Biomedical Waste Management in Hospitals

biomedical Waste Management in infirmarysCHAPTER II suss out OF LITERATUREbiomedical drive offbiomedical Waste Management and discussion Rules, India (1998) defines the biomedical ravage as Any mishandle which is produced by credit of problem, immunization of human beings or animals or treatment or in research activities pertaining or in the production or testing of biological11. accord to WHO around 85% of the biomedical shove along generated in the hospital were non- septic/ non-hazardous idle similar to domestic abandon. Only 15% of the dispel were infectious or hazardous waste which were a jeopardy for environment and wellness (10%- infectious and 5%- radioactive or chemical waste). The hospital waste was classified advertisement as sharp waste, infectious waste, pathological waste, pharmacological or cyto ototoxic waste, chemical waste, radioactive waste, non-hazardous general waste.Management of Safe waste from health dread activities keyed the biomedical wast e were hazardous in personality as it contain one or more following proportion 1) Infectious 2) Contain cytotoxic chemical composition 3) presence of toxic or hazardous chemicals 4) Radioactivity 5) Contain used sharped materials. Everyone coming unaired to hospital waste were at jeopardize. The main group of individuals at risk was doctors, faculty checks, para medical and supportive rounds, patients, and their attenders. If hospital waste were given up of improperly, it also risks for general public12.Rational for Biomedical Waste Management in HospitalBiomedical waste wariness is a part of hospital hygiene and maintenance activities. Only 15% of the waste generated in the hospital were infectious. If improper segregation of waste at source leads to ampere-second% of biomedical waste to be infectious. Even though biomedical waste attention require lot of resources same manpower, money, material and machinery support, it is important for the following reasons13Sharps w aste like needles, hypodermic needles, scalpels and other blades, knives, infusion sets can cause tell apart injuries or puncture wounds. If these items were infected, it can infect tot every last(predicate)y health c ar provider in hospital and waste handlers.Infection control practices and unworthy waste guidance can lead to the spread of hospital acquired transmittal among patients.Improper treatment and disposal of biomedical waste can be a potential risk to the general public especi all in ally to scavengers.Genotoxic and cytotoxic waste in hospital waste is hazardous and brook mutagenic, teratogenic, carcinogenic properties. Improper disposal of genotoxic waste raises serious safety problems, both inside(a) hospitals and after disposal, and should be given special attention. The Risk associated with chemical hazardous, at all levels the drugs to persons can handle wastes.Radioactive wastes were produced as a conduce of procedures such as analysis of body tissue and fl uid, organ visualise and tumor localization and various investigative and therapeutic practices. These radioactive waste were a hazard to health and surrounding environment.There is a risk of air, water and soil pollution can occur directly due(p) to improper disposal of waste or due to defective incineration emissions and ash.Biomedical waste way in IndiaIn 1998, the Ministry of Environment and Forests, Government of India, introduced the Biomedical Waste (Management and Handling) Rules which mandate to notify for the way and handling of bio-medical waste in the hospital. This rule was amended in 2003 and 2011. Even though strong law in India most of the hospitals were yet to achieve the recommended standards for biomedical waste oversight practices. An evaluation withdraw was carried out by INCLEN (International Clinical Epidemiology Network) Program paygrade Network (IPEN) in 2009. The line of business was carried out in Model shooter Centers (MICs) at 25 Partner check up Colleges (PMC) in India. The study pass showed that the biomedical waste management was poor in 82 % of native c be health centers, 60 % secondary negociate centers and 54 % tertiary divvy up health centers. This showed that on that point was need for urgent interventions for improving systems expertness and resource in both public and private sectors14.Knowledge regarding Biomedical Waste ManagementChudasama et al. (2013) conducted an data- found hospital ground dawn sectional study on knowledge, placement and practice of bio medical waste handling and its management in a tertiary hospital in Rajkot city, India. The study take ond all health c atomic number 18 provider like resident physician doctors, intern doctors, c atomic number 18 for cater, research lab technicians, ward boys, and sweepers worker. Among the hit study participants282, 92(32.6%) where ar staff nurse. The force shows that 95% of participants know approximately BMW, and 44% of the partic ipant had BMW training. Around 87% of participant known the biomedical waste symbolic representation, 85% of participant know active excuse codes and 89% of the participant argon aware that biomedical waste can ship malady like human immunodeficiency virus and Hepatitis15.Vanesh Mathur et al. (2011) conducted an data-based hospital based cross-section(a) study on KAP (Knowledge, location, and Practices) some BMW (Biomedical Waste Management) among health care Personnel, degree centigrade stratified hospital Allahabad city India. The study included all doctors, nurses, and laboratory technicians have better knowledge than strong staff regarding biomedical waste management among the congeries study participants 283,60(21%) where are staff nurse. The provide shows that color-coding waste containers 56 (93.3), 55(91.6) of the participant are aware that biomedical waste can change over disease like HIV and Hepatitis16.Rekha Sachan et al. (2012), conducted a cross-sectional st udy on KAP regarding BMW among the Paramedical Staff and Medical in Tertiary hopital in the division of Obstetrics and Gynaecology of CSM Medical University, Luck now, India. The Sample was 10 doctors and 20 nurses. Group A- Nursing female staff (20 nurses), Group B Doctors (10 jr. Doctors, 8 from Obstetrics and Gynaecology, 2 from Paediatrics) two groups were made. 30% of the doctors and 20% nursing staff have more than 70% knowledge close BMW. 100% doctors and 60% nurses have a definitive attitude towards biomedical waste management17.Sarika P Patil et al.(2011), conducted the cross-sectional study was conducted during1st August 2011 to 30th September 2011. healthcare Workers sentience regarding Biomedical Waste Management (BMW) at Tertiary Hospital Government in Dhule (India). The sample was 302 health care workers in which 156 are nurses 45 are technicians and 101 are sanitation workers. The Sanitation workers include 18 attendants laboratory and 83 sweepers performing job of transportation and waste collection Undergone Training of BMW management 49 (60.5%) nurses were training about biomedical waste management, Knowledge regarding the Number of class Colour Bags to be provided for BMW collection68 (84%), out of 153 participants, 41.8% (64) and 81.7%(125) were immunize for tetanus and hepatitis B. It was derived that no vaccination of Hepatitis B among 49.4% (40) nurses and 45.7% (16) laboratory technicians during 89.2 %( 33) sanitary workers.18Sanjay Kini B et al. (2014) conducted a observational hospital based cross sectional study on knowledge, attitude and practice of bio medical waste management among staff of a tertiary healthcare Centre in coastal Karnataka Kasturba Medical College, Udupi district of coastal ,India. The study included all health care provider among consultants, junior residents, staff nurses, laboratory technicians and house-keeping staff in Kasturba Hospital in manipal, Among the total study participants 337, 189(56%),whe re are staff nurses, the dissolving agent shows that nurses (62.4%) of participants know about BMW and 44% of participant had BMW training, and 46 (24.3%) Knowledge among the participants about biomedical waste management among the total staff 71 (37.6%) shows that little knowledge about biomedical waste management19.S.B. Salve, et al. (2012) conducted an observational hospital based cross sectional study on knowledge, attitude and practice of biomedical waste handling and its management in tertiary hospital Mahatma Gandhi missionary stations Medical College and Hospital, Aurangabad MS India. Resident Doctors, Nursing Staff and class Employees were selected by the Stratified random sampling method acting. Among the total study participants110, 47 (42.7%) where are staff nurse. The result shows that 31 (66%) were having average score and 8 (17%) were having poor score, satisfactory knowledge 8 (17%), the result shows that 89.3% of participants had BMW training, remaining 10.7% pa rticipants un proficient about the biomedical waste management20.Bathma Vishal et al. (2013) conducted an observational knowledge estimation of hospital staff regarding biomedical waste management in a tertiary care hospital. Bhanpur road, Bhopal, India. The study included all health all health care personals, doctors, nurses, and Lab technicians and 7 waste handlers/supporting staff. Among total participants110, 44(40%) where the nursing staff. The result shows that about the knowledge of Categories of waste in nurses 59.0%, and identify the bio hazard symbol 81.8% knows the symbol, Waste segregation in colour containers 70.5%nurses have knowledge, how to disposal method 75.0% have knowledge about the biomedical waste management, which type of disease spread in improper hospital waste management knows about 84.0%, Correct method of treatment disposal knows about 77.3% of HIV and Hepatitis21.Savan Sara Mathew et al. (2011) conducted an observational hospital based cross sectional study on appraisal of BMW practices in a tertiary care teaching hospital in Ludhiana city, India. The study included all health care provider like resident doctors nurses and paramedical staff, among the total study participants 100, 48(48%) were staff nurses. The results show that better knowledge of the nurses more in practical aspects of BMW management. categories of BMW was 97.4% , 92.1% was color coding system, 94.7% knew the methods of segregation, 92.1% knew that waste should not be stored for more than 48 hours, and 100% of aware about the methods of waste disposal. Nurses were equal to or better than the doctors in the aspects of practice. Their knowledge was less in theoretical aspects. 73.7% were aware of BMW Management Rules 1998 86.8% were set the biohazard symbol duration 92.1% knew the diseases spread by improper waste management22.Md. Asadullah, et al. (2013) conducted A descriptive cross-sectional study on knowledge, attitude and practices among nursing staff in p rivate hospitals in Udupi City. India. The study included randomly 17 hospitals (as clusters) and 4 hospitals. A pre-structured questionnaire was used. Data were collected from 166 nursing staff, HIV may transmit through BMW 130(78.3), and Hepatitis-B may transmit through BMW 137(82.5), was answered Hepatitis-C may transmit through BMW 119(71.7), Training on biomedical waste management 122(73.5%) and vaccinated about hepatitis-B 153(92.2%) was immunized23Biomedical waste management PracticeChudasama et al.(2013) conducted an observational hospital based cross sectional study on knowledge, attitude and practice of bio medical waste handling and its management in a tertiary hospital in Rajkot city, India. The study included all health care provider like resident doctors, intern doctors, nursing staff, laboratory technicians, ward boys, and sweepers worker. Among the total study participants282, 92(32.6%) where are staff nurse. Study result shows 74.5% of participants reported that t here is good maintenance of BMW records in wards and 87% reported having hub cutter in wards. Around 84% of participants are exploitation personal protective measures like a mask, gloves, etc. while handling BMW. The fabricate practice of handling disposal plastic waste, soiled dressings/ daub casts/linen paper waste, sharps and needles waste and human anatomical waste are 80%, 66.8%, 63% and 63.1% respectively.Vanesh Mathur et al. (2011) conducted an observational hospital based cross-sectional study on Knowledge, Practices, and Attitude about Biomedical Management Waste among Healthcare Personnel, 100 bedded hospital Allahabad city India. The study included all doctors, nurses, and laboratory technicians have better knowledge than sanitary staff regarding biomedical waste management among the total study participants 283, 60(21%) where are staff nurse Study result show 44(73.3%) were correct color coding containers are used, The correct practice of handling disposal plastic wast e, soiled dressings/plaster casts/linen waste, sharps and needles waste and human anatomical waste are 42(71.0), The report of injurys 18(30%), about the biomedical waste managementRekha Sachan et al (2012) conducted cross-sectional study on knowledge, attitude and practices regarding BMW amongst the Paramedical Staff and Medical in Tertiary Health Care Centre in the surgical incision of Obstetrics and Gynaecology of CSM Medical University, Luck now, India. 70% and 65% of the doctors and nurses were practicing high than 70% of the right practices as according to the university norms. The comparison of Knowledge, with practice and Attitude of groups, shows that the people with high education qualification have better knowledge. This result can attributed to their commitment and accountability in patient and ward management.Sarika P Patil et al.(2011), conducted the cross-sectional study was conducted during 1st August 2011 to 30th September 2011. Awareness of Healthcare Workers rega rding BMW at government tertiary care Hospital in Dhule India. The study included of total 302 health care workers in which 156 are nurses, 45are technicians and 101 are sanitation workers. The result shows that Color coding correct disposal in block cover general waste 37 (45.7%),disposal of boy fluids 30 (37%),sharp and other type of container 65 (80.2%),72 (88.9%) of participants are using personal protective measures like mask, gloves, etc. while handling BMW. The correct practice of handling disposal plastic waste, soiled dressings/plaster casts/linen waste,Sanjay Kini B et al (2014) conducted a observational hospital based cross sectional study on knowledge, attitude and practice of bio medical waste management among staff of a tertiary healthcare centre in coastal Karnataka Kasturba Medical College, Udupi district of coastal ,India. The study included all health care provider among consultants, junior residents, staff nurses, laboratory technicians and maintain staff in Kast urba Hospital in Manipal, Among the total study participants 337, 189 (56%), where are staff nurses, Study result show 45 (23.8) % of participants reported that there is good maintenance of biomedical waste management, all nurses are immunized against hepatitis B, disinfecting sharps at the point of generation and undergone any formal training biomedical waste management, Less practice of 44 (23.3%)S.B. Salve, et al. (2012) conducted an observational hospital based cross sectional study on knowledge, attitude and practice of biomedical waste handling and its management in tertiary hospital Mahatma Gandhi complaints Medical College and Hospital, Aurangabad MS India. Resident Doctors, Nursing Staff and class Employees were selected by the Stratified random sampling method. Among the total study participants110, 47(42.7%) where are staff nurse. Practice about biomedical waste management among staff nurses 87.2% was good practice .comparative assessment of practice among trained and un trained individuals was made, which revealed 41 (59.42%) of trained individuals had Good practices as compared to 6 (19.5%) untrained individuals.Bathma Vishal et al. (2013) conducted an observational knowledge assessment of hospital staff regarding biomedical waste management in a tertiary care hospital. Bhanpur road, Bhopal, India. The study included all health all health care personals, doctors, nurses, and Lab technicians and 7 waste handlers/supporting staff. Among total participants110, 44(40%) where the nursing staff. All nurses are according biomedical waste management rules are followed by 54.5%.