Disposal of disposable instruments

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Hi advice needed. I have been in private practice for nearly two years now and because my practice is mainly domicilliary (I also rent a room in a GP practice one day a week) I have been using vacuum packed sterile disposable instruments which I keep for collection/disposal by a separate company. Due to inconvenience/poor service and cost my question is - as they are not clinical waste do I need to have a contract which shows that they are being disposed of or could I just collect them and regularly dispose of them at the local amenity skips as scrap metal? All comments gratefully received.

 

Hi Jacqui,

You do not mention where you are located. Any waste generated by a business is not (in my experience) permitted to be disposed of other than by a registered waste collection carrier.

As podiatrists we have to abide by a 'Duty of Care' concerning the appropriate disposal of all waste.

Regards,

Mandy.

 

Thanks for the reply.
Having read other posts regarding disposable instruments versus autoclave there are a lot of misconceptions out there. There are assumptions that the used instruments go to landfill, whereas I know that mine are collected and sent for melting down, as is most scrap metal at local amenity sites.
The HPC document requires us to know the correct procedures for decontamination etc but given that this isn't clinical waste (dressings/blood/tissue etc) what are the requirements/correct procedures for the disposal of disposable instruments (excluding sharps).
Advice is always given on the best practice example or gold standard, which is fine if you are clinic based but ask most district nurses what they do with the soiled dressings when on domiciliary visits and the answer will be it goes in the patients bin, and not carried back to the surgery for disposal in the clinical waste.
Ideally I would love to have my own clinic, or failing that the space at home to have my own autoclave and vacuum pack my instruments before going out, but I have to work within the constraints I have, and this means single use instruments and a contract for their collection, which all adds to costs and inconvenience.
If there are practitioners out there that have found reliable cost effective means of disposal I would love to hear from them.
Jacqui

 

Hi Jacqui,
Hope all is well. I too have been using disposable instruments and am looking into disposal services available in my area. Will keep you posted when I've found someone, if I find a national company that services your area, all well and good.
Tara :drinks

 

I would disagree with you here. The reason you either reprocess the instruments or use single use, is because of the risk of cross infection due to instrument contamination, which is the same reason you change blades, don't reuse dressings etc. So the disposable instruments are clinical waste and should be disposed of accordingly (though the UK definitions may be different to the Aust ones.) All of our single use instruments are disposed off as clinical waste, and most often in a sharps container.

 

Hi Tara,
I have a contract with a national company, not happy about the quality/regularity of the service - I have to keep reminding them how many times a year they are supposed to collect!! So have been looking around myself, when the question was posed by one supplier - 'why are they categorised as clinical waste when the companies disposing of them put them to landfill?' :craig: I am unable to find any legislation regarding the disposal, so realised there is nothing to stop people putting them in amenity sites themselves. Wondered what others were doing? KEEP WELL :morning: Jacqui

 

Thanks for the reply. I already have them collected in a sharps container and classed as clinical waste, the question arose when searching for another contractor as having problems with the current one, why pay for collection and disposal of clinical waste, when they are probably going to landfill anyway? Busy weighing up renting vacuum autoclave and buying quality instruments and time/cost involved against ease of disposable and the cost of disposal. :dizzy: Jacqui

 

Hi Jacqui,

Not wishing to be argumentative.....

I contacted my local authority a few years ago RE: recycling (in this instance it was to recycle the empty water bottles I then used for my autoclave). I was informed that as a business I was NOT permitted to recycle any waste whatsoever as the council has no facility to recycle trade waste. I asked could I not place the containers into the usual recycling facility either at home for collection or indeed take the containers directly to the local site. I was told that if I did I would be liable to a large fine for disposing of trade waste in a domestic facility!

Made no sense to me but hey ho they're in charge. :hammer:

Good luck. Perhaps your council are more progressive than Doncaster

Regards,

Mandy.

 

Thanks, Some would say I'm cynical - I think I'm a realist - I don't think any of the amenity sites are run for the use of the customers, just for someone in the council office that makes the decisions - try turning up in a van and disposing of your old washing machine - it's automatically assumed you are a plumber and therefore trade waste!!! :craig: But put it in the back of your car - and hey ho no problems - only a scratched car When are people at the council going to realise that as long as it's going to them it's not in some roadside ditch - which costs them money to clean up!! You have now raised another issue. I put the packaging from the disposable instruments into my recycling bags at home, and put them out for collection as normal with the household waste, so looks as if I shall get into trouble with that!:bang: A job with the NHS is starting to look more promising and less hassle!!:boohoo:

 

Found a company that provides yellow waste bins in various sizes and collects when full (H&A services, who cover most of the South West, sorry Jacqui checked but they do not cover your area). The disposable instruments are classed the same as sharps and are incinerated. They are going to charge £28 for an 11.5 litre box. They were really helpful on the phone and provide a certificate of disposal for my records.

:drinks

 

Stephen

Like you and others, I have worked in many hospital, community and private health care facilities. Outpatient clinics, operating theatres and poky little podiatry practices.

One thing I have always had a little trouble grappling with is the concept of what is 'clinical waste' and what isn't. And more to the point, what is reasonable and cost effective, rather than seeking the highest common denominator simply because we work in health care.

Let me cite some examples. In many operating theatres, disposable drapes which may have small amounts of blood or other human tissues are put in general waste, whilst heavily soiled items, free flowing blood from suction, etc, is put (quite rightly) into clinical waste. After seeing this several times, it made me question the 'default' setting that we take in podiatry.

It leads one to start thinking about other forms of common biological waste. Feminine hygiene products, used bandaids thrown out by the kids, soiled nappies...the list goes on. There are certainly guidelines on all of this...

Sharps go in sharps bins so we don't stab ourselves while we take the rubbish out. Fair enough.

I think, in some respects, we carry the can (joke) a bit far on clinical waste. I also accept that it is never the *wrong* thing to discard contaminated items in clinical waste.

Based on the RACGP Guidelines, the General Practice Australia Accreditation definition is;

Another interesting comment is from the Queensland Government EPA:

Anyway, don't get me started on individually packaged sterile instruments for simple nail cutting...I'm sure that would spark a debate :dizzy:

LL

 

Jacqui Walker - I'm assuming you are a HPC registered Podiatrist?

I must admit I am shocked you would consider disposing of them in the way you describe above. I would have though it would be obvious to you that used disposable instruments ARE classed as clinical waste. Disposing of them in civil amenities sites may see you in a FTP hearing.

I sometimes use disposables for doms patients, taking care to dispose of them in the sharps waste in my practice as soon as I can. If your waste contractor can't deliver, I suggest you find an other. If they are destined for landfill eventually, that is not your problem; protecting your patients/the public and preventing cross-infection is.

 

Hi I am based in london and have a contract with my local council for clinical waste. They will collect on request and charge by the bag/sharps box, they will guide you through the paperwork logisitcs and supply the containers. I rarely use disposable intruments (as i use a benchtop vacume autoclave) but when i do i dispose of via the sharps bin. The council as clinical waste managers have a duty to transport and dispose of the waste appropriately (hence the paper trail/registration process) so I cant imagine that it would end upo in landfill!