This article will appear in the upcoming May print issue of Surgical Products. To subscribe to Surgical Products magazine, click here.

Hospital acquired infections are a constant concern. They harm both the patient and/or the staff member who was exposed. They also have a very negative financial impact on the hospital.

How often are we asked if we are doing everything we can to protect our patients, and ourselves as healthcare workers, from the hazards of a hospital acquired infection?

One area where technology is rapidly advancing is in the collection and disposal of infectious fluid waste from the OR. But, as technology continues to advance, we must make sure our requirements for safety keep pace.

Potentially infectious fluid waste is one of the most challenging hazards in our job, every day. The dangerous days of pouring open canisters into the hopper are numbered (thankfully!), so we must find safe ways to collect and dispose of infectious fluid waste from the OR. The closed, cart-based fluid collection systems offer a safe approach to fluid collection and disposal, especially compared to the tradition of canisters and hoppers.

Regardless of which manufacturer makes the cart system that is used in your OR, there are a few important guidelines you should follow to ensure your system is safe for you, your patient, and the staff.

In my opinion, here are the four most important attributes of a cart-based fluid waste management system:

  •  Closed System
  • Thorough Cleaning Process
  • Air Filtration
  • No Short Cuts

Closed System
If a cart system is truly closed, then exposure should be virtually eliminated. Therefore, whether fluid is being collected, transported, or disposed, a closed system stays closed – from collection through cleaning. Any approach that falls short of that mark is not a truly closed system. In other words, if the manifold must be removed when collected fluid is in the cart, that is a potential exposure risk and that system is no longer closed. Make sure you follow the manufacturer’s instructions to ensure the cart stays closed.

Thorough Cleaning Process
How many times have you docked your cart to clean it, but when processing is complete it still comes back with a smell? Odor from the cart is an indication that it has not been properly cleaned on the inside, and potentially infectious material has taken up residence inside the cart. However, it is possible to neutralize this issue when a robust cleaning process is applied inside of the cart.

All systems available apply enzymatic cleaner to the inside reservoirs of the cart, where the fluid sits. However, when it comes to safety we must look beyond the basics! During the cleaning process for your cart, is hot water used? Is a disinfectant, like bleach, applied to the inside of the cart? After cleaning, can manifolds be recycled or do you have to pay to dispose of them in red bag trash? Get these questions answered so you have peace of mind for you, your patients, and the entire staff.

Air Filtration
Does your cart system have air filtration on the vacuum pump? If so, is it a HEPA filter? Air filtration is very important in the OR to prevent harmful bacteria from entering the breathing space. But, having a HEPA filter is not enough. Best practices indicate the HEPA filter itself must also be protected from moisture contamination to prevent bacteria from growing directly on the filter.

No Short Cuts
Cutting corners when disposing of potentially infectious waste is not a recommended practice. Even if your cart system has a short cut in its evacuation process, avoid using it. Is saving three or four minutes in the evacuation worth it if the cleaning process is short-changed and the risk for exposure goes up?

How is your docking station installed?  Make sure you have a clear path for docking to prevent accidental disengagement during cleaning.

We are constantly looking to reduce OR time and increase turnover efficiency. But, the handling of potentially infectious fluid waste is a task where cutting time increases the risk for exposure. Until we are doing everything we can to protect our patients, ourselves, and our staff, short cuts must be avoided!

Safety Reminder
It is easy to focus only on the collection of the infectious waste, but the disposal of it matters just as much. Whether your hospital uses a canister or cart system, make sure you and your patient are as protected as possible. Keep the four key attributes of a fluid waste management system in mind when you are evaluating your own system, or seeking a new solution. Remember, the level of safety you practice is up to you – don’t compromise!

Candace L. Samudio is an accomplished healthcare professional with nearly four decades of experience ranging from OR nurse to senior administrator. She currently leads the Clinical Excellence team in the Surgical division of Zimmer, Inc., and resides in Northern California. The opinions are the author’s own.