After attending a Clean Med Conference in 2004, the Hospital Safety Officer at Green Medical Center (our fictitious hospital which is based on an actual Philadelphia-area hospital) had learned about Di(2-ethylhexyl) phthalate (DEHP) (a vinyl plasticizer that was used to manufacture many IV bags and IV tubes). DEHP is a toxin known to cause reproductive changes in the organs of developing animals. The National Toxicology Program (NTP) convened an expert panel in 2000 and again in 2005, to review data pertaining to exposures and effects of DEHP. In 2006, the NTP concluded that DEHP is a reproductive and developmental toxicant in animals. The NTP further concluded that these animal studies are relevant to humans, and that current exposure levels are of particular concern for three distinct human populations: critically ill infants; healthy infants and toddlers; and pregnant and lactating women.
The Patient Safety Committee at Green Medical Center, equipped with this information, agreed to phase out DEHP beginning with the neonatal intensive care unit (NICU), Pediatrics, Labor & Delivery and Maternity Units, where the potential risk to low weight developing infants and fetuses was believed greatest.
After evaluating options, the Patient Safety Committee agreed to a complete phase out of DEHP. The decision to switch to Hospira’s new DEHP-free, VisIV containers paid off through increases in waste reduction, patient safety and staff satisfaction. The hospital was an early adopter of the new Hospira, VisIV containers. These containers were DEHP-free, latex-free, PVC-free and had specific design features to enhance patient and caregiver safety. In 2010, Green Medical Center converted nearly all containers over and the entire hospital is virtually DEHP-free.
We appreciated the containers having no protective over wrap, which reduced waste by approximately 10 tons per year and increased the ease of use for the pharmacist and for the caregiver. In the pharmacy batch processing, IV bag preparation and set up times were faster. Also, the containers were designed with a longer shelf life of up to 24 months. The containers also featured new tamper-resistant ports.
Green Hospital Initiative:
The next leg of sustainability, evolved when the Pennsylvania Department of Environmental Protection (DEP) launched a Green Hospitals Initiative. The program involved approximately twenty local hospitals, the Health Care Improvement Foundation and the Women’s Health & Environmental Network (WHEN). The initiative was supported by an EPA grant and targeted best practices for regional healthcare facilities. The initiative had a major impact in reducing wastes, toxins and pollution and got hospitals to work together, share ideas and improve practices. The hospitals were formed into four groups:
Pharmaceutical and Toxic Waste Management
Green Facilities
Red Bag Waste Reduction
Green Purchasing
Please share your experiences with similar initiatives in our comments section below. What has worked and what hasn’t?
In Part 3 of this series, we will discuss our efforts to reduce red bag waste at Green Medical Center, so stay tuned.