title: [What nurses see? Occurrence and typology of wastes in medical and surgical wards: a cross-sectional study.]
abstract: To describe the occurrence and the typology of waste in the nurses clinical practice as well as the differences between the medical and surgical area.
  
  
  
  A cross-sectional study was conducted in a north eastern Italian hospital. Data collection, conducted on 100 nurses in September 2015, was carried out using a semi-structured questionnaire consisting of 56 items and eight dimensions (Overproduction / Underutilisation, Wait, Stocks, Process, Inefficiency and Errors, Material Transport and Information Flows, Movements, Dispersion of Knowledge).
  
  
  
  In a nurses' working week 2,028 ± 9.2 waste occurrences were reported, with an average of 20.2 ±9.2 per nurse. Seven hundred fifty-nine (37.4%) of them occurred in the medical area, while 1,269 (63.6%) occurred in the surgical area. The most frequent number of waste (398; 19.6%) occurred in the "Process" dimension. Across the investigated dimensions, the main types of waste were: the inappropriate use of energy (30.0%), waiting for the physician (17.1%), shortage of materials (33.1%), the excess of human resources distributed in a sub-optimal manner (31.8%), human resources shortage (22.4%), incomprehensible and/or incomplete therapeutic prescriptions (22.6%), the search of materials in distant warehouses or in outside locale (23.9%), the transfer of team members from one department to another (30.0%), and limited application of scientific evidence in clinical practice (51.7%). No statistical differences emerged between the two investigated clinical areas (p-value = 0.480).
  
  
  
  The study is a contribution to the national debate on the phenomenon of waste in health care organizations, and provides useful insights on the possible strategies of its containment.
authors.affiliation: PhD, MSN, RN, Tutor e docente, Corso di Laurea in Infermieristica - Università degli Studi di Trieste Correspondence: adante@units.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Dante
authors.affiliation: RN, Università degli Studi di Trieste.
authors.forename: Michela
authors.initials: M
authors.lastname: Marega
authors.affiliation: RN, Dipartimento Medico, Azienda per l'Assistenza Sanitaria n. 2 "Bassa Friulana - Isontina" di Gorizia.
authors.forename: Adriana
authors.initials: A
authors.lastname: Peteani
authors.affiliation: RN, Dipartimento Chirurgico, Azienda per l'Assistenza Sanitaria n. 2 "Bassa Friulana - Isontina" di Gorizia.
authors.forename: Adriana
authors.initials: A
authors.lastname: Checchi
authors.affiliation: RN, MSN, Associate Professor, Dipartimento di medicina cinica, sanità pubblica, scienze della vita e dell'ambiente.
authors.forename: Loreto
authors.initials: L
authors.lastname: Lancia
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D013502:General Surgery; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006797:Housekeeping, Hospital; D006801:Humans; D007388:Internal Medicine; D007558:Italy; D008297:Male; D017744:Medical Waste Disposal; D008875:Middle Aged; D024802:Nurse's Role; D011795:Surveys and Questionnaires; D000078329:Workforce
chemical_list: D017744:Medical Waste Disposal