NOTE: This sample survey is included as a model for hospitals that
are designing their own process for auditing waste management practices.
Please do not fill in this survey and return it to the Sustainable
Hospitals Project or to the Center for Health, Environment
and Justice / Health Care Without Harm.
Name of Hospital: ______________________________________
Please complete each question by circling the correct answer. Thank you very much for your cooperation.
Waste Management Practices
1. What is your hospital's current method for the treatment and disposal of regulated medical waste?
On site:
A) Autuclave
B) Incineration
C) Other (please explain)
_____________________________
Off site:
A) Autoclave
B) Incineratiaon
C) Other (please explain)
______________________________
Combination:
A) Onsite:_______________________
B) Offisite:______________________
If your hospital uses incineration as a waste disposal method, do you also burn unregulated waste?
A) Yes
B) No
2. In light of the new medical waste incinerator regulations (August 1997) are you in the process of re-evaluating how to handle your hospital's regulated medical waste?
A) Yes
B) No
If yes, what options are you considering?
A) Upgrading incinerator with new pollution controls
B) Shutting down incinerator
C) Contracting for off site services
D) Exploring alternative technologies for on site treatment and disposal
E) Other (please explain)____________________________________
3. Has your hospital done a waste audit in the last three years?
A) Yes
B) No
4. Please circle the items your hospital currently collects for recycling.
A) White office paper
B) Mixed office paper
C) Corrugated cardboard
D) Boxboard
E) Newspaper
F) Magazines
G) Books
H) Junk Mail
I) Aluminum
J) Steel Cans
K) Glass
L) Plastics (circle types)
#1 PET
#2 HDPE
#3 PVC
#4 LDPE
#5 PP
#6 PS
#7 Mixed
M) Batteries (circle types that are recycled)
1. Ni-cad
2. Mercuric oxide
3. Alkaline
4. Lead acid
5. Zinc air
6. Lithium
7. Dry cell
8. Others
N) Toner cartridges
O) Overhead transparency film
P) Fluorescent lights
Q) Silver (x-ray film and solution)
R) Formatin
S) Xylene
Procurement Practices
5. Does your hospital have a program in place to eliminate the use of mercury-containing products?
A) Yes
B) No
6. Does your hospital require a disclosure by your vendors of mercury concentration in chemicals/reagents?
A) Yes
B) No
C) In certain areas only (e.g., Lab/Pharmacy)
7. Does your hospital purchase mercury-containing:
Patient thermometers?
|
Yes
|
No
|
Blood pressure monitoring devices?
|
Yes
|
No
|
Gastrointestinal diagnostic equipment?
|
Yes
|
No
|
Thermometers (lab use)?
|
Yes
|
No
|
Fixatives (B5, Zenkers, others)?
|
Yes
|
No
|
8. Does your hospital have a program in place to reduce PVC (#3) plastic packaging and containers?
A) Yes
B) No
9. Does your hospital have a program in place to minimize the purchasing of PVC (#3) products?
A) Yes
B) No
10. Does your hospital luse PVC (#3) plastic IV bags?
A) Yes
B) No
C) Unsure
11. Does your hospital have guidelines that specify a purchasing preference for products in minimal packaging or in packaging that is recyclable or made from recycled materials?
A) Yes
B) No
12. Does your hospital have a policy that promotes the use of reusable prodoucts rather than single use, disposable products where feasible?
A) Yes
B) No
13. Does your hospital have a policy that promotes the use of office paper that is
A) Chlorine-free?
B) Greater than 20% recycled content?
C) Both?
D) Neither?
14. Does your hospital have a policy that promotes the purchasing of unbleached, processed chlorine-free or totally chlorine-free sanitary napkins, napkins, paper towels and toilet paper?
A) Yes, for three or four of the products
B) Yes, for one or two of the products
C) No
Employee Education
15. Are staff members given annual training on the health and environmental effects of mercury?
A) Yes
B) No
C) Included in hazard communication program
16. Does your hospital provide employee training on how to propely clean up a mercury spill?
A) Yes
B) No
C) Only to designated personnel
17. Does your hospital provide annual education on waste management for employees?
A) Yes
B) No
If yes, does that education include information on waste segregation including proper identification and disposal of red bagged or infectious waste?
A) Yes
B) No
Community Health
18. Have your hospital's sewer traps or catch basins every been cleaned to remove mercury?
A) Yes
B) No
19. Does your hospital distribute mercury containing thermometers to new parents as a take-home item?
A) Yes
B) No
|
