Final slides of 6 days onsite training to Healthcare Professionals of Bheri Hospital.pptx

infection prevention and waste management

1. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5g\ : tflnd sfo { qmd tyf jftfj /0f : jf:Yo : jf:YohGo kmf ]x/ d} nf Joj:yfkg vfg ] kfgL ;/; kmfO { tyf :jR5tf -o;kl5 EH/HCWM/WASH / flvg ]_ ; DaGwL Ifdtf clej [l4 cEof;sf ] nIo / p2] Zoaf /] atfpg . tflndsf ] l;4fGt atfpg .

2. EH/HCWM sf g] kfnsf sfg"gL k|fjwfgx ?

3. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5gM\ ▶ g] kfnsf ] ;+ ljwfgdf pNn ]v ul / Psf EH/HCWM ; DaGwL k|fjwfgx?af /] atfpg . ▶ EH/HCWM sf] cj:yf , kx'Fr tyf sfo {;~ rfngaf /] P] gdf ePsf k|fjwfgx?sf ] cfwf / df n] vfhfvf ] ug { .

4. g] kfnsf ] ;+ ljwfg ▶ wf /f #% sf] bkmf –$) df k|To ]s gful / snfO { ;'/ lIft kfgL / ;/; kmfOdf kxF'rsf ] xs x'g ]5 . ▶ wf /f #)–!) cg';f / k|To ]s gful / sn ] :jR5 / : j:y jftfj /0fdf jfFRg kfpg ] xs x'g ]5 . ▶ wf /f #)–@) cg';f / jftfj /0fLo k|b"if0faf6 x'g ] Ifltjfkt k|b"ifsaf6 Ifltk"lt { kfpg ] xs x'g ]5 . ▶ wf /f #%–$) cg';f / k|To ]s gful / snfO { :jR5 vfg ] kfgL tyf ;/; kmfO { df kx'Frsf ] xs x'g ]5 . : yfgLo ;/sf/ ;~ rfng P]g @)&$ ▶ jftfj /0fLo k|b"if0f tyf kmf ]x/ Joj:yfkgaf6 hg:jf:Yo / jftfj /0fdf kg]{ k|efjaf6 hfufpg ] lgod tyf lgodfjnL agfpg ;+3Lo ;/sf/ lhDd ] jf / x'g ]5 . g] kfnsf sfg"gL k|fjwfgx ?

5. g] kfnsf sfg"gL k|fjwfgx ? jftfj /0f ;+/If0f lgodfjnL @)&& ▶ lzIf0f ;' ljwf ; lxtsf ] @% b]lv !)) z}of ePsf ] c:ktfnsf] lgdf {0fdf k|f / lDes jftfj /0f k/LIf0f clgjfo { u/]sf] 5 . ▶ lzIf0f ;' ljwf ; lxtsf !)) eGbf a9L z}of / xg ] c:ktfn lgdf {0fsf nflu jftfj /0fLo k|efj dNofÍg clgjfo { u/]sf] 5 . hg:jf:Yo ;] jf lgodfjnL , @)&& ▶ jftfj /0f, ;+qmd0f /f] syfd tyf lgoGq0f, : jf:Yo ;+: yfhGo kmf ]x/ Joj:yfkg / : jf:Yo ;+: yfdf kfgL / 9n lgsf ; kfngf u/ fpg ] d'Vo lhDd ] jf /L dGqfnonsf ] x'g ]5 .

6. g] kfnsf sfg"gL k|fjwfgx ? hg:jf:Yo ;] jf lgodfjnL , @)&& ▶ lgod !@ sf cg';f / gofF cg'dlt – kq lng tyf gljs /0f ug {sf nflu x/]s : jf:Yo ;+: yfn ] s] xL u'0f:t/sf dfkb08x? kfngf ug '{kg]{ x'G5 . ▶ dfkb08sf] kfngf gu /]sf] eP : jf:Yo ;+: yfnfO { kfngf ug { nufpg jf ; DalGwt lgsfonfO sf/ jfxLsf nflu l;kmfl /; ug '{kg]{ x'G5 . ▶ kmf ]x/d} nf Joj:yfkg P]g @)^* -@)&$ sf] ;+ zf ] wg;lxt _ ▶ : jf:Yo ;+: yfhGo kmf ]x/ Joj:yfkgsf ] sfg"gL cfwf / k|bfg u5{ . ▶ kmf ]x/ Joj:yfkgsf ] lhDd ] jf /L / pQ / bfloTj : yfgLo ;/sf/ df lglxt /xG5 .

7. : jf:YohGo kmf ]x/d} nf Joj:yfkg ; DaGwL gLlt tyf /0fgLlt /fli6«o : jf:Yo gLlt @)&^ ▶ ;'/ lIft kfgL / ;/; kmfOdf kx'Fr a9fpg], kmf ]x/d} nf Joj:yfkg cflb If] qx?df ;' wf / ug '{kg]{ . ▶ cfwf / e"t ;] jfdf lgMz'Ns ? kdf :jR5tf / ;/; kmfOsf ] k/ fdz { nfO {{ klg ; dfj ]z ul / Psf ] 5 . ▶ ;? jf /f]u lgoGq0f tyf : jf:Yo ;+s6sf] ; dodf Joj:yfkgsf nflu ;a} txnfO { Ps 7fpFdf NofP / kxn ug ]{ . lgDg /0fgLltdfly hf ]8 lbPsf ] 5 M ▶ jftfj /0f tyf : jf:YodqL } k|ljlwnfO { k|f ] T;flxt ul /g]5 . ▶ 3/ fo;L tyf ; fd'bflos kmf ]x/ Joj:yfkg / jftfj /0fsf] ;/; kmfOnfO { k|j4{g ug { ; dGjo tyf k}/ jL ul /g]5 .

8. l ;4f+t / dfGotfx ? s= Ifltk"lt { sfg"g tyf l;4fGt ▶ c?nfO { xflg –gf] S;fgL x'g ] u/L s;}n] s'g } sfo { u/] df pQm kIfn ] gf] S;fgL k'u ]sf] kIfnfO { Ifltk"lt { lbg ' kb{5 eGg ] dfGotfdf of] sfg"g cfwfl /t 5 . : jf:YohGo kmf ] xf ]/d} nf d} nf Joj:yfkg ; DaGwdf lgDg dfGotf nfu ' x'G5 . v= lhDd ] jf /L lgjfxsf {] dfGotf ▶ kmf ]x/ nfO { ;'/ lIft lj;h {g ug ]{ bfloTj klg kmf ]x/ pTkfbg ug ]{ ;+: yfsf ] xf ] . ▶ kmf ]x/ nfO { s;/L sG6]g/ df / fVg ], To;nfO { s;/L hDdf ug ]{ / cGTodf s;/L pkrf / / lj;h {g ug ]{ eGg ] vf ; lhDd ] jf /L : jf:Yo ;+: yfd } /xG5 .

9. l ;4f+t / dfGotfx ? : jf:YohGo kmf ] xf ]/d} nf Joj:yfkg ; DaGwdf lgDg dfGotf nfu ' x'G5 . u= ; fjwfgLsf ] dfGotf ▶ s'g } hf ] lvdsf ] cfsf / clglZrt 5 eg ] Tof ] si6;fWo x'g ] cf+sng u/L : jf:Yo / ;'/ Iffsf nflu cfjZos Joj:yf ul /g' kb{5 . ▶ ;'/ lIft 5 eg ]/ k|dfl0ft geP;Dd kmf ]x/ hflvdo'Qm 5 eGg ] dfGg ' kb{5 . 3= ;lGgs6tfsf] dfGotf ▶ hflvd Go"gLs /0f tyf 9'jfgLdf nfUg ] vr {sf] ldtJolotfsf nflu hflvd ] o'Qm kmf ]x/sf] pkrf / tyf lj;h {g oyf;Dej pTkfbg:ynsf ] glhs } ug '{ kb{5 . ▶ pTkfbg u/]sf] kmf ]x/sf] pkrf / tyf lj;h {g cfkmg }\ ef } uf ] lns ; Ldfleq ug '{ kb{5 .

10. l;4f+t / dfGotfx ? 3= ;lGgs6tfsf] dfGotf ▶ cfk"mn ] pTkfbg u/]sf] kmf ]x/sf] ;'/ lIft Joj:yfkg tyf jftfj /0fd} qL j;h { gsf nflu sfg'gL tyf cfly {s ¿ kdf cfk"m :jo+ hjfkmb ] xL x'g ' kb{5 . ▶ kmfxf ]/d}] nfsf ] v/fa Joj:yfkgsf sf/0f k|b"if0f ePdf : jf:Yo ;+: yf g} lhDd ] jf / x'g ' kb{5 . ▶ pkrf /: ynsf ] v/fa dfkb08sf sf/0f k|b"if0f x'g uPdf : jf:Yo ;+: yf / pkrf / stf { b'jnfO {} k|b"if0fsf] lhDd ] jf / dflgG5 . ▶ jftfj /0fdf kg{ uPsf ] c;/sf] dNo k|b"ifsn ] Joxf ]g'{ kg]{ Joj:yfnfO { kmf ]x/ sd lgisf;g ug ]{ / / fd |/L k[ ysLs /0f ug ]{ k|efjsf /L clek |]/s dflgG5 .

11. : jf:YohGo kmf ]x/ Joj:yfkg ; DalGw dfkb08, lgb ]{ lzsf tyf sfo { ;+ rfng lgb ]{ lzsf

12. : jf:YohGo kmf ] xf ]/ Joa:yfkg ; DaGwL /fli6«o dfkb08 tyf sfo {;+ rfng ljlw @)&&

13. : jf:YohGo kmf ]x/d} nf Joj:yfkg /fli6«o dfkb08 tyf sfo {;~ rfng ljlw – @)&& p2] Zox ¿ sfo {: yndf sd {rf/L, ;] jfu|fxL , cfuGt's / ;Dk"0f{ ; d'bfonfO { : jf:YohGo hf] lvdo'Qm kmf ]x/sf] hf]lvdaf6 ;'/ lIft kfg {' . : jf:YohGo kmf ]x/ nfO { Go"gLs /0f ug'{sf ; fy } ;'/ lIft ¿ kdf To;sf ] lj;h { gsf nflu jftfj /0fd} qL k|ljlw k|j4{g u/L jftfj /0fsf] ;+/If0f ug{‘ . ;+3, k|b ]z tyf : yfgLo ;/sf/ nfO { lgb ]{ lzsf pknAw u/ fpg'sf ; fy } k|of ] ustf {sf nflu ;/n xft ]– k'l:tsf : jf:Yo ;+: yfx¿df pknAw u/ fO : jf:YohGo kmf ]x/ Joj:yfkgsf ] pko'Qm k4lt sfof { Gjogdf Nofpg ' .

14. : jf:YohGo kmf ]x/d} nf Joj:yfkg /fli6«o dfkb08 tyf sfo {;~ rfng ljlw – @)&& p2] Zox ¿ Go"gtd sfg'gL cfjZostfx ¿ -: jf:Yo ;+: yfsf ] Go"gtd ;] jf dfkb08, : jf:Yo ;+: yfdf vfg ] kfgL , ;/; kmfO tyf :jR5tf ; DaGwL dfkb08, : jf:Yo ;+: yf : yfkgf , ;~ rfng tyf :t/f] Gglt ; DaGwL dfkb08 cflb _ kfngfdf ; xlhs /0f ug{' . kmf ]x/ Joj:yfkgdf ;' wf / u/]/ : jf:Yo ;+: yf tyf k|of ] uzfnfh:tf : yfgdf ;ª\qmd0f /f] syfd ; DaGwL cEof;x¿nfO { nfu ' u/L ; Defljt hf] lvd Go"gLs /0f ug{' . b] zdf pknAw k|ljlwsf ] pkof ]u ub }{ pQd jftfj /0fd} qL pkrf / ljlw tyf lj;h {g ljsNksf ] 5gf]6 ug]{ sfo {df : jf:Yo ;+: yfnfO { ; xh u/ fpg ' .

15. : jf:YohGo kmf ]x/d} nf Joj:yfkg /fli6«o dfkb08 tyf sfo {;~ rfng ljlw – @)&& sf] nlIft ; d"x : jf:Yo ;+: yfhGo kmf ]x/ Joj:yfkgdf ;+ nUg /fli6«o, k|fb ] lzs tyf : yfgLo:t /sf lgsfox ¿ k|of ] uzfnf nufot ;a}:t/sf : jf:Yo ;+: yfdf sfo {/t : jf:YosdL {x¿ kmf ]x/ Joj:yfkg ;] jf k|bfosx ¿ hg:jf:YosdL {x¿ lghL If]q kz'lrlsT;s /fli6«o tyf cGt /f{li6«o u}/;/sf/L ;+: yf ; d'bfodf cfwfl /t ;+: yfx ¿ ; d'bfo:t /sf lSnlgs , cf } iflw k;n , : jf:Yo lzlj /, cGo ; DalGwt ;/f]sf/ jfnf / : jf:YohGo kmf ]x/ Joj:yfkgdf ;+ nUg JolQmx ¿

16. : jf:YohGo kmf ] xf ]/d} nf gd'gf Joj:yfkg k4ltsf r/0fx¿ ▶ : jf:YohGo kmf ] xf ]/d} nf Joj:yfkg ; ldltsf u7g ▶ kmf ]x/d} nfsf ] n] vfhf ] vf ▶ of] hgf th '{ df ▶ pkrf / s] Gb|sf ] l8hfOg tyf lgdf {0f ▶ 9'jfgL dfu {sf] of] hgf ▶ pkrf / k|ljlwsf ] k/LIf0f ▶ Ifdtf clej [l4 tyf ;+r] tgf sfo ▶ : jf:YohGo kmf ] xf ]/d} nf Joj:yfkg k|0ffnL sfof { Gjog ▶ : ynut cg'udg , k|lzIf0f tyf ;'kl/j]If0f

17. df ]8\ o'n @ jftfj /0fLo : jf:Yo

18. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5g\M ▶ Jfftfj /0fsf] kl/ rofTds JofVof ug { . ▶ Jfftfj /0fLo : jf:Yosf ] ;du| cjnf ]sg ub }{ jftfj /0fLo : jf:Yo s] xf ] atfpg . ▶ jftfj /0fLo ;+s6sf] af /] df JofVof ug { . ▶ Jfftfj /0fLo k|b'if0f s] xf ] tyf laleGg k|sf /sf jftfj /0fLo k|b'if0fx? af /] atfpg .

19. jftfj /0f s] xf ] < ▶ Jfftfj /0f eg ]sf] hLjsf ] glhssf ] kl/j]z xf ] . ▶ The World Health Organization (WHO) defines environment, as it relates to health, as “ all the physical, chemical, and biological factors external to a person, and all the related behaviors.” ▶ Jfftfj /0fLo : jf:Yo hg:jf:Yosf ] zfvf xf ], hf ] dfgj : jf:YonfO { c;/ ug ]{ ;a} k|fslts kIf / dfgj lgld {t Jfftfj /0f;+u ; DalGwt 5 . Source: WHO. Preventing disease through healthy environments. Geneva, Switzerland: WHO; 2006.

20. laleGg k|sf /sf jftfj /0fLo k|b"if0f ▶ jftfj /0fLo k|b"if0f eGgfn ] k[ YjL tyf jftfj /0fdf k|b"lift kbfy {x? cTolws ; ld >0f x'g ' xf ], h;n ] ubf { ; fdfGo jftfj /0fsf ; fy } k|fs [ lts k|lqmofdf k|lts"n c;/ kb{5 . ▶ b"lift kbfy { x?sf ] ld >0fn] jftfj /0fsf] ?k / ljz ] iftfx?df kl/ jt {g NofpF5 . ▶ b"lift kbfyx?n ] Zjf;k|Zjf ; /f] ux?sf ] ljZjJofkL ? kdf j[l4 x'Fb } uPsf ] 5 . ▶ k|b"if0fn] jftfj /0fLo : jf:Yodf k|lts"n c;/ u/]sf] 5 / jfo ' k|b"if0f : jf:Yosfnflu k|d'v hf ] lvd b] lvPsf ] 5 . ▶ k|b"if0fn] kfgL , jfo ' / df6f] nfO { c;/ u5{ h;sf sf/0f dfgjLo : jf:Yodf k|lts"n hflvd a9\5 .

21. jfo ' k|b"if0f ▶ jftfj /0fLo : jf:Yodf k|lts"n c;/ ug ]{ sf/ sx ¿ dèo ], jfo ' k|b"if0f Ps k|d'v sf/s xf ] . ▶ Xfjfdf @=% dfOqmf ]ld6/ eGbf sd Jof ; - PM2.5 _ ePsf ] k|b"lift s0fn] : jf ;–k|: jf ; k|0ffnLdf c;/ ug ]{ . ▶ pBf ] lus / ; jf /L ;fwgx?jf6 lg:sg ] wF'jf+sf sf/0f g] kfnsf k|d'v zx /x¿ c:j:Yos/ aGb } uPsf ] 5 . ▶ sf7df8f} df jfo ' k|b"if0f a9fpg] sf/ sx?df gLlt / sfo { qmdsf ] k|efjsf /L sfofGjogdf { lkmtnf ]kg . ▶ lg /Gt/ jfo'sf ] u'0f:t/ cg'udg ePsf ] 5}g -g] kfn : jf:Yo cg'; Gwfg kl/ ifb , @)&!_ . ▶ : jf:YohGo kmf ] xf ]/d} nf hnfpg ] cEof;nfO { g] kfn ;/sf/4f/f lg?T;flxt ul / Psf ] 5 . ▶ 8fOclS;g, k\ mo '/ fg / kf ] lnSnf ]l/g]6]8 jfOk ] mgfon (POPs) jftfj /0fdf g6'qmLsg vfB kbfy {sf] z+[ vnfdf hDdf x'g ] .

22. Wjlg k|b"if0f ▶ pRr cfj [ ltsf ] (Frequency) Wjlgn ] dfgj jf cGo hLjx¿nfO \{ k|lts"n k|efj kfg { ;S5 . ▶ WjlgnfO { 8] l;an (Decibel-dB ) df gflkG5 . ▶ &) 8LaL - dB _ eGbf sd cfjltsf ][ Wjlg lhjx¿sf ] nflu xflgsf /s x'Fb }g . - WHO _ ▶ *% 8LaL - dB _ eGbf al9 cfj [ ltsf ] Wjlg * 306f eGbf a9L ; Dks {n] pRr hflvd x'g ;S5 . ▶ Jo:t ;8s jf / fhdfudf { sl /a *% l8aL - dB _ ; Ddsf ] 6«flkms Wjlg k|b"if0f x'g ] . ▶ d] l;g , oftfoft tyf k|;f/0f k|0ffnL WjgLsf ] afXo k|b"if0fsf] d'Vo >f]t dflgG5 .

23. df6f] k|b"if0f ▶ df6f] df ljiffQm /; fogsf ] pkl:ylt jf k|fs [ lts : j?kdf kl/ jt {g x'g ' xf ] . ▶ cßf ] lus ultljlw , s[ lifdf k|of ]u x'g ] /;fog jf kmf ] xf ]/sf] cg'lrt la;h {g . ▶ k|fs [ lts ¿ kn ] ljleGg k|sf /sf of} lusx ¿ x'G5g\ - kmf:km ]6;,\ gfO6«]6\;, kLPPr , cNsf ] xn _ . ▶ of} lusx ¿ d'Vo ¿ kn ] df6f]sf] dfOqmflaon ] ultljlwdf ;3fFp5g\ . ▶ df6f] k|b"if0fn] ljiffQm kbfyx¿sf ] cfb {| tfsf ] dfWodaf6 df6f] nfO { k|b"lift kf5{ . ▶ hg:jf:Yo hflvd ] lgDTofpF5 . -a]+ hLg pRr eP / Qm SofG ;/ sf] hflvd a9fpF5_

24. / f;folgs ;'/ Iff - kf /f] jf ds{/L_ ▶ ef /L, uGw / lxt , rdlsnf ] ch } ljs / h} ljs wft ' h'g @%℃ ; Dd t/n / xg ;Sb5 . ▶ : jf:YohGo kmf ] xf ]/d} nf OlG;g ]/]6/jf6 !)Ü jftfj /0fLo kf /f] pT;h {g . ( USA 2052) kf /f] ; Dks { df s;/L cfpg ;S5 < ▶ kf /f]sf] km}nfj6, bxg / cf }Bf] lus lgj {xgjf6 lg:sg ] afkm . ▶ k|b"lift df5fsf] ;] jg .

25. / f;folgs ;'/ Iff - kf /f] jf ds{/L_ : jf:Yo ;] jfdf kf /]sf] k|of ]u ▶ yd {dL6/ ▶ bGt cdfnud ▶ lah'nLsf l:jrx¿ ▶ ˆ nf ]/f];]G6 n} Dk / CFL aNa ▶ k|of ] uzfnf /; fogx ¿ ▶ B5 / Zenkers lkmS ;]l6e, ODo"gf ]On]S6«f] kmf ]/f]l;; bfu, Thiomersal h:tf k/LIf0f ls6x¿ ▶ : kmfO { Udf ] dfgf ]dL6;{ (Sphygmomanometers) ▶ cf } iflwhGo - kmfdf {:o"l6sN;_ ▶ u}:6«f]OG6]:6fOgn 6\ o"ax ¿ ▶ UV sL6f0f'gfzs, ˆ nf ]/f];]G6, High Frequency Vapour Lamps ▶ Aof6«Lx¿ ▶ la4'lto pks /0f – kf /f] l:jr, ˆ nf ]6 lgoGq0f

26. Government of Nepal ban import, purchase and use of all mercury based equipment's in health in Nepal sectors , 2013 Mercury

27. MOHP BAN DENTAL AMALGAM

28. df ]8\ o'n # : jf:YohGo kmf ] xf ]/ d} nf Joj:yfkg kl/ efiff / k|sf /

29. : jf:Yo ;+: yf hGo kmfxf ]/ sf] kl/ efiff : jf:YohGo kmf ]x/d} nf eGgfn ] : jf:Yo ;] jfsf qmddf pTkfbg x'g ] ;a} k|sf /sf] kmf ]x/ x?nfO { a'lemG5 . lrlsT;sLo sfo { df /f]u kQf nufpg , lgbfg ug {, la/ fdLsf ] : jf:Yo hLjgofkgdf ; xh agfpgsf nflu ul /g] pkrf / tyf pQm ljifodf cWoog , cg'; Gwfg , pTkfbg jf h} ljs j:t'x?sf] k/LIf0f h:tf ljifo kb{5g\ . o;sf nflu ul /g] k|zf;lgs tyf cGo lqmofsnfksf qmddf pTkfbg x'g ] kmf ]x/ klg : jf:YohGo kmf ]x/d} nf cGtu {t kb{5 .

30. : jf:Yo ;+: yf hGo kmfxf ]/d} nfsf >f] tx ? ljleÌ :t/sf ;/sf/L tyf lglh c:ktfnx¿ k|fylds : jf:Yo s]Gb|, : jf:Yo rf } sL , vf ]k lSnlgs , k|fylds : jf:Yo ;] jf ufpF3/ lSnlgs cGo : jf:Yo ;+: yfx ? -d]l8sn, k|;" lt u[x, 8fOnfl;; s]Gb|, gl ;{ª xf ]d, bGt ;] jf , kf / fd ]l8S;, nfu"kbfy { k'g:yf { kgf s]Gb|, e]6]l/g/L c:ktfn tyf lSnlgs _ k|of ] uzfnf tyf cg'; Gwfg s]Gb| - lrlsT;f lj1fg;DaGwL cg'; Gwfg s]Gb|, An8 a}+s, / Qm ;~ rf / s]Gb|, jfof ]d]l8sn, jfof ]6] Sgf ] nf ] hL tyf dfOqmf ] jfonf ] hL k|of ] uzfnf _, cf } iflw k;nx ? zju [x tyf zjk /LIf0f s]Gb| PDa'n ]G; tyf cfsl:ds ;] jf 3/ df lbOg ] : jf:Yo ;] jf .

31. jftfj /0f d} qLo kmf ]x/ Joj:yfkgsf ] qmda4tf ( Responsible Waste Management Hierarchy) 36fpg '/ REDUCE -b} lgs lhjgdf kmf ]x/ pTkfbg sd u/ fpg '_ k'gM k|of ]u / REUSE - dd {t ug ]{ jf cGo sfddf k|of ]u ug ]{ _ k'gM k|zf ] wg / /RECYCLE -k'/ fgf ] j:t' af6 gofF ; fdfg agfpg ] _ k'g { nfe / RECOVERY - s'g } O{ Gwg , ljh'ln jf cGo zlQm lgsfNg ' _ laifh {g / DISPOSAL -;'/ lIft tlsfn ] ljifh {g ug ]{ _ ;a} eGbf pQd pbfo

32. >f]td} kmf ]x/ 36fpg] tl / sfx ? != k'gM k|of ] uhGo emf ] nf tyf ef8f] x?sf ] k|of ]u ug ]{ @= kfgL / fVg ] ef8f], skmL du, Kn ]6sf] k|of ]u ug ]{,reusable and refillable kitchenware. #= cgfjZos Kofs ] lhusf ; fdfg , vfg ]s'/ fx ? glsGg ], Ps k6s dfq k|of ]u ul / kmfNg'kg ]{ j:t'x?sf] k|of ]u gug ]{ . $= >f]td} s'lxg ] j:t'x?sf] sDkf ]i6 ug ]{ %= : df {6 sfdx ?, h:t} cgnfO {g lan ltg ]{, sfuhsf ] k|of ]u sd ug ]{ ^= sfuhsf ] g] klsg , Psk6s k'5]kl5 kmfNg kg]{ j:t‘sf] k|of ]u gug ]{ . &= xf ]n;] nd } lsGg ] *= cfkm'nfO { sfd gnfUg ] c?nfO { bfg , ; xof ]u ug ]{ cflb

33. : jf:YohGo kmf ] xf ]/sf] k|sf / :jf:YohGo kmf ] xf ]/ xfgLsf /s kmf ] xf ]/ s"lxg] kmf ] xf ]/ gs"lxg] kmf ] xf ]/ ; fwf /0f kmf ] xf ]/ ;+ qmldt kmf ] xf ]/ wf / Lnf ] kmf ] xf ]/ Kofyf ] nf ] lhsn kmf ] xf ]/ Sofg ;/ hGo kmf ] xf ]/ cf } iflwhGo kmf ] xf ]/ ljls /0fhGo kmf ] xf ]/ /; foghGo kmf ] xf ]/ / fli6«o : jf:YohGo kmf ] xf ]/ Joj:yfkg dfkb08 tyf ;~ rfng k|s [of @)@)

34. - ljZj : jf:y ;+u7g4f/f @)@) u/ LPsf ] Ps cg'; Gwfg cg';f /M c:ktfnaf6 lgisg ] kmf ] xf ]/M b} lgs @ b]lv $ lsnf ] k|lt z}of ;f] dWo ] ;+ qmldt kmf ] xf ]/M b} lgs )=@ b]lv )=$ lsnf ] k|lt z}of Psf So"ljs ld6/ df : jf:YohGo kmf ] xf ]/sf] 3gTj !)) b]lv @)) lsnf ] ; Dd kfOPsf ] 5 . : jf:YohGo kmf ] xf ]/ Joj:yfkgsf ] /fli6«o dfkb08 tyf ;~ rfng k|s [of @)@) cg';f /M g] kfndf : jf:YohGo kmf ] xf ]/sf] pTkfbg b} lgs )=(( b]lv !=&# lsnf ] k|lt z}of 5 . ;f] pTkfbgdf vt / fhGo kmf ] xf ]/ cz + b} lgs )=## b]lv )=%( lsnf ] k|lt z}of /x]sf] hfgsf /L u/ fPsf ] 5 . : jf:YohGo kmf ] xf ]/ ; DalGw s]lx hfgsf /L &% - ( ) % ; fwf /0f kmf ] xf ]/ !)—@% % hf ] lvdo"Qm kmf ] xf ]/

35. ljZj : jf:y ;+u7g / o"lg ;]km 4f/f k|: t't u/ LPsf ] h]= Pd = lk l/ kf ]6{ g] kfne / /x]sf : jf:Yo ;+: yfx ? dWo ]M hDdf % % ;+: yfx?df dfq ;'/ lIft tl / sfn ] kmf ] xf ]/ k[ ylss /0f x'g ] u/]sf] kfOPsf ] 5 . / hDdf @! % ;+: yfx?df dfq ;+ qmldt kmf ] xf ]/sf] ;lx pkrf / / lj;h {g x'g ] u/]sf] kfOPsf ] 5 . ;g\ @)!(

36. : jf:yhGo kmf ] xf ]/af6 x'g;Sg ] hf ] lvd k|of ]u ePsf ;'O{n]3f]r ;Sg] dfgj z/L/af6 lg:sg ] t/n kbfy { -/ ut , lk;fa , cGo _ sf] l5§f cfFvf , gfs, sfg , d'vdf kg{ ;Sg] Kmf ] xf ]/sf] ; dks { df cfpFbf To;df /x]sf ls60f'z/L/ df ;g{ ;Sg] pkrf / sfnflu cfPsf la/ fdL csf ]{ ladf / Lsf ] lzsf / aGg ;Sg] hyfefjL kmflnPsf kmf ] xf ]/ df cfjf /f hgfj /sf] kx'Frdf k'Ug ;Sg] a] Rgsf nflu ljleÌ lsl;dsf ; fdfg vf ]Hg saf8L tyf km]l/ ofjfnf cfpg ] ; Dks { df cfPsf /;fog tyf cf } iflwn ] z/L/ df k|lts"n c;/ ug { ;Sg]

37. : jf:yhGo kmf ] xf ]/af6 x'g;Sg ] hf ] lvd c:ktfn kl/;/ ; kmf / ;'3/ / fVg jleÌ lsl;dsf /f]u -P8\;\, x]kf6fOl6;\, cflb _ x?sf ;+qmd0f /f] syfd tyf lgoGq0f ug { jftfj /0fLo / dfgj : jf:ysf ] arfp tyf jftfj /0fLo k|b"if0fdf sld n]/ fpg vt /gfs tyf hf ] lvd kmf ] xf ]/sf] pTkfbgdf sld n]/ fpg kmf ] xf ]/ cf ];f/÷ k;f / df ;+ nUg sd { rf / Lx?nfO k] zfut hf ]lvdaf6 ;'/ lIft x'g : jf:y ;+:yfaf6 lgisg ] hf ] lvdo'Qm kmf ] xf ]/sf] b'? kof ]u /f] syfd ug { kmf ] xf ]/ nfO { k'gMrqmLo k|s [[ odf k|f ] T;fxg k'¥ ofpg kmf ] xf ]/d} nf Joj:yfkg ;+ alGw /fli6«o lglt tyf lgodsf ] kfngf ug {

38. cJojl:yt : jf:yhGo kmf ] xf ]/sf] glthf

39. kmf ] xf ]/sf] plrt e08f/0f gx'Fbf cfOkg ]{ ; d:ofx ?

40. : jf:yhGo kmf ] xf ]/sf] juL {s/0f , kmf ] xf ]/ sf] 9'jfgL tyf e08f/0f

41. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5g\M jf:YohGo kmf ] xf ]/d} nfsf ] jlu {s/0f af /] atfpg kmf ] xf ]/sf] k[ ysLs /0f eGgfn ] kmf ]x/ nfO { pTkfbg ljGb'd } k[ ysLs /0f ug ]{ ; d:t k|lqmof af /] atfpg . k|efjsf /L kmf ] xf ]/sf] e08f/0fsf ljlwx?af /] hfÌ ] . k|efjsf /L kmfxf ]/sf] b'jfgLsf ljlwx?af /] yfxf kfpg ] .

42. ; fdfGo : jf:YohGo kmf ] xf ]/ hf ] lvdo'Qm : jf:YohGo kmf ] xf ]/ : jf:YohGo kmf ] xf ]/

43. ; fdfGo : jf:YohGo kmf ]x/ s'lxg ] kmf ]x/ gs'lxg ] kmf ]x/ hf ] lvdo'Qm : jf:YohGo kmf ]x/ ;+ qmfds kmf ]x/ wfl / nf kmf ]x/ ljiffQm ;fO6f]6lS;s (Cytotoxic) kmf ]x/ cf } ifwLhGo kmf ]x/ Kofyf ] nf ] lhsn kmf ]x/ /; folgs kmf ]x/ /]l8of] wdL { kmf ]x/

44. km'6]sf ] l ; ;f Knfl:6s sf u h ब ोतल s'l x g ] km f ] x f ]/ h :t } M vfP / pa|]sf vfg]s'/f cflb . ; fdfGo : jf:YohGo kmf ]x/

45. ljZj : jf:Yo ;+u7g–: jf:YohGo kmf ] xf ]/d} nfsf ] jlu {s/0f jlu {s/0f ljj ] rgf tyf pbfx /0f Wffl / nf ] kmf ]x/ k|of ]u ul / Psf jf gul / Psf - h:t } 5fnf, df +;k] zL jf g;fdf nufpg ] ;'O{, : jtM aGb x'g ] l;/ L~h - Auto disable Syringe_, ;'O{ hl8t l;/ L~h , g;fåf /f lbOg ] cf } iflwhGo kbfy {sf] l;l;x ?, kQLx ?, rSs'x ?, tyf km'6]sf ; L;fsf 6'qmfx?_ ;ª\ qmfds kmf ]x/ /f]u ; fg { ; DefJo xfgLsf /s hLj;lxtsf ] kmf ]x/ kbfy { pbfx /0fsf nflu / uthGo tyf cGo t/n kbfy { k|b"lift kmf ]x/ kbfy {, jf8{ jf k|of ] uzfnfdf z'Id h} ljs k|b"lift z+sf:kb lj / fdLsf ] lb;f , lk;fj tyf cGo t/n kbfy {_

46. : jf:YohGo kmf ] xf ]/d} nfsf ] jlu {s/0f jlu {s/0f ljj ] rgf tyf pbfx /0f Kofyf ] nf ] lhsn kmf ]x/ dfgj tGt ' (Human Tissue), c+u jf t/n kbfy {, e|'0f, k|of ]u gul / Psf / QmhGo kbfy {x? cf } iflwhGo kmf ]x/ nfdf ] ; do;Dd k|of ]u gePsf , Dofb ; lsPsf cf } iflw , cf } iflwhGo k|b"lift kmf ]x/ kbfy {, ;fO6f]6lS;s kmf ]x/ SofG ;/ hGo cf } iflw jf /;fog jf cf } iflwhGo kbfy {

47. : jf:YohGo kmf ] xf ]/d} nfsf ] jlu {s/0f jlu {s/0f ljj ] rgf tyf pbfx /0f / f;folgs kmf ]x/ kmf ]x/ k|b"lift /;fog kbfy { - h:t }M k|of ] uzfnfdf k|of ]u ul /g] /; folgs kbfy {, nfdf ] ; do;Dd k|of ]u gu /]sf kmf ]6f] lkmNd , b"if0f lgjf /s kbfy {, 3f]ns, s8f wft'hGo a]6«L, km'6]sf ydf {ld6/ / / Qmrfk dfks ; fdu|L _ /]l8of] wdL kmf ]x/ ljsL /0f k|b"lift kbfy { - h:t }M ;] sfO { ubf { jf k|of ] uzfnfdf cg'; Gwfg ug {] t/n kbfy {, k|b"lift ; L;f , zf ] ig ] sfuhhGo kbfy {, zLnaGbL gul / Psf ljsL /0faf6 la/ fdLsf lb;f , lk;fj tyf cGo zLnaGbL ul / Psf ; fwgx ?_

48. : jf:YohGo kmf ] xf ]/d} nfsf ] jlu {s/0f eGgfn ] s] a'lemG5 ,5nkmn ug ]{ . k|: t'lts /0fsf] ;f/ f+z lgsfNg ] ; fd'lxs cEof ; tyf r/0fx?

49. kmf ]x/ nfO { >f]td} k[ ysLs /0f (Segregation at Source) kmf ]x/ nfO { >f]td} ( pTkfbg ljGb'd } ) cnu – cnu 5'6\ ofP / / fVg ], hDdf ug ]{, c:yfoL e08f/0f tyf 9'jfgL;Ddsf ; d:t k|lqmof . >f]td} k[ ysLs /0f : jf:YohGo kmf ]x/sf] ; kmn Joj:yfkgsf ] dxTjk"0f{ r/0f . ; Defljt hf ] lvdo'Qm kmf ]x/ nfO { 5'6\6} / fVbf c? ; fwf /0f kmf ]x/ nfO { ;+ qmldt x'gaf6 hf ] ufpg ;lsG5 . : jf:YohGo kmf ]x/d} nfnfO { >f]td} k[ ysLs /0f ug ]{ sfdnfO { k|fyldstfdf / fVg ' kb{5 .

50. xfn tkfO { sfo {/t : jf:Yo ;+: yf jf : yfgLo txdf : jf:Yo ;+: yfhGo kmf ] xf ]/ Joj:yfkg ubf { s:tf] k|lqmofx ? cjnDjg ul / Psf ] 5 ?

51. k[ ysLs /0f ; kmn kfg { s] ug {'k5{ ? kmf ]x/ pTkfbgsf ] >f]td} k[ ysLs /0f ug ]{ . : jf:Yo ;+: yfsf lrlsT;s tyf : jf:YosdL { ÷ sd { rf /L ;a} nfO { hfgsf /L u/ fpg ] . ; fwf /0f t/ ;+: yfleq Ps¿ktf canDag ug ]{ . k|lqmof cg';/0f ul / Psf ] ;' lglZrt ug { lgoldt cg'udg ug ]{ .

52. ; fdfGo : jf:YohGo kmf ]x/ s'lxg] kmf ]x/ gs'lxg] kmf ]x/ ;+ qmfds kmf ]x/ wfl / nf kmf ]x/ ljiffQm ; fO6f]6lS;s (Cytotoxic) cf } ifwLhGo kmf ]x/ Kofyf ] nf ] lhsn kmf ]x/ /;folgs kmf ]x/ hf ] lvdo'Qm : jf:YohGo kmf ]x/ /]l8of] wdL { kmf ]x/ k[ ysLs /0fsf nflu ; f+s ] lts /Ë

53. >f] tdf g} k[ ysLs /0f ( hf ] lvd / lxt : jf:YohGo kmf ]x/ )

54. pkrf / df k|of ]u x'g ] 6«nL (Medication Trolley) df k[ ysLs /0f

55. kmf ] xf ]/ 9'jfgL / e08f/0f eÌfn ] s] a'lemG5 <

56. : jf:y ;+: yfhGo kmf ] xf ]/sf] 9'jfgL c:ktfnsf ljleÌ jf8{ af6 lg:s ]sf kmf ] xf ]/ nfO ;'/ lIft tj /n] e08f/0f sIfdf n} hfg ] cj:yfnfO { 9'jfgLsf];+1f lbOPsf ] xf ] . : jf:Yo ;+: yfhGo kmf ] xf ]/ nfO { pTkfbg : ynb ]lv e08f/0f ug ]{ jf pkrf / ug ]{ 7fpF;Dd ;+ sng u/]/ 9'jfgL ubf { ljz ]if ;'/ Iff;lxtsf ] Joj:yf lgwf {/0f ul / Psf ] x'g'kb { 5 .

57. s] of] kmf ] xf ]/ 9'jfgL ug ]{ ;lx t/ Lsf xf ] <

58. kmf ] xf ]/ ;+ sngsf ] lhDdf kfPsf ; xof ] uL sd { rf /Ln] l;kmfl /; ul / Psf lglZrt s'/ fnfO { cg'z /0f ug '{kb{5M kmf ] xf ]/ ;+ sngsf ] nflu ;} åflGts ¿ kdf x/]s 8\o'6L l;ˆ6 kl5 cyjf b} lgs jf cfjZostf cg';f / ;+ sng ug '{k5 { / : jf:Yo ;+: yfsf ] lgwf {l/t d'Vo e08f/0f s]Gb|; Dd 9'jfgL ug '{k5{ . kmf ] xf ]/ lgisf;g : yn glhs } gofF hu ]8f efF8f jf Aofux ¿ pknAw x'g ] Joj:yf ug '{k5{ . s'g } klg kmf ] xf ]/sf] efF8f] jf AofunfO { n] alnË cyjf lrGx gul /sg lgwf {l/t :ynaf6 - c:ktfn , jf8{ jf ljefu _ cGoq ; fg {' x'Fb }g . 6f] kL df:s k~hf k"0f{ z/L/ 5f]Kg] ufpg h'Qf

59. kmf ] xf ]/ 9'jfgL ubf { Wofg lbg'kg ]{ s'/ fM kmf ] xf ]/ nfO { kfË|f ePsf ] ; fwgdf pRr ; ts { tf ; fy n} hfg ] kmf ] xf ]/ cf ]; fbf { lj / fldsf ] rfk sd x'g ] : yfg / ;do tf ]ls n} hfg ] ;+ qmldt / ; fwf /0f kmf ] xf ]/ nfO { 5'§f 5'§} ;do / ; fwgdf n} hfg ] kmf ] xf ]/ cf ]; fg { tf ] lsPsf ] dfu { dfq k|of ]u ug ]{ kmf ] xf ]/ nfO tf ] lsPsf ] ; fwgdf 9fs]/ dfq cf ]; fg ]{ kmf ] xf ]/ nfO 9'jfgL ubf { k|of ]u stf {n] hlxn ] klg JolQmut ;'/ Iff kf ] zfs clgjfo { nuffpg ] .

60. wf / Lnf ] kmf ] xf ]/ ;+ sng ug ]{ a§f , efF8f], aS;f , cflb #÷$ el/g ] lalQs } ;Ln u/L / fVg ' kb{5 . ;f] efF8fdf Ifdtf eGbf al9 o:tf j:t' ;+ sng x'Fbf kf ] lvP / hf ] ;'s} nfO 3f] Rg jf sf6\g ;Sb5 . olb ;]lˆ6 aS;sf ] Xof08n 5}g eg ] pQm aS;af6 ;'Ox? lgl:sPsf ] 5 jf 5}g eGg ] s'/f cjnf ]sg u/]/ dfq 9'jfgL ug '{ kb{5 . wf / Lnf ] kmf ] xf ]/sf] 9'jfgL ubf { x]le 8\o"l6 UnE ;÷ k~hf clgjfo { nufpg h?/L 5 . wf / Lnf ] kmf ] xf ]/ nfO jf8{af6 9'jfgL ug { hfFbf hlxn ] 5'§ }efF8f 6«nLdf lnP / hfg ' kb{5 . wf / Lnf ] kmf ] xf ]/sf] 9'jfgL

61. xftsf ] k|of ]un] kmf ] xf ]/sf] 9'jfgL ub }{ kmf ] xf ]/ Joj:yfkgdf ;+ nUg sd {{ rf /Lx?

62. s]lx c:ktfndf k|of ; ePsf kmf ] xf ]/ 9'jgLsf] cEof ;

63. hf ] lvo'Qm kmf ] xf ]/ nfO 5'§} 6«lndf a]Un} ; dodf ;+ sng u/L 9'jfgL ub }{

64. >f] tdf juL {s[t ; fwf /0f kmf ] xf ]/sf] 9'jfgL ub }{ u/]sf sd { rf /L

65. pkrf / u/L cGoq nfg'k"j { kmf ] xf ]/sf] 8ª\u'/ y'k|g glbg To;nfO { hDdf ug ]{ / : jf:Yo ;+: yfleq } /x]sf] kmf ] xf ]/sf] s] Gb|Lo e08f/0fdf : yfgfGt /0f ug ]{ ug '{ kb{5 . ;+ qmfds kmf ] xf ]/sf nflu pkrf / jf lj;h {g ug '{ k"j { o;/L e08f/0f ug ]{ clwstd cjlw hf8f] ofddf $* 306f / udL { df @$ 306fdf l;ldt ug '{ kb{5 . kmf ] xf ]/ e08f/0f : yn : jf:Yo ;+: yf kl/;/ leq } x'g'kb {5 / of] lgdf {0f ubf { pTkfbg x'g ] kmf ] xf ]/sf] kl/df0f, kmf ] xf ]/ hDdf x'g ] b/, pkrf / tyf lj;h { gsf cGo pkfotkm { Wofg lbg'kb {5 . e08f/0f ubf { Ps 7fpFdf Pp6f ju {sf] kmf ] xf ]/ dfq } / fVg ' kb{5 h:t}M ;+ qmfds kmf ] xf ]/ nfO { cf } iflwhGo kmf ] xf ]/;Fu ld;fpg'x'Fb }g . x/]s ju {sf] kmf ] xf ]/ 5'§f 5'§} e08f/0f ubf { ltgdf k|:6 a'lemg ]u/L n]an 6fFl;lbg ] ug '{kb{5 . : jf:y ;+: yfhGo kmf ] xf ]/sf] e08f/0f

66. kmf ] xf ]/sf] plrt e08f/0f ug { agfOPsf ] kmf ] xf ]/ Joj:yfkg s]Gb« - a]Un} ;+/ rgf _

67. kmf ] xf ]/sf] Jojl:yt e08f/0f

68. olb lgDg tl / sfn ] kmf ] xf ]/ e08f/0f ug ]{ xf ] eg ]=====

69. ====o; tl / sfn ] kmf ] xf ]/sf] plrt Joj:yfkgdf ; xof ]u x'g ]5

70. ;+: yf kl/;/ df 9'jfgL kmf ]x/ pTkfbg x'g ] 7fpFaf6 e08f/0f ul /g] jf pkrf / If] q;Ddsf ] 9'jfgL rSsf ePsf ] b'?:t 6«nL, sG6]g/ jf uf8fdf ul /g' k5{ . ;Dej eP;Dd 9'jfgL ul /g] af6f] la/ fdL jf cfuGt'ssf ] eL8ef8 x'g ] If] qeGbf cnu x'g ' kb{5 . hf ] lvdo'Qm jf ;+qmd0fo'Qm : jf:YohGo kmf ]x/d} nf / hf ] lvd / lxt ; fwf /0f kmf ]x/sf] 9'jfgL a] Unf a]Un} 6«nLdf ul /g' k5{ . 9'jfgL ug ]{ 6«nL jf uf8Ldf x'g'kg ]{ ljz ] iftfx ? M kmf ]x/ eg { / emfg { ; lhnf ] vfnsf ], kmf ]x/ ebf { / emfbf { ; Defljt emf ] nf 5]l8g] wfl / nf ] rf ];f] gePsf ], ; kmf ug { ; xh vfnsf ], b'?:t tyf rSsf ePsf ]

71. : jf:YohGo kmf ]x/ 9'jfgL ug { k|of ]u ul /g] jfxg ;Dej eP;Dd o;} sfddf dfq k|of ]u ul /g] x'g'k5{ . jfxgdf nf ]8 ug {, cgnf ]8 ug {, ; kmf ug { / r'xfj6 x'g glbg pko'Qm Joj:yf ePsf ] x'g ' k5{ hf ] lvdo'Qm tyf ;+ qmfds j:t' ;+s]t lrGx k|:6;Fu b] lvg ] u/L c+lst ul / Psf ] x'g'k5{ . b'3{6gf tyf r'xfj6sf] hf ] lvd Go"gLs /0f ug { hf ] lvdo'Qm kmf ]x/ 9'jfgL ug ]{ jfxg tf }n b] vfpg ] / ljBdfg ;8sdf u'8\ g;Sg ] x'g'k5{ . : jf:YohGo kmf ]x/d} nf 9'jfgL ug ]{ jfxgn ] lgDg dfkb08 lgwf {l/t k"/f u/]sf] x'g'k5{MM rfnssf ] Soflag / jfxgsf ] j8LaLr k|z:t b"/L x'g ' k5{, l/ Qf ] Knfl:6s Aofu , cfjZos ;'/ lIft klx /g, ;/; kmfO { ug ]{ pks /0f, cf } hf /, lgd { lns /0f ug ]{ ; fdu|Lsf ; fy } t/n j:t' r'lxFbf Joj:yfkg ug ]{ ljz ]if ls6 jfxgsf ] 5'6\6] sIfdf /x]sf] x'g'k5{ jfxg tyf sG6]g/ df cGt //f{li6«o vt / fsf ] lrGx c+lst ul / Psf ] x'g'k5{, ; fy } cfsl:ds 6] lnkmf ]g g+=;d]t n] lvPsf ] x'g'k5{ . 9'jfgL eO /x]sf] kmf ]x/sf] ljj /0f jfxg rfnsnfO { pknAw u/ fOPsf ] x'g'k5{ . ;+: yf kl/;/ aflx / 9'jfgL

72. Group Work Learning Outcomes Suggestions Important take aways

73. 6 Days onsite Training ON HCWM to Healthcare Professionals at Rapti Academy of Health Science

74. pb \3f6g , kl/ ro , k'j {–kl/ Iff , tflndsf ] nIoÙ p2]Zo tyf k|d'v l;4fGtx?

75. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5g\ : tflnd sfo { qmd tyf jftfj /0f : jf:Yo : jf:YohGo kmf ]x/ d} nf Joj:yfkg vfg ] kfgL ;/; kmfO { tyf :jR5tf -o;kl5 EH/HCWM/WASH / flvg ]_ ; DaGwL Ifdtf clej [l4 cEof;sf ] nIo / p2] Zoaf /] atfpg . tflndsf ] l;4fGt atfpg .

76. kmf ] xf ]/ pkrf / tyf la;h {g lalwx ?

77. p2]Zo o; ; qsf ] cGtdf ; xefuLx ? lgDg ljifo j:t'df ; Ifd x'g ]5g\M ▶ : jf:YohGo kmf ] xf ]/d} nfsf ] pkrf / 5gf]6df Wofg lbg ' kg]{ s'/f af /] atfpg . ▶ : jf:YohGo kmf ] xf ]/d} nf pkrf /sf nflu xfn ; Dd pknAw k|ljlwx ? af /] atfpg . ▶ pkrf / k|ljlwsf ] ;lx 5gf}6 .

78. : jf:YohGo kmf ] xf ]/sf] pkrf / df k|of ]u x'g ] k|lqmofx ¿ ▶ hf ] lvdo'Qm - wfl / nf , ;+ qmfds / xflgsf /s_ : jf:Yo ;] jfhGo kmf ] xf ]/ x¿sf pkrf /sf] nflu kfFr cfwf / e"t k|lqmofx ¿ k|of ]u ul /G5, ▶ yd {n ( Thermal) ▶ / f;folgs (Chemical) ▶ ljls /0f ( Irradiation) ▶ h} ljs ( Biological) ▶ oflGqs ( Mechanical) - cGo k|lqmofx¿sf ] nfuL k"/s k|lqmof

79. yd {n pkrf / k|lqmofx ¿ ( T h erma l T r e atment process) ▶ /f] uhgs ls6f0f'x? gi6 ug { tfkqmddf e/ kb{5 . ▶ tfkqmdsf cfwf / df b'O { k|sf / df ljeflhtM ▶ sd – tftf ] yd {n k|0ffnLx¿nfO{ gg–ag{ jf gg– OlG;g /] zg pkrf / k|ljlwx ¿ klg elgG5 . ▶ pRr – tfk yd {n k|0ffnL h;df bxg - OlG;g /] zg _ /÷ jf : jf:Yo kmf ] xf ]/sf] kfO /f] lnl ;; ; dfj ]z x'G5 .

80. sd – tftf ] yd {n k|0ffnL (Low-Heat Thermal Process) ▶ /f] uhgsx ¿ gi6 ug { kof { Kt pRr tfkqmd (100ºC and 180ºC) / yd {n pmhf { k|of ]u ub {5, t/ of tfkqmd kmf ] xf ]/sf] bxg jf kfO /f] lnl ;; ug { kof { Kt x'Fb }g . ▶ of] k|0ffnL cf ] l;nf ] / cfb {| M (moist) jf ;' Vvf (dry) b'O { k|sf /sf] jftfj /0fdf x'g ] ub {5 cfb {| tfk (Moist heat) M ; fdfGotof c6f]Sn]e jf cGo :6Ld– cfwfl /t k|0ffnLdf kmf ] xf ]/ nfO { sL6f0f'/ lxt ug { :6Ld k|of ]u ul /G5 . o;nfO { Wet yd {n k|lqmof klg elgG5 . ;' Vvf tftf ] (dry heat) M kfgL jf afkmsf ] k|of ]u yk lagf ;' Vvf tftf ] tfkqmddf sfd ub {5 .

81. / f;folgs pkrf / lawL ▶ Snf ]/ Lg 8fOcS;fO8 3f]n (dissolved chlorine dioxide) , AnLr ( So d ium hypochlorite), k/ P;]l6s Pl;8 ( peracetic acid), r'gf 3f]n (lime solution), cf ] hf ]g Uof ; (ozone gas) , jf ;' Svf csfa { lgs /; fogx ¿ (dry inorganic chemicals) h:tf / f;folgs sL6f0f'gfzsx¿ k|of ]u ul /G5 . ▶ / f;folgs pkrf / lawL k|of ]u ubf { k|foM / f;folgs Ph ]G6df kmf ] xf ]/sf ;+ ks {a9fpgsf] nflu kmf ]x/ nfO { 6'qmf 6'qmf , jf kL ; kf /]/ / fd |/L ld;fOG5 . ▶ pkrf /n] ; fdfGotof sterilization sf] ;§f disinfection sf] kl/0ffd lbG5 . ▶ t/n k|0ffnLx¿sf nflu , kmf ] xf ]/x¿af6 sL6f0f'gfzs (disinfectant) x6fpg / k'gM k|of ]u ug {sf] nflu kfgL lgsfNg ] r/0f (dewatering stage) df hfg ;lsG5 .

82. h} ljs pkrf / lawL ▶ ljz ]if u/L k|s [ ltdf x'g ] k|lqmofx ¿ af6g} h} ljs kmf ] xf ]/ nfO { ;8fOG5, unfOG5 cyf {t x|f ; kfl /G5 . ▶ pbfx /0fsf] nflu , sDkf ]l:6ª, eld { sNr /, h}j– kfrg , / zjx ¿ -d[t z/L/_, tGt'x ¿ / zf / Ll /s efux ¿ biodegradable kmf ] xf ]/ hldg d'gL uf8]/ k|fs [ lts ? kdf ;8\g], jf gi6 u/ fOg ] ul /G5 . ▶ s] xL k|ljlwx¿n ] h} ljs kmf ] xf ]/sf] lj36gnfO{ ult lbg OGhfOdx ¿ ylkG5 . ▶ Knf ;]G6f / c:ktfnsf] efG;fsf ] kmf ] xf ]/sf] nflu sDkf ]l:6ª / jdL { sNr / ; kmntfk"j {s k|of ]u ul / Psf ] 5 .

83. ▶ k|zf ] wg la;h {g ug {' kg]{ kmf ] xf ]/sf] k|sf / / dfqf ▶ kmf ] xf ]/sf] dfqf XofG8n ug { : jf:Yo ;: yfsf ] Ifdtf ▶ k|fljlws cfjZostf , Ifdtf / pknAwtf ▶ pkrf /sf laleGg ljsNk / k|ljlwx¿sf ] pknAwtf ▶ k|zf ] wg k|0ffnLsf] Ifdtf ▶ pkrf / k|efjsfl / tf - dfOqmf ]loan, /; folgs hf ] lvdx ? lgliqmo / sd kfg { ;Sg] _ ▶ k] zfut : jf:Yo ;'/ Iff / jftfj /0fLo k|lta4tf ▶ dfqf (Volume and Mass) 36fpg] ▶ pks /0f : yfkgf (Installation) sf] nfuL k"jf { wf / - cfjZos 7fp, ; fdfg / ;' lawfx ?_ pkrf / 5gf]6df Wofg lbg'kg ]{ s'/ fx ?

84. ▶ ;~ rfng / dd {t ;Def/sf nflu cfjZos , cf } hf /, ; fdfg / l;k ▶ kmf ]x/ pkrf / / la;h {g ;fO6sf] cj:yf ▶ kmf ]x/ pkrf / kl5 k'g k|of ]u / laqmL ug { ; lsg ] ; Defjgf ▶ clGtd la;h { gsf ] nflu pknAw ljsNkx ¿ ▶ ;fj{ hlgs : jLsfo { tf ▶ lgofds cfjZostfx ¿ ▶ : yfkgf / pks /0fsf] ;'?sf] nfut ▶ pks /0fsf] ;~ rfng / dd {t nfut ▶ 9'jfgL, eG;f / z'Ns , cjz ] ifx¿sf ] pkrf / / la;h {g, / l8sldzlgª ; lxt cGo nfutx ¿ pkrf / 5gf]6df Wofg lbg'kg ]{ s'/ fx ?

85. pkrf / tyf lj;h { gsf nflu xfn pknAw k|ljlwx ¿ -!_ h} ljs k|lqmof -@_ c6f]Sn]e -#_ PsLs [t jfikdf cfwfl /t pkrf / k|0ffnL (Hybrid Steam Systems) -$_ dfOqmf ]j]e -y_ /; folgs pkrf / -^_ 3if{0fLo tfk (Frictional Heat) åf /f pkrf / k4lt -&_ OgSofK ;'n] zg (Encapsulation) tyf Og /6fO{h] zg ( Inertization ) Joj:yf -*_ :oflg6/L Nof08lkmn -(_ vf8ndf uf8\g] -!)_ ;]lK6s s+lqm6 eN6 -!!_ hnfpg ] (Incineration) k|ljlw -!@_ ;do ; fk ]If cfpg ] cGo k|ljlwx ¿

86. c6f]Sn]e (Autoclaves ) ▶ laleGg k|sf /sf : jf:yohGo kmf ]x/sf] pkrf / ug { ; Ifd ▶ o;df k|of ]u ePsf ] wft'n ] w]/} pRr tfks|d tyf k|];/ nfO { wfGg ;Sb5 . ▶ Sealed Door, afkm nfO { leq aflx / ug { kfOksf ] / fd|f ] Aoa:yf , h;n ] ubf { jfik kmf ]x/sf] leq;Dd k'Ub5 . ▶ Afflx / lg:sg ] jfkmdf klg xflgsf /s tTjx ? xg ;Sg] ePsfn ] high-efficiency particulate air (HEPA) lkmN6 / dfk { mt aflx / k7fOG5 .

87. c6f]Sn] esf k|sf /x? u|flel6- Gravity) & EofSo'd - Vacuum _ c6f]Sn]e

88. c6f]Sn]e kmfObfx ? ▶ k|of ]u eO /x]sf] tyf k|rlnt k|ljlw ▶ Go'g dd {t ;+ xf / vr ▶ Eofln8]6 ug { ; lhnf ] a] kmfObfx ? ▶ ;a} : yfgdf ;a} df ]8]n pko'Qm x'b }g ▶ z¢ kfgL tyf # km]h nfOg ▶ leq xfjf afsL ePsf ] v08df kmf ]x/ lgd { lns /0f gx'g ;S5

89. cfjlws dd {t (Preventive Maintenance) sfo { lsg ? ▶ ulDe / b'3{6gf x'g af6 arfFp5 . ▶ k|ljlwn ] plrt (Efficient) sfo { ub {} 5 elg ;' lglZrt ub {5 . ▶ pks /0fsf] cfo ' a9fpb5 . ▶ pks /0f a] nf a] nfdf dd {t ug ]{ ;do tyf k}; fsf ] art . ▶ phf { vkt sd ub {5 .

90. cfjlws dd {t sfo { ▶ : jf:Yo ;+: Yffx?n ] pks /0f lgdf { tf tyf las]| tfx ? ;Fu a;]/ cfjlw dd {t of] hgf agfpg ' kb{5 . ▶ : jf:Yo ;+: yfsf pks /0f ;+ rfnsx?nfO { klg ; fdfGo dd {t sfo { x?sf ] tflnd lbOPsf ] x'g ' k5{ . ▶ dd {t ;+ xf /sf] cfjZos /]s8{ x? / fVg kb{5 . ▶ ;+: yfsf OlGhlgo / tyf Joj:yfksx ? cfkm }n] klg cg'udg ug {' kb{5 .

91. c6f]Sn]e ;+ rfng c6f]Sn]e ;+ rfngsf nfuL tn pNn ] lvt r/0fx? ; dfj ]z x'G5 . ▶ km] fx / ;+ sng (Waste collection) ▶ ;+ rfng k"j { ttfpg ] (Pre-heating) ▶ pks /0fdf kmf ]x/ xfNg ] (Waste loading) ▶ pks /0fdf ePsf ] xfjfnfO { aflx / lgsfNg ] (by gravity or vacuum) ▶ Jffikaf6 pkrf / (Steam treatment) ▶ Jffik lgisfzg (Steam discharge) ▶ kmf ]x/ nfO { aflx / lgsfNg ] (Unloading) ▶ cfjZos sfuhft , /]s8{ / fVg ] (Documentation) ▶ vfb \g] jf 6'Ss|ofpg] (Compaction or shredding if desired) ▶ cfjlws hfFr (Frequent testing/validation)

92. c6f]Sn] esf ] dd {t;+ xf / ▶ plrt tl / sfn ] ;+ rfng u/]sf c6f]Sn]e aiff }{ ; Dd rnfpg ;lsG5 . ▶ cfjlws dd { tsf nfuL tn pNn ] lvt h:t} tflnsf lgdf {0f ug { ;lsG5 . ▶ pks /0f ;+ rfnsn ] r'jfx6 eP gePsf ], ;/; kmfO , lkmN6/ tyf 9f] sfx?nfO { x/]s lbg ▶ pks /0f ;+ rfnsn ] OlG8s]6/ nfO6x?, tfks|d tyf k|]z/ dfkg oGqx ?, x/]s xKtf ▶ pks /0f ;+ rfnsn ] 9f]sf tyf Uof;s ]6x?, afOnf ] lhsn ;' rsx ? / fv ]/ hFfr , x/]s dlxgf ▶ OlGhlgo / x? af6 eNex ?, kfOkx ?, lelq efu tyf dfkg oGqx ?, tf / x?sf ] cjZyf , xfjf leq aflx / ug ]{ cj:yf , x/]s q} dfl;s ▶ OlGhlgo / x? af6 6'6] km'6]sf], ydf ]{ sknx ?, kfgLsf ] ;' rsx ?, uhx ?, dfkg oGqz ?, cGo eNex ?, x/]s aif {

93. dfOqmf ]j]e k4lt (Mic r owa v e B a sed T r eatment) ▶ dfOqmf ]j]e pkrf / Go'g tfks|d pkrf / k|0ffnL xf ], h;df dfOqmf ]j]e pmhf {n] kmf ]x/sf] cfb {| tfnfO { ttfP / cfb |{ tfk tyf jfik pT;h {g ub {5 . : jf:Yo ;:+ yfhGo ;ª\ qmfds kmf ]x/sf] pkrf / df dfOqmf ]j]e /]l8P;g k|of ]u ul /G5 . sl /a b'O { xhf / $ ;o %) d] ufxh { tyf !@=@$ ;]lG6ld6/sf] j] en ] Gyn ] kmf ]x/ df ePsf ] kfgLnfO { ttfP / jfkmdf kl/0ft ub5{ . ▶ ;ª\ qmfds kmf ]x/, wfl / nf kmf ]x/, k|of ]uzfnfaf6 lg:s ]sf kmf ]x/ nufot c6f]Sn] edf pkrf / ul /g] kmf ]x/sf] pkrf / dfOqmf ]j]eaf6 x'G5 . cf } iflwhGo , / f;folgs , ljiffQm sf] lifsfhGo kmf ]x/ tyf wft'sf ] dfOqmf ]j]e k4ltdf pkrf / ul / g'x'Fb }g .

94. dfOqmf ]j]e kmfObfx ? ▶ yf ]/} ultlzn (moving) efux ? ▶ ;+ rfngsf ] nfuL Go'g nfut ▶ ; Defjgf ePsf ] pQd k|ljlw ▶ kmf ]x/ nfO { pkrf / kZrft k'g rs|df k7fpg ;lsG5 . a] kmfObfx ? ▶ pRr nufgL nfut ▶ wftnfO { pkrf / ug { ldNb }g ▶ g] kfndf kmf ]x/sf] pkrf / s]lx : yfgdf l;ldt

95. uf8\g] vf8n jf NofG8lkmn ▶ hf ] lvdo'Qm kmf ]x/ nfO { ljz ]if vf8n agfP / k'g { ;lsG5 . ▶ o;sf nflu vf8n @–y ld6/ ulx /f] / !–@ ld6/ km/ flsnf ] x'g'kb {5 . ▶ vf8nsf] lkFw kfgLsf ] ; tx ( Water Table) eGbf sDtLdf @ ld6/ dfly x'g'k5{ . kmf ]x/ xfln;s ]kl5 x/]s k6s !)–#) ;]lG6ld6/; Dd df6f]n] 5f]Kg'k5{ . ▶ df6f]n] k'g { g;lsg ] cj:yfdf kmf ]x/ dfly r'g 5s{g' kb{5 . ; txsf ] #) b]lv y) ;]lG6ld6/ ulx / fO;Dd kmf ]x/ cfOk'u ]kl5 To;nfO { k'g ]{, l;n ug ]{ / cfjZos eP gofF vf8n agfpg ] ug '{kb{5 . ▶ dxfdf / Lsf ] ; dodf o:tf vf8ndf r'gf / df6f] / fvL 5f]Kg' kb{5 . 56

96. ;]lK6s sªlqm6 eN6 ( Septic or concrete vault/ Sharp Pit) ▶ o:tf] Joj:yf k|of ]u ul / Psf wfl / nf j:t' tyf l;l / Ghsf ] lj;h { gsf nflu ul /G5 . ▶ o;sf nflu kSsL vf8n -! ld = X ! ld = X !=* ld = ulx /f]_, lglZrt cjlw;Dd wfl / nf kmf ]x/ tyf l;l / Gh lj;h {g ug { k'Ug ] u/L agfOG5 . ▶ t/ o:tf] ;+/ rgf e"ldut kfgLsf ] tx g5'g] vfnsf ], kfgLsf ] ;|f]t / dflg;sf ] cfjfudgeGbf sDtLdf % ld = 6f9f PsfGt:yfgdf x'g ' k5{ . 58

97. OGSofK ;'n];g tyf Og6f{h];g 59 ▶ o; ljlwcGtu {t kmf ]x/ d} nfnfO { s'g } sG6]g/ df xflnG5, ToxfFleq kmf ]x/ gxlǔnof ];\ eg ]/ dflyaf6 c? ; fdu|L vfFlbG5 / sG6]g/ nfO { l;n ul /G5 . ▶ o;df pRr 3gTj ePsf ] kf ] lnyfOlng jf wft'af6 ag]sf 8«dsf] k|of ]u x'G5 . o:tf] sG6]g/sf] tLg efu el/g] u/L kmf ]x/ xfn ]/ To;nfO { gxlNng ] kfg { Knfl:6s kmf ]d, afn'jf , l;d ]G6 df6f{/] cyjf lxnf ]df6f] yk ]/ e/L kfl /G5 . dflyaf6 el/ Psf ] j:t' ;'s]kl5 To;sf ] d'v aGb u/]/ ;'/ lIft ¿ kdf hldgdf ufl8G5 . ▶ o;/L OGSofK ;'n];g u/L lj;h {g ubf { kmf ]x/af6 ; fdfg a6'Ng] hLjx¿n ] hf ] lvdo'Qm kmf ]x/ e]6g\ ;Sb}gg\ . vf;u /L cfiflwhGo } tyf aftfj /0fdf ; lhn } ldl;g ] xflgsf /s kmf ] xf ]/ h:t} x] jL d]6n o'Qm v/ fgL h:tf kmf ]x/sf nflu of] ljlw pko'Qm dflgG5 . ▶ o:tf] ljlwdf : jf:Yo ;+: yfhGo kmf ]x/ ^% k|ltzt , !% k|ltzt r'g , !% k|ltzt l;d ]G6 / % k|ltzt kfgL ld;fOG5 . ▶ o:tf] ld >0fnfO{ 3gfsf/ jf ;–; fgf 8ǔnfdff kl/0ft u/L pko'Qm e08f/0f:yndf : yfgfGt /0f ul /G5 . o:tf] ld >0fnfO{ 3gfsf/ jf dl;gf 8ǔnf cfsf / lbg kmf ]x/ nfO { w'Nofpg ' / fd|f ] x'G5 . ▶ j} slǔks k|lqmofdf , t/n ld >0f agfO { NofG8lkmndf nu]/ ;'/ lIft ¿ kdf vGofpg ;lsG5 . ▶ o:tf] ljlw ckgfpFbf ljiffQm j:t' aUg ] jf e"ldut kfgLdf ldl;P / ;ªq\md0f u/ fpg ] jf kmf ]x/af6 ; fdfg a6'ǔg] dflg;nfO { gf] S;fgL k'Ug ] hf ] lvd Go"g x'G5 .

98. hf ] lvdo'SQ : j:YohGo kmf ] xf ]/ plrt Aoj:yfkg k|ljlw kmf ] xf ]/sf] ju { k|sf / ;+ qmfds wfl/nf Kofyf]nf]lhsn /; folgs kmf]xf]/sf] ju{ k|sf/ ;+ qmfds k|ljlwsf k|sf/ h} ljs ljlw x'Fb}g x'Fb}g x'G5 x'Fb }g x'Fb}g x'Fb}g c6f]Sn]e x'G5 x'G5 x'Fb}g x'Fb}g x'Fb}g x'G5 dfOqmf]j]e x'G5 x'G5 x'Fb}g x'Fb}g x'Fb}g x'G5 /;folgs pkrf/ x'G5 x'G5 x'Fb }g x'G5 x'Fb}g x'G5 lgliqmo kf/]/ OGSofK;'n];g x'Fb}g x'G5 x'Fb}g x'G5 x'G5 x'Fb }g :oflg6/L Nof08lkmn x'G5 lgd{nLs/0f kZrft\ x'G5 OGSofK ;'n];g kZrft \ x'Fb }g x'G5 OGSofK ;'n];g kZrft \ x'G5 OGSofK ;'n];g kZrft \ x'G5 lgd { nLs /0f kZrft \ Uf8g / k'g ]{ x'G5 lgd { nLs /0f kZrft \ x'Fb}g x'G5 x'Fb }g x'Fb }g x'Fb }g ;]lK6s s+lqm6 eN6 x'G5 lgd { nLs /0f kZrft \ x'G5 x'Fb }g x'Fb }g x'Fb }g x'Fb }g

99. Assessment of Rapti Academy of Health Science Recommended treatment and disposal method S.N Waste Category Treatment Final Disposal 1 Hazardous waste Pathological waste   Placenta Pit Sharp waste Autoclave Sharp pit Pharmaceutical waste No recommended treatment Return back policy/ Encapsulation Non recyclable Infectious waste (cotton, gauze, PPE etc.) Autoclave Landfill Tubing and bags Autoclave Recycle Gloves Autoclave Recycle Syringes Autoclave Recycle 2 General waste Paper Not required Recycle Recyclable Plastic Not required Recycle Bottles and cans Not required Recycle food waste Not required Compost pit Unrecyclable plastic Not required Handicraft/ Landfill Remaining waste Not required Landfill

100. : jf:YohGo kmf ] xf ]/ Joj:yfkgdf ;+ nUg sd { rf / Lsf k] zfut : jf:Yo tyf ;'/ Iff

101. : jf:YohGo kmf ]x/d} nfdf sfo {/t sd { rf / Lx?sf ] k] zfut : jf:Yo tyf ;'/ Iff sfod ug ]{ / ;f] sf] t/ Lsf af /] ;r]t x'g ] . p2]Zo

102. Joj;fohGo ;'/ Iff tyf : jf:YoM ; fdfGo kl/ ro ;a} Aoj;fodf sd { rf / Lx?sf ] ef } lts , dfgls / ; fdflhs : jf:Yosf ] pRrtd k|awg \ tyf ;+/If0f ug '{‘ Aoj;fhGo : jf:Yo xf ] .

103. Joj;fohGo ;'/ Iff tyf : jf:YoM ; fdfGo kl/ ro Pp6f sfdbf / cyjf sd { rf /L sfd z'?u /]sf] pd ]/ df h'g l:yltdf lyof ] cjsfz x'bf klg pd ]/ df x'g kl/ jt {g jfx ]s cGo s'g } kl/ jt {g of : jf:Yodf x|f ; gx'g ' xf ] .

104. ;+/If0f tyf k|j4{g sd { rf /L Jfftfj /0f k|s [of ; DktL

105. Needle stick injury ▶ 70% of clinical staff and 63% of non-clinical staff reported of incidents of needle stick injury (NSI) or other sharps injury at some time Source: A major occupational hazards among the health care workers in Nepal NSI 2013 . ▶ Among 1, 2 78 i n f orma l w a s t e w or k e r s (IWW ) 38% reported handling medical waste and 66% had been injured at work within 1-year period Source: Health status and occupational risks in Informal Waste Workers in Nepal conducted by MDM France 2018 .

106. Hazard, Exposure and Risk ( vt /f ) Hazard Possibility something causing harm ( hf ] lvd ) Risk Probability of Harm occurring Required Exposure Hazard may convert into Risk E.g.: Chemicals is Hazard but handling without gloves is risk it can happen skin problems

107. Hazards A hazard is any source of potential damage, harm on something or adverse health effects on someone under certain conditions at work. vt / fM ef } lts cj:yf h;n ] wg , hg jf jftfj /0fnfO{ Iflt k'¥ ofpg ] ; Defjgf .

108. Hazards: Substance, material, process, practice, etc. that can cause harm or adverse health effect to a person under certain conditions Chemical, contact with infected patient, infected waste and sharp

109. Risk Risk is the chance or probability that a person will be harmed or experience an adverse health effect if exposed to a hazard. hf ] lvdM s'g } ; dofjlw jf kl/ l:ytLdf s'g } cnlIft l:ytL pTkGg x'g ;Sg] ; Defjgf / kl/0ffd .

110. W orkplac e / Exposure Dose of exposure – magnitude, timing, duration of exposure Characteristic of the Hazard R o u t e of exp o sure Hygiène Influencing factors of risk from hazard

111. Classification of occupational hazard and risk Example of hazard Risk Classification of hazard Physical Needle, broken glass, and blade Injury/cut Ergo nomics Poor working position, Heavy lifting, long working hours Musculoskeletal related problems (backache, body ache), Biological Blood borne viruses, bacterial, Fungus exposure to rodents and animals /dog bite, Body fluids (lab ) Viral hepatitis B & C, HIV and AIDs, Parasitic infestation, Tetanus. Scrub Typhus, Rabies, COVID

112. Ergonomic/Physical hazad hazard fit the job to the worker not fit the worker to the job

113. Biological Hazard hazard VIR U S E S F U NGI B A C T E R IA P ARA S ITES

114. Classification of occupational hazard and risk Classification of hazard Example of hazard Risk Chemical Harmful chemical compounds; liquid, gases related to organic waste (methane), heavy metal waste like lead, mercury). Shot term; headache, nausea skin irritation, Long term; cancer, liver and lungs disease Psychosocial Verbal abuse, violence Stigmatization, social representation of the job, over and under load of job. Stress, anxiety and Depression……. )

115. Chemical and psychosocial hazard 1 18

116. Major possible risk to Health care workers Needle Stick Injury Blood and body fluid splash Transmission of blood borne pathogens Hepatitis B,C and HIV Chemical exposure Musculoskeletal problems Risk Groups: Nurses, Physicians, Ward staff, Cleaners & Waste handlers

117. Risk control measures 120 Replacement by safer tools Improved and guarding machine

118. Infection Prevention and Control (IPC) ;+qmd0f /f] syfd tyf lgoGq0f

119. Objectives We will discuss on State the concept of Infection prevention and control State the definition of Infection Prevention and control Outline the importance of IPC Describe the disease transmission cycle State the scope of IPC Explain health care associated infections

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122. Definition of IPC Infection prevention and control is scientific approach and practice designed to prevent harm caused by infection to patients and healthcare workers. It focuses on evidence-based practices and procedures that can prevent or reduce the risk of transmission of microorganisms

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124. pbfx /0f c:ktfn jf : jf:Yo ;+: yfx?df sfo {/t ;a} : jf:YosdL {x? tyf cGo sd { rf /Lx? ;a} ;+qmd0f x'g ] vt / fdf x'G5g\ . h:t} cd]/ Lsfdf c6'6 ? kdf 1fg lzk lbP / ; Sbf ] ? kdf w]/} eGbf w]/} arfjsf pkfox ? k|of ]u u/L d]x] gt ubf { klg jif { df *)),))) eGbf a9L klxn ] k|of ]u eO;s ] sf ] l;of ]n] 3f] Rg ] ( needlestick injuries ) 36gf ePsf ] kfOG5 - Rogers 1997 _ . o:tf] vt /f /f] Sg ePsf k|of;x ?, h:t}M Auto-Disable Syringes / Needles x?, Ps k6s k|of ]u ul /g] Standard Disposable Syringes / Needles eGbf a9L ;'/ lIft / laZj;gLo 5g\ . cgfjZos / c;'/ lIft ? kdf ;'O{ nufpg ] sfo { gug ]{, Auto-Disable Syringes / Needles x?, Ps k6s k|of ]u ul /g] Standard Disposable Syringes / Needles eGbf a9L ;'/ lIft / laZj;gLo 5g\ . cgfjZos / c;'/ lIft ? kdf ;'O{ nufpg ] sfo { gug ]{,

125. Healthcare associated infection (HCAI) It is the infection acquired by patient after 48 hours of hospitalization, or during the course of receiving treatment within a healthcare settings and was not present or incubating at the time of admission. Associated with the devices used in medical procedures such as ventilators or catheters. Formerly known as N osocomial infection.

126. :t/Lo ; fawfgLsf efux ? (Components of Standard Precautions) != xftsf ] ;/; kmfO (Hand Hygiene) @= AolStut ;'/ Iffsf ; fdfu|Lx?sf ] k|of ]u (Use of PPE) #= Zjf ; k|Zjf;sf ] :jR5tf (Respiratory hygiene and cough etiquette) $= ;'/ lIft tl / sfn ] ;'O nufpg ] Aoaxf / (Safe Injection Practice) %= ;/; kmfO / lg ;+s|d0f (Cleaning and disinfection) ^= k'g k|of ]u x'g ] cf } hf / tyf n'ufsf ; fdfuL|x?sf ] ;/; kmfO (Process reusable instruments and textile items) &= kmf ]x/ a:t'x?sf] la;h {g / Aoa:yfkg ( Waste Disposal /management )

127. { xftsf ] ;/; kmfO { HAND HYGIENE : jf:YosdL { x?sf ] xft : jf:Yo ;] jf k|bfg ug ]{ s|ddf la/ fdLx?nfO { ;+qmd0f ; fg ]{ Pp6f k|d'v dfWod xf ] .

128. AolStut ;'/ Iffsf ; fdfu|Lx ? PERSONAL PROTECT EQUIPMENT

129. ;'/ lIft tl / sfn ] ;'O{ nufpg ] Aoaxf / SAFE INJECTION PRACTICE

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131. : jf:Yo ;+: yfsf ] ;/; kmfO { CLEANING AND DISINFECTION IN HEALTH FACILITY lg ;+s|d0f ug ]{ / f;folgs 3f] nx ? - Disinfectants ) Chlorine Solution (0.5 % or 0.1%) Alcohol (60%-90%) Isopropyl, ethyl alcohol, surgical spirit

132. b} lgs cg'udg / ko {j]If0f

133. jf8{​ x ? / pkrf / s] Gb|sf ] cg'udg Standard structured checklist for daily supervision and monitoring of wards and treatment center We monitor the source segregation status, functioning of logistics, logistics setup is as per standard Monitor the use of color coded plastic liners, reported incident, cleaning and disinfection of treatment center, Monitor the status of autoclave, supply of water and electricity in treatment, segregation of waste in chamber, use of PPE, regular weighing of waste

134. b} lgs cg'udg / ko {j]If0fsf kmfObfx ? Gives Clear and Concise Information on What is Happening Improved compliance with local, state, and federal regulations on health care waste management Reduction in the environmental impact of the facility's waste disposal practices Reduction in the risk of exposure to hazardous waste for staff and patients Cost savings by reducing the amount of waste that needs to be treated or disposed of

135. ; d'x sfo {​ Prepare monitoring checklist for treatment center Prepare monitoring checklist for wards

136. Post-Test

137. Thank You

138. Field Visit