Date of Award

Summer 2023

Project Type


College or School




Program or Major

Direct Entry Masters of Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten


Background: The operating room (OR) is known to be one of the largest producers of medical waste and of the surgical specialties, orthopedic surgery tends to the largest portion of this. Waste from the OR can be mitigated by recycling non-contaminated materials. This reduces the number of raw materials needed to create new products, decreases landfill use, and lowers hospital costs.

Local Problem: It was observed that a gap in knowledge existed related to recyclables in the OR of a large medical center in New England. Also, it was observed that there was potential for waste and recycling to be more accurately segregated and for blue wrap to be separated from general recycling.

Specific Aims: The aim was to increase circulating nurses’ and surgical technologists’ confidence in knowledge of recyclables in the operating room. Additionally, the aim was to increase the proportion of recycling by 15%, increase the accuracy of recycling to 95%, and increase the accuracy of blue sterilization wrap segregation to 100%.

Methods: The Plan-Do-Study-Act (PDSA) model was used for implementation. Pre- and post-education waste audits of primary total knee arthroplasties were performed to assess recycling, blue wrap, and waste. Pre- and post-education surveys were utilized to assess staff confidence.

Interventions: An educational presentation was given to orthopedic surgical service circulating nurses and surgical technologists. Additionally, a visual poster board was displayed in the staff breakroom.

Results: Survey data indicated an increase between pre- and post-education confidence in staff, which met the specific aim. Waste audit data showed a 26% increase in pre-operative proportions of recycling and an approximate 4% decrease in blue wrap by weight. There was a decrease in recycling accuracy by 6.6% but an increase of about 25% in the accuracy of blue wrap segregation post-intervention.

Conclusion: Education for a subset of perioperative staff aided in increased confidence in recycling in the OR. Further improvements in staff confidence, recycling, and blue sterilization wrap segregation throughout surgical specialties may be possible through additional education and physical resources.