透析室感染廢棄物減量之專案

REDUCING THE WEIGHT OF INFECTIOUS WASTE IN A HEMODIALYSIS ROOM

本院透析室每月產生的廢棄物重量，總是位居全本院榜首，故成立專案小組探討感染性廢棄物過重之原因，並進行缺失改善，以達減量之目標。專案期間為2009年9 月至2010 年7 月，改善前經查檢缺失率為48%，透析後平均每人次之感染廢棄物重量為 0.803 公斤，清運費為40.1 元。掌握6 個主要導因包括：人工腎臟、穿刺針、透析管路水未瀝乾、無明確標準流程及標準書及垃圾分類未確實等。因此進行本專案，改善後缺失率降為9.7%；透析後平均每人次之感染廢棄物重量降為0.57公斤，清運費降為28.5 元。2010 年2 月至7 月持續專案之追蹤評值，6 個月總共節省48,350 元。亦即正確的廢棄物處理可以降低感染性廢棄物重量、減少醫院清運支出，此結果可為其他機構之參考。

This study examined the factors associated with overproduction of infectious waste and took action to reduce the production of waste from September 2009 to January 2010 in the hemodialysis center of a regional hospital. Before the study, the defective rate was 48%, the weight of infectious waste after hemodialysis was 0.803kg per person-time on average, and the cleaning charge was NT$40.1/kg. We found that the overproduction of infectious waste could be attributed to six major factors: (1) high water contents of artificial kidneys, (2) dirty water in the puncture needles, (3) dirty water from HD sets, (4) unclear operation standards, (5) the lack of standard procedures and (6) incorrect waste sorting. After clarifyingthe attributed factors, the defective rate was reduced to 9.7%, and the weight of infectious waste after hemodialysis was reduced to 0.57kg per person-time on average. The cleaning charge was reduced to NT$28.5/kg. We kept evaluating the results for six months from March to August 2010. A total of NT$48,350 was saved. This study revealed that accurate management of infectious waste can effectively decrease the weight of infectious waste, and lower cleaning costs. Further studies should investigate whether the reduction of infectious waste decreases nosocomial infections. This study can also be used as a reference by other hospitals.