NYS Governor's Awards for Pollution Prevention - University of Rochester
University of Rochester - Strong Memorial Hospital, Rochester
The 750-bed Strong Memorial Hospital is the primary teaching hospital of the University of Rochester School of Medicine and Dentistry, and the School of Nursing. Further, it serves as the tertiary care hospital for the Finger Lakes Region of Upstate New York, and is designated by New York State as the region's Trauma Center.
The hospital was approached by the Monroe County Health Department to participate in a pilot program that would document the facility's mercury usage, disposal practices, and training programs. Areas of opportunity for reduction or replacement were explored and these activities were recorded. A manual was then developed by the Monroe County Health Department in conjunction with Strong Memorial Hospital and the Eastman Dental Center to provide guidance for other facilities on ways to reduce mercury usage and improve handling.
Methodologies and Procedures
The senior director of operations for the hospital formed a multidisciplinary workgroup to achieve the goals of identifying mercury usage and methods to reduce or eliminate uses. If no substitute could be found, waste management procedures were reviewed and altered as necessary. This was backed up with staff training and revised policy.
An initial qualitative survey of mercury usage and management practices was performed to determine the processes and areas of the facility in which mercury was used. Surveys were then distributed to different departments to quantify mercury usage and to identify any mercury containing equipment. This survey included questions regarding disposal. Material Safety Data Sheets were reviewed and vendors contacted to identify mercury-containing products.
A baseline (1997) was established for mercury thermometer usage by using existing materials distribution records. Hazardous Waste disposal records were also helpful in establishing a baseline for usage of other mercury-containing materials.
Mercury thermometers were replaced with non-mercury thermometers including electronic, tympanic and alternative alloy. Mercury sphygmomanometers were replaced with aneroid units. Tungsten-filled gastrointestinal tubing replaced mercury-filled tubing. Histopathology and other clinical laboratories switched to non-mercury processes wherever feasible. The collection and storage system for mercury containing items such as mercury thermometers was improved by placing specially labeled collection containers within each patient care unit. A point of use label was placed on or near each sharps shelters to remind staff not to place mercury thermometers in the medical waste containers. Easy to access battery drop-off locations were established, as was a centralized point for used fluorescent lamp collection. In addition, policy was established against sending mercury thermometers home with patients.
Existing training programs were revised. These revisions included sections specifically about mercury uses, as well as a review of mercury disposal and policy. New training initiatives include the following: A pamphlet about mercury and its uses/disposal for patient care staff; several articles regarding the mercury reduction program in employee distributions; mercury specific training during annual staff training; a check item on inspection lists noting the presence of any mercury containing sphygmomanometers during routine safety surveys so that they can be replaced; and a mercury facts and policy poster presentation for newly hired nurses.
The program was used as an example of a quality improvement initiative during the 1998 JCAHO accreditation survey.
The rate of mercury thermometer usage during the last half of 1998 dropped by nearly 90% from 1997.
Mercury sphygmomanometers have almost all been replaced. Over 900 non-mercury sphygmomanometers are now in use.
Spill response to mercury has been virtually eliminated.
Waste disposal costs for mercury and mercury spill debris has dropped from approximately two 55-gallon size drums per quarter costing around $3,000 per drum for disposal, to less than a 5-gallon size pail costing around $325.
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This page was last modified April 21, 2000