Assessment of bmw Management at Mahila chikitsalay,.pptx

Assessment

1. Assessment of Bio-medical Waste Management at Mahila C hikitsalay , Jaipur Presented By: Dr. Shyam Lal Meena Dr. Sadhana Meena Dr. Kuldeep Meena Dr. Yamini Singh Dr. Hemnandini Pathak

2. INDEX: Introduction Aim & Objectives of BMWM Principle Of BMWM BMW Act Categories of BMW (Table.1) Differences in BMWM act- 1998 v/s 2016 (Table.2) Schedules of BMW- 1998 v/s 2016 (Table.3) Reporting Formats (Table.3) Findings at visit CBMWTF: Brief

3. Introduction: Bio-medical waste defined as any waste that is generated during the diagnosis, intervention and treatment or immunisation of human being or animals or in the research activities pertaining thereto or in the production or testing of biologicals products . Hospital waste defined as wastes that generated during administrative work, during house-keeping work and during health care work known as hospital waste . Overall it have significant health impact on health care workers, waste handlers, patients, general public and on environment. According to WHO :- 85% -Domestic waste and non-hazardous waste 10% -Infectious waste 5% -Non-infectious waste but hazardous Non-Hazardous Waste ( Non-Infectious) 75-90% Household and administrative waste Hazardous Waste 10-25% Healthcare waste

4. Hazardous Waste categories (10-25%):

5. Average Composition of hospital waste in India- Materials Percentage (wet-weight basis) Paper 15 Plastics 10 Rags 15 Metal (sharp etc.) 1 Infectious waste 1.5 Glass 4 General waste (food waste, sweeping from hospital premises etc.) 53.5 Ref- Source- NEERI 1997 (National Environmental Engineering Research Institute)

6. Causes of improper BMW management: The absence of proper waste management, Lack of awareness about the health hazards from BMW, Insufficient financial and human resources and, Poor control of waste disposal

7. Need of BMW Management : Injuries from sharps leading to infections to all category hospital personnel and waste handlers Nosocomial infections in patients from poor infection control practices and poor waste management Infections: Growth and multiplication of vectors like insects, rodents and worms and may lead to transmission of diseases like typhoid, cholera, hepatitis (A& E) and Transmission of AIDS & Hepatitis-B through syringes and needles . Risk of infection outside hospital to waste handlers and scavengers and at times general public “disposables” being repacked and sold by scrupulous elements without even being washed Disposed drugs beings repacked and sold off to unsuspected buyers Risk of air, water and soil pollution . Genotoxicity & Cytotoxicity, Chemical toxicity, Radioactivity hazards

8. Aim & Objectives of Visit: Aim : To gaining & sharing knowledge of BMW Management for educational purpose. Primary Objective : -To Assess the status of BMW Management at Mahila Chikitsalay , Jaipur Secondary Objective : -To Find out quantum of BMW generation Per Bed/Day.

9. Principle of BMW Management: Basic Principle of BMW Management based on the concept of 3Rs , Reduce , Recycle and Reuse . A im at avoiding generation of waste or recovering as much as waste as possible, rather than disposing. Therefore , the various methods of BMW disposal, according to their desirability, are prevent, reduce, reuse, recycle , recover, treat, and lastly dispose. Hence, the waste should be tackled at source rather than “end of pipe approach.” [1]

10. Bio-Medical Waste (Management & Handling) Rules: Rules was passed on 28 th .July 1998 by GoI , by Ministry of Environment and forest . The BMW 1998 rules were modified in the following years – 2000 & 2003 Ministry of Environment, Forest and Climate change in March 2016 have amended the BMWM rules, BMWM rules further amendment in 2018 & 2019.

11. Challenges in the Implementation of New Biomedical Waste 2016 Rule One of the biggest challenges the government hospitals and small HCFs will face, during the implementation of BMW 2016 rules will be due to the lack of funds. To phase out chlorinated plastic bags, gloves, blood bags and to establish a bar code system for bags/ containers the cost will be high and time span for doing this i.e. two years is too short.

12. Steps of effective BMWM:- Survey of waste generated, Segregation of hospital waste, Collection and categorisation of waste, Storage of waste, Transportation of waste, Treatment of waste

13. Findings of Visit, Regarding BMW Management: Visit done on date: 19 th Oct.2020 Manpower: Nodal officer : Dr. Renu Meena (phone- 9460570210) Supervisor : 1. Mr . Shivnarayan Kumawat (phone- 9828289621) 2. Mr . Hari Singh Meena (phone- 8561957645) 3. Mrs . Merry Vargis (phone- 9785556992 )

14. Findings of Visit, Regarding BMW Management: Authorization for BMW : 01/04/2020 to 31/03/2021, Agreement with Instromedix India private limited company for Transportation, Treatment and Disposal of BMW, which will last for 31/03/2023 for the current contract. (5 year) Frequency of training of health workers : in every 2 months Total Health workers trained are: 32 Waste collection frequency (from generation points): 2 times a day Waste transportation from storage place to CBMWTF : every 24 hours

15. Findings of Visit, Regarding BMW Management: The hospital staff was following the BMW management guidelines. There were proper colour coded bins and containers in all the wards, Labour room, operation theatre, OPD rooms and laboratory . Segregation of waste was done at the time of generation. The bins were tagged with dates of when the new colour coded plastic bag is set up in the bins. A record system was maintained for the waste collection which included the date and time of collection and weight of the waste collected . There were charts (flex benner ) demonstrating the guidelines for waste segregation displayed at every dustbin point .

16. -Bins with covered, -Colour coding directions Displayed

17. Wrong date Right Date Bleaching Solution Bins not covered

18. Bio-Medical Waste Quantum statistics (WHO): In developed countries: 1-5 kg/bed/day . In India 484 TPD ( tonnes per day) from 1, 68,869 HCFs. Out of them, only 57 % waste undergoes proper disposal . Reference: ( Datta P et al. BMWM in India:Critical appraisal. J Lab Physicians 2018;10:6-14 )

19. BMW Quantum at Mahila Chikitsalay , Jaipur: Quantity of wastes in Month- Sept.2020 : Container/ Plastic Bag Non- Covid Waste (Weight in Kg) Covid Waste (Weight in Kg) Total (Weight in Kg) Red 414 63 477 (19.84% Yellow 1328 304 1632 (67.89%) Blue 207 88 295 ( 12.27%) Total (Weight in Kg) 1949 (81%) 455 (19%) 2404 (100%) Total Bed in Mahila Chikitsalay = 504 Total Waste Generated Per Day = 80.13 Kg (in Sept. 2020) Total waste generated per bed/ day = 0.15 kg (in Sept. 2020)

20. Common BMW Treatment Facility (CBMWTF) : Brief Currently, in India, there are 198 CBMWTF in operation and 28 are under construction.[13 ] No. of HCFs using CBMWTFs = 1,31,837 No. of HCFs have their own treatment facilities on‑site= 21,870 Currently, in Rajasthan, there are 5 CBMWTF in operation which collect waste from all govt hospitals & Pvt hosp. ( Instromedix India Pvt. Ltd. Company) 5 CBMWTF: Jaipur ( Kanota ), Alwar , Ajmer, Chittodgad & Kota 6 th . n ew project under constructions in Village- Maheshpura ( Jalore ). Catchment area under CBMWTF Kanota - Jaipur City & Rural, Dausa , Sikar & Jhunjhunu. Functions of CBMWTF: Transportation, Treatment & Disposal of BMW Treatment Processess are: Autoclave, Incineration, Chemical Tt Disposal : Ash dispossed off in Deep Burial Pit

21. Thank You.