Biomedical waste management ppt

Biomedical management is one of the most important tasks in healthcare settings. An attempt has been made here to share some knowledge about this.

1. Biomedical waste management Anju Rana

2. BIOMEDICAL WASTE MANAGEMENT Bio medical waste (BMW) is generated in the form of solid, liquid or tissues from humans or animal origin. It also includes containers, packings or any other product generated while short term or long term patient care like observational, diagnostic, therapeutic or rehabilitative services provided to a person who is suffering or is suspected to be suffering from some disease or injury.

3. Biomedical waste includes the waste originating from minor or scattered sources such as that produced in the course of health care undertaken at the home e.g. dialysis, insulin injections, etc.

4. The management of biomedical waste is a crucial challenge faced by all hospitals. With expansion of health care facilities as well as the recent trend of using disposables there has been increase in burden of health care related waste. Since the last three decades, unregulated handling of biomedical waste is emerging as a serious threat to human health and safety . If bio-medical waste is not managed properly, it could cause environmental, occupational and public health hazard.

5. Environmental Hazard Inappropriate treatment and disposal of bio-medical waste contributes to environmental pollution , uncontrolled incineration causes air pollution , dumping in tanks and other water sources cause water pollution and unscientific land filling causes soil pollution .

6. Occupational Hazard It is a risk to all those who generate, collect, segregate, handle, package, store, transport, treat and dispose biomedical waste. Children and rag pickers are particularly at risk who come in contact with infectious waste. Occupational exposure to blood can result from percutaneous injury

7. Public Health Hazard Poor management of bio-medical waste can cause serious disease to health-care personnel, to waste workers, patients and to the general public. The greatest risk posed by infectious waste is accidental needle stick injuries, which can cause hepatitis B and hepatitis C and HIV infection.

8. Why do we need to manage BMW With the introduction of Biomedical Waste Management and Handling Rules, 1998 and emergence of various diseases due to mismanagement of bio-medical waste, it has become important in health care settings to manage the waste properly. The concern over human immunodeficiency virus (HIV), transmission of hepatitis B virus (HBV) and other blood borne infections has led to an increased professional and environmental concern towards this issue.

9. Identify the source of waste generation The first step is to identify the areas of waste generation in the hospitals. In almost all the units i.e. out-patient, wards, operation theatre, labour room, pathology labs, intensive care units etc., waste is generated, the only difference is in quantity and category.

10. Categorisation The second step is to categorize the waste according to Bio-Medical Waste management and handling Rules. The categorisation helps in placing the different bins with coloured codes at the appropriate places as close to the waste generation site as possible.

11. Category 1: The anatomical waste such as human tissues, organs and body parts. Category 2: Waste generated in animal houses and veterinary hospitals, colleges and clinics like animal tissues, organs, body parts, fluid, blood. The tissues and carcases are also generated as waste during research. Category 3 : Microbiology and biotechnology waste like wastes from laboratory cultures, stocks or specimens of bacteria, live or attenuated vaccines, cell cultures, wastes from production of toxins, vaccine and sera from institutes, dishes and devices used in the labs, pharmaceutical industries and hospitals.

12. Category 6: Soiled Waste such as items contaminated with blood and body fluid including cotton, and dressings; soiled plaster casts, linens, bedding, other material contaminated with blood. Category 7: Solid wastes like waste generated from disposable item other than waste sharp such as tubings , catheters, intravenous sets etc. Category 8: Liquid Waste such as waste generated from laboratory and washing, cleaning, housekeeping and disinfection activities. Category 9: Incineration ash from any biomedical waste. Category 10: Chemical waste from the chemicals utilised in production of biologicals, insecticides and disinfectants used in a healthcare setting.

13. Segregation The segregation of waste generated in a hospital is a very important factor in bio-medical waste management system. Depending on the categories of biomedical waste, specific colour coded containers are used for proper segregation and storage of wastes for further appropriate treatment and disposal.

14. Human anatomical and pathological waste is segregated in yellow plastic bags . Red bags and containers are for plastic wastes like catheters, injections, i /v bottles, etc. Blue plastic bags , containers are used for placing all types of glass bottles, broken glass articles outdated and discarded medicines. Black bag is for needles without syringes, blades, sharps and all metal articles.

15. Handling of BMW The bio-medical waste should be segregated into colour coded containers, bins, bags as soon as it is generated. When these containers are three quarter full, the bags should be picked up from the neck and placed in the trolley and should be transported to the temporary storage area or waste disposal sites. Manual handling of waste bags should be minimized to reduce the risk of needle prick injury and infection.

16. On-site biomedical waste disposal Autoclave : This is mostly used in laboratories and clinics for treating infectious wastes being generated in clinical and research labs. It is a process of steam sterilization under pressure. When steam comes in contact with the waste material it kills the infectious microorganisms. Microbiological and biotechnological waste, waste sharps, soiled and solid waste is treated in an autoclave.

17. Chemical treatment : It is a useful method to deactivate liquid waste and is useful in small places like clinics. Depending on the type of waste various chemicals can be used for treatment of waste like chlorine, sodium hydroxide or calcium hydroxide. Microwave treatment : Microwaves of the frequency of about 2450 MHz are used to decontaminate medical waste. The waste to be treated must be humid as in presence of moisture microwaves penetrate and sterilises the material. Before starting the process, medical waste is changed into shreds and mixed with water to moisten it. Microwaving is suitable for the treatment of most infectious waste with the exception of body parts and large metallic items.

18. Off- site biomedical waste disposal Incineration : This is a safe method of treating large solid infectious waste, particularly anatomical waste, amputated limbs, etc. This is a high temperature thermal process and burns the waste under controlled conditions to ashes. The biomedical waste is converted into inert material and gases are released. This reduces weight and volume of the BMW.

19. Deep Burial : It is a method adopted to bury human anatomical waste when no other facility is available or affordable. The method is efficient in waste disposal but it must be carried out under supervision. The burial must be carried out in pits situated away from human habitation.

20. Sanitary landfills : These are sites for keeping segregated and isolated waste away from the human dwellings. The waste can be stored here for long time. A trained staff along with appropriate design is needed before the sanitary landfill site is ready to accept waste. The landfill is about 60 metres in depth and 500 metres in width.

21. Needle Cutter / Needle Burner : The device helps in destroying the used needle and syringes, therefore prevents the transmission of blood borne infections in the society.

22. Disinfection of Waste in BMW Disinfection is an important phenomena in bio-medical waste management. The aim of disinfection is to eliminate microorganisms or at least reduce their numbers to a satisfactory level. However, selection of disinfectants depends not only on their effectiveness, but also on their corrosiveness and other hazards related to their handling. The types of chemicals used for disinfection of health-care waste are mostly aldehydes, chlorine compounds, ammonium salts and phenolic compounds.

23. Points to remember while managing biomedical waste : 1. Generate waste when it is essential. 2. Segregate waste as soon as it is generated and segregate at the point of generation into specific categories of waste in specific colour coded covered bins. 3. Clean the bins regularly with soap and water or disinfectant. 4. Collect the domestic waste/eatables, wrappers, fruit peels, papers etc., in green bin. 5. Carry/transport the waste in closed containers. 6. Transport waste through a pre-defined route within the hospital.

24. 7. Mutilate the needle soon after injection. 8. Mutilate plastic waste as soon as it is generated. 9. Disinfect needle and solid waste (plastic) after mutilation. 10. 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. 11. Waste sharps should be kept in white translucent bin, ¾ filled with disinfectant solution . 12. Avoid incinerator for individual establishment.

25. Role of nurse A nurse plays a significant role in bio-medical waste management. A nurse has to determine and implement the desired standards of any institution. She/he has to work in coordination with waste management programme of the healthcare facilities. Collection and disposal of hospital waste is based on scientific principles. For a proper management of the biomedical waste a nurse has to follow certain guidelines. Contd ……

26. 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. Nursing staff should ensure that waste bags are tightly closed or sealed when they are about 3/4 full. Matron or senior nursing officer is responsible for training new nurses and medical assistants in good bio-medical waste handling.

27. Staff nurse is a first level professional nurse who provides direct patient care or group of patients assigned to her / him during duty shift and assist in management of wards / units / special departments etc. In the whole process a lots of biomedical waste is generated like wrappers of medicines, injections, syringes, cotton, plasters, etc.

28. 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. She should perform duty with responsibility .

29. 4. Staff nurse is a first level professional nurse who provides direct patient care or group of patients assigned to her / him during duty shift and assist in management of wards / units / special departments etc. In the whole process a lots of biomedical waste is generated like wrappers of medicines, injections, syringes, cotton, plasters, etc. 5 . The nursing staff must be trained in safe handling of waste and its procedures. 6. Adherence to the universal precautions while performing surgical and instrumentation procedures is also very helpful and the biomedical waste generated should be disposed of according to the hospital policies.

30. Thank You