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The essence of this was aptly captured by Dravidians, who in 5000 BC gave due emphasis to immaculate town pla nning and safe and effective sewerage systems who got rid of all solid and liqui d wastes generated by the pollution. They were indeed the pioneers as far as sci entific waste management is concerned ; which is borne out from excavation of Mo hanje-Dora and Harapa. The modern hospitals and health care institutions includi ng research centres use a wide variety of drugs including antibiotics, cytotoxic s, corrosive chemicals, radio active substances, which ultimately become part of hospital waste. The advent of disposables in the hospitals has brought in its w ake, attendant, ills i.e. inappropriate recycling, unauthorised and illegal re-u se and increase in the quantum of waste. All round technological progress has le ad to increased availability of health related consumer goods, which have the pr opensity for production of increased wastes. The issue of improper Hospital Wast e Management in India was first highlighted in a writ petition in the Hon’ble Supr eme Court; and subsequently, pursuant to the directives of the court, the Minist ry of Environment and Forests, Govt. of India notified the Bio-Medical Waste (Ma nagement and Handlings) Rules on 27th July 98; under the provisions of Environme nt Act 1986. These rules have been framed to regulate the disposal of various ca tegories of Bio-Medical Waste as envisaged therein; so as to ensure the safety o f the staff, patients, public and the environment. The Govt. Medical College Jam mu is a referral, tertiary care hospital. It has many associated hospitals like Govt. Medical College Hospital Jammu, SMGS Hospital, Dental Hospital, Psychiatry Disease Hospital and Chest Disease Hospital. The GMC Hospital is biggest of all , with bed strength of 850 beds. It has the clinical specialities like Medicine, Surgery, Orthopaedics, Eye, Radiodiagnosis, Radiotherapy and Anaesthesiology. T he para/non-clinical specialities which provide support to the hospital are Anat omy, Physiology, Pharmacology, SPM, Blood Bank, Pathology, Microbiology, Forensi c Medicine and Biochemistry. The indoor complex of the hospital has 1 to 15 ward s (Surgery, Medicine, Eye, Ortho & RT). The specialised nursing care units like ICU, CCU, dialysis Unit, spinal and burn ward etc. are also available. The hospi tal has 11 major operation theatres and 4 minor operation theatres. The major op eration theatres are in a separate OT complexes like Main Surgical OT, Ortho OT, Eye OT and Emergency OT. The separate Out patient department (OPDs) for Medicin e, Surgery, Orthopaedics, Eye, Radiotherapy, Physiotherapy and Electro Medical D iagnosis Deptt. (including facilities for ECG, EEG, TMT, Endoscopic procedures e tc.) are also available. Almost 1000 patients (average) attend these OPD every d ay. The Emergency Department of the hospital runs round the clock with almost mo re than 400 patients attending the Casualty of the hospital every day. The facil ities of emergency lab. X-Ray, ultrasound, ECG, CT Scan and Blood Bank are avail able 24 hours in the emergency. An emergency indoor ward, post operative recover y ward, emergency OT complex and disaster ward is also attached to the casualty. The OPD Labs. (Pathology/Microbiology/Biochemistry) are also separately located near the OPD blocks for the benefit of OPD patients. The separate Blood Bank an d the Immunisation Section (Antirabic) is also available. The hospital has its o wn CSSD, Laundry, Kitchen, Mortuary and hospital stores. These activities genera te a lot of waste which should be managed properly with care. II. WASTE MANAGEME NT POLICY The Bio-Medical Waste Management policy at GMC has been framed to meet the following broad objectives :–
by which the rules must be conformed with. and (eventually) the general public. or in the production or testing of biologicals. and is not int ended for further use. treatment or immunisation of human beings or animals. deadline for GMC was 31st December’ 1999. (ii) Defining the various categories of waste being generated in the hospital/health care institution. (iv) Identifying and utilising proper “treatment technolog y” depending upon the category of waste. body fluids and specimens along with their containers. (v) Creating a system where all categorie s of personnel are not only responsible. or i n the production or testing of biologicals and the animal waste from slaughter h ouses or any other like establishments. failing which legal action can be initiated.” . which is generated during its diagnosis.” (c) Clinical Waste : Is defined as “any waste coming out o f medical care provided in hospitals or other medical care establishments. but also accountable for proper waste m anagement. water and soil pollution. (b) Health hazar ds associated with improper hospital waste management: A number of hazards and r isks are associated with this viz. * Risks of infections outside h ospitals for waste handlers. bo dy parts. including its container a nd any intermediate product. c) Environmental hazards : Improper hospital waste man agement also results in air. being handled by persons handl ing wastes at all levels. especially due to imperfe ct treatment and faulty disposal methods. drugs. * Injuries from sharps to all categories of h ospital personnel and waste handlers. organ. * Nosocomial infections in patients from p oor infection control and poor waste management. so that each category is treated in a suitable manner to render it harmless. fluid or liquid waste. (vi) Changing the use patterns from single usage to multiple usage wh enever possible. the policy statement aims to provi de for a system for management of all potentially infectious and hazardous waste s in accordance with the Bio-Medical Waste (Management and Handling) Rules 1998. III. NEED FOR BIO-MEDICAL WASTE MANAGEMENT (a) (Statutory) Legal Obligation : I n accordance with the provisions of the Bio-Medical Waste (Management and Handli ng) Rules 1998.” (b) Medical Waste : Is a term used to des cribe “any waste that is generated in the diagnosis. (iii) Segregation and collection of various categories of was te in separate containers. * Risks associated with hazardous chemicals. in research pertaining thereto. but d oes not include waste generated at home. in research pertaining thereto. biological or non-biological that is generated from a hospital. POLICY STATEMENT Summing up. (e) Pathological Waste : Is defined as “waste removed durin g surgery/autopsy or other medical procedures including human tissues. scavengers. treatment or immunisation of human beings or animals. (a) Bio-Medical Wast e : May be defined as “any solid. IV.” (d) Hospital Waste : Refers to all waste . DEFINITIONS It is important to know the definitions so as to be able to understand the categ orisation and other steps of waste management subsequently.(i) Changing an age old “mind set” and attitude through knowledge and training.
other material contaminated with blood) (Wastes generated from dispo sable items other than the waste sharps such as tubings. waste generated by veterinary hospitals. etc. bacterial or parasitic diseases. that may cause puncture and cuts. 4 Waste Sharps (needles. blades.(f) Infectious Waste : Refers to that portion of Bio-Medical Waste which may tra nsmit viral. CATEGORISATION OF BIO-MEDICAL WASTES Bio-Medical waste have been categorised into ten different categories as mention ed in the table below :– OPTION WASTE CATEGORY WASTE CONTENT Category No. corrugated cardboard. floor swe epings and also includes kitchen waste. intravenous sets etc. chemicals used in dis infection. as insecticides. housekeeping and disinfecting activities) (ash from incineration of any bio-medical waste) Ch emical Waste (chemicals used in production of biologicals. body parts carcasses. reclaimed silver from X-ray developing solution. public areas. solid linen. catheters. organs. dressings. bleeding pa rts. body Wastes parts) Catego ry No. 7 Solid Waste Category No. X-ray film. fluid. stocks or specimens of m i c r o organisms live or attenuated vaccines. waste from production of biologicals.) Category No. dishes a nd devices used for transfer of cultures) Category No. plaster casts. stores.2 Animal Wastes (animal tissues. cardboard containers. blood and experimental animals used in research. catering areas. letters. discharge from hospitals. metal cans. human and animal cell culture used in research and infectious agents from research and industrial laboratories.10 VI. This i ncludes both used and unused sharps). aerosol cans and disposable compressed gas containers. it may be solid. paper. cleaning. In addition. 8 Liquid Waste Category No. liquid or gaseous waste. documents. These are generated from in-vitro analysis of body fluids and tissues. if concentration and virulence of pathogenic organisms is sufficiently high. etc. alumi nium.3 Microbiology & Biotechnology waste (waste from laboratory cultures . scalpels. HOSPITAL WASTE MANAGEMENT COMMITTEE . organs. comprisin g of newspapers. (g) Hazardous Waste : Refers to that portion of Bio-Medical Waste which has a potential to cause hazards to health an d life of human beings. (k) Recyclable Waste : Includes the foll owing: Glass after cleaning and disinfection. Category No. glass.1 Human Anatomical (human tissues. other types of waste generated in hospitals are : (h) Radioactive Waste : Which includes waste contaminated with radionucli des. syringes. beddings. toxins. (i) Pressurized Waste : Include compressed gas cylinders.) (waste generated from laboratory and washing. in-vitro imaging and other therapeutic pro cedures. 9 Incinerati on Ash Category No. 6 Solid Waste (items contaminated with blood . (j) General Waste : Includes general d omestic type waste from offices. and body fluids including cotton. animals houses) Category No. linen . V. Plastics afte r disinfection and shredding. 5 Discarded Medicines (waste comprising of outdated contaminated an d discarded medicines) Category No.
nursing station. Pantries in wards. Rest ro oms Hostels. It is now universally accepted that segregation is the responsibility of the gener ator of wastes . Conversely small errors at this stage can create lot of subsequent problems. Medical Waste Isolation ro oms. tra nsportation. Cashier. This smaller core group is responsible for implementation of these rules. clinical departments. Stores. collection. collection. Dialysis and Endoscopy rooms. Treatment GMC-as per Bioroom. It is a broad based committee with representative from hospital administration. Administration. C T Scan. pathology and microbiology departments and has powers to take decisions on all matters relate d to Bio-Medical Waste Management in the respective hospitals. Kitchen Cafeteria. Minor OTs. Disposal by Muni cipal/ Civic Authorities (ii) Hazardous (Infectious and toxic) Wards. Pharm acology OPDs’ Injection rooms and procedure rooms. Blood Bank Pharmacy and Medical Stores. All laboratories. OPERATIONAL ASPECTS The practical operational aspects regarding proper management of Bio-Medical Was tes has been described under each step starting with the generation and ending w ith final disposal of wastes. etc. treatment and disposal of wastes is formulated and impl emented by this committee. has been considered as the “key” for the entire process as it allows special attention to be given to the relatively small quantities of infec tions and hazardous waste. Rules Operation theatres. Billing. MRI rooms and various followup clinics * Quantum of Wastes : Studies carried out have indicated that about 2 Kg.A Hospital Waste Management Committee has been established in each of the associ ated hospitals with a view to improve and streamline Hospital Waste Management a nd for proper implementation of Bio-Medical Waste Management Rules’ 98. thus reducing the risks and cost of waste management. VII. under the chairmanship of the Medical Superintendents. (A) Generation of Wastes : The following table dep icts wastes generated at GMC Hospitals :– Type (i) Non-Hazardous (General) Site of Generation Office. of was tes are generated per bed per day which gives an idea about the tremendous volum e of waste generated on a day to day basis. Residential areas. (B) Segregation of Wastes : Segregat ion or the separation of different types (categories) of waste by sorting at the point of generation. The responsibilities of the various categories of the staff involved in the generation. Intensive Care Units and post operative recovery room.
which should be changed at least once times. and it becomes a truly Herculean ta sk to segregate or sort out various categories. this job is always relegated to the sanitation staff. (iii) Facilities provided for segregation * Proposed system for segregation: SITECONTA INER I. nurse or para-medical personnel. *Colour coded *She should ensure that punct ure (yellow. and at both these places. *Doctors / nurses and parainstructed to use the same.i. Laboratories and Sample Co llection centres incl. once they have been mixed up. *She shoul d ensure that twice in a day these are replaced by the centralised gang and sign in the register. to des troy the needle. II.e. Wards – Treatment Room *Colour coded *Sister I/C should ensure that and sl uice room (yellow. Blood Banks stroyer and put in *Colour coded *Officer Incharge of the lab/unit (yellow.e. * Factors affecting segregation at source: (i) Hospital policy and procedures (ii) Motivation and training of “generators” i. and put the syringe in the solution. two large black) large size bins (w ith cover) of hundred ltrs. RESPONSIBILITY medical staff should be puncture proof container. and to ensure that the polythene bags black) medium sized are regularly replaced and sent bins lined wi th for treatment/disposal coloured polythene bags *Electrical/manual *Clinical & Para Clinical staff needle deshould segregate the waste generated at source app ropriate container . doctors. with 1% Hypochlorite sol. blue and proof container contains 1% Sod black) large size bins Hyp ochlorite in a day. However. the doctor. containers lined with capacity are present lined wit h priate colour appropriately coloured polythene polythene bags bags. nurses and paramedics. in reality. – Bathroom and *Only black coloured Toilets bags bins lined by b lack polythene bags – Nursing station *Needle destroyer *Sister I/C should ensure that the (electric / manual) equipment is functional at all *Puncture proof In c ase of fault she should inform containers (double bin) the Officer I/C to get it replaced.
TABLE: COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTES Co lour Coding Identification Waste Category & Constituents Treatment Option Yellow colour Plastic bag withCategory No. wastes from laboratory cultures. soiled plaster cas ts. all human tissues.e. (If disinfected locally. scalpels. and body fluids including cotton. 4-Waste Sharps i. stocks or s pecimens of micro-organisms live or attenuated vaccines. 3-Micro biology & Biotechnology Wastes i. *Puncture proof con*Syringes to be put in puncture ainter with 1% Sod. body parts which are gesizes in yellow coalong with symbol nerat ed in patient care areas lourd bins/drums “Biohazard” and Category No.Incineration polythene inscription “for mical Wastes i. human and animalcell cu lture used in research and infectious agents from research and industrial labora tories. dressings.III. blades only” with symglass etc. discharge from hospitals. 1-Human Anato. waste generated by vet erinary hospitals.e.e. Operation theatres and Intensive Care Unit *Colour coded medium or large sized bags (depending upon quantity of waste gener ated) with coloured polythene bags-yellow.e. blood and experimental animals used in research. organs. Autoall needles. (This includes both used a nd hazard” and Cytounused sharps) . Category No. Blue colour polythene bags of diffclaving erent sizes in bl ue coloured bins/ bols of “Biodrums. animal houses.e. “Cytotoxic” all animals tissues. 2-Animal Wast es i. other material contaminated with blood except plastics. *Clinical and Para Clinical staff to segregate the waste generated at source and put in appropriate container. fluid. wastes from production of biologicals. Puncture Inscription on bag “For autoclaving Ca tegory No. & black Supervisor/Sister I/c to ensure that these are present. linen. bags of different incinerat ion only” organs. that may cause punture & cuts. body parts carcasses bleeding parts . all items contamin ated with blood. 6-Solid Waste i. dis posables and sharps. toxins. need not to be put into bags) Category No. polythene bags are chang ed regularly. proof container with 1% Sod. syringes. HyHypochlorite WHAT GOES WHERE ? – A GUIDE po chlorite solution. beddings. *Electrical/manual *Sharps like needles to be desneedle destroyer troyed by usin g the destroyer.
7-Solid Waste i.e. 10-Chemical Waste i. all chemicals used in pro duction of biological used in disinfection. (should be returned back to medical stores for fur ther disposal) Category No. ash from incineration of any Bio-Medical Waste Category No.e. during transportation of the waste. There is a need to be vigilant so that intermixing of different categories of waste is no t done inadvertently by the patients. proof container a ll wastes generated from disshould be inscriposable items (other than the waste bed. – The proce ss of collection should be documented in a register. During this period it is the responsibility of the clinical and para-medical staff to c heck that there is proper segregation and no subsequent recycling of disposables and other items. catheters. after which it is transported for treatment and disposal by the sanitation staff of centralised gang. . (C) Collection of Waste : Collection of Bio-Medical Wastes should be done as per rules in colour coded plastic bags as mentioned in the earlier table. during which the waste is “stored” opposite the mor tuary. (sh ould be cut into smaller pieces with the help of scissors) Black colour No inscr iption plastic bags of different sizes Category No.proof container toxic”. all wastes comprising of outdated. after which it is sent for treatment and disposal . “For sharps sharps) such as tubings. 5. Subsequently. * Operational Aspects: – From these sites the sanitatio n staff from the centralised gang will collect the waste during morning and afte rnoon.e. The containers for collection should be strategically located at all points of generation as menti oned in the earlier table. waste is stored in the areas of generation (as mentioned in table 1) for a n interim period varying from two to twelve hours. (D) Storage of Waste : Storage refers to the holding of Bio-Medical Waste for a certain period of time.Discarded Secure Medicine s and Cytotoxic drugs land fill i. At GMC Hosp ital. Puncture Category No. (E) Transportation of Waste : Transportatio n of Bio-Medical Waste can be divided into intramural (internal) and extra mural (external) transportation. It is the responsibility of the sanitation staff and security staff to en sure that rag pickers and other unscrupulous elements do not gain entry and sort out the waste for “recycling” purposes. only” intravenous sets etc. contamin ated and discarded medicines. as insecticides. under supervision of the staff nurse and sanitation supervisor. the coloured polythene bags should be replaced and the garbage bin should be cleaned with disinfectant regu larly. attendants or visitors. All General Wa stes Civil Authorities treatment would NOTE : Autoclave facility not available in the hospital so the waste after chemi cal be put in yellow bins. there is a l ag period of two to three hours. 9-Incineration Ash i. etc. In other words it means the duration of time wastes are kept at the site of ge neration and transit till the point of treatment and final disposal.e.
the waste will be taken through main ramp in covered trollies to the ground floor. outer cover or wrapping of disposable items l ike syringes. . The supervisor will ensure tha t rag pickers and other unwanted persons do not gain access to the waste stored there. adjacent to the generator room. The request will be made to the Municipal authorities to send the vehicle once in day without any failure. This waste is non toxic and non infectious. peels of fruits. Regular monitoring of the process shoul d be carried out by the engineers as per J&K Pollution Control Board norms and f eed back provided to officer incharge. and it is his/her responsibility to get the res pective trolleys/carts cleaned and disinfected. card boards boxes. Th e incinerator is maintained on contract basis by the Engineering services depart ment and is manned by a supervisor and workers. The process of deposition of the waste for autoclaving and shredding will also be documente d and a register will be maintained for the same. These general wastes should be put into black co loured polythene bags and are deposited at the municipal dump opposite to the mo rtuary. The functioning of the autoclave and shredder including the number of cycles per day will be maintained in a log tabl e and periodically monitored by engineers as per J&K PCB norms. It is the responsibility of the supervisor to ensure that rag pickers and other unwan ted elements do not rummage through the waste for re-using of disposables and pl astics. nursing station and treatment room of each w ard on push carts and garbage trollies. it is the responsibility of the h ospital security(Police/contractor) to ensure that rag pickers are not allowed e ntry into the dumps. From all the floors and wings. the waste collected in blue bags will be transported to the site of autoclaving and shredding for treatment. After the waste (in yellow colou red bags) is deposited in the custody of the supervisor. * Autoclaving and Shredding : Once the autoclave facility is installed in the hospital. It is subsequently collected by the local municipal authorities for disp osal every day. and the entire process should be documented. needles sets etc. and fr om there to the area near the incinerator/mortuary. prior to autoclaving and shredding. left over food articles. The functioning of the incinerator and the number of cycles operated per day should be documented in a log book. (F) Treatment and Disposal of Hospi tal Waste : * Civic Authorities : Most of the waste (about 80%-90%) generated in the hospital is general waste which is similar to the waste generated in house and offices. The ash produced by incineration should b e sent for secure land filling. * Extramural (external) transpor t : This will be required only for the general waste collected in the black colo ured plastic bags. the sanitation staff sh ould obtain a proper receipt. Any spillage or leakage should be reported t o Sanitation Inspector Incharge. However. opposite the mortuar y adjacent to the incinerator site. * Incineration : The waste collected in yellow coloured bag s is transported to the site of incineration. disposable and paper containers for t ea/coffee etc. The Sanitation Officer is responsible for proper co-ordination b etween municipal authorities and GMC..* Intramural (internal) transport : The sanitation staff from the centralised ga ng will be responsible for transporting the different coloured polythene bags in garbage bins from the sluice room. and comprises of paper. These bags will be transported in the vehicle by the Municipa lity authorities. The general waste (in black polythene bags) should be deposited at the municipal dumps.
Gaseous ra dioactive waste can be diluted through dispersal in the outside atmosphere. 4. Responsibility of chemical waste should be with the persons/staff using the chemicals and generating the waste. Concen tration and storage under strict supervision in a large drum/container till it h as decayed is principally used. therapeutic processes in Radiotherapy Depa rtment. urine and faeces can be handled as non-radioactive waste so long as the room is routinely monitored for radioactive contamination. GMC Hospital He has the overall responsibility for the form ulation and implementation of guidelines for hospital waste management and has t o ensure that waste is handled without any advance effect to human health and en vironment. (B) Function s of Hospital Waste Management Committee 1. tumour localisation. These applications of radioactive materials generate some solid radioact ive waste i. Pathology wi ll make one Faculty Member responsible for supervision of segregation in their a rea of activities. As the “occupier”. protective clothing etc. Unde r normal circumstances.* Radioactive Waste : Radioactive wastes are generated during the process of bod y organ imaging. Lab Services. To ensure the circulation of enough copies of Bio-Medical Waste Rules and guidelines for implementation of the same in Clinical Departments. absorbent paper. he is responsible for applying for grant of authorisat ion (in Form I) to the prescribed authority i. and with the nursing staff in case of routine cleaning. . and then discharged into drai ns/sewers where it is taken care of by the principle of dilution and dispersal. syringes. Microbiology.e. Nursing Professionals and Sanitation Profe ssionals. collection. To conduct training programmes for Medical Professionals. The radioactive material in liquid form (includi ng patients urine) are generally diluted and dispersed in the sewers. He is answerable to the higher authorities in the Ministry. storage and transport of waste from all the patient care areas. He is also responsible for submitting an annual report in Form II to the J&K Pollu tion Control Board (prescribed authority) by 31st January regarding information about categories and quantities of Bio-Medical Wastes handled during the previou s year. To procure the items req uired in this regard and make them available in all patient care areas. Each Clinical Department (Unit).e. 5. J&K Pollution Control Board. Blood Bank. vials. To hold meeting of the Hospital Waste Management Committee and form ulate the detailed plan of action in regard to segregation.ROLE OF PERSONNEL INVOLVED IN WASTE MANAGEMENT The following paras outline the roles and responsibilities of the various personnel in confirmation to the B io-Medical Waste Management (management and handling) Rules 1998:(A) Role of Med ical Superintendent. * Liq uid and Chemical Wastes : These wastes should be disinfected by chemical treatme nt using at least 1% sodium hypochlorite solution. The responsibility for proper disposal of liquid wastes lies with the sanitation supervisor in case of weekly “gang” cleaning of indoor patient care areas.” 3. To conduct “Awareness Programme”: Clinical combined/grand round will be held for making the Faculty and the Residents awar e of the “Biomedical Waste (Management & Handling) Rules’ 98. 2. The responsibilities of the individual professionals wi ll be highlighted in these guidelines. VIII.
With regard to the departments which generate radioactive w aste one of the consultants should be designated as Radiation protection officer and he will be responsible for implementation of the necessary guidelines.6. They will also be responsible for getting all s taff. demonstrations and behavioural science inputs. She will conduct surprise rounds and wil l review and evaluate the various aspects of scientific hospital waste managemen t at all levels from generation and segregation to final disposal. nurses. trained in hospital waste m anagement. paramedical staff. He will be the mem ber of the Hospital Waste Management Committee. Before the training is carried out the training needs t o be identified content varied accordingly.e. He w ill be responsible for circulation of all policy decisions and the hospital wast e management manual. it is mandatory to provide training to all categories of staff i. generation. segrega tion. They will be responsible for the formulation and implementation of waste management procedures for their departments in conformity with the general guid elines issued by administration. He w ill also provides feed back information to Officer Incharge Waste Management in case of accidents and spills. hospital and sanitation atten dants. who will be responsibl e for close monitoring of the activity. patient and their attendants. He will be responsible for monit oring the programme from time to time at various levels i. nurses. In each and every OT the sa me instruction of supervision will be followed and one Sister Incharge will be r esponsible. monitoring and evaluation of hos pital waste management from collection and storage of hospital waste to its fina l disposal. IX TRAINING ON HOSPITAL WASTE MANAGEMENT In order to be able to comprehend and implement the Bio-Medical Waste (Management and Han dling) Rules’ 1998. Floor wise one Nursing Sister (Nursing Supervisor) will be responsible for su pervision of segregation in the wards of each floor. operation of Bio-Medical Was te treatment facilities. He will be responsible for accident reporting in Form III t o the prescribed authority.e. (E) Role of Matron The Matron will designate one of the senior administrative level deputies as Sister Incharge of Hospital Waste Management. transportation and treatment including disposal. collection. He will attend the Hospital Waste Management Committee meetings and will ensure the training of the staff posted under him. Regular in-service train ing and evaluation of the sanitation attendants will be carried out by him. and will liaise with the Officer Incharge of waste management for adm inistrative support. resident doctors. Units/ Deptts. (D) Role of concerned Heads/Incharge of Labs. paramedics and group-D staff. doctors. (F) Role of I/c Sanitation Inspector The Incharge Sanitation Inspec tor will be responsible for the implementation. canteen staff. It should be interactive and should include awareness sessions. storage. reduction in use of disposa bles . She will also attend the meetings of Hospital Waste Management Committee on behalf of the Mat ron and co-ordinate the training of nurses on Hospital Waste Management with adm inistration. Infection Control Officer and Matron. It sh ould definitely include the following : (i) Awareness of different categories of waste and potential hazard (ii) Waste minimization. (C) Role of Officer Incharge of Waste Management The Officer Incharg e of waste management will be incharge of implementation and will liaise with th e Heads of Departments.
16-18 Jaipur. Anand R. 3. Do immunise all waste handlers...K. Draft Bio-medical wastes (Management a nd Handling) rules 1998. Aggarwal R. Do collect waste in color coded containers/bags : (a) Yello – Infectio us waste for incineration. 7. Legal and administrative requirements in management of Hazardous Waste.O. 1983 . gum boots to transporters and handlers. AIIMS. Do use syringe and needle destroyer. Hospital Waste Manag ement–A holistic approach. Problems in community wast e management.W. Euro Report and Studies No . Do decontaminate all sharps and plasti c waste by chemical/autoclave. 3.K. 1998 Apr. Govt. Report of high power committee on Urban based Waste Management. 5. New Delhi. 2. Proceedings of National Workshop as Management of hospi tl waste. 1998 Jul y 1(2). IIRD and Shristi 1998.. 97 WHO. *(1) . gloves. of I ndia. Huisman J. Geneva 1969. Public Health Paper. J uly 1995. . New Delhi. 1996 7(2). 38 W. Journal of Academy of Hospital Administration. 1-61. Management of Waste from Hospitals and other health care establishments. 55-7. 9. Journal of Academy of hospital Administration. 6. Satpathy 1998 edition. Module on Hospital Waste Management by Sulabh Internat ional Institute of Health and Hygience. Do transport through covered trolleys/wheel barrows. Manag ement of Hospital Waste. WHO Regional Publication No. Gazette of India Extraordinary. 8. Do segregate waste at point of generation to : (a) Infection (b) Non-Infectious/Garbage (c) Sharps/ Needles. (b) Black – Garbage for dumping in municipal bin.N. 1985 . 7. (c) B lue (inner perforated) – Sharps/needles.(iii) Segregation policy (iv) Proper and safe handling of sharps (v) Use of prot ective gear (vi) Colour coding of containers (vii) Appropriate treatment of wast e (viii) Management of spills and accidents (ix) Occupational health. Hospital Waste Management . 6. Do shred plastic waste (cul all tubings into p ieces by scissors). plastic aprons. Sarma R. S. Jain T. Hospital Waste Mana gement. 25-35 . 35-47. 4. A holistic view. 10. Points to remember for Waste Management in the Hospital 1. Mathur S. Jan. 9.H. Part II Section 3 Sub-s ection (ii) dated 27th July. Book published by Department of Hospital administration. 2. Issues involved in Hospital Waste Management : an experience fro m a large teaching Institution.. Basu R. Planning Commission. 8. 4. Do incinerate blo od soaked dressings/body parts etc.J.P.C. 14. No. 7983. 1995 . Do cover waste collection containers. Do provide protective we ar (mask. 10. References : 1. Suess M. 1998. 5.
6. Wear appron and boots if spla shing is expected. Don’t use open buckets for infe ctious waste or sharps. 2. Don’t incinerate plastic waste. Do’s and Dont’s for Chemica l Treatment 1. Proper concentration is essential. Do handle with gloves and mask. Don’t chemically treat incinerable waste. Don’t recap the needle or bend or break needles by hand. Do use 1% hypochlo rite or equivalent disinfectant. 3. Do change chemical solutions frequently (wit h every shift). Don’t throw sharps in the trash or into non-puncture proof containers. 6. 3. Do let the con tact time be atleast 30 minutes. Don’t mix the infectious with n on-infectious waste. 5. Don’t allow unauthorised pe rsons access to waste collection/storage areas. 2.Dont’s for handing and Disposal of Hospital Waste 1. 4. Don’t fi ll the waste container more than 3/4th of capacity. 7. . 5. 4. 7. Do apply to sharp or infectd plastic waste. Do ensure all surfaces come in contact with chemical (including lumen).
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