The cost of medical supply waste: peripheral venipuncture and bed baths

Reichert, Magaly Cecília Franchini; D’Innocenzo, Maria

doi:10.37689/acta-ape/2022AO0238666

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Acta Paulista de Enfermagem

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Original Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AO0238666 copy

The cost of medical supply waste: peripheral venipuncture and bed baths

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To measure the costs of medical supply waste in two nursing procedures; to define waste into avoidable and unavoidable; to classify these materials according to the ABC classification and estimate the annual cost of these types of medical supply waste.

Methods

This was a quantitative, exploratory-descriptive single case study. Data were collected between March 2016 and February 2017 in two units of a university hospital in the city of São Paulo, Brazil. The following nursing procedures composed the sample: peripheral venipuncture and bed baths. Medical supply waste was calculated as the sum of the cost of each item of wasted materials. The data were analyzed descriptively in terms of absolute and relative frequencies, average, and standard deviation.

Result

The total of medical supply waste of peripheral venipuncture was R$ 27.20 (US$ 7.31) of which R$ 3.50 (US$ 0.94) were “avoidable”, R$ 23.70 (US$ 6.37), “unavoidable”. The total volume of waste for bed baths was R$ 214,63 (US$ 57.73), of which R$ 149.59 (US$ 40.24) were “avoidable” and R$ 65.04 (US$ 17.49) “unavoidable”. More than 70% of the wasted supplies were class A materials in both procedures. The projected annual cost of medical supply waste was R$ 83,858.53 (US$ 22,557.94).

Conclusion

Medical supply waste presented a distinct behavior in the observed procedures, which points to the need for it to be identified, analyzed and calculated for nurses to make decisions efficiently.

Material resources in health; Costs and cost analysis; Nursing care; Hospital care

Items	Materials	Reference unit	Amount wasted	Average waste	Standard Deviation	Maximum
1	White surgical tape 25mm X 10m	Cm	21	0.318	1.915	14
2	70% ethyl alcohol 70% 100ml btl	mL	9	0.136	0.821	6
3	Hydrophilic cotton 500g	Grams	5.0	0.076	0.404	3.0
4	0.5% Chlorhexidine gluconate alcohol sol l100 mL btl	mL	3	0.045	0.369	3
5	Gauze compress 7.5x7.5 cm 13F pkg with 10 sterile units	Units	166	2.515	4.058	18
6	Adhesive 25 mm x 10 M	Cm	3	0.045	0.369	3
7	2-way Y extension with clamp	Units	2	0.030	0.173	1
8	Hypoallergenic tape for dressing 10 x 4.5 M	Cm	30	0.455	3.693	30
9	Glove for non-sterile procedure	Units	5	0.076	0.267	1
10	0.9% saline solution 10mL amp	mL	150	2.273	1.368	10
11	0.9% saline solution 100mL bag	mL	1.060	16.061	32.717	90

Items	Materials	ABC Classification ^(a)	“Unavoidable” waste	Reference Unit	Average unit cost (R$)	Amount wasted	Cost of waste (R$)	Cost of waste (US$)
	TOTAL						27.20	7.31
1	White surgical tape 25mm X 10m	A		cm	0.003	21	0.06	0.01
2	70% ethyl alcohol 70% 100ml btl	A	x	mL	0.011	9	0.10	0.02
3	Hydrophilic cotton 500g	B		grams	0.022	5.0	0.11	0.03
4	0.5% Chlorhexidine gluconate alcohol sol l100 mL btl	A	x	mL	0.014	3	0.04	0.01
5	Gauze compress 7.5x7.5 cm 13F pkg with 10 sterile units	A	x	units	0.039	166	6.47	1.74
6	Adhesive 25 mm x 10 M	A		cm	0.005	3	0.02	0.005
7	2-way Y extension with clamp	B		units	0.840	2	1.68	0.45
8	Hypoallergenic medical tape for dressings 10 x 4.5 M	B		cm	0.031	30	0.93	0.25
9	Glove for non-sterile procedure	A		units	0.140	5	0.70	0.19
10	0.9% saline solution 10mL amp	A	x	mL	0.015	150	2.25	0.61
11	0.9% saline solution 100mL bag	A	x	mL	0.014	1,060	14.84	4.00

Items	Materials	Reference unit	Amount wasted	Average waste	Standard Deviation	Median	Minimum	Maximum
SOP materials
1	Wooden tongue depressor	units	11	0.13	0.373	0	0	2
2	White surgical tape 25mm X 10m	cm	1,705	20.30	18.504	15	0	80
3	70% ethyl alcohol 100 mL btl	mL	1.000	11.90	21.772	0	0	75
4	Disposable long-sleeved faux fabric apron	units	24	0.29	0.785	0	0	5
5	Twill shoelace 10m x 10mm	cm	90	1.07	3.112	0	0	10
6	0.12% chlorhexidine glucose w/o alcohol 250 mLbtl	mL	22	0.26	1.424	0	0	10
7	Gauze compress 7.5x7.5 cm 13F pkg with 10 sterile units	units	1,076	12.81	14.208	10	0	60
8	Gauze compress 7.5x7.5 cm 13F pkg with 500 non-sterile units	units	2	0.02	0.153	0	0	1
9	Disp plastic cup 120 ml	units	9	0.11	0.311	0	0	1
10	Adhesive 25 mm x 10 M	cm	120	1.43	11.101	0	0	100
11	Geriatric disposable diaper w/ gel	units	35	0.42	0.779	0	0	4
12	Fabric sheet	units	34	0.40	0.494	0	0	1
13	Glove for non-sterile procedure	units	69	0.82	2.095	0	0	16
14	Dispo rectang triple mask with BFE filter and cords	units	1	0.01	0.109	0	0	1
15	Garbage bag thickness 0.07 - 200 L capacity l red	units	1	0.01	0.109	0	0	1
16	Saline solution (sodium cl) 0.9% 10 ml amp	mL	100	1.19	0.476	0	0	20
Extra materials
1	Crepe bandage 13 strands 20 comx 4.5 M	units	2	0.02	0.153	0	0	1
2	2% chlorhexidine glucose detergent 100 ml btl	mL	300	3.57	15.101	0	0	100
3	Intravenous device no. 21	units	5	0.06	0.324	0	0	2
4	Adult disposable electrode	units	54	0.64	1.189	0	0	5
5	Adhesive tape crepe 19 x 50m	cm	21	0.25	0.890	0	0	100
6	Sterile surgical glove	units	4	0.05	0.214	0	0	1
7	PPF mask-Biohazards	units	1	0.01	0.109	0	0	1
8	3 way disposable faucet with Luer lok	units	22	0.26	0.679	0	0	2
9	Disposable hair cap	units	21	0.25	0.955	0	0	5

Items	Materials	ABC Classification^(a)	“Unavoidable” waste	Reference unit	Average unit cost (R$)	Amount wasted	Cost of waste (R$)	Cost of waste (US$)
TOTAL							214.63	57.73
Standard material							170.24	45.79
1	Wooden tongue depressor	C		units	0.020	11	0.22	0.06
2	White surgical tape 25mm X 10m	A		cm	0.003	1,705	5.22	1.40
3	70% ethyl alcohol 100 mL btl	A	x	mL	0.011	1,000	11.30	3.03
4	Disposable long-sleeved faux fabric apron	A		units	0.970	24	23.28	6.26
5	Twill shoelace 10m x 10mm	B		cm	0.0002	90	0.02	0.005
6	0.12% chlorhexidine glucose w/o alcohol 250 mL btl	B	x	mL	0.025	22	0.55	0.15
7	Gauze compress 7.5x7.5 cm 13F pkg with 10 sterile units	A	x	units	0.039	1,076	41.96	11.29
8	Gauze compress 7.5x7.5 cm 13F pkg with 500 non-sterile units	A	x	units	0.030	2	0.06	0.02
9	Disp plastic cup 50 ml	A		units	0.010	9	0.09	0.02
10	Adhesive 25 mm x 10 M	A		cm	0.005	120	0.56	0.15
11	Geriatric disposable diaper w/ gel	A		units	0.810	35	28.35	7.63
12	Fabric sheet ^(b)	-		units	1.370	34	46.58	12.53
13	Glove for non-sterile procedure	A		units	0.140	69	9.66	2.60
14	Dispo rectang triple mask with BFE filter and cords	A		units	0.100	1	0.10	0.03
15	Garbage bag thickness 0.07 - 200 L capacity l red	A		units	0.790	1	0.79	0.21
16	Saline solution (sodium cl) 0.9% 10 ml amp	A	x	mL	0.015	100	1.50	0.40
Extra materials							44.39	11.94
1	Crepe bandage 13 strands 20 comx 4.5 M	B		units	0.800	2	1.60	0.43
2	2% chlorhexidine glucose detergent 100 ml btl	A	x	mL	0.019	300	5.55	1.50
3	Intravenous device no. 21	B		units	0.150	5	0.75	0.20
4	Adult disposable electrode	A		units	0.32	54	17.28	4.65
5	Adhesive tape crepe 19 x 50m	B		cm	0.00052	21	0.01	0.002
6	Sterile surgical glove	A		units	1.04	4	4.16	1.12
7	PPF mask-Biohazards	B		units	1.89	1	1.89	0.51
8	3 way disposable faucet with Luer lok	A		units	0.55	22	12.10	3.25
9	Disposable hair cap	A		units	0.05	21	1.05	0.28

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author: Magaly Cecília Franchini Reichert E-mail: magaly.reichert@unifesp.br