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Health care waste educational intervention

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educational intervention on knowledge , attitude and practice on biomedical/ health care waste management

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Health care waste educational intervention

  1. 1. Educational Intervention on Healthcare Waste(HCW) Management among Health care staffs at Annapurna Neurological Institute & Allied Sciences Gajuryal S¹ , Shrestha G¹, Satyal N¹ Annapurna Neurological Institute & Aliied Sciences (ANIAS)
  2. 2. Introduction Healthcare waste are the waste produced in the course of health care activities during treating,diagnosing, and immunizing human being or animals or while doing Study/Research activities. 75-90% Non-Hazardous/General Waste 10-15% -Hazardous
  3. 3. WHO Classification Waste Categories Description and Examples 1.General Waste No risk to human health e.g.: office paper, wrapper, kitchen waste, 2.Pathological Waste Human Tissue or fluid e.g.: body parts, blood, body fluids etc. 3.Sharps Sharp waste e.g.: Needle,scaples,knives,blades etc. 4.Infectious waste Which may transmit bacterial, viral or parasitic disease to human being, waste suspected to contain pathogen eg:labrotory culture, tissues(swabs)bandage etc. 5.Chemical waste E.g.: Laboratory reagent, disinfectants, Film Developer 6.Radio-active waste E.g.: unused liquid from radiotherapy or lab research, contaminated glassware etc.
  4. 4. Waste Categories Description with examples 7.Pharmacutical Waste Expired outdated drugs /chemicals 8.Pressurized container Gas cylinder, aerosol cans etc 9.Genotoxic Waste Waste Containing Cytotoxic Drugs(often Used In Cancer Therapy) Types and nature of hospital waste depends upon the service available in hospital and nature of the hospital.
  5. 5. Magnitude of the problem  GLOBALLY- Developed countries generate 1 to 5 kg/bed/day  Developing countries: 1-2kg/bed/day  Issues of poor segregation and management
  6. 6. Nepal Context • Kathmandu Metropolitan City & ENPHO have conducted a study on biomedical waste in hospitals located in kathmandu. • Results:1.72kg waste/bed/day • Out of which 26% of waste was infectious and hazardous waste.
  7. 7. Issues & Problems ? Exponential growth in health care sector together with low or non-compliance with guidelines/ protocol and recommendations.
  8. 8. Categories of Person exposed Sanitation workers Medical , laboratory & Paramedical staff Patients+Visitors
  9. 9. Problems associated with Healthcare Waste  Hospital Acquired Infection  Environmental problem pollution – water ,air  Public Health Problem Infectious disease transmission, unsafe use of needle etc
  10. 10. Objectives General To Access the Impacts of Health Education on Knowledge, Attitude and Practice of Health Care Staffs Regarding Healthcare Waste Management Specific - To access the Knowledge, attitude and Practice of health care personnel - To compare the knowledge, practice and attitude of health care staffs before & after educational intervention.
  11. 11. Methods Research Method: Quantitative Study type: Comparative Cross-sectional study Study Area: ANIAS Study Period : 6 months ( July 2017-January 2018) Study Population: Health care workers (Medical officers, Nurses, Sanitation staffs ) Sampling Methods/ Techniques: Census Sampling (all the health care workers) Sample size (with justification): 65(Census Sampling)
  12. 12. Data Collection Tools: Standard Knowledge(9), Attitude(9) & Practice(10) Questionnaire Data Collection Technique / Methods (Specify): Pre test regarding biomedical waste management to the health care workers with interventional training session followed by post-training data collection through same questionnaire after one month.
  13. 13. Statistical analysis : Data collected was entered into structural Microsoft excel and analysed using SPSS version 17 . Frequency and percentage was presented in graphical and tabular form. The significance of differences between pretest and post test score of the participants was calculated using paired t test. Ethical Consideration : Nepal Health Research Council ( NHRC)
  14. 14. RESULT
  15. 15. Fig 1 :Age wise distribution of participants 4 39 9 6 3 4 0 5 10 15 20 25 30 35 40 45 16-20 21-25 26-30 31-35 36-40 Above 40 Mean Age±SD = 24.03±3.5
  16. 16. Fig 2 : Profession wise distribution 36 23 6 0 5 10 15 20 25 30 35 40 Nursing staff Housekeeping Staff Medical Officer
  17. 17. Table 1: Pre-post findings on Knowledge (n=65) Healthcare Waste Management elements Pre-intervention Correct responses N(%) Post-intervention Correct responses N(%) Classification of Healthcare waste 45 (69.2%) 54 (83.1%) Hospital Healthcare waste manual 50 (76.9%) 60 (92.3%) Responsibility to dispose Waste 63 (96.9%) 65 (100%) Waste Collection 60 (92.3%) 65 (100%) Waste Storage 5 (7.7%) 51 (78.5%) Healthcare Waste Symbol 25 (38.5%) 62 (95.4%) Disease from Biomedical Waste 55 (84.6%) 56 (86.2%) Disposal of Infected waste 10 (15.4%) 29 (44.6%) Categories of hazardous waste 30 (46.2%) 50 (76.9%)
  18. 18. Table 2 :Pre-post findings on Attitude (n=65) Attitude on Healthcare Management elements Pre-intervention Positive responses N(%) Post-intervention Positive responses N(%) Healthcare Waste Management is an issue 15 (23.1%) 45 (69.2%) HCW management is the responsibility of the government 45 (69.2%) 44 (67.7%) It is the responsibility of health professionals 50 (76.9%) 59 (90.8%) It should be segregated 60 (92.3%) 63(96.92%) Healthcare Waste should be made part of the undergrad curriculum 65 (100%) 56 (86.2%) Safe Healthcare waste management is extra burden 65 (100%) 56 (86.2%) Knowledge regarding HCW management is adequate 54 (%) 48 (73.8%) Requirement of further training 60 (92.3%) 51 (78.5%) HCW as unnecessary financial burden 60 (92.3%) 49 (75.4%)
  19. 19. Table 3 :Pre-post findings on practice (n=65) Practice on HCW Management elements Pre-intervention Positive Practice N(%) Post-intervention Positive Practice N(%) Segregation of Healthcare Waste 55 (84.6%) 60 (92.3%) Disposal of cotton, gauze and other items contaminated by blood 63 (96.9%) 65 (100%) Disposal of waste sharps 16 (24.6%) 51 (78.5%) Disposal of hazardous liquid waste 50 (76.9%) 54 (83.1%) Immunized against hepatitis B and Tetanus infection 59 (90.8%) 59 (90.8%) Annual medical examination 20 (30.8%) 35 (53.8%) Practice recapping of used needles 36 (55.4%) 37 (56.9%) Aware of prophylactic procedures after contact with blood/body fluids 39 (60%) 52 (80%) Practice of post-exposure prophylaxis for prevention of HIV infection 50 (76.9%) 41 (63.1%) Practice the use of protective clothing. during the collection, segregation, and transportation of wastes 10 (15.4%) 35 (53.8%)
  20. 20. Table 4: Educational interventional impact on Knowledge , Attitude & Practice Test Knowledge Attitude Practice Mean ±SD p value Mean ±SD p value Mean ±SD p value Pre -Test 5.46 ±1.23 <0.001 6.62 ±1.22 <0.001 7.01± 1.05 <0.001 Post -Test 7.31 ±1.468 7.25± 1.41 7.84 ±1.30
  21. 21. Obstacle ? Implementation, Training, Supervision
  22. 22. Conclusion • Strict implementation of biomedical waste management rules & compliance is the need of the hour • Education intervention can help in upgrading the knowledge, attitude and practice of the health care waste management • Training should be given to respective personal time to time and should not become merely a one-time activity • Proper HCW management leads to a healthy & harmless environment improving the quality of care.
  23. 23. Thank You

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