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SRI SATHYA SAI SANJEEVANI INSTITUTE OF NURSING AND ALLIED

HEALTHCARE SCIENCES,
NAYA RAIPUR

SUBJECT: - MEDICAL-SURGICAL NURSING-I

TOPIC: - TEACHING PRACTICE ON

BIO-MEDICAL WASTE MANAGEMENT

SUBMITTED TO; SUBMITTED BY;

MR. SHIV PATEL SIR MR. NAGESHWAR

ASSISTANT PROFESSOR MSC NURSING 1st YEAR STUDENT

(MSN)
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TEACHING PRACTICE
NAME OF THE PRESENTER : - Mr. Topeshwar kanwar

COURSE & YEAR : - M.Sc. Nursing 1st year

NAME OF THE SUPERVISOR : - Ms.osin chandrakar

SUBJECT : - Medical- surgical nursing-I

TOPIC : - Biomedical waste management

NO. OF GROUP : - 20 student

DATE : - 2105/2020

TIME :- 11am

VENUE : - Seminar hall

METHOD OF TEACHING : - Explanation, discussion, and lecture etc.

MEDIA OF TEACHING/ A.V. aids : - Hand out, Flash card, chart and PPT etc.

PREVIOUS KNOWLEDGE LEVEL : - Student adequate knowledge about biomedical waste management and their sources problems
category of waste and management of biomedical waste.
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GENERAL OBJECTIVE:-

At the end of the teaching student acquire moderate knowledge about biomedical waste management and their sources problems
category of waste and management of biomedical waste.

SPECIFIC OBJECTIVE:-at the end of the teaching student will be able to:-

 define biomedical waste management.

 discuss about various types of biomedical waste.
 explain about various biomedical waste category.
 enumerate the sources of biomedical waste.
 enlist the needs of treatment of biomedical waste.
 explain various process of treatment of biomedical waste.
 detail about treatment and disposal of biomedical waste management.
 discuss about benefits of biomedical waste management.
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BIO-MEDICAL WASTE MANAGEMENT

INTRODUCTION:-
Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, nursing home authorities but also
to the environment. the bio-medical wastes generated from health care units depend upon a number of factors such as waste management methods,
type of health care units, occupancy of healthcare units, specialization of healthcare units, ratio of reusable items in use, availability of
infrastructure and resources etc.

The proper management of biomedical waste has become a worldwide humanitarian topic today. Although hazards of poor management of
biomedical waste have aroused the concern world over, especially in the light of its far-reaching effects on human, health and the environment.2
Now it is a well established fact that there are many adverse and harmful effects to the environment including human beings which are
caused by the “Hospital waste” generated during the patient care. Hospital waste is a potential health hazard to the health care workers, public and
flora and fauna of the area. The problems of the waste disposal in the hospitals and other health-care institutions have become issues of increasing
concern.
S. Time Specific Content Teaching Learning A.V. Evaluation
No. Objective Activity Activity aids
1. 2 mins Define DEFINITION:- Lecture and Listening PPT, What is bio-
biomedical (1) According to Biomedical Waste (Management and discussion white medical
waste Handling) Rules, 1998 of India “Any waste which is board, waste?
management. generated during the diagnosis, treatment or immunization
hand
of human beings or animals or in research activities
pertaining thereto or in the production or testing of out.
biological.
(2)The Government of India (notification, 1998)
“specifies that Hospital Waste Management is a part of
hospital hygiene and maintenance activities. This involves
management of range of activities, which are mainly
engineering functions, such as collection, transportation,
operation or treatment of processing systems, and disposal
of wastes”
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2. 2 mins Discuss TYPE OF WASTE PERCENTAGE % Lecture and Listening PPT, How many
about General waste(food waste, 53.5% discussion white types of bio-
various sweeping in hospital etc.) board, medical
types of Paper 21.5% hand waste?
biomedical Rags 10% out.
waste. Plastics 8%
Glass 4.5%
Infectious waste 1.5%
Metal (sharps) 1%
8. 4 mins Explain WASTE CATEGORY, DESCRIPTION AND Lecture and Listening PPT, What are the
about EXAMPLE discussion white various
various Infectious waste:- board, category of
biomedical Waste suspected to contain pathogens, e.g. laboratory bio-medical
hand
waste cultures; waste from isolation ward; swabs, or equipment waste ?
categories. that have been in contact with infected with patient; out.
excreta.
Pathological waste:-
Human tissues or fluids, e.g. body parts; blood and other
body fluid; fetuses.
Sharps:-
Sharp waste, e.g. needles, fusion sets, scalpels, knives,
blades, broken glass.
Pharmaceutical waste:-
Waste containing pharmaceuticals, e.g. pharmaceutical that
are expired or no longer needed; items contaminated by or
containing pharmaceutical (bottles, boxes).
Genotoxic waste:-
Waste containing substances with genotoxic properties, e.g.
waste containing cytotoxic drugs (often used in cancer
therapy).
Chemical waste:-
Waste containing chemical substances, e.g. laboratory
reagents; film developer, disinfectants that are expired or
no longer needed; solvents.
Heavy metals:-
Batteries; broken thermometer, blood pressure gauges, etc.
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Pressurized container:-
Gas cylinder, gas cartridges, aerosol canes.
Radioactive waste:-
Waste containing radioactive substance, e.g. unused liquid
from radiotherapy or laboratory research; contaminated
glassware, packages, or absorbent paper, urine and excreta
from patients treated or tested or tested with unsealed
radionuclide’s, sealed sources.
9. 5 mins Enumerate SOURCES OF BIOMEDICAL WASTE:- Lecture and Listening PPT, What are the
the sources discussion white sources of
of Hospitals produce waste, which is increasing over the years bio-medical
board,
biomedical in its amount and type. The hospital waste, in addition to waste ?
the risk for patients and personnel who handle them also hand
waste.
poses a threat to public health and environment. out.
Major Sources
 Govt. hospitals/private hospitals/nursing homes/
dispensaries.
 Primary health centers.
 Medical colleges and research centers/ paramedic
services.
 Veterinary colleges and animal research centers.
 Blood banks/mortuaries/autopsy centers.
 Biotechnology institutions.
 Production units.
Minor Sources
 Physicians/ dentists’ clinics
 Animal houses/slaughter houses.
 Blood donation camps.
 Vaccination centers.
 Acupuncturists/psychiatric clinics/cosmetic piercing.
 Funeral services.
 Institutions for disabled persons
10. 5 mins Enlist the NEED OF BIOMEDICAL WASTE MANAGEMENT Lecture and Listening PPT, What are the
needs of IN HOSPITALS:- discussion white needs of bio-
treatment of board, medical waste
biomedical The reasons due to which there is great need of management?
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waste. hand
management of hospitals waste such as:-
out.
1. Injuries from sharps leading to infection to all
categories of hospital personnel and waste handler.
2. Nosocomial infections in patients from poor infection
control practices and poor waste management.
3. Risk of infection outside hospital for waste handlers
and scavengers and at time general public living in the
vicinity of hospitals.
4. Risk associated with hazardous chemicals, drugs to
persons handling wastes at all levels.
5. “Disposable” being repacked and sold by unscrupulous
elements without even being washed.
6. Drugs which have been disposed of, being repacked
and sold off to unsuspecting buyers.
7. Risk of air, water and soil pollution directly due to
waste, or due to defective incineration emissions and
ash.
11. 5 mins Explain BIOMEDICAL WASTE MANAGEMENT PROCESS:- Lecture and Listening PPT, How many
various discussion white steps for bio-
process of There is a big network of Health Care Institutions in medical waste
board,
treatment of India. The hospital waste like body parts, organs, tissues, management?
hand
biomedical blood and body fluids along with soiled linen, cotton,
waste. bandage and plaster casts from infected and contaminated out.
areas are very essential to be properly collected,
segregated, stored, transported, treated and disposed of in
safe manner to prevent nosocomial or hospital acquired
infection.
1. Waste collection
2. Segregation
3. Transportation and storage
4. Treatment & Disposal
5. Transport to final disposal site
6. Final disposal

COLLECTION AND SEGREGATION

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Hospital waste should be collected at the site of

generation only. Segregation (classification) aims to keep
the harmful and infected material separate from the
harmless and non- contagious waste. For this purpose, use
of specially colored dustbin and plastic bag is mandatory.

Procedures and facts should be kept in mind during

the collection and segregation of biomedical waste:-

1. Bins and bags should bear the symbol of biomedical

hazards.
2. Never mix infectious waste with non infectious waste.
3. Needles should be destroyed with a needle cutter.
Manual mutilation of sharps should never be tried as it
may cause injury. All other sharps must be strongly
disinfected (chemically) before they are shredded or
finally disposed off.
4. All sharps should be kept in puncture, proof box and
properly labeled.
5. Disposable items (syringes, IV bottles, catheters,
rubber gloves etc.) should be undertaken only when
they have been mutilated (cut ) and chemically
disinfected dipping in 1% hypochlorite solution for 30
minutes).
6. Waste should not spill outside. Non infections waste
can be dealt with as normal household waste and does
not require any special treatment.

TRANSPORTATION AND STORAGE

Ideally as soon as a bag is full, it should be tied,

labeled and sent to the site of final disposal. Temporarily
stored at a central area in the hospital and from there it may
be sent in bulk to the site of final disposal once or twice a
day.
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Important precautions regarding transportation and storage

are:-

 Before taking the bag away, ensure that it is properly

tied and labeled and there is no possibility of spillage.
 Persons handing the waste bags should not touch the
items of public use.
 A covered, bio hazard symbolized hand cart may be
used to transport the waste to the central storage area of
the hospital.
 Do not throw the bags haphazardly as this may tear
them apart and the waste may spill out.
 A full time person should be posted at the central site
of storage for regular receiving and dispatching the
waste.
 Unauthorized people should not enter in the storage
area.
 As per rules, bio-medical waste cannot be stored for
more than 24 to 48 hours.
 Always use closed transportation from the site of
central storage to final disposal site.
12. 5 mins Detail about BIOMEDICAL WASTE TREATMENT AND Lecture and Listening PPT, Which type
treatment DISPOSAL discussion white treatment used
and disposal board, for bio-
of Health care waste is a heterogeneous mixture, which is medical waste
hand
biomedical very difficult to manage as such. But the problem can be management?
waste simplified and its dimension reduced considerably if a out.
management. proper management system is planned.
(1) CHEMICAL DISINFECTION:-
Solid waste as plastic, rubber and metallic item, IV
sets, blood bags, gloves, catheters, Urobeg, syringes,
needles etc. must be disinfected before they are sent for
final disposal (landfill). Chemical disinfection is also most
appropriate method to treat, the liquid waste such as blood,
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urine, stools or hospital sewage. 1 % hypochlorite solution

can be used for chemical disinfection.
(2) THERMAL MEASURES (wet and dry):-
a) Autoclave (Wet thermal treatment);- It is effective
method of sterilization for microbiology and
biotechnology waste. But it cannot be used for human
anatomical waste or animal carcasses. Also, it is not
effective for pharmacological or chemical waste.
b) Hydroclave (Dry thermal treatment):- In this method,
shredded infectious waste is exposed to high
temperature, high pressure steams like autoclaving. It
dries 80% liquid of waste and waste is reduced to 20-
30% in weight. Adequately trained operators or
technicians are needed for its operation.

(3) INCINERATION TECHNOLOGY

Incineration is a high temperature dry oxidation
process that reduces organic, incombustible matter. It also
reduces the volume and weight of the waste.
It is usually related to the waste that cannot be
reused, recycled or disposed off by a landfill treatment.
Generally three kinds of incinerators are used:-
i. Single chamber furnaces: these are simple and
cheapest units.
ii. Double chamber paralytic incinerators: most suitable
and commonly used process for health care waste. Is
first paralytic chamber, waste is destroyed through an
oxygen deficient, medium temp.

iii. Rotary –kiln: It comprises a rotating oven and a post

– combustion chamber. It is specially used to burn
chemical wastes (including cytotoxic drugs and
pharmaceutical).
 Wastes to be incinerated.
 Human materials (body parts, blood and body fluid )
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 Animals wastes
 Laboratory wastes
 Dressing material
(4) NON-INCINERATION TECHNOLOGY
 Pressurized gas containers.
 Large amount of reactive chemical waste.
 Radiographic/photographic waste.
 Halogenated plastics such as PVC (poly vinyl chloride)
 Waste with high mercury or cadmium (such as
thermometers, used batteries etc.)
 Sealed ampoules/ampoules containing heavy metals.
(5) AUTOCLAVING
 The autoclave operates on the principle of the standard
pressure cooker.
 The process involves using steam at high temperatures.
 The steam generated at high temperature penetrates
waste material and kills all the micro organism.
 These are also of three types: Gravity type, Pre-vacuum
type and Retort type.
In the first type (Gravity type), air is evacuated with the
help of gravity alone. The system operates with
temperature of 121 deg. C. and steam pressure of15 psi.
For 60-90 minutes. Vacuum pumps are used to evacuate air
from the Pre vacuum autoclave system so that the time
cycle is reduced to 30-60 minutes. It operates at about 132
deg. C. Retort type autoclaves are designed much higher
steam temperature and pressure. Autoclave treatment has
been recommended for microbiology and biotechnology
waste, waste sharps, soiled and solid wastes. This
technology renders certain categories (mentioned in the
rules) of bio-medical waste innocuous and unrecognizable
so that the treated residue can be land filled. 8
(6) MICROWAVE IRRADIATION
 The microwave is based on the principle of generation
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of high frequency waves.

 These waves cause the particles within the waste
material to vibrate, generating heat.
 This heat generated from within kills all pathogens.
(7) PLASMA PYROLYSIS

Plasma pyrolysis is a state-of-the-art technology for

safe disposal of medical waste. It is an environment-
friendly technology, which converts organic waste into
commercially useful byproducts. The intense heat
generated by the plasma enables it to dispose all types of
waste including municipal solid waste, biomedical waste
and hazardous waste in a safe and reliable manner. Medical
waste is pyrolysed into CO, H2, and hydrocarbons when it
comes in contact with the plasma-arc. These gases are
burned and produce a high temperature (around 1200oC).
(8) INERTIZATION
In this process, cement and other substances are
mixed with waste before disposal. Mixing of cement etc.
reduces the risk of migrating toxic substance into surface
water or ground water. After making homogeneous
mixture, cubes are prepared at site, then transported to final
disposal site.
(9) LANDFILL
It is quite effective, provided practiced
appropriately a sanitary landfill observing certain rules can
be acceptable choice for disposal of biomedical waste,
particularly in developing countries like India.
Some guidelines for sanitary landfill are:-
 A specific designated place with authoritative
permission.
 Site away from the residential areas/ water sources.
 Appropriate engineering preparation of site.
 Easy transportation facilities.
 Daily coverage of waste.
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 Constant supervision.
13.2 mins Discuss BENEFITS OF BIOMEDICAL WASTE Lecture and Listening PPT, What are the
about MANAGEMENT discussion white benefits of
benefits of  Cleaner and healthier surroundings. board, bio- medical
biomedical  Reduction in the incidence of hospital acquired and waste
hand
waste general infections. management?
management.  Reduction in the cost of infection control within the out.
hospital.
 Reduction in the possibility of disease and death due to
reuse and repackaging of infectious disposables.
 Low incidence of community and occupational health
hazards.
 Reduction in the cost of waste management and
generation of revenue through appropriate treatment
and disposal of waste.
 Improved image of the healthcare establishment and
increase the quality of life
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BIOMEDICAL WASTE MANAGEMENT RULES

Safe disposal of biomedical waste is now a legal requirement in India. The Biomedical Waste Management & Handling) Rules, 1998 came into
force on 1998. In accordance with these rules, it is the duty of every “occupier” i.e. a person who has the control over the institution or its
premises, to take all steps to ensure that waste generated is handled without any adverse effect to human health and environment. It consists of six
schedules.
CATEGORY OF BIOMEDICAL WASTE IN INDIA
SCHEDULE- I

Category no. Waste category Treatment and disposal

Category no. 1 Human anatomical waste (human tissue and organs and body parts) Incineration & deep burial
Category no. 2 Animal waste (animal tissue, organs, waste generated in veterinary hospital, Incineration & deep burial
colleges)
Category no. 3 Microbiology & biotechnical waste (waste from laboratory cultures, human and Local
animal cell culture used in research & infectious agent from research and autoclaving/microwaving/incineration
industrial laboratories)
Category no. 4 Waste sharps (needles, syringes, blades that can cause cut, etc.) Disinfecting(autoclaving/microwaving/
chemical)
Category no. 5 Discarded medicine and cytotoxic waste Incineration
Category no. 6 Soiled waste (cotton, dressing, soiled plaster cast, bedding other material infected autoclaving/microwaving/incineration
with blood, etc.)
Category no. 7 Solid waste (generated from disposables items such as tubing’s, catheters and Disinfecting(autoclaving/microwaving/
intravenous set) chemical)
Category no. 8 Liquid waste (waste generated from laboratory, cleaning, and disinfecting Chemical treatment and discharge into
activities) drains
Category no. 9 Incineration ash (Ash from incineration of any biomedical waste ) Disposal in municipal landfill
Category no. 10 Chemical waste (chemical used in production of disinfection, as insecticides) Chemical treatment and discharge into
drains for liquids
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COLOR CODING AND TYPE OF CONTAINNER FOR DISPOSAL OF BMW

SCHEDULE-II

Color coding Type of container Waste category Treatment as per schedule -I

Yellow Plastic bag Cat. 1, 2, 3, 6 Incineration /deep burial
Red Disinfected container/ plastic bag Cat. 3, 6, 7 Autoclaving/Microwaving/Chemical treatment
Blue/white Plastic bag/puncture proof container Cat. 4, 7 Autoclaving/Microwaving/Chemical treatment &
translucent Destruction/Shredding
Black Plastic bag Cat. 5, 9, 10 Disposal in secured landfill