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Hosp Waste Management

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0% found this document useful (0 votes)
27 views41 pages

Hosp Waste Management

Uploaded by

Raksha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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Biomedical Waste Management

“WE HUMANS HAVE AN AMAZING

POTENTIAL TO CONVERT

EVERYTHING USEFUL INTO WASTE”

-ANONYMOUS
Biomedical waste
Definition: “waste generated during the diagnosis, treatment or
immunization of human beings or animals or in research
activities pertaining there to or in the production of testing
biologicals.”

85% • Non-hazardous

10% • Infectious

5%
• Non-infectious but
hazardous
Non-hazardous waste
Bio- Non-
degradeable biodegradeable

Kitchen
Wrappings
waste

Office
Foils
waste

Plastic
Bouquets
bags
Hazardous waste
Instruments
Potentially
Lab wastes used in patient
infectious
care

Dressings Samples Endoscopes

Swabs Glassware Probes

Cultures & stock Syringes,


Contaminated
of infectious needles &
with body fluids
agents sharps
Potentially infectious waste

Animal
Surgical Pathological
wastes

Placenta Diagnostics Tissues

Tissues Research Autopsy

Medical
Tumors &
procedure
limbs
specimens
Radioactive waste

• Solids, liquids or gases

• Used for:

– Analytical procedures

– Body organ imaging

– Tumor localization & Rx


Hazardous chemical waste
• require safe disposal which will ensure that human or
environmental problems do not arise during storage, transport, and
final disposal
• May be:

Toxic

Corrosive

Inflammable

Reactive

Genotoxic
Pharmaceutical waste
• Surplus stock
• Spillage or contamination
• Past Expiry date

• Do not open
• Wrap container to prevent breakage
• Place in opaque plastic container & wrap
• Duct tape to conceal
• Dispose in trash
• Chemo drugs – may require special
handling!
Persons exposed to risk
• Patients attending the health care facilities.
• Medical and paramedical personnel
• Persons involved in collecting and disposing the
waste material
• Those involved in cleaning the instruments , floor
surfaces and washing of glass wares and linen.

If potentially hazardous / infective waste gets mixed


with solid waste from other activities , the entire
chain of workers /persons involved in solid disposal.
Hazards of poor management
• Injuries from sharps to all categories of hospital
personnel (HIV and HBV).
• Nosocomial infection in patients.
• Risk of infections outside hospital for waste
handlers & eventually the general public.
• Risks associated with hazardous chemicals, drugs
being handled by persons handling wastes at all
levels
• Disposable – recycled – repacked and sold
Routes of infection
• through non – intact skin (cuts
and puncture) or intact skin.
• Through mucous membranes
• Inhalation of dust particles
containing germs.
• By ingestion - through
contaminated unwashed hands,
water and foodstuff.
Precautions
• All personnel must be vaccinated against
Hepatitis B
• Heavy duty gloves while dealing with infectious
waste specially sharps
• Sharps should not be left casually on counter
tops, trays or beds
• Recapping needles should be discouraged
STEPS IN WASTE MANAGEMENT :

 Waste survey
 Waste segregation
 Waste accumulation & storage
 Waste transportation
 Waste treatment
 Waste disposal
 Waste minimisation
 Recycling
Segregation of Wastes
• KEY for the entire waste disposal process, as it
happens “at source!”
• Reduces the risks and cost of waste management.
• Small errors at this stage can create lot of
subsequent problems.
• Segregation is the responsibility of the generator
of wastes i.e. the doctor, nurse or para-medical
personnel. In reality, this job is relegated to the
sanitation staff – leading to mix-ups..
WASTE SEGREGATION

• Schedule I of BMW rules show the


categories of bio-medical waste in
India.

• Schedule II of BMW rules elaborate


about the colour coding of the bags.
CATEGORY 1
incineration

Human anatomical waste


Deep burial
CATEGORY 2
Animal waste

Incineration Deep burial


CATEGORY 3

Microbiology & Biotechnology waste

Autoclave Incineration

Microwave
CATEGORY 4
Waste sharps

Mutilation & shredding

Chemical Autoclave Microwave


treatment
CATEGORY 5
Incineration
Discarded medicines & cytotoxic drugs

Secured
Landfill
CATEGORY 6 Incineration

Soiled waste

Autoclave

Microwave
Chemical
CATEGORY 7 disinfection Microwave

Solid waste

Mutilation / shredding

Autoclave
Chemical
CATEGORY 8 treatment

Liquid waste

Discharge
Into drain
CATEGORY 9

Municipal land fill

Incineration ash
CATEGORY 10 Chemical treatment

Liquids Solids

Chemical waste
Objectives of waste management policy
1. Changing an age old “mind set” and attitude through
knowledge and training.
2. Defining the various categories of waste being
generated in the hospital.
3. Segregation and collection of various categories of
waste in separate containers, so that each category is
treated in a suitable manner to render it harmless.
4. Identifying and utilising proper “treatment
technology” depending upon the category of waste.
5. Creating a system where all categories of personnel
are not only responsible, but also accountable for
proper waste management.
6. Changing the use patterns to minimize wastes.
Data on waste surveillance

• Generated in your hospital daily :- Total Wt. 75-


80 Kg (OT & ICU – 2 kg / bed / day!)
• Maximum soiled waste and sharps produced are
in OT & ICUs, Gyn , Surgery and Medicine wards
• Wards have colour coded bags, sharps
containers.
• Sharps are separated from syringes and
disinfected with Na hypochlorite solution before
disposal
• Most of the wards have needle destroyer but
their use is ?
Legal & Policy Requirements

• Bio-Medical Waste (Management and


Handling) Rules 1998.
• Karnataka State Pollution Control Board.
• ISO 9001:2008 Quality Management Policy
• NABH Accreditation
Factors affecting segregation

• Hospital policy and procedures


• Motivation and training of “generators”
• Facilities provided for segregation
• Surveillance
• Positive & negative reinforcement!
Segregation policy to remember!
• Body parts, placenta, blood, pus,
Yellow cotton, infected items

• Plastics & rubber – plastic IV bottles, IV


Red sets, blood & uro bags, plastic syringes,
gloves

• Glass bottles & syringes


Blue • Glass Slides

White
• Needles, sharps, blades
Sharp container
Collection of Wastes
• The containers for collection should be strategically
located at all points of generation.
• Collection should be done as per rules in colour-
coded plastic bags.
• Be vigilant - that intermixing of different categories
of waste is not done inadvertently by the patients,
attendants or visitors.
• The process of collection should be documented in a
register, the coloured polythene bags should be
replaced and the garbage bins should be cleaned
with disinfectant regularly.
Storage of Wastes
• At our Hospitals, waste is stored in the areas of generation
for an interim period varying from two to twelve hours,
after which it is transported for treatment and disposal by
the sanitation staff.
• During this period it is the responsibility of the clinical and
para-medical staff to check that there is proper segregation
and no subsequent recycling of disposables and other
items.
• Subsequently, during transportation, there is a lag period of
2 – 3 hours, during which the waste is “stored” outside the
hospital. It is the responsibility of the sanitation staff and
security staff to ensure that rag pickers and others do not
gain entry and sort the waste for “recycling.”
WASTE TRANSPORTATION
Inside Hospital on wheeled trolleys or carts or containers
Off site transportation of BMW
Transport of Wastes
• The general waste (in black polythene bags)
should be deposited at the municipal dumps,
outside the hospital.
• Any spillage or leakage should be reported to
Sanitation In-charge, and it is his/her
responsibility to get the respective
trolleys/carts cleaned and disinfected.
Role of Adminstrator
1. overall responsibility for the formulation and
implementation of guidelines for hospital waste
management.
2. ensure that waste is handled without any threat to human
health and environment.
3. responsible for applying for grant of authorisation (in Form
I) to the State Pollution Control Board.
4. responsible for submitting an annual report in Form II to
the PCB by 31st January regarding information about
categories and quantities of Bio-Medical Wastes handled
during the previous year.
5. answerable to the higher authorities in the Health &
Environment Ministry.
Our role?
1. Awareness of different categories of waste and
potential hazard
2. Waste minimization, reduction in use
3. Segregation policy
4. Proper and safe handling of sharps
5. Use of protective gear
6. Colour coding of containers
7. Appropriate treatment of waste
8. Management of spills and accidents
What’s in it for us?
"Always do the right thing. This will gratify
some people and astonish the rest" -Mark
Twain.
1. Be responsible – YOU are a LEADER!
2. Keep yourself safe.
3. Look after the safety of the people around you.
4. Make sure all personnel know & follow the
disposal policies.
5. Today’s conscious action becomes tomorrow’s
habit!
• Avoid passing sharps & recapping of needles.

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