Impact of intervention on healthcare waste management practices in a tertiary care governmental hospital of Nepal

Abstract

BackgroundHealthcare waste is produced from various therapeutic procedures performed in hospitals, such as chemotherapy, dialysis, surgery, delivery, resection of gangrenous organs, autopsy, biopsy, injections, etc. These result in the production of non-hazardous waste (75–95%) and hazardous waste (10–25%), such as sharps, infectious, chemical, pharmaceutical, radioactive waste, and pressurized containers (e.g., inhaler cans). Improper healthcare waste management may lead to the transmission of hepatitis B, Staphylococcus aureus and Pseudomonas aeruginosa.MethodsThis evaluation of waste management practices was carried out at gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards at Government of Nepal Civil Service Hospital, Kathmandu from February 12 to October 15, 2013, with the permission from healthcare waste management committee at the hospital. The Individualized Rapid Assessment tool (IRAT), developed by the United Nations Development Program Global Environment Facility project, was used to collect pre-interventional and post-interventional performance scores concerning waste management. The healthcare waste management committee was formed of representing various departments. The study included responses from focal nurses and physicians from the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards, and waste handlers during the study period. Data included average scores from 40 responders. Scores were based on compliance with the IRAT.ResultsThe waste management policy and standard operating procedure were developed after interventions, and they were consistent with the national and international laws and regulations. The committee developed a plan for recycling or waste minimization. Health professionals, such as doctors, nurses and waste handlers, were trained on waste management practices. The programs included segregation, collection, handling, transportation, treatment and disposal of waste, as well as occupational health and safety issues. The committee developed a plan for treatment and disposal of chemical and pharmaceutical waste. Pretest and posttest evaluation scores were 26% and 86% respectively.ConclusionsDuring the pre-intervention period, the hospital had no HCWM Committee, policy, standard operating procedure or proper color coding system for waste segregation, collection, transportation and storage and the specific well-trained waste handlers. Doctors, nurses and waste handlers were trained on HCWM practices, after interventions. Significant improvements were observed between the pre- and post-intervention periods.

Management of solid healthcare wastes in some government healthcare facilities in Enugu state, Southeast Nigeria: a cross-sectional study

“…28,29 To quantify the wastes generated by each Department of a HCF, modified methods of inventory taking were used. 10,14 Segregated wastes were collected daily in polythene waste bags.…”

Impact of an intervention programme on knowledge, attitude and practice of healthcare staff regarding pharmaceutical waste management, Gaza, Palestine

“…34 In contrast, studies conducted in Jordan and Nepal found that all collected medical waste was stored in a central storage area within the hospital premises. 40,41 The mean practice score was 36.9% (SD 24.7%) ( Table 6), demonstrating a poor level of PWM practice. This could be explained by the lack of guidelines, lack of training courses and programmes, inadequate supplies, lack of supervision, and lack of incentive for proper waste management.…”

Logística Reversa de Resíduos da Classe D em Ambiente Hospitalar: Monitoramento e Avaliação da Reciclagem no Hospital Infantil Cândido Fontoura

“…Estudos realizados na África demonstraram que a prática do manejo correto dos RSS ainda é incipiente, seja pela total ausência de leis, seja pela falta de conscientização de funcionários (Tesfahun, Kumiel, Legesse, Kloos, & Beyene, 2014;Sapkota, Gupta, & Mainali, 2014).…”