A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON BIO-MEDICAL WASTE MANAGEMENT AMONG CLASS -IV EMPLOYEES
IN SELECTED HOSPITALS OF BELLRY.
PROFORMA FOR REGISTRATION
OF
SUBJECT FOR DISSERTATION.
BAIREDDY. MARIA THERESA.
INDIAN COLLEGE OF NURSING
BELLARY
2008.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF
SUBJECTS FOR DISSERTATION.
1. Name of the candidate : BAIREDDY MARIA THERESA.
And address. M.Sc. Nursing student (1st year)
IndianCollege of Nursing.
Bellary.
2. Name of the Institution : Indian College of Nursing.
Bellary.
3. Course of Study and Subject : M.Sc. Nursing (1st Year).
Medical Surgical Nursing.
4. Date of Admission to course : I6-06-2008.
5. Title of the Topic :
“ A Study to assess the effectiveness of structured teaching programme
On Bio-Medical waste management among class 1V Employees
In selected hospitals of Bellary.”
Brief Resume of intended work.
6, 1. .INTRODUCTION
The management of Biomedical waste (or) hospital waste has Assumed great importance the world once because of the serious hazards it poses to the environment in general and the public in particular. A hospital is an institution which produces many types of waste material ie,. Pathological waste (blood soaked dressings and ,amputated organs etc. Hospital wastes still finds its way to road side heaps of rubbish where it mixes with municipal
(or) corporation solid waste, rendering it hazardous for the environment and the public. Al these year the management of hospital waste was delegated to the hands of nurses, wardboys, ward aayahs sweepers and sanitary workers. The effects of associated with poor hospital waste management include Health Hazards, environment Hazards, Air contamination, Head and fire Hazards, Eye Injury Hazards, Noise.
The Need for Biomedical waste management
In recent years the no of health care facilities both in the government and private sectors have grown considerably. No reliable figures about the quantum of waste generated per person per day are available. How ever Studies have estimated that the quantum of waste generated from hospitals ranges from 1.5 to 2.5 kg/day/pt. In a study of pattern of wastes in Indian
Cities, the quantity of refuse varied from 0.48 to 0.06kg/capita/day with
Total compostable matter varying from 30-40 percent [Bhide A.D. 1975].
So far as hospitals in advanced countries are concerned average refuse in hosp3itals in Denmark, and West Germany is 3kg/bed/day and in U.S.A.,
Up to 14kg/bed/day (Hanser L & Hanser A 1977). The quantum and type
Of waste reflects the life style of society and this fact must be borne in mind
In the planning or waste management in hospitals. On an average the volume
Of totalsolid waste in hospitals in India is estimated to range between 1-3 kg/day/bed. In teaching hospitals of 700 beds, solid waste averaged 1.5kg/bed/day (Ray DB Bhaskaran R etal 1978).
India many of our hospitals neither have a satisfactory waste disposal
System nor a waste management and disposable policy. Injuries by sharp are the most common and rise in Hepatitis‘B, HIVetc.Positively among health care personnel. In view of the above studies and magnitude of the problem, the investigator felt need to study the level of knowledge of class-Iv employees regarding Bio-Medical waste management. During my experience I observed there was no awareness regarding proper handling and disposal of Bio-medical waste management. So I planned to conduct as structured..
Teaching programme to pr6vide inf6rmation about how hazardeous the Bio-medial waste is.1
REVIEW OF LITERATURE
A Review of literature on the research topic makes the researcher familier with exhisting studies & provides information ,which helps to focus on a perticular problem, lay a foundation upon which to base new knowledge. It creates accurate picture of the information found on the subject. Polit & Hungler 2000.2
Gupta S, Boojh R, Mishra A, Chandra M. etal 1998 Conducted Case
study, on Rules and management of biomedical waste at Vivekananda Polyclinic. Environmental Sciences, Department of Geology, University of Lucknow, Lucknow 226007, India. Hospitals and other care establishments have “duty of care for the Environment and for public health, and have particular responsibilities In relation to the waste they produce (i.e., biomedical waste).Negligence in terms of biomedical waste management, significantly Contributes to polluting the environment, affects the health of human beings, and depletes natural and financial resources. The present paper provides a brief description of the Biomedical waste (Management and Handling) Rules 1998 . The objective in undertaking this study analyzed the biomedical waste management system, including policy practice (i.e., storage, Collection, transportation and disposal), . There is a need to create awareness among all other stake holders about the importance of biomedical waste management and related regulations. Furthermore, healthcare waste management should go beyond data compilation, enforcement of regulations, and acquisition of better equipment. It should be supported through appropriate education, training, and the commitment of the health care staff and management and health care managers within an effective policy and legislative framework.3
V. Rajagopalan etal; NCT DELHI conducted a case study on Bio-medical waste management. Biomedical waste is an issue of growing concern since it is a source for contamination & pollution , capable of causing diseases& illness either through direct contact or indirectly through contamination 0f soil, ground water surface water and air. the health care establishments are integral part of life support system .improper disposal of waste generated from such establishments can have direct and indirect health impact as well as pose potential threat to the surrounding environment ,persons handling it and the public in general. There is an urgent need to improve up on the medical waste management practices in the country based on systematic and scientific planning of medical waste disposal The Govt .of India has enacted bio medical waste [ management & handling ] Rules, 1998 making it mandatory for disposal of medical waste in the prescribed manner .There are various technologies available for treatment of medical waste . thermal processes of treatment such as auto- claving, microwaving & incineration are effective for treatment of most types of waste. However, those treatment technologies should be operated as per guide lines to achieve the standards prescribed .The present report seeks to collate information on status of medical waste management and , in particular, methodology of testing autoclaves /thermoclaves using bacillus stearothermophilus spores. We hope that the report will be useful to all concerned with bio medical waste management.4
Students of Sophia Poly clinic Mumbai conducted a study on
STUDY HIGH LIGHTS GROWING MENACE OF RECYCLING OF BIO-MEDICAL WASTE.” And a talk was organized by G.S.K. the contents of the study unvailed. While hospitals claim to dispose off their waste as per the stipulated norms, it is shocking to note that Much of the infectious waste is being recycled only to find its way back into the market. In India, about one person dies every 20 seconds, making it a million Every year, due to the use of contaminated needles, Further, 13 out of the 17 brands of syringes that are being used do not fall under desired standards. These were a couple of grim statistics high lighted in a study on hospital waste management conducted by the students of generates about 50,000 kg of Biomedical waste everyday from 1200 hospitals and 15,000 nursing Homes/clinics. Of this about 90 per cent of the waste is non-infectious While the rest 10% disinfectious consisting of 1Vfluids, catheters, Syringes, scalpels, bandages, gloves, etc. While hospitals claim to Dispose off their waste as per the stipulated norms, it is shocking to Note that much of the infectious waste including, needles, syringes, Catheters, etc, are being recycled only to find its way back into the Market. The study pinpointed rag pickers as the chief reason behind this menace as they pick up improperly discarded gloves, syringes, needles, Iv fluid bags, catheters and urine bags from various disposal Sites across the city and eventually sell them off to wholesale dealers, who in turn clean and repackage these items to sell them into the market once again. Smalltime pharma companies are also known to be involved in the Racket where in used injection vials and medicine bottles are washed And resold in packages which are deceptively similar to the original. Much of this activity is known to take place at Dharavi the largest slum Colony in Asia. The findings of this study is an eye – opener as it exposes the horrendous procedures that occur in the recycling of hospital wastes and medicine packs’ said V. Kashyap, vice president- Marketing, GSK. SAID “In our country about 15-20 percent of the drugs which are manufactured are found to be spurious. Given this fact, many patients who use allopathic medicines usually go unaware of these foul practices and eventually end up becoming innocent victims. At such times, it is unto the regulatory authorities to adopt adequate measures and see that such practices are curbed.” By the students of Sophiya Polytechnic, GSK hopes to disseminate valuable information to various corporates, NGOs and consumer welfare bodies who could be instru-mental in spreading the message to the masses and educating them about the menace.5
Sahar Mohamed Soliman, Amel Ibrahim Ahmed, etal conducted a pilot study on Bio medical waste management in selected Governorates in Egypt.
Inadequate management of biomedical waste can be associated with risks to
Health care workers, patients, communities and their environment. This study was conducted to assess the handling and treatment of biomedical waste in different healthcare settings in Egypt. Five hospitals and ten primary health care settings were surveyed using a modified survey questionnaire for waste management . This questionnaire was obtained From the World Health Organization(WHO), with the aim of assessing the processing systems for biomedical waste disposal. Rea\searchers found that biomedical waste is inadequately processed in hospitals and primary healthcare settings due absence of written policies and protocols. Accordingly healthcare staff , patients the community and the environment may be negatively affected by exposure to the hazards of biomedical waste. The development of waste management policies, plans and protocols are strongly recommended, in addition to establishing training programs on proper waste management for all health care workers Accordingly healthcare staff , patients the community and the environment may be negatively affected by exposure to the hazards of biomedical waste. The development of waste management policies, plans and protocols are strongly recommended, in addition to establishing training programs on proper waste management for all health care workers.6
Bert Golla, Senior Financial Auditor etal 1994 conducted “a study on bio medical waste regulation enforcement “. The major findings of study are
The Environmental Health Division – site monitoring reviews, permit fees were not sufficient to cover monitoring costs, clear records , limited informational materials. The study of biomedical waste regulations enforcement was included in the 1994 County Auditor’s Office work program, it was requested by the County Council in response to health concerns relating to the potential effects of improper disposal of biomedical waste. The Environmental Health Division of the Health Department is charged with the responsibility of protecting the public from the hazards of improper disposal of solid waste, including biomedical waste, by regulating its handling, storage, collection, transportation, treatment, and disposal. The biomedical waste regulations in title 10 of the king county solid waste regulations were adopted in 1989 by the king county board of health.
Study procedures also included observation of Health Officer’s inspections of the facility and vehicles of a generator and transporter of biomedical waste and interviews with management and staff involved in the enforcement of the biomedical waste regulations. The study recommended that the Environmental health Division should develop an annual program for on-site inspection of generators and transporters of biomedical waste to determine their compliance with the county regulations After every inspection, a written report should be issued to monitored entities. Environmental Health should require them to respond in writing regarding the violations, if any, and include corrective plans and actions that are to be implemented. The study recommended that Health Department should consider requiring annual permit fees from generators of biomedical waste. The study recommended that Health Department should produce brochures and other educational materials containing information such as a description and recognition of biomedical waste, hazards, safety guidelines, proper handling and storage, emergency information resources. These materials should be made available to the general public and to generators, transporters, and operators of storage and treatment site facilities for biomedical waste.7
V. Rajagopal etal; on Bio medical waste management case study conducted. Bio-medical waste is an issue of growing concern since it is a source for contamination and pollution, capable of causing diseases and illness either trough direct contact or indirectly through contamination of soil, ground water, surface water and air. The health care establishments are integral part of life support system. Improper disposal of waste generated form such establishments can have direct and indirect health impacts as well as pose potential threat to the surrounding environment, persons handling it and the public in general. There is an urgent need to improve upon the medical waste management practices in the country based on systematic and scientific planning of medical waste disposal. The Govt. of India has enacted Bio-medical Waste (Management and Handling) Rules. 1998 making it mandatory for disposal of medical waste in the prescribed manner. There are various technologies available for treatment of medical waste. Thermal processes of treatment such as autoclaving, microwaving and incineration are effective for treatment of most types of hospital waste. However, these treatment technologies should be operated as per guidelines to achieve the standards prescribed. The present report seeks to collate information on status of medical waste management and, in particular, methodology of testing autoclaves / Thermoclaves using Bacillus stearothemophilus spores. We hope that the report will be useful to all concerned with Bio-medical waste management.8
Lalji K. Verma, Shayamala Mani, Nitu Sinha and Sunita Rana etal;2001
Conducted a study on Biomedical waste management in nursing homes and smaller hospital in Delhi. The management of biomedical waste is a crucial issue in health and environmental management. Rules in India were promulgated in 1998, originally with a deadline of December 2000 and extended to December 2002; however, the actual situation remains far from satisfactory. A study conducted in 2001 by CEE, New Delhi; indicated an implementation deficit. To gauge the present situation, a survey was undertaken during 2005-2006. A systematic analysis of current biomedical waste management practices in smaller nursing homes and hospitals in Delhi was carried out. A total of 53 nursing homes, with bed strengths ranging from 20 to over 200were included. The survey results show that there is a marked improvement in the segregation practices of biomedical waste in small private hospitals and nursing homes. The majority of nursing homes and hospital were found to be using a service provider for the collection, management and disposal of healthcare waste. Data was collected through a questionnaire and field visits. This paper discusses the relevant data indicative of current practices of health ware management in the nursing homes and smaller healthcare facilities in Delhi.9