2018 FSA Posters

P056: STANDARDIZED PULSE OXIMETRY PLACEMENT TO REDUCE PERIOPERATIVE WASTE
Jordan Miller; University of Florida

Introduction: Medical waste in the perioperative setting is a significant, but often overlooked issue. Operating rooms account for 70% of hospital waste (2). Hospitals generate approximately 850 million pounds of plastic waste per year (1). Anesthesiologist should take an active role in trying to curtail this amount of waste as it affects the environment and can lead to unnecessary institutional expenditures. At our institution the placement of disposable pulse oximeters occurs in the preoperative area and is performed by nursing staff. There is no institutional standard as to the anatomical placement of this monitor. We believe that the disposable pulse oximeter should be placed on the same upper extremity as the IV and the noninvasive blood pressure (NIBP) cuff should be placed on the opposite side. This is to ensure that the NIBP cuff does not interfere with the administration of  IV medications or cause an artificial desaturation during inflation of the cuff. Often, the disposable pulse oximeter monitor is placed on the upper extremity opposite of the IV which leads to anesthesia providers removing it and placing a new monitor in the operating room. The goal of our project was to create a standard policy to reduce the number of disposable pulse oximeter probes that are wasted in the operating room.

Methods: We randomly surveyed 51 preoperative patients that had IVs and pulse oximeters placed by nursing staff. We then made the policy that nondisposable pulse oximeters would be used preoperatively followed by use of a disposable pulse oximeter in the operating room by anesthesia providers. After two months of the new policy we randomly surveyed 57 preoperative patients to assess compliance.

Results: Initial data collection showed that 55% of patients had pulse oximeters placed incorrectly, contralateral to their IV. The remaining 45% had pulse oximeters placed ipsilateral to their IV. Therefore, 55% of pulse oximeters would be replaced in the operating room. After the intervention, data showed 91% of patients, in accordance with the new policy, did not have a disposable pulse oximeter placed. 4% had a disposable pulse placed correctly on the same side as the IV. 5% had the pulse oximeter placed incorrectly on the opposite side of the IV.

Conclusion: Our initiative to reduce the number of wasted pulse oximeter probes was successful.  With 6,926 surgeries performed in our hospital and the cost of the pulse oximeters being $6 each, the hospital could save approximately $23,000 annually as well as reduce the amount of perioperative waste.