Planning and monitoring healthcare waste management
Managing the safe and proper disposal of healthcare waste is an essential part of infection protection and control for you (the healthcare worker), your clients/patients and the general public. In addition to meeting national and local guidelines on infection prevention, it helps you prevent nosocomial infections (i.e. healthcare facility/hospital acquired diseases).
Planning and preparation for proper waste disposal will help you ensure the availability and correct functioning of infection control facilities in the health facility, including sanitising materials and hazardous healthcare waste management and disposal equipment. Forward planning can also help reduce the likelihood of accidents; for example, the chance of needlestick injury will be reduced if you always think ahead and have the sharps box close to you when you give an injection.
The table below is a template for waste management planning in the health facility. It lists various waste management activities and indicates how often they should be done, the materials and equipment needed and who is responsible. You may wish to adapt this for your own health facility and draw up your own management plan. Having a plan similar to this will help to ensure that waste is managed correctly.
Example template for a Health Facility waste management plan
Key: R = routinely (at a specific time, if possible); BP = before procedure; AP = after procedure; O = occasionally
| Activity | When? | Equipment/materials needed | Who? | Comments |
|---|---|---|---|---|
| Handwashing | R, BP and AP | Water, soap, disinfectant/alcohol | Health professional | Sullage should be disposed of into a seepage pit |
| Disposing of sharps | R (when the safety box gets ¾ filled), AP | Safety box, incinerator, sharps pit | Health professional | Avoid needle recapping |
| Disposing general waste and solid infectious waste | R | Waste bin, incinerator, gloves, matches, burial pit | Health professional and others | Incinerate in a brick incinerator, or metal drum or burn in an open pit |
| Inspecting waste disposal facilities | O | Heavy-duty gloves, protective clothes | Health professional | |
| Sterilisation of instruments/materials | AP | Autoclave, indicator | Health professional | An indicator is a strip or tape that changes colour when the material/equipment reaches sterilising temperature |
| Disposal of liquid/semi-liquid infectious waste | AP | Placenta pit | Health professional | Pit should be fenced and locked |
| Disposal of expired drugs | O | List of drugs expired, reporting, disposal pit | Committee from district office, community and health professional | You need to notify the committee if you have drugs that need to be disposed of |
| Cleaning the Health Facility | R | Water, detergents, disinfectants, gloves, protective clothing, broom, mops, dustbin, etc. | Health professional and others |
You can monitor the management of healthcare waste at your health facility and identify possible improvements that you could make by checking your current practices. For example:
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Could you reduce the amount of waste produced in your health facility (waste minimisation)?
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Do you separate infectious from non-infectious waste?
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Is infectious waste packaged before disposal to reduce contact and exposure?
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Do you have adequate supplies of gloves, colour-coded bins and other waste management supplies?
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Is everyone at the health facility properly trained in correct healthcare waste management procedures?
There may be other questions you can think of to include on your checklist.
Concluding note
As you know, poor hygienic and environmental health conditions are the major cause of illness and death in developing countries. It is our sincere hope that this course will enable you to understand the concepts and principles of hygiene and environmental health. By putting these concepts and principles into practice, your community disease profile will improve significantly to a level that common infectious diseases that arise due to poor hygiene and environmental health, such as diarrhoea, intestinal parasites, malaria, pneumonia and TB, will not be major causes of morbidity or mortality in your area. Moreover, as well as learning about the protection of human health, you have also learned how to keep our environment safe.