliminates traditional disposable suction canisters and associated red-bag waste; it empties, cleans, and disinfects all fluid-collection devices prior to reuse or disposal; it handles all suction-canister waste, including whole blood, blood clots, and body fat; it minimizes on-site fluid-waste—management equipment and maintenance needs; and it supports visually verifiable blood-loss measurements."

What about cost? Hosler said the "up-front costs for Transposal equipment may be more" than that of some other providers, but it can save money because it’s "the only system that offers reusable canisters, eliminating as much as 25 percent of a facility’s red-bag waste." With red-bag waste costs at about 25 cents per pound, and a 3-liter canister weighing approximately 7.5 pounds when full (cost and weight can be higher if a solidifier is added), that can represent a significant cost savings for some facilities."The ongoing operating expense for Transposal is about $3.75 per surgical case," he added.

SAF-T-Pump is another product that saves on solidification and red-bag costs. Scott Leece, marketing manager, Cardinal Health, McGaw Park, IL, described how it works: "The SAF-T-PUMP needs only moving water and a sanitary-sewer connection.

Cardinal’s SAF-T-Pump

It’s mounted on a wall and plumbed into a water source. The canister is connected to the SAF-T-PUMP by a dip tube. When the valve is opened, water flows through the SAF-T-PUMP, creating suction and pulling the contents out through a big straw-like tube. Clean water and waste blend and go directly into the sanitary sewer. The dip tube is single-use, but the pump tube is "resposable," meaning it can be reused an average of 50 to 100 times. Becuase the system is powered entirely by tap water and does not require motorized or electrical components, it is virtually maintenance-free. Also, when used with Cardinal Health canisters, it is a closed system, which is important in reducing the risk of staff being exposed to potentially infectious particles.

Another safety advantage of the SAF-T-PUMP, said Leece, is that "it can be mounted in or near the operating room, so staff members don’t have to transport full canisters over great distances. It solves a pressing issue in a simple way that also increases staff safety. The ‘proof is in the pudding:’ when you launch a product and it is well received, you feel you’re doing something right. We have many very satisfied customers. I believe we’ll continue seeing good market growth for the SAF-T-Pump ."

While declining to provide information on cost, Leece noted that the SAF-T-PUMP is cost-competitive with other waste-disposal products.

Cost is always an important factor when purchasing products, but Margaret Hand, marketing manager, health care, Bemis Manufacturing Company, Sheboygan Falls, WI, has observed a couple of growing trends where management of medical waste is concerned: Safety, for staff and for the environment, and involvement of multiple departments in decision making. "Safety is always a concern, as are environmental and waste-reduction issues," she said. "It’s not just because it’s politically correct; facilities want to be responsible for the safety of staff and for reduction of waste. A whole team—operating room, environmental services, purchasing, infection control staff—of decision makers are concerned with managing liquid medical waste, It’s not just one area looking for effective ways to reduce costs and waste and to increase safety anymore."

Bemis just introduced the newest version of Quick-Drain, which has large-volume capacity. It looks much the same as the original Quick Drain, but the difference is a reusable drain tube in the side and a disposable dip tube that is used when large volumes of fluid need to be emptied. The cost for the larger volume is $8,995; tubes are 50 cents each. Hand noted: "The great majority of the time, the disposable tube isn’t needed." The regular size of Quick-Drain, as well as similar units produced by competitors, costs in the $7,000 range, said Hand. The difference is that others’ products require a dip tube all of the time, at an average cost of 75 cents each.

Quick-Drain is economical and easy to use, she said: "Drop the canister into the Quick Drain unit, turn it over, and the contents drain into a sanitary sewer. It’s very user-friendly. Rinse the canister out, and run an enzymatic cleaner through it at the end of the day. It’s simple, reliable, and easy to use. It has few moving parts; nothing is electronic. It runs off water pressure. Pulling down the drain handle starts the water flowing, and its pressure is the power behind the unit."

Hand told Healthcare Purchasing News that a number of Bemis’s accounts converted to Quick-Drain because of concern over staff exposure to chemicals when solidifiers were used. "Staff complained of respiratory issues. There’s also a cost factor. Using a solidifier can easily cost the hospital more than the cost of the canister. The weight of red-bag waste and the cost of the solidifier are eliminated with Quick-Drain. Even more important is the safety factor. Quick-Drain minimizes exposure to bloodborne pathogens. Pouring is not outlawed if staff is wearing the correct personal protective equipment, but Quick-Drain gets waste into the sanitary sewer without risk of exposing staff."

Still pouring? Here’s help

There is cost-effective help for those who are still pouring. The Shield is an affordable, simple means of protecting staff from infectious waste. "The CDC and OSHA say that any direct contact with a patient, particularly their body fluids, has the potential for transmitting disease and is considered to be a potential source of infectious agents," related Steve Rausch, director of marketing, Apollo Corporation, Somerset, WI.

"Healthcare workers [HCWs] should wear personal protective equipment—gown, goggles, mask, gloves—when handling infectious waste, but in a time crunch, they might not do it. The Shield gives HCWs an extra level of safety by providing a barrier between them and infectious liquid or solid waste. It’s a simple, one-of-a-kind device with patented design and material. The material is ULTROS, which is almost like a flexible Plexiglas. ULTROS bends with the body, which means the HCW can lean into The Shield when, say, a bedpan is being dumped, but some part of it is always in front of the body or face. ULTROS is clear, so you can see what you’re doing, too. There are machines that can dump and sterilize containers, but they’re more costly."

The cost of The Shield and costs saved by avoiding incineration or transporting of solidified waste are advantageous, too. "It’s an easy, low-cost solution when compared to alternative products on the higher end of the cost scale. We want people to understand that they don’t have to spend thousands of dollars for a basic level of protection," said Rausch. "It’s a terrific investment for the money, and it has its niche for what role it can play in waste disposal at healthcare facilities. Blood can’t go down a hopper sink, but urine, feces, and vomit can, and The Shield provides an inexpensive means of HCW protection in those cases."

Much of The Shield’s charm is its simplicity. Here’s how it works: The Shield clips onto the lip of a hopper sink, explained Rausch. "It takes only 3 minutes to snap it together and put it on. The only tool required is a screwdriver." Cleaning is a snap, too. "Just pop it off and disinfect it at least once per day with a quaternary disinfectant," such as Apollo’s Cidal.

The Shield is now available in two sizes, medium and large, with other sizes possibly to be added at a later date.

Whichever product or method of fluid and waste disposal your facility uses, bear in mind that, while cost of products is an important factor to consider, cost in human life and suffering, i.e., safety of staff, is of paramount importance. The safety bandwagon is the place to be. HPN