Second OpinionsDisposal of arthroscopic irrigant

Disposal of arthroscopic irrigant

Does anyone have a policy or procedure with evidence based support for the discard of arthroscopic irrigation fluid? We have always brought the bags to the soiled hold. Recently several nurses are draining them in the scrub sinks because it is closer and more convenient.

Thank you, Terry S.

Started by: Terry Schenfeld (OR Manager/Supervisor) at January 17, 2019 (7:02 am)

Comments and Responses

 

If discussing unused irrigant, we dump that into our scrub sinks. If discussing contaminated, used irrigant, we use a floor vacuum to catch what our Neptune did not, and suck it straight into the Neptune that then gets docked and cleaned.

Jennifer B. (Other) at January 18, 2019 (8:44 am)

It seems some responses are assuming the questions is regarding used or spent irrigant. I am assuming the question is regarding unused irrigant. Our customers generally just suction the unused fluid into our Streamway System, which sends it directly to the drain. Also, in response to the comment about saline and plumbing compatibility, your Neptune docking station is connected to the drain system so ultimately that's where all your saline ends up anyway. Although saline is slightly acidic, drain plumbing materials are typically made of PVC or galvanized steel. These materials are well equipped to handle the slightly acidic saline solution. Consider normal groundwater can have a pH of 6, the pH of saline at 5.5 really isn't that much different. To put it in perspective Coca-Cola has a pH of 2.5.

David Dauwalter (Other) at January 17, 2019 (1:37 pm)

Arthroscopic irrigating solution cannot go back into a clean area. The bags need to go to the decontamination area and be drained. The remaining solution can also be drained into a fluid system such as the Neptune system by Stryker.

Caryn Solomon (Director, Surgical Services/Director of Nursing) at January 17, 2019 (11:35 am) [last edited on January 17, 2019 (11:36 am)]

Why would anyone introduce a biological or potentially infectious material into a hand hygiene sink. Particularly one used for surgical scrubbing.

Craig P. (Other) at January 17, 2019 (11:09 am)

Suctioning at point of use is the most optimal of solutions. If you do not have that as an option it should be a hopper that has a splash guard. Scrub sinks should never be an option.
Teresa S.(Sterile Processing Manager)

Teresa Wahl (OR Manager/Supervisor) at January 17, 2019 (11:06 am)

I would not believe the surveyors would like to see soiled items discarded in a designated scrub sink.
In the Joint Commission 9/2018 "Accreditation Data Update: Ambulatory Care Program" page 9 states Most Frequently Cited EPs
IC.02.02.01, EP 2 example #1 showed -Dirty colposcopy instruments were being rinsed in the exam room sink that was also being used for hand hygiene.

I think this is very similar in example of use.

Don Y. (Other) at January 17, 2019 (10:57 am)

I would be concerned, since it was used on a patient, potential infection control issue. Staff may touch the patient and then touch the bag?
I was always taught the saline is corrosive to the plumbing. Same reason you do not soak your surgical instruments in saline. We either drain in hopper or suction it up in the Neptune.

Melissa W. (OR Manager/Supervisor) at January 17, 2019 (10:56 am)

Agreed either suctioned up and disposed of as biohazardous waste or in a hopper with appropriate PPE.

Michele McKinley (Other) at January 17, 2019 (10:55 am)

We solidify all our fluid from suction with Isosorb then dispose of the solid matter as biohazardous waste. My understanding is that this fluid should not be poured into a sink or hopper.

Anthony Pierini (OR Manager/Supervisor) at January 17, 2019 (10:55 am)

Definitely into the hopper with the dirty fluids. The unused fluid go there too!

Julie S. (Administrator/Director/Manager/Owner/Executive Officer) at January 17, 2019 (10:52 am)

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