Biomedical waste management

This PPT includes-
Recent protocols based on Biomedical Waste Management

1. BIOMEDICAL WASTE MANAGEMENT Presented by: Anjali Arora M.Sc. Nursing -1 ST Year College Of Nursing Institute Of Liver and Biliary Sciences

2. “There is no such thing as away when we throw any thing ‘away’ it must go somewhere”

3. Introduction Health-care activities protect and restore health and save lives. But what about the waste and by-products they generate? Hospital waste is a potential reservoir of pathogenic microorganisms and requires appropriate, safe and reliable handling. BMW has been emerged as issue of concern and day to day challenge faced by healthcare providers world over. BMW is a real problem for Man, community and environment. BMW Management is a need of an hour to help providers to become better providers.

4. Wastes “ Something which is not put into proper usage at a given time”

5. Historical aspect In the late 1980’s – Items such as used syringes washed up on several East Coast beaches of USA and Concerned about HIV and HBV virus infection which Leads to development of Biomedical Waste Management Law in USA. However, in India the seriousness about the management came into lime light only after 1990’s.

6. Definition Biomedical waste means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological. - According to Biomedical waste (Management and handling) rules,1998 of India

7. Classification Infectious waste:  waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples), cultures and stocks of infectious agents from laboratory work (e.g. waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g. swabs, bandages and disposable medical devices). Pathological waste:  Human tissues, organs or fluids, body parts and contaminated animal carcasses. Sharps waste:  Needles, disposable scalpels and blades, etc.

8. Classification Chemical waste:  Solvents and reagents used for laboratory preparations, disinfectants, sterilant and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries. Pharmaceutical waste:  Expired, unused and contaminated drugs and vaccines. Genotoxic/Cytotoxic waste:  waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites.

9. Classification Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials. Non-hazardous or general waste: waste that does not pose any biological, chemical, radioactive or physical hazard. Pressurized waste: Gas cylinders, gas cartridges, aerosol cans.

10. Need of Biomedical waste Management Within the domain of municipal solid waste, biomedical waste acquires a special dimension, since it is infectious and hazardous and capable of spreading disease or be harmful to individuals. In the absence of proper segregation, packaging, segregation, treatment and disposal of bio medical waste, the non-infectious waste becomes infectious and poses environmental threat to the society.

11. Every year an estimated 16 billion injections are administered worldwide, but not all of the needles and syringes are properly disposed of afterwards. Developed Countries- 1-5 kg/bed/day, with variations among countries. In India- 1-2 kg/bed/day with variation among Govt. and Private establishments. Approximately 506.74 tons/ day wastes generated. Out of which only 57% waste undergoes proper disposal Biomedical waste Statistics.

12. Legislation Recognizing the deadliest nature of the Bio-Medical Waste, the Government and Pollution Control Boards under the guidelines of Ministry of Environment and Forests (MOEF). Promptly designed and issued guidelines to the hospitals to ensure a proper and safe disposal of bio-medical waste “BIO-MEDICAL WASTE Management & Handling RULE 1998 came into effect. Provides uniform guidelines and code of practice for Bio-medical waste management.

13. Principles of Biomedical Management Biomedical wastes ,1998 The Government of India as contemplated under Section 6,8 and 25 of the Environment (Protection) Act,1986, has made the Biomedical Wastes (Management & Handling) Rules, 1998. The rules are applicable to every institution generating biomedical waste.

14. Principles of Biomedical Management Biomedical Wastes (Management & Handling) Rules, 1998. revised in 2011, Now known as BMW Rules, 2011.It includes- Develop a waste management plan that is based on an assessment of the current situation and which minimizes the amount of waste generated. Segregate clinical (infectious) waste from non-clinical waste in dedicated containers. Transport waste in dedicated trolleys. Store waste in specified areas with restricted access.

15. Principles of Biomedical Management Collect and store sharps in sharps containers. Sharps containers should be made of plastic or metal and have a lid that can be closed. Mark the storage areas with a biohazard symbol . Ensure that the carts or trolleys used for the transport of segregated waste collection are not used for any other purpose – they should be cleaned regularly. Identify a storage area for waste prior to treatment or being taken to final disposal area.

16. Principles of Biomedical Management The Central Government vide notification on 19 th  March 2019, has published in the e-gazette, the Bio-Medical Waste Management (Amendment) Rules, 2019. The key highlights of the amended Rules (2019) are as follows: The occupier of all bedded health care units shall maintain and update on a day to day basis the bio-medical waste management register. All bedded healthcare units shall display the monthly record of waste disposal management on its website. Such health care facilities (irrespective of any number of beds), shall make the Annual Report available on its website before 19 Mach 2021.

17. Principles of Biomedical Management Health Care Facilities having less than ten beds shall have to comply with the output discharge standard for liquid waste by 31st December 2019. PENALTIES AS PER RULES The PENALTIES are as specified in Environment (Protection) Act 1986. Imprisonment for up to five years with fine up to one lakh rupees, or both. In case the failure additional fine up to five thousand rupees for every day.

18. Sources of Health care waste

19. Health Hazards of Biomedical waste Health-care waste contains potentially harmful microorganisms that can infect hospital patients, health workers and the general public.

20. Who is at risk

21. Treatment and disposal technologies for biomedical waste Incineration Incineration Inertization Land Disposal Wet and dry thermal Treatment Chemical Disinfection

22. Categories of Biomedical waste

23. Color coding of Biomedical wastes Colour coding   Types of Containers Waste Category Treatment Options Based on the Category YELLOW Plastic bag 1, 2, 3 and 6 Incineration/Deep Burial RED   Disinfected container/plastic bag 3,6 and 7 Autoclaving/Microwaving Chemical treatment BLUE/WHITE TRANSLUCENT Plastic bag/puncture proof container 4 and 7 Autoclaving/Microwaving Chemical treatment and destruction/Shredding BLACK   Plastic bag 5, 9 and 10 (solid) Disposal in secured landfills

24. Steps in the management of hospital waste

25. Generation of waste

26. Segregation of waste

27. Proper labelling of Bins

28. Collection

29. Storage

30. Transportation

31. CDC Guidelines, 2016 Categories of Regulated Medical Waste. Disposal Plan for Regulated Medical Wastes. Handling, Transporting, and Storing Regulated Medical Wastes. Treatment and Disposal of Regulated Medical Wastes.

32. Safety devices for Biomedical waste management

33. Reason for failure of Biomedical waste Management Lack of awareness about the health hazards related to health-care waste. Inadequate training in proper waste management, absence of waste management and disposal systems. Insufficient financial and human resources and the low priority given to the topic are the most common problems connected with health-care waste. Many countries either do not have appropriate regulations, or do not enforce them .

34. Ways to Improve Biomedical waste Management Generate waste when it is essential. Segregate waste as soon as it is generated and segregate at the point of generation into specific categories of waste. Clean the bins regularly with soap and water or disinfectant. Collect the domestic waste/eatables, wrappers, fruit peels, papers etc., in green bin. Carry/transport the waste in closed containers. Transport waste through a pre-defined route within the hospital.

35. Ways to Improve Biomedical waste Management Mutilate needle and plastic waste soon after generation. Dispose body parts in yellow bin. If Common Bio-Medical Waste Treatment Facility is available, hand over to them within 48 hours, otherwise dispose by incineration or deep burial where population is less than five lakhs people. Waste sharps should be kept in white translucent bin.

36. Role of Nurse in Biomedical waste Management

37. A nurse plays a significant role in bio-medical waste management. A nurse has to determine and implement the desired standards in coordination with waste management programme of the healthcare facilities. The head nurse should keep an inventory of materials required such as bags, bins, containers, mutilating aids, protective aids etc. and check for the adequate supply.

38. She should see that the reusable items must be disinfected, cleaned, repacked and sent for sterilisation. Infected material should be discarded and incinerated wherever possible. Floor wise, one nursing supervisor is responsible for supervision of segregation. Matron or senior nursing officer is responsible for training new nurses in good bio-medical waste handling.

39. The nursing staff must be trained in safe handling of waste and its procedures. Biomedical waste generated by the Nurses should be disposed of according to the hospital policies. Nursing staff should ensure that waste bags are tightly closed or sealed when they are about 3/4 full .

40. Summary

41. Conclusion Let the waste of the “sick” not contaminate the lives of “The Healthy”

42. Thank you