Case study: Nebraska Ebola unit details waste removal

Washington, DC, December 1, 2014 – The Nebraska Biocontainment Unit, located at the Nebraska Medical Center, shares best practices for Ebola waste removal, in a commentary published in in the December issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

One of the key areas of concern related to the treatment of Ebola patients in the United States is waste removal. According to the case study, Ebola patients treated by the Nebraska team produced about 23 cubic feet – more than 50 pounds – of solid waste per day, most of which was personal protective equipment (PPE) worn by healthcare workers. Additionally, the patients produced approximately 2.3 gallons of liquid waste per day.

According to the U.S. Department of Transportation, which regulates hazardous material, Ebola waste is considered category A – meaning the waste is known or expected to contain a pathogen that is capable of causing fatal disease. Waste in this category requires many steps, and even a special permit, to ensure safe disposal.

The Nebraska Biocontainment Unit developed a strategy to convert the category A waste into category B medical waste, to enable safe disposal. This was done by transferring all solid waste, including PPE, patient linens, scrubs, towels, etc., to a pass-through autoclave system. After it was sterilized by the autoclave, the waste was placed in biohazard bags and into rigid packaging to be disposed of as category B medical waste. 

Liquid waste produced by the Ebola patient was disposed of into a toilet with hospital-grade disinfectant and held for 2.5 times the recommended time before flushing the waste. This method was fully vetted by numerous stakeholders and surpasses the CDC guidance regarding Ebola liquid waste removal. 

This case study seeks to provide other hospitals and facilities with guidance on the best practices associated with Ebola waste removal.


ABOUT AJIC: AMERICAN JOURNAL OF INFECTION CONTROL

AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.

 

ABOUT APIC

APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at www.apic.org. Follow APIC on Twitter: http://twitter.com/apic and Facebook: www.facebook.com/APICInfectionPreventionandYou. For information on what patients and families can do, visit APIC’s Infection Prevention and You website at www.apic.org/infectionpreventionandyou.  

 

NOTES FOR EDITORS 

“Nebraska Biocontainment Unit perspective on disposal of Ebola medical waste” by John Lowe, Shawn Gibbs, Shelly Schwedhelm, John Nguyen and Philip Smith appears in the American Journal of Infection Control, Volume 42, Issue 12 (December 2014).

Authors:

John J. Lowe, PhD (Corresponding Author)
Department of Environmental, Agricultural & Occupational Health, University of Nebraska Medical Center College of Public Health, Omaha, NE
Nebraska Biocontainment Unit, The Nebraska Medical Center, Omaha, NE

Shawn G. Gibbs, PhD
Department of Environmental, Agricultural & Occupational Health, University of Nebraska Medical Center College of Public Health, Omaha, NE
Nebraska Biocontainment Unit, The Nebraska Medical Center, Omaha, NE

Shelly Schwedhelm, RN, MSN
Nebraska Biocontainment Unit, The Nebraska Medical Center, Omaha, NE
The Nebraska Medical Center, Omaha, NE

John Nguyen, BS
The Nebraska Medical Center, Omaha, NE

Philip W. Smith, MD
Nebraska Biocontainment Unit, The Nebraska Medical Center, Omaha, NE
Division of Infectious Disease, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE

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