HOPESHOPES Planning & Management of Bio Medical Waste MS. JAGRUTI BHATIA
HOPESHOPES 2 The History Awareness campaign by Dr Paul Connetts visit. NGO and public pressure on the govt. & Policy makers. Involvement of the medical fraternity. Pilot project to understand the implications. Change in law.
HOPESHOPES 3 The Waste Plan Setting up a team Create Awareness/Sensitization Conducting a waste audit - Identify quantum of waste category wise Decision on end treatment options Drawing up a facility wise detail plan Allocating resources Training of Trainers Extend the program to all staff from CEO to sanitary attendants Monitor - Implementation of plan Record / Report Monitoring, Review & Refresher training
HOPESHOPES 4 The Team A responsible person designated as Waste Manager. Housekeeping manager / Attendant In Charge (Mukadam). Nursing Director/Superintendent. Infection Control Nurse, Key members from the Infection Control Team. A representative from the management. A representative from the Doctors / Consultants. Sister In Charges.
HOPESHOPES 5 Awareness Bio Medical Waste Management The Whys??? and Why Nots???
HOPESHOPES 7 Environmental Hazard : Hospital waste contains a higher amount of chlorinated plastics. Dumped in dumping grounds where rag pickers burn it leading to high levels of pollution Burning chlorinated plastics under incomplete combustion releases many harmful pollutants key among them being Dioxins & Furans Awareness
HOPESHOPES 8 Awareness Dioxin : A Unique Killer Two aspects of Dioxin toxicity from the public health perspective: - wide variety of harmful health effects - low levels of exposure - EPAs acceptable daily exposure 0.01 picograms/kg/day. Gets transferred through the food chain causing various health effects Humans routinely consume 300 to 600 times this amounts
HOPESHOPES 9 Classification Of Hospital Waste The Waste Plan
HOPESHOPES 10 Color Coding System - Segregation Incinerator ash (sec landfill), chemical waste (neutralise), Household / kitchen waste, Non-infectious bio degradable Plastic Bag Bio degrad Black Waste SharpsPuncture Proof cont Blue / White Microbiology & Biotechnology, toxins, Soiled waste(contaminated with bld & body fluids, plaster, cotton, dress), Solid Wastes (disposables) (Cat.3, 6,7) Disinfected Container / Plastic bag Red Human Anatomical Waste, Discarded medicines, cytotoxic drugs (Cat. 1,2 &5) Plastic BagYellow Waste CategoryType of Container Color Coding
HOPESHOPES 11 Color Coding System - Treatment Disposal In secured landfill - Bio degradable – vermi-composting / composting Black Autoclaving / Micro-waving / Chemical treatment and destruction & shredding Blue / White Autoclaving / Micro-waving / Chemical treatment Red Incineration / Deep BurialYellow Treatment OptionsColor Coding
HOPESHOPES 12 Color Coding System - Segregation
HOPESHOPES 13 Based on the facility plan, areas for sample audit are selected for hospitals > 100 beds, for smaller hospitals all areas are covered Is conducted in 2 phases – Before starting the training program – After waste management planning & training The waste management team is trained to instruct, segregate & quantify waste as is the current hospital practice Time frame one to two weeks based on the hospital size Conducting a waste audit
HOPESHOPES 15 After waste audit decision on the end facility to be developed Should be based on type of waste generated, quantity & statutory requirement Will also depend on available options from central facility. Population etc. End treatment facility
HOPESHOPES 16 Central Treatment Facility - Mumbai
HOPESHOPES 18 Implementing Waste Plan Allocating color coded bags and bins in accordance with facility plan ensuring segregation as per the rules TOT – explaining the plan, to also include worker safety measures Scheduling the collection timings within the hospital Transportation system within hospital Developing Storage facilities in-house
HOPESHOPES 19 Institute a sharps management plan Available option: – Needle burners (are a better option) – Needle cutters after which you disinfect & discard – Disinfect in puncture proof jerry cans with disinfecting solution (like 1% Na Hypochorite) if tranporter takes authorisation from PCB for responsibility of pilferage, the better option is still to mutilate and disinfect before discard. Sharps Management Plan
HOPESHOPES 20 Color Coding System - Segregation
HOPESHOPES 22 Points to be remembered: The containers to be puncture proof and bags to be sturdy, leak proof for high risk waste The bags to be tied by the neck while transportation Transportation trolleys and specific lifts or timings to be designated Staff handling this to wear protective clothing, gloves, mask, aprons etc. If bags tear or get contaminated they be placed in a new clean bags ( double bagging ) Never allow any person to put hands inside the bag Stringent Infection Control Policies to be formed & implemented Transportation:
HOPESHOPES 23 Evaluation Training Tools: Conducting pre and post training tests Monitoring of model sessions by Trainers Post training exams conducted for trained staff by trainers Monitor & Review Training
HOPESHOPES 25 Records & Reports: Waste Audit & record keeping Ward reporting format checklist – Nurse Station – Sanitation Supervisor – Program In Charge As per the MOEF Rules, Annual Report format (Form II, Rule 10) Accident Reporting (Form III, Rule 12)
HOPESHOPES 30 Teach employees responsibility Issuance of protective equipment like gloves, mask Establishment of an occupational health program that includes immunization, post-exposure prophylaxis, and medical surveillance Worker Safety:
HOPESHOPES 31 THANK YOU THINK TODAY TO ENSURE A BETTER TOMMOROW
HOPESHOPES 32 Contact: HOPES – HELP ORGANISATION FOR PEOPLE ENVIRONMENT & SOCIETY 119, UDYOG BHAVAN SONAWALA ROAD GOREGAON (EAST) 400 063. TEL: 28777214 FAX: 28777431 EMAIL: email@example.com@hopesindia.com WEB: www.hopesindia.comwww.hopesindia.com