5.8.1. Empty Containers - Used Equipment
Empty containers and used equipment, from which the contents have been fully discharged, should not be returned to the Pharmacy. These should be disposed of in the ward or department as follows:
Vials, ampoules, glass containers, syringes, infusion bags, infusion administration sets and medicinal bottles must be placed in a sharps container. See clinical waste colour coding for appropriate coloured lid.
Plastic/metal ointment and cream tubes must be disposed of via incineration in the appropriate yellow coloured packaging.
If hazardous residues remain (e.g. cytotoxic/cytostatic drugs) dispose of in relevant cytotoxic/cytostatic stream (see section 5.8.4).
5.8.2. Medicinal Products no longer required or expired
All “Prescription Only” Medicines are subject to disposal under the Control of Pollution Act Regulations 1996 and the Hazardous Waste Regulations 2005
All medicines, which are no longer required in the ward or department, must be returned to the Pharmacy for disposal in accordance with the Pharmacy Waste Disposal Policy. This must include patient’s own medicine if the patient no longer requires it. (see Pharmacy SOP)
Controlled drugs are dealt with as in Section 5.8.3 and undischarged aerosols are dealt with in section 5.8.5
Other drugs should be sealed and packaged to prevent breakage during transport.
Pharmacy staff examines returned items. Those suitable for re-issue are returned to stock, the remainder are disposed of as follows:
Returned TPN feeds are to be disposed of via the sink. All other waste is to be incinerated. All other pharmaceuticals, must, after removal of as much packaging as possible, be
Pharmacy Waste Disposal Policy(see SOP). This includes a consignment note system, with disposal to a licensed contractor and final disposal in a licensed incinerator.
Partly used aerosols may still be classed as “prescription only medicines” and must be disposed of as a Hazardous pharmaceutical waste e.g. used dental cartridges containing local anaesthetics. Arrangements should be made toreturn to Pharmacy or dispose of on the wards in containers labelled “pharmaceutical waste” for incineration.
For packaging requirements refer to the Trusts Transportation of Dangerous Goods Policy. 5.8.3 Controlled Drugs
It is a legal requirement that the consumption of these medicines is accurately recorded and that satisfactory reconciliation is achieved. All empty containers can be disposed of as under Section 5.4.2 in the ward or department.
All controlled drugs surplus to requirements or which have expired must be brought to the attention of the Ward Pharmacist when he/she visits the ward.
Disposal of all other controlled drugs must be carried out periodically by the Pharmacy staff, and witnessed by an authorised person, a Pharmacist and recorded in the staff CD register.
For full details see Trust Controlled Drugs Policy (section 6). 5.8.4. Cytotoxic / Cytostatic Products
These products present a major hazard to all staff that handle them. Special care must be taken to prevent serious short and long-term health problems. Cytotoxic / Cytostatic drugs are supplied ready-for-use by the Pharmacy and are labelled “Cytotoxic” to aid identification to hospital staff.
All unused cytotoxic / Cytostatic products surplus to requirements or expired must be returned to the Pharmacy in the container in which they were supplied, well-sealed to prevent leakage. All Cyto products, once returned to the Pharmacy, must be safely packed into yellow plastic clinical waste drums reserved for cyto products. These containers must be labelled
“CYTOTOXIC PHARMACEUTICAL WASTE” with the name and address of the hospital. At Denmark Hill these are passed by Pharmacy to Medirest to hold in a designated store (See Appendix 4– Waste Management Matrix) awaiting removal to a licensed off-site incineration facility. Consignment documentation is completed by Pharmacy.
At PRUH – 770 L waste carts are placed in a secured area on the lower ground floor by the Pharmacy corridor for the disposal of All cyto and pharmaceutical products. These must be segregated accordingly and removed by ISS porters at the scheduled collection times.
Only trained staff using appropriate spillage kits and following planned procedures must handle spillages of Cyto products. All designated clinical areas must have a spillage kit prior to the administration of cytotoxic / cytostatic drugs.
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After the administration of cytotoxic/cytostatic drugs to a patient, the empty infusion bags or syringes that have contained the cytotoxic/cytostatic agent should be disposed of in a purple lidded sharps bin (see 5.4.3) and labelled appropriately. See Waste Management Matrix (Appendix 4)
If wards have part used bottles of chloraphenical eye drops and is not provided with the appropriate disposal route as outlined in appendix 4. send back to Pharmacy.
For a full list of cytotoxic and cytostatic drugs used throughout the Trust, see Appendix 14. 5.8.5. Undischarged Aerosols and Gas Cylinders
All undischarged pharmaceutical aerosols no longer required or expired should be returned to the Pharmacy. Those not fit for use will be listed with the name of the drug and approximately
quantity and stored with other pharmaceutical waste in the Pharmacy (no more than 2 per 60 litre bin), whilst awaiting collection by the contractor.
All undischarged and discharged gas no longer required should be removed to the cylinder store. Contact the Gas Porter for collection and removal.
Faulty gas cylinders should be notified to the following helpdesks;
Site Extension
Denmark Hill Redacted
Princess Royal University Hospital Redacted
Orpington Porters Redacted
Beckenham Beacon front desk Redacted
For porters to return to the gas store. The gas cylinder must be labelled with the fault, area returned from and a contact name. Pharmacy must be made aware of the cylinder for return. BOC will be contacted by Pharmacy for a replacement cylinder.
Undischarged and discharged gas should not be stored or left within corridors or staircases. All undischarged aerosols and gas cylinders require specialist disposal and MUST NOT be disposed of in the domestic or clinical waste stream.
5.8.6. Blood Gas Analyser gas cylinders - ABL800 or ABL700 series and ABL90 FLEX
No ABL800 or ABL700 series and ABL90 FLEX Blood Gas Analyser gas cylinders to be taken directly to Unit 8 for disposal by departments.
No ABL800 or ABL700 series and ABL90 FLEX Blood Gas Analyser gas cylinders to be abandoned in corridors or external areas.
The disposal of all single-use calibration gas cylinders, including depressurised calibration gas cylinders, MUST NOT be disposed of via the domestic, recycling or clinical waste streams.
Collection and disposal of these items must be arranged through the relevant Helpdesk above in accordance with Trust Policy + Procedure giving clear location of storage location and ensuring that the cylinders are depressurised.
Porters on collection of these items ( ABL800 or ABL700 series and ABL90 FLEX Blood Gas Analysers) MUST ensure that the cylinders are depressurised prior to collection. If not, this need to be highlighted to a senior staff member or the Blood gas Biomedical scientist so that arrangement can be made to depressurise the cylinders appropriately before disposal.
Porters to dispose of these items into the Bulk waste disposal skip.