Pharmaceutical Waste Management Program St. Joseph Mercy Oakland. Pharmacy/Patient Care

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Theresa Walker
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1 Pharmaceutical Waste Management Program St. Joseph Mercy Oakland Pharmacy/Patient Care

2 Objectives Understand the background and regulatory requirements Identify pharmaceutical waste and how to dispose Identify the different pharmaceutical waste containers and what goes in each Define Oncology Pharmaceuticals Describe how to label waste handling containers 2

different pharmaceutical waste containers and what goes in each

3 BACKGROUND AND REGULATORY REQUIREMENTS 250 million pounds of pharmaceutical waste disposed is from hospitals and long-term care centers annually, most of which ends up in our waterways. There are many rules and regulations regarding pharmaceutical waste management. 3

centers annually, most of which ends up in our waterways.

4 Background In a US Geological Survey tested 139 rivers in 30 states and found that over 80% of stream samples showed evidence of prescription and non-prescription drugs, antibiotics, steroids and hormones. Hospitals are under the close watch of the Michigan Department of Environmental Quality (DEQ) and the Environmental Protection Agency (EPA) to follow laws governing proper pharmaceutical waste disposal. 4

5 Associate Training Associates must be trained if handling hazardous waste Employees whose responsibilities include hazardous waste management, storage, transport, or recordkeeping require hazardous waste training. Employees must receive initial training within six months of the date of their employment or a change in job requirements. Annual training required thereafter 5

6 WHAT IS PHARMACEUTICAL (RX) WASTE? 6

7 Pharmaceutical (Rx) Waste Black containers in the medication room and in the soiled utility will be used for: All medication EXCEPT: incompatible drugs No Controlled Substances and sharps are NOT to be put in black containers Unused IV drug solutions Tablets and capsules Partial vials Partial vaccine vials Nicotine, Warfarin & Nitroglycerin wrappers 7

Substances and sharps are NOT to be put in black containers Unused IV drug solutions

8 Incompatible Drugs All Pharmaceutical Canisters/ Inhalers/ Aerosols The items listed below must be sent home with patient or returned to pharmacy: Albuterol Dermoplast Symbicort Atrovent Combivent 8

sent home with patient or returned to pharmacy:

9 Incompatible waste sent back to pharmacy These items must be returned to pharmacy: Amyl nitrate Granulex Silver nitrate (unused) Cyanide Antidote Kit Cortisporin Otic 9

10 Bulk Chemotherapy Waste BULK Chemotherapy containers with residue, including oral chemotherapy containers Partial chemotherapy IV bags, tubing and vials Chemotherapy Spill Clean Up Kit Contaminated gloves, goggles, gowns 10

Partial chemotherapy IV bags, tubing and vials

11 Trace Chemotherapy Waste TRACE Non Contaminated: Empty Chemotherapy vials, syringes, needles, IVs, tubing Personal Protective Equipment (PPE) used to prepare or administer chemotherapy

12 Dual Waste Infectious and hazardous waste Pharmaceuticals that are both infectious and hazardous waste cannot be disposed of in red bags due to hazardous constituent. Put these in the black containers. For example: a soiled dressing that has a medication on it. 12

13 Not Hazardous Waste Regulated Medical Waste Sharps containers (needles, etc.) Red bag wastes Controlled Substances IV 13 Witness and waste to drain Can still cut and drain non-pharmaceuticals to the drain Maintenance IVs and Fluids (saline, dextrose, etc.)

14 Sharps containers Sharps containers: All empty sharps, needles and ampoules Lancets & scalpels Empty vaccine vials/syringes Broken glass ampoules IV catheters, stylets, butterflies Disposable suture scissors

Empty vaccine vials/syringes Broken glass ampoules

15 Disposed in sink or toilet All controlled substances- injections, infusions Oral controlled medication -solids crush and flush Patches of controlled medications -fold and flush Cut and drain Maintenance electrolyte IV solutions (sodium, potassium, magnesium) Dextrose IV solutions WITHOUT medication instilled: Potassium chloride Potassium phosphate Sodium phosphate Calcium Sodium bicarbonate Dextrose Saline

electrolyte IV solutions (sodium, potassium, magnesium) Dextrose IV solutions WITHOUT medication

16 Waste Handling Movement of Containers Spill Response

17 Container Requirements 17 Hazardous (Universal) wastes must be stored in a closed and labeled container. The label must have at least the words Universal Waste, a description of the contents, and the dates that the container was both started and filled.

The label must have at least the words Universal Waste, a

18 Protect Yourself Always protect yourself when handling wastes: Wear proper Personal Protective Equipment (PPE) such as gloves Make sure that containers are tightly sealed before moving them Hold containers or liners away from your body when moving them

Make sure that containers are tightly sealed before moving

19 Movement of Containers The containers will be transported to the Hazardous Waste Storage Area when full by Environmental Services (EVS). A new empty container will replace the removed container. When assembling the containers, ensure the lid is securely fastened and absorbent is placed into bottom of container. 19

A new empty container will replace the removed container.

20 Movement of Containers ALWAYS CHECK to make certain that the container is closed prior to moving it. Always move containers in an upright position to prevent spills and leaks. 20

21 Spill Response If there is a spill of hazardous wastes: Notify Environmental Services Secure Area Identify Material Contain and Clean-up if safe to do so Spill Kits, Absorbents Dispose of Hazardous Clean-up Materials Properly Hazardous Waste Container 21

22 Pharmaceutical Wastes Don t know where to put it? Black container, or drain? Contact Pharmacy Ext

Vanderbilt University Medical Center Pharmaceutical Waste Program USER INSERVICE

Vanderbilt University Medical Center Pharmaceutical Waste Program USER INSERVICE Training and Education Plan This session is intended to train and provide super-users with necessary resources to effectively