Assessing Waste-Reduction Knowledge and Practices in the Operating Room

INTRODUCTION: The World Health Organization (WHO) estimates that high-income countries create up to 0.5 kg of hazardous waste per hospital bed per day. A large proportion of that hospital waste is generated by operating room (OR) procedures, which provides a unique opportunity to impact waste production. Additionally, few studies have looked at operating room personnel knowledge and attitudes towards reducing waste and correct allocation of OR waste. OBJECTIVE: This is a two-part observational study. The first part seeks to find opportunities to improve upon appropriate waste allocation and waste reduction in the hospital operating room. The second part assesses the knowledge and beliefs of the surgical staff surrounding recycling and appropriate waste allocation. METHODS: We recorded weights of hazardous and nonhazardous waste production, as well as patient and surgery characteristics from hysteroscopy procedures. We also measured the amount of waste produced during a proctored procedure with the correct allocation of materials. Finally, we created an anonymous online survey that assessed knowledge and attitudes toward OR waste allocation and recycling. All personnel working in the OR were given the opportunity to complete the survey. Both study parts were analyzed using descriptive and inferential statistics, including chi-square, ANOVA, and t-tests as appropriate. RESULTS: In part one, data was collected on 27 hysteroscopies. Most cases were completed on premenopausal (71%), nonsmoking (78%) patients with at least one comorbidity (89%) in the main OR (75%) and involved Myosure devices (67%) without additional procedures (81%). Hazardous waste receptacles were utilized for 3 (11%) procedures. A trend between waste weight and history of gynecologic surgery (r=.35, p=.08) was identified, but no other factors were associated with waste weight. In part two, 75 survey responses were received. Respondents included attendings (33.8%), residents (29.7%), and OR staff (36.4%). Most respondents (92%) stated that they care about correct disposal of waste, and they disposed of waste correctly in the OR (68%). Respondent care (t(73)= −2.15, p=.035) and interest (t(73)=−2.12, p=.038) were associated with increased correct identification of waste allocation while self-reported knowledge of correct allocation of waste was not (t(73)=0.28, p=.784). We did not identify differences in knowledge, care, or interest, based on provider type or gender. CONCLUSIONS: From part one of our study, we found that surgical weight volume was not associated with investigated factors, and hazardous waste was underutilized. A lack of hazardous waste production suggests that survey responders incorrectly report appropriate disposal of surgical waste in part two of our study. Most survey respondents cared about reducing OR waste and would like to learn more. Overall, we found several opportunities for improved waste management in the OR and that providers have great interest in participating in these improvements.