Medical Waste Management in Contemporary Clinics

As summer starts to transition to fall, back-to-school physicals, flu season, and mishaps that may require a tetanus booster are right around the corner.

Medical procedures often generate sharps and other medical waste, so being prepared with a compliant process for disposing of those used needles, red-bag waste, and spill cleanup materials is important for your team, patients, and community. Also, for your patients or employees who unexpectedly experience an accident where blood or vomit is involved, you need to be ready to handle and clean up those events, as well.

Contemporary clinics must implement a medical waste management program that complies with not only federal regulations such as OSHA, but also state and local rules for the handling, containment, disposal, and documentation of medical waste generated in the clinic. Compliance with all applicable regulations, as well as the clinic’s bloodborne pathogens exposure control plan and training program, should be the goal of every organization.

For example, the OSHA Fact Sheet, “Protecting Yourself When Handling Contaminated Sharps,” spells out several ways to protect employees and patients, including:

• Dispose of contaminated syringes immediately after use.Although the syringe has a safety mechanism, OSHA still requires it to be placed in a sharps container as soon as feasible.
• Sharps containers must be located as close as possible to the area where the injection is to be administered.It’s important to determine whether a wall-mounted sharps container or a container that can be carried to the point of use would work best.
• Sharps containers must be puncture-resistant.Even if they’re puncture-resistant, sharps containers should be handled safely.
• Sharps containers must have a lid or way to effectively close the opening.Prior to moving the container, always close the lid first.
• Sharps containers must be kept upright to avoid spills.If placing the container in a cabinet for storage between uses, make sure the lid is secured and is maintained upright.
• Sharps containers must not be overfilled and must be replaced routinely.Each sharps container has a fill line that must be adhered to. Overfilled sharps containers can lead to needle sticks. Remember, OSHA requires a specific individual identified in the clinic’s exposure control plan to be responsible for replacing containers prior to overfilling.
• Biohazard spill cleanup materials including proper disinfectant, personal protective equipment, and disposal are required in health care facilities.In a clinic, an all-inclusive mailback containment and disposal system assures employee safety and keeps biohazard waste out of the trash.

In addition to OSHA obligations, individual states have additional requirements. For example:

• Sharps containers or red bags can only be stored onsite for a specified period of time.
• Documentation of transport and proof of destruction is required.
• Employee training specific to how your sharps container and red-bag disposal systems work must be provided.
• Different containment systems for different types of waste (eg, sharps, red-bag waste, unused pharmaceuticals, and hazardous waste such as batteries) are required.
• Generators of medical waste must register with the state in which they do business.
• Containers, red bags, and transport boxes must be labeled per federal and state regulations.

These requirements can easily be met by using a mailback sharps container and medical waste disposal system manufactured by a company that provides support and compliance services.

Mailback systems are the perfect solution for small clinics. Not only do they comply with federal and state-requirements, a variety of sizes and types of mailback systems are available to fit any size clinic in any state. Each system comes with complete instructions providing training for both current and new employees on how to use it.

Mailback systems make it easy to comply. Once the sharps container’s fill line is reached, or the red-bag container or spill kit is full, the container is simply closed, placed into the prepaid, plastic bag-lined mailback box and shipped through a common carrier such as USPS or UPS to a permitted treatment facility. Each system is treated and/or recycled with the most cost-effective and environmentally responsible method.

To ensure that a clinic always has a replacement sharps container, red-bag containment system, or spill kit, it is advisable to have an extra for each room. To make sure that a replacement for the full container is not overlooked, the mailback system can be set up on an auto-reorder schedule so that a new system is sent to the clinic once the full one is received by the medical waste disposal facility.

Although medical waste collection and disposal is not often discussed, it is a very important part of the health and safety of yourself, your team, and your patients. By streamlining the medical waste disposal process, it allows your team to focus on the most important part of your clinic: the patient.

Robin Watson, MPH, MS, is the Director of National Accounts for Sharps Compliance, Inc, a nationwide provider of solutions for improving safety, efficiency, and costs related to the proper disposal of medical waste by health care professionals.

Jan Harris, MPH, BSDH, is the Director of Environmental Health & Safety for Sharps Compliance, Inc.