WASTE MANAGEMENT PROGRAM

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WASTE MANAGEMENT PROGRAM

• Ballarat Health Services
• 2008
• Marilyn Kearney
• RN., M. Ed.Tng., B. Ap.Sci., BCN., Cert IV
  Assess.Tng., Adv. Prac..Reflex., Basic Cert.
  Reflex., MRCNA.

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December 1993Incineration Licence Expires

• The Ballarat Base Hospital may have to find an
  extra 150,000 in its budget to pay for the
  disposal of hospital waste. Stringent new
  guidelines from the Environmental Protection
  Authority (EPA) for high temperature incinerators
  means the current licence which expires in
  December is unlikely to be renewed
• (The Ballarat Courier, 20/11/93, pg. 1)

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When We Began

• Waste management committee established late 1995
• Staff from all areas invited (environmental
  services, nurses-acute subacute and residential
  care, infection control, pathology )
• starting point conduct an audit

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Our First Audit

• An investigation of
• All Infectious Waste
• All General Waste
• One (1) Large Sharps Container
• A Staff Survey

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• Our audit indicated there was potential for the
  hospital to reduce the cost of disposing of
  infectious waste by up to 43 (19,000 per
  annum), by the accurate segregation of general
  waste from the Infectious Waste stream.

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Philosophys of thought for a Waste Management
Program

• From Cradle to Grave
• And
• The 3 Rs
• REDUCE, REUSE, RECYCLE

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Strategies for Waste Management

• 1. Education Program to all
• staff
• 2. Posters
• 3. Recycling
• (accurate segregation)

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Strategy OneEducation Program

• All areas given education
• Updates annually and as
• required
• Included in Staff Induction Program of all new
  staff

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Strategy Two Posters

• Strategically placed in all departments

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Poster Example SHARPS

• Needles
• Syringes (discard intact where practicable)
• IV Giving Sets (intact)
• Stitch Cutters
• Lancets
• Trocars
• IV Cannula Stilettes
• Broken Glass
• Discard into Designated
• SHARPS CONTAINER

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Strategy Three Recycling

• All wards and Departments have Recycling Stations
• Initially Recycling Station one unit (Red
  Earth style)
• Now Separate Bins (labelled)

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Strategies for Waste Management Published paper.

• Talking Rubbish Getting Serious
• a paper written regarding BHS s strategies
  introduced to staff to encourage accurate
  segregation of waste .
• the approach utilized
• Prevention, Reduction and Recycling
• Principles
• Authors Marilyn Kearney Hilton Bourke
• This paper was printed and published as a case
  study in the Waste Reduction Manual of Eco
  Recycle Victoria May 1998

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RECYCLING

• Types of items to recycle ?
• What can be recycled ?
• AN ONGOING PROCESS
• Ideas are progressively developed and added to
  the recycling program

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Recycling Examples A-Z

• Aluminium Cans
• Co-mingled with glass and plastic
• Eg. Soft drink
• water milk
• bottles
• All clean plastics
• (Non medical waste)
• Collected by Cleanaway (local contractor)

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Recycling Examples A-Z

• Batteries
• Large batteries (from engineering ) and smaller
  rechargeable batteries
• - Collected by a local recycler
• Small alkaline batteries
• - Yet to find an adequate grave site

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Recycling Examples A-Z

• Disposable Trays
• Egs. Dressing, Suture,
• mouth toilet trays,
• syringe used for
• IV flush
• 
  
• Encourage Clinical/Biomedical Waste Disposal
• helps to eliminate some plastics biodegrading
  in the environment

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Recycling Examples A-Z

• Fluorescent tubes
• Replaced with Triphosphor tubes
• Higher efficiency - energy saving
• Longer life span
• Low mercury (lt3mg)
• Less than 3 mg meets the environmental protection
  technology parameter
• 1 fluorescent tube can pollute 30,000 litres
  water
• Collected by Sita Environmental Solutions

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Recycling Examples A-Z

• Ink Cartridges
• All ink cartridges are collected for
  recycling
• The users send to environmental services
  Dept in a sealed plastic bag-avoid leakage
• BHS boxes the cartridges ready for collection
• Collected by Mammoth Recycling Company.
  (Melbourne)
• Mammoth separate the metal, plastic and ink and
  recycle

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Recycling Examples A-Z

• Metal
• Scissors, forceps, etc.
• -separate bin
• -washed/sterilized
• Purchased by local scrap metal
• company (ACE Metals) for
• melt down

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Recycling Examples A-Z

• Oxygen Masks Tubing
• and other equipment/
• stock that can be
• used
• packaged and sent to
• 3rd World Countries

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Recycling Examples A-Z

• Paper Waste
• Survey 97 of paper waste is Recyclable
• 
  (Eco-Recycle Victoria 1998)
• Cardboard recycling boxes (Visy Recycling)
• for the collection of paper
• available from environmental services

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Recycling Examples A-Z

• General Paper including Newspaper
• some is given to BRI (local industry)
• -pulped mixed with cement for cement
  bricks
• BHS shreds some
• -local Vet, RSPCA and staff

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Recycling Examples A-Z

• Confidential Paper
• -locked bin with mailing slot
• Collected by company
• (Recall Melbourne)

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Recycling Examples A-Z

• Cardboard
• Compressed
• Collected locally
• BRI and Cleanaway

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Recycling Examples A-Z

• Pharmaceuticals
• Tablets etc.- Returned to Pharmacy
• Collected by an authorized
  collector
• Injections/IV bags-discarding fluid
• Sharps containers-absorbent
  layer
• Take Care of Waterways

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Recycling Examples A-Z

• Pinkies Vs Blueys
• Variable size alternative
• bed overlays (laundered-
• reusable product)
• vs
• Plastic paper blue liners

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Recycling Examples A-Z

• Plastics
• 1000s of N/S and Water Bottles
• single use items
• eg. bowl sets theatre
• plastic jugs-midwifery
• Collected by Cleanaway local contractor

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Recycled Plastic Becomes

• garden furniture
• garden creeper trellis
• road works witches hats
• racing car barriers
• Local outlets sell garden furniture in Ballarat

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Recycled Plastic Initiative

• Geelong City Council constructed the longest 100
  recycled plastic boardwalk in Victoria
• Now in the process of creating Podium Signs that
  promote their initiative
• Taronga Park Zoos demonstration arena- recycled
  plastic seat slats.

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Recycling Examples A-Z

• Supply Packaging
• Requested companies to change from
  Polystyrene packaging ? paper
• Some containers/crates are wood
• and are returned
• Bubble/Shrink plastic wraps recycled in
  plastic

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WORM FARMING
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Worm Facts

• Have no eyes but are sensitive to light
• Have no ears but are sensitive to noise and
  vibration
• Have no lungs but breathe through their skin
• Double their number every two months
• Eat their body weight each day
• Have between 3 and 5 pairs of hearts
• Are hermaphrodites, having both male and female
  reproductive organs
• Are disease resistant, and present no health
  related problems to humans

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Worm Facts

• Produce a cocoon every 10 days
• Reduce any dead plant and animal matter back to
  soil
• Produce a casting (manure) which contains all the
  nutrients that the plant need
• Produce the richest plant food known to man
• Live in complete harmony with each other and
  living things in the earth

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Worm Facts

• Compost worm castings
• attract the tunnelling worms
• into the garden to aerate
• the soil

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Worms Eating Habits

• Food Scraps
• Flowers
• Vacuum dust
• Some paper hand-towel

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Worm Farming

• 23 of our 37.5 recycling is for the worm farm
• BHS 2007 Data

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Just a load of old garbage?

• Estimated that Australian hospitals produce more
  than 600 tonnes of solid waste each day
• Waste Reduction Manual Eco-Recycle Victoria
  1998

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• Many Research Articles suggest that 89 of
  hospital waste can be recycled

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Current Statistics of the many Waste Streams at
BHS (Feb 2008)

• General Waste 49
• Waste to Landfill
• Recycled Waste 37.5
• Aluminium, Batteries, Fluorescent tubes,
  Food scraps, Flowers, Ink cartridges,
  Metal,Oxygen masks, Paper, Plastics,
• Clinical Waste 13.5
• Biomedical, Sharps, Pharmaceuticals, and
• Cytotoxic Waste.
• The total waste has increased 30in the last 6
  years

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Waste Minimisation Hierarchy

• Waste Avoidance
• ?
• Waste Reduction
• ?
• Waste Re-use/recycling/reclamation
• ?
• Waste Treatment
• ?
• Waste Disposal

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• -----------Residues------------

Licensed Incineration Eg. Cytotoxic waste
Licensed Treatment Eg. Clinical/ Biomedical Waste
WHERE DO I PUT THIS WASTE?
Recycle
Compost
Landfill
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Secrets to Success

• Maintain a high level of Consultation, Education,
  Communication and Information

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Secrets to Success

• An active committee with willing staff and
  management
• Executive/management support is essential for
  success
• Consult with managers and union reps, changes
  that will affect departments
• Accessible information
• Savings data sent to management
• Adequate resources displaying graphs, photos
  and charts
• Adequate resources

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Secrets to Success

• Ongoing auditing including Regular updates
  regarding progress
• (notice board displays, annual report,
  individual areas receive data)
• Being prepared to listen and a Constant search
  for new ideas
• Media release
• Library journals (Waste Management and
  Environment)
• Continued development and delivery of waste
  education program
• Green Frog Award

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Green Fog Award
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Further Waste Initiatives

• Electricity/Gas --- Energy Saving
• Areas currently being fitted with people
  sensor lighting
• Plant Control Equipment fitted with Opto
  computer
• -selective time clocks - on/off day and night
  heating/cooling/air handling etc.

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Further Waste Initiatives

• Water ---Savings
• Flow restrictors in showers in many patient
  care areas (gt 5oo)
• Recycle all steam
• (condensation-gtwater-gtback to boiler house)

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Further Waste Initiatives

• Water ---Savings
• Reverse osmosis Unit (CSSD)
• -processed water directed to
• flusher system
• (offsets fresh water usage)
• Instillation of water tanks

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Current Review

• Biodegradable Bags
• (made of vegetable starch)
• Nurse/Patient gowns
• (made of SMS Polypropylene)
• -ability to recycle

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Current Review

• EverLed Fluorescent tube
• No mercury, no lead, no phosphor powders,
  long life(10yrs), no light wasted on reflector
• Worm Farmer
• Future retirement

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Waste Management Strategy

• By adopting Waste Strategy recommendations and
  acting on them we can
• Minimise the impact of Hospital Waste on our
  environment
• Minimise Costs (1000s of dollars to be saved)
• Reduce Workcare Incidents
• Make better use of our resources

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• We only have one earth
• Please
• Protect and Care for the Environment

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Thankyou to Don Colbert and Shane Quinlan for
their contributions
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For Further Information

• Contact
• Marilyn Kearney
• Co-ordinator Graduate Nurses
• Equipment Resource Nurse
• Ballarat Health Services
• PO Box 577
• Ballarat 3353 Victoria
• Telephone [phone]
• Email marilynk_at_bhs.org.au