Abstract
BACKGROUND: Improving regulated medical waste (RMW) management is crucial for enhancing planetary health and cost savings. We sought to assess an educational intervention on clinical staff understanding and behavior regarding RMW management. METHODS: This two-month (2023-2024) controlled, prospective educational intervention at the University of Pennsylvania Health System surveyed healthcare workers, including physicians, nurses, and medical assistants, from four inpatient medicine floors and two dermatology clinics. Half of the medicine and dermatology settings were controls. The intervention included in-person staff training sessions and printed materials (posters, bin stickers) describing waste segregation and RMW's environmental, health, and cost impacts. A deidentified online survey pre- and post-intervention measured RMW knowledge and behaviors. The primary outcome was a change in performance on survey questions on proper RMW disposal and RMW's negative externalities. Secondary outcomes were self-reported changes in environmental beliefs and waste stewardship motivators and behaviors, qualitative responses around stewardship barriers, and the impact of clinical role on intervention efficacy. RESULTS: Average baseline inpatient knowledge scores were 6.17 of 9 versus 7.51 for outpatient. The inpatient intervention increased the odds of answering each question correctly by 3-fold (odds ratio: 3.71, 95% CI: 2.218-6.401, p < 0.001). The outpatient clinical role was associated with receptivity to the intervention: the intervention effect was 12.7 times stronger for nursing staff than for physicians (95% CI: 1.86, 263.29, p = 0.024). The intervention improved the overall understanding of RMW's negative environmental impact. CONCLUSIONS: An educational intervention can improve understanding of RMW's proper disposal and environmental impact, particularly among nursing staff, and inform future interventions.