information on hospital waste management
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Hospitals are important sites for the generation of waste. Every department in the hospital generates waste and the overall product is waste of different kinds; healthcare, household and administrative waste. Healthcare waste includes infectious, chemical, expired pharmaceutical and radioactive items and sharps. These items can be pathogenic and environmentally adverse. They are referred to in this article as hazardous healthcare waste. Other waste items generated through healthcare but not hazardous include medication boxes, the packaging of medical items and food, remains of food, and waste from offices.
The management of hospital generated waste is not only the responsibility of the hospital administration but also of every department and every healthcare providing personnel in the hospital. It is a process that should begin at the site of generation where medical waste has to be properly collected and segregated from other non-hazardous waste in specific color-coded receptacles. Transportation of hazardous healthcare waste should be well mapped in the hospital and conveyed by special carts. Storage should be carried out in utility rooms specially prepared for this purpose. Various methods, on-site or off-site are available for the final treatment of hazardous healthcare waste.1,2 The work force handling this kind of waste should be thoroughly trained.
There are reports of programs directed at the reduction of hazardous healthcare waste and the control of the cost of disposal.3 Evaluating the individual hospital profile of generation and flow of hazardous healthcare waste is a necessary primary step required for initiating effective management of hospital generated waste. This article reports the plan designed and used by the hospital waste management committee in King Fahd Hospital of the University (KFHU), Alkhobar, Saudi Arabia, to upgrade the management of hospital waste. This plan which is efficient, cost-effective and that requires no extra human resources can also be used in other hospitals.
PLAN
The committee was composed of the director of the hospital, associate director of nursing, infection control nurses and the director of housekeeping.
The plan was in four phases: background information, identification of problems, intervention and monitoring.
A. Background information
The following are the requirements: (1) Test of the awareness of the healthcare staff of the hospital generated waste. (2) Review of the items of medical supplies used by the hospital. (3) Determination of the weight of the generated hospital waste. (4) Review of policy and procedure on the handling of healthcare waste and lists of items designated as hazardous healthcare or other types of waste. (5) Assessment of the number, location, condition, proper color coding and content of the means of collection. (6) Mapping and inspection of the storage areas and the route of transportation.
B. Identification of problems
The following are the possible problems envisaged: (1) Change of contracted housekeepers and/or environmental cleaning services. (2) Lack of awareness of healthcare staff. (3) Inaccurate disposal of waste items in the designated receptacles. (4) Failed means of collection, transporting or storage. (5) Injuries resulting from inaccurate disposal of hazardous healthcare waste items such as needles and glassware.
C. Interventions
The following actions are recommended: (1) Launching of educational and orientation campaign. (2) Amendment of the policy and procedure on the handling of healthcare waste. (3) Modification of the means of collection, transportation systems and storage areas in accordance with the setting and layout of the hospital. (4) Appointment of inspectors to oversee the handling of waste. (5) Establishment of management plans for individual departments with the active participation of the departmental chiefs, head nurses or chief technicians. (6) Establishment of contingency plans to deal with spills of hazardous healthcare waste and the possible failure of the final treatment method.
D. Monitoring
The following measures are suggested: (1) Regular inspection of the means of collection, transportation and storage. (2) Feed-back from the departments. (3) Assessment of the weight of healthcare waste. (4) Re-testing the awareness of the healthcare staff of the generation of waste in hospitals. (5) Auditing the upgraded management.
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