Solid waste management in primary healthcare centers: application of a facilitation tool

Abstract

Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services.

Nursing professionals' knowledge regarding the management of waste produced in primary health care

“…Production of healthcare waste (HCW) increased significantly in the past decades as a consequence of the growth of the population worldwide and the resulting higher demand for health services. This issue is even more critical in populous and developing countries, such as Brazil, given that inadequate waste management represents a potential risk for the population (1)(2)(3) .…”

“…The phases related to the management of this type of waste include separation, identification, collection, internal and external transportation, temporary and external storage, treatment, and final disposal. These steps are indispensable and interdependent, although the absence of separation results in an inadequate waste destination, underused reusable materials, and increased risk of occupational accidents (1)(2)(3) .…”

Gerenciamento de resíduos sólidos na atenção primária à saúde

“…8 It is important, even if there is no regulation in force in Brazil that requires the identification of common waste, this initiative because it allows the implementation of selective collection programs, because many social and environmental impacts are avoided. 5 It was found in research conducted in 3 Basic Units of Pelotas, Rio Grande do Sul, that 57.8% of professionals who attend there reported not knowing the legislation on solid waste, 89.5% perform segregation, but 73.7% reported not knowing their classification and 36.8% were unaware of the specific care for each waste group 12 .…”

“…Thus, the management of these wastes is supported by the 1988 Constitution, reaffirmed by the Organic Health Law. [5][6] According to the 2006 National Health Surveillance Agency (ANVISA) Manual on Collegiate Board Resolution (CBR) 306/2004, for the effectiveness of this management, there are relevant points ranging from the segregation made where it was produced until the proper disposal of these wastes for optimal treatment. Thus, it is clarified by the integrated waste management, that priority should be given to non-generation, minimization of generation and reuse of waste, to avoid negative effects on the environment and public health.…”

“…This profile results from the types of services performed in these places, which are standardized according to the National Policy of Primary Care. 7 It becomes the segregation of waste, when it is generated, of great relevance to the health of professionals involved in care and the community, since it allows the collection and treatment differentiated according to their class 5 . It was identified in this study that there is no segregation of chemical waste.…”