A

PROJECT REPORT

ON

“ A STUDY TO ASSESS THE KNOWLEDGE REGARDING BIOMEDICAL WASTE

MANAGEMENT AMONG STAFF NURSES IN SELECTED AREAS OF DR.D.Y PATIL

HOSPITAL,PUNE ’’

SUBMITTED T0

INSTITUTE OF DISTANCE LEARNING

Dr. D.Y .PATIL VIDYADEETH, PUNE

IN PARTIAL FULFILMENT OF DEGREE OF MASTERS OF BUSINESS

ADMINISTRATION

BY

MS SIYONA SANJAY BANSODE

PRN: 2105021604

BATCH – JULY 2021-JULY 2023

 CERTIFICATE

To whomsoever it may concern

This is to certify that Ms Siyona Sanjay Bansode PRN: 2105021604

has completed her internship at Dr.D.Y Patil Hospital, Pune starting from 1ST April to 31st
May.

Her project ‘A study to assess the knowledge regarding biomedical waste management
among staff nurses in selected areas of Dr.D Y Patil Hospital,Pune” was a part of the MBA
(distance learning) 2021-2023 and development tasks. The project is about assessing the
knowledge regarding biomedical waste management among staff nurses in selected areas of
Dr.D Y Patil Hospital, Pune and includes research as well as industry practices. He was very
sincere and committed in all tasks.

We wish him all success in future endeavors.

Course Coordinator Director

Examined by: 1) ______________ 2) ________________

Date:-
 Dr. D. Y. Patil medical college, Hospital and

Research Center, Pimpri, Pune.

To

THE DEAN

Dr. D. Y. Patil Hospital,

Pimpri, Pune

SUBJECT: - PERMISSION TO CONDUCT A STUDY FOR THE DISSERTATION

SIR, MADAM,

This is for your kind information that Ms. Siyona Sanjay Bansode MBA student of
Dr. D.Y Patil institute of Distance learning is permitted to conduct research on hospital staff
as partial fulfillment of MBA Course.

Topic: A study to assess the knowledge regarding Biomedical waste management among
hospital staff in selected area of Dr. D.Y Patil Hospital, Pune.

Thanking You

Yours Faithfully
 DECLARATION BY STUDENT

This is to declare that I have carried out this project work myself in part fulfillment of the
M.B.A (Hospital administration and health care Management) Programme of institute of
Distance Learning of Dr.D.Y.Patil Vidyapeeth’s, Pune – 411018

The work is original, has not been copied from anywhere else and has not been submitted to
any other University / Institute for an award of any degree / diploma.

Date: - Signature:-

Place: Name: Ms Siyona Sanjay Bansode

 ACKNOWLEDGEMENT

It is something beyond one’s human ability to put words one’s sincere feeling of
gratitude to those whom one owes something.

Firstly I am grateful to Almighty God whose grace, unconditional love and blessings
accompanied me throughout and support of Dr. J S Bhawalkar, Faculty, and Dept. Of P.S.M
at Dr.D.Y. Patil Medical College Pimpri. It was a privilege to be guided by him.

I take this opportunity to sincerely express my gratitude; devotion & regards for my
esteemed guide for her continuous guidance, sustained patience, valuable suggestions &
timely support from the inception till completion of the study

My sincere & whole hearted thanks to the Medical Superintendent Dr. D.Y. Pati
Hospital, Pimpri, Pune for extending their constant support & granting me permission to
conduct the study.

I also express my gratitude to my parents & all the friends who were a constant source of
inspiration. They have been supportive & helpful to me throughout the study, without them I
would not have been able to complete this study.

This effort in my academic endeavor would not have been a reality but for the
constructive and purposeful support, guidance and encouragement rendered by a number of
persons, whose help I specially recognize through this acknowledgement.

The proverb that ‘One can never make alone’ could never be truer than in this
situation. I have so many well-wishers that I find it impossible to name them all, however,
deep down in my heart; I will always remember each & every one for their contribution.

Ms Siyona Sanjay Bansode

i
 ABSTARCT

The main of the study was to asses the knowledge regarding biomedical waste management

among staff nurses in selected areas of Dr.D Y Patil Hospital, Pune.

Objectives of the study were;

 To asses the knowledge level regarding biomedical waste management among staff

nurses in selected areas of Dr. D Y Patil Hospital, Pune.

 To determine the association between level of knowledge regarding biomedical waste

management and the selected demographic variables

The researcher adopted the non experimental descriptive design. The sample comprised of 30

staff nurses from Dr D Y Patil Hospital, Pune and were selected using non probability

purposive sampling technique. Data was collected using a structured questionnaire on items

regarding biomedical waste management. Descriptive and inferential statistics were

employed and data was analyzed and interpreted.

The study concluded that Half (50%) of the staff nurses had average knowledge (score 7-13),

26.7% of them had poor knowledge (score 0-6) and 23.3% of them had good knowledge

(score 14-20) regarding biomedical waste management. Staff training activity like continuing

nursing education, workshops and seminars on the concerned topic should be undertaken.

Also periodic assessment through competency matrix and evaluation is required.

ii
 TABLE OF CONTENTS

Chapter No Detail / Description Page No

Title Page 1

Institute Certificate 2

Company Certificate 3

Declaration by Student 4

Acknowledgement 5

INDEX

1 Executive Summary**

2 Introduction

3 Objective and Scope / Purpose of Study

4 Suggestions / Recommendations

5 Conclusions

6 Bibliography

iii
Sr. No Content Page No

I Acknowledgement i

II Abstract ii

III Table of content iii-vi

CHAPTER I

INTRODUCTION

1) Background of study 2-3

2) Need of the study 4-7

3) Statement of the problem 7

4) Objectives of the study 8

5) Operational definitions 8-9

CHAPTER II

REVIEW OF LITERATURE

6) Review related to biomedical waste management 10-13

7) Review related to knowledge regarding biomedical waste 13-16

management among staff nurses

CHAPTER III

RESEARCH METHODOLOGY

8) Research approach 17

9) Research design 17

10) Setting of the study 17-18

11) Population 18

12) Sample 18

13) Sample size 18

14) Sampling technique and criteria 18-19

15) Data collection technique and tool 19-20

16) Development of tool 20

17) Description of the tool 21

18) Validity 21

19) Reliability 22

20) Pilot study 22

CHAPTER IV

ANALYSIS AND INTERPRETATION OF DATA

21) Organization of the data 24

22) Description of sample (staff nurses) based on personal 25-30

characteristics

23) Analysis of data related to the knowledge level regarding 31-33

biomedical waste management among staff nurses

24) Analysis of data related to association between level of knowledge 34

regarding biomedical waste management and selected demographic

variables

CHAPTER V

FINDINGS, DISCUSSION, SUMMARY & CONCLUSION

25) Findings 35-37

26) Discussion 37-38

27) Summary 38-39

28) Conclusion 39

29) REFERENCES 40-42

v
SR. NO CONTENT PAGE NO

1 Description of sample according to age by percentage 26

2 Description of sample according to gender by percentage 27

3 Description of sample according to education by 28

percentage

4 Description of sample according to years of experience by 29

percentage

5 Description of sample according to knowledge level 31

regarding biomedical waste management among staff

nurses

LIST OF FIGURES

vi
 LIST OF TABLES

SR.NO CONTENT PAGE NO

1 Description of sample (staff nurses) based on personal 25

characteristics in terms of frequency and percentages

2 Knowledge level regarding biomedical waste management 30

among staff nurses

3 Item analysis-knowledge level regarding biomedical waste 32

management among staff nurse

4 Association between level of knowledge regarding 34

biomedical waste management and the selected demographic

variables
CHAPTER I

1
 CHAPTER I

INTRODUCTION

All human activities and living thing on earth produce waste in some form or the

other. Normally, aerobic and anaerobic process in the environment degrades such products.

These waste, both biodegradable and non-biodegradable hardly had any impact on the

environment until the invention of plastics by the modern man. The process of natural

degradation could not keep pace with the increase in waste generated by the over increasing

population of mankind and its necessities. The air, water, and land are today becoming

disposal sinks for the waste.

Waste is a useful to first user but with its transportation after use, some of the waste

items are useful to subsequent users. If subsequent utilization is harmful, waste should be

removed with such precautionary measure keeping it out of reach for others but, the trouble

comes throw away society.

Hospitals produce a verity of wastes that can be utilized as a resource after recycling

it properly. Comprehensive recycling and waste minimization programme can decrease, the

financial burden on facilities and at the same time systematic waste management practices

can helpful to save the environment.

Waste reduction strategies go beyond recycling which comes into play only at the end

of a products of lifecycle. Good strategies have first place. This involves switching to less

wasteful practice & using products that are non polluting. All waste can be used as resources

through recycling or composing. A good segregation system in the hospital, therefore, helps

in generating extra resources.

 The hospital medical waste is responsible for serious health hazards. Though the

persons involved in this aspect the existing status of biomedical waste management cannot be

said satisfactory due to many shortcomings and constrains. No specific guidelines and

parameters are being followed or implemented by the staff concerned. They are poorly

educated guidance and supervision is poor.

Some hospital waste generated are too hazardous to be treated negligently and if any

carelessness is followed by the management of these wastes it is a hospital that tends to

spread infection and contamination of the entire living environment prevailing in the hospital.

The delay in the recovery and overburden for weak patients. It affect the most of the

patient’s survival and also generate health hazards to working personnel in & around the

hospital environment.

Now today nursing is considered as a professional discipline that includes the art of

applying scientific knowledge to practice.

 Background of the study

The hospital generated waste is concerned by the growing problem of the disposal of

waste. Though generate large amount of medical wastes each year. Surprisingly until recent

days not enough very much of attention. Was paid to the disposal of hospital waste. Proper

disposal of health care waste is of paramount importance because of its infections and

hazardous characteristics. Some of the specific problems of improper waste management.

 Organic portion, of health care waste ferments and attracts fly breeding, which may

increase the risk of infection of waste handlers, and (eventually) the general public.

 Poor management can increase risk of infections to medical, nursing and other hospital

staff.

 Injuries from sharps can results to all categories of hospital personnel and waste

handlers.

 Poor waste management and poor infection control can lead to noscomial infections in

patients.

 Increase in risks associated with hazardous chemicals & drugs being handled by

persons handling waste at all levels.

 Poor hospital waste management encourages disposable being repacked and sold

without proper disinfection.

 Poor management practices can lead to disposed drugs being repacked and sold.

The Government of India has promulgated the Bio-chemical waste management &

handlings rules, 1998. These are a welcome step towards improving the overall waste

management of health care units in India. These waste management of health care units in

India. These rules are applicable to all persons who generate, receive, store, transport, treat,
dispose or handle bio-medical waste. These rules are also applicable to any institution

generating bio-medical waste including hospitals, nursing homes, clinics, dispensaries

veterinary institution, animal houses, pathological laboratories and blood bank, or authorities

in charge of these institutions.

 Need for the study

Nursing as a profession is now accountable of staff and students nurses for competence and

performance. The nurses spend maximum time with patients in the ward than any other

member of the health team, increases their exposure and risk to the hazards present in

hospital environment, mainly biomedical waste they need to be well equipped with latest

information, skills and practice in managing this waste besides reducing hospital acquired

infections to protect their own health they are also responsible for preventing risk due to

waste to the other members of health team and community at large.

Nursing as a profession is now accountability of staffs and students, nurses, for

competence and performance this has seen the birth of the language of “outcomes” outcomes

is a mechanism to evaluate quality, improve effectiveness and risk practice to professional

accountability.

Many health care wastes poses a serious public health problems. The main causes are

improper disposal of health care waste aesthetically damages the environment and however

the transmission modes of agents associated with blood born diseases are still not understand

therefore the disposal of health care waste and their potential health care impact are important

public health issue. In the past 10 years, due to the increased numbers and size of health care

facilities, medical services and use of medical disposable products, the generation rate of

health care wastes has increased rapidly. So now it has become important to provide

information on the hazards and practices of management of health wastes for formulating

policies, enacting legislation and developing technical guideline.

So many our hospitals have neither a satisfactory waste disposal system nor a waste

management and disposal policy. The disposal of waste is entrusted to junior most staff from

the housekeeping department without any supervision. Even pathological waste are observed
to be disposed off in the available open ground around hospitals with scanty regards to

aesthetic and hygienic considerations.

In the study pattern of waste in India cities, the equinity of refuge varied from 0.48 to

0.06 kg/capital/day. On an average the volume of total solid waste generated is Indian

hospitals is estimated to range between 1 kg to 3 kg.

Health care waste management is India is receiving greater attention due to recent

regulations of BMW management and handling rules,1998. The prevailing situation is

analyzed covering various issues like quantities and preparation of different constituents of

waste, handling treatment and disposal methods in various health care units (HCVS). The

waste generation rate ranges between 0.5 and 2.0 kg/bed/day. It is estimated that annually

about 0.33 million tones of waste are generated in India. The solid waste from the hospitals

consist of bandages, linens and other infectious waste 30-35 % plastics, 7-10% disposable

syringes 0.3-0.5 % glass 3-5 % of other general waste including food of 40-45 %. In general

the waste are collected in a mixed form transported and disposed of along municipal solid

waste. At many places authorities are failing to install appropriate system for a verity of

reasons, because of non availability of appropriate technologies, inadequate financial

resources and absence of professional training on waste management and one of the reasons

is lack of staff educational programme.

The WHO study was conducted on health care waste has estimated that, the total

waste generated in health care facilities, about 85% of the hospital waste are actually non

hazardous, 10% are infective hence, hazardous and the remaining 5% are non-infectious but

hazardous. In the use for example, about 15 % of hospital waste are regulated as infectious

waste. In India this could range from 15 to 35% depending on the total amount of waste

generated BAN and HCWH. 1999. Based on these estimates the total health care waste
generated as per 1993 date can be taken as 544040 tones/ annum and hazardous waste can be

taken as 27,202 tons/annum. A proper waste segregation scheme for separating hospital waste

into infectious and noninfectious categories is thus desired.

The biomedical waste has become a serious health hazard in many hospitals. The

waste has been disposed off illegally in to the garbage and into the severs in most of the parts

of the world including India. In many places, the waste is disposed carelessly and

indiscriminate disposal of this waste by healthcare. So many hospitals waste spread serious

disease such as hospitals and AIDS(HIV) among though who handle it and also among the

general public the waste disposal is at generator site and nurses are highly responsible for

biomedical waste management they play a leading role in managing and supervising hospital

waste.

Nurses are the largest occupational group in any health care agency. By virtue of their

job responsibilities they are frequently exposed to biomedical waste. The nurse’s risk of

exposure to health hazard and the nurses as a cause of cats organic infection to the patients

are equally challenging issues to the nurses all over the world of only the Nurses are aware of

the risks and proper management techniques they can effectively handle the same challenge.

Early recovery of patents and health of hospital staff depends on clean healthy and safe

hospital atmosphere. Thus the researcher felt it as a need to educate the staff nurses

regarding bio-medical waste management as an effective strategy to improve the prevailing

health care.

Health and safety of the nursing staff is cardinal feature of biomedical waste

management. The medical superintendent or head of institute must provide training to

strengthen their skills for safety. Although biomedical waste management can’t be achieved

without the co-operation of each and every worker and patient, however, nursing personnel

play a significant role is this whole process. They need to be informed about current available

technology and safe practices among all health care staff need to be strengthened.

My need for the study of the waste management also found that the present awareness

among health personnel is poor regarding biomedical waste management and imparting

training do improve their attitude knowledge practices. The waste management is needed to

be well equipped with latest information skill and practices in managing this waste besides

reducing hospital acquired infections to protect.

Staff nurses are thus challenge to assimilate knowledge and develop critical thinking

skills necessary to apply that knowledge on self protection practices, the knowledge of the

current prevention and control measure can assist the staff nurses in educating the patients

and family, students nursing, regarding the mode of waste management they can apply self

protection and prevention measure in the daily working in hospital the biomedical waste

cross infection can be prevented by careful self-protection attitude practices. So the

researcher felt that is need to assess the self-protection attitude knowledge and practices

followed by the staff nurses in daily working hospital.

 Problem statement

A study to assess the knowledge regarding biomedical waste management among staff nurses

in selected areas of Dr. D Y Patil Hospital, Pune.

Objectives of the study

 To assess the knowledge level regarding biomedical waste management among staff

nurses in selected areas of Dr. D. Y Patil Hospital, Pune.

 To determine the association between level of knowledge regarding biomedical waste

management and the selected demographic variables

Operational definitions

1. Assess

According to dictionary;

Evaluate or estimate the nature, ability or quality of

In this study;

Assess refers to the process of evaluating the ability of or level of knowledge regarding

biomedical waste management.

2. Level

According to dictionary;

A horizontal plane or line with respect to the distance above or below point
In this study;

Level refers to the extent of knowledge demonstrated by the staff nurses as measured by

structured questionnaire.

3. Knowledge

According to dictionary;

It is information, understanding or skill obtained from experience or education.

In this study;

It refers to the responses given by staff nurses in the aspect of the questionnaire regarding

biomedical waste management.

4. Biomedical waste management

According to dictionary;

It refers to any waste which is generated during diagnosis, treatment or immunization of

human beings, animals and research activities.

In this study;

It refers to any waste which is generated during diagnosis, treatment or immunization of

human beings and research activities in the selected area of Dr DY Patil Hospital.

5. Staff Nurse

According to dictionary;

A professional individual holding qualification in terms of statutory regulations according to

national or state legislation regarding nursing practice involved in caring for general well-

being of patients.

In this study;

Same as above
CHAPTER II
 CHAPTER II

REVIEW OF LITERATURE

Review of literature is regarded as preparatory stage for gathering data, which serves

to acquire the researcher with previous research findings on the topic under study. A review

of literature is a compilation of resources that provide the ground work for further study. It is

frequently found as a sub section of a published research study.

The investigator carried out an extensive review of literature on the research topic in

order to give deeper insight into the problem and to collect maximum relevant information

for building the foundation of the study.

In order to collect the information the investigator used online resources like websites

and also latest books and journals. Review was done on the research and non-research

literature.

In the present study review of literature is organized under the following:

 Review related to biomedical waste management

 Review related to knowledge regarding biomedical waste management among staff

nurses

Review of literature related to biomedical waste management

The study was conducted in hospital waste management awareness and practice

Andhra Pradesh, Maharashtra and Uttar Pradesh in Hospitals/nursing homes and private

medical practitioners in urban as well as rural areas and those from the private as well as the

government sector were covered. Information on (a) awareness of bio-medical waste

management rules, (b) training undertaken and (c) practices with respect to waste

management. Awareness of Bio-medical Waste Management Rules was better among

hospital staff in comparison with private medical practitioners and awareness was

marginally higher among those in urban areas in comparison with those in rural areas. About

70% of the healthcare facilities used a needle cutter/destroyer for sharps management.

Access to Common Waste Management facilities was low at about 35%. Dumping

biomedical waste on the roads outside the hospital is still prevalent and access to Common

Waste facilities is still limited.1

A study was carried out bio-medical waste management in the U.T. Chandigarh to

assess the generation and disposal of biomedical waste in the various medical establishments

in the urban and rural areas of the U.T. Chandigarh. It was found that there were 474 medical

establishments in the U.T., Chandigarh including Nursing Homes, Clinics, Dispensaries,

Pathological labs, Hospitals, Veterinary Institutions and Animal houses. The total quantity of

bio-medical waste generated in Chandigarh is 811.35 kg/day and the rate of generation of

bio-medical waste varies from 0.06 kg/day/bed to 0.25 kg/day/bed. Though the major

hospitals are equipped with incinerators, proper bio-medical waste management system is yet

to be implemented. The medical establishments in the rural area and smaller ones in the urban

area dispose off their bio-medical waste along with municipal solid waste and no waste

management system exists.2

A study was conducted Bio-medical solid waste management in an Indian Hospital to

assess the waste handling and treatment system of hospital bio-medical solid waste and its

mandatory compliance with Regulatory Notifications for Bio-medical Waste (Management

and Handling) Rules, 1998, under the Environment (Protection Act 1986), Ministry of

Environment and Forestry, Govt. of India, at the chosen KLE Society's J. N. Hospital and
Medical Research Center, Belgaum, India and (ii) to quantitatively estimate the amount of

non-infectious and infectious waste generated in different wards/sections. During the study, it

was observed that: (i) the personnel working under the occupier were trained to take adequate

precautionary measures in handling these bio-hazardous waste materials, (ii) the process of

segregation, collection, transport, storage and final disposal of infectious waste was done in

compliance with the Standard Procedures, (iii) the final disposal was by incineration in

accordance to EPA Rules 1998, (iv) the non-infectious waste was collected separately in

different containers and treated as general waste, and (v) on an average about 520 kg of non-

infectious and 101 kg of infectious waste is generated per day (about 2.31 kg per day per bed,

gross weight comprising both infectious and non-infectious waste).3

A study conducted on awareness and training need of bio-medical waste management

among undergraduate student. Here in this study I have seen that 463 undergraduate students

216 males and 247 females of ASRAM medical waste management. Most of the students

have heard about biomedical waste. Some of them were aware that it causes health hazards.

But knowledge about category of wastes duration of waste storage responsibilities of waste

type of bags used for collection identification of bio hazard symbol was poor. Awareness of

biomedical waste management and handling rule 1998 was also poor. These were gaps in

various aspects of BMW management among medical students appropriate training or

inclusion of a topic in undergraduate medical curriculum can fulfill this.4

A study was conducted on health care waste management in India. In this study has

shown several operational plans and is receiving greater attention to recent regulation rules

1998. The waste generation rate ranges between 0.5 & 2.0 kg bed-one-day-one. It is

estimated that annually about 0.33 million tones of waster are generated in India. The solid

waste from the hospitals consist of bandages, liner and other infections waste 30-35% plastics
7-10 % disposal syringes 0.3-0.5% glass (3.5%) and other general waste including food 40-

45% in general the waste are collected in a mixed from transported and disposal of along

municipal solid wastes. The rules for management and handling of bio-medical waste are

summarized giving the categories of different waste suggested storage containers including

colour coding and treatment options existing and proposed system of health care waste

management are described waste management plan for health care establishment is also

proposed appropriate technologies, appropriate staff training programmes.5

Review of literature related to knowledge regarding biomedical waste management

A study was conducted to assess Knowledge, Attitude and Practices (KAP) about

Biomedical waste (BMW) management among nursing, technical and housekeeping staff.

The study was conducted in the private hospitals and nursing homes in Karimnagar town of

Andhra Pradesh. There are approximately 267 private hospitals, and clinics. By a systematic

random sampling method, 47 private hospitals were selected and study was performed on 500

study subjects. The KAP of the nursing, technical and the house keeping staff of the

concerned hospitals. Analysis of data was done by using various statistical measures i.e.,

percentage, Chi-square test. The data was collected from 47 Private hospitals having 237

nurses, 131 technicians and 132 housekeeping staff. Assessment of knowledge regarding

BMW Management among study subjects reveals that 95.8% of subjects had knowledge

about the health hazards. Only 1.6% of study subjects had knowledge about the 10 categories

of BMW. It is also found that 47.2% of Nurses, 26.4% of Technicians and 26% of

housekeeping staff were having positive attitude towards BMW management (P<0.05,

significant). Study also reveals that 45.4% Nurses, 25.8% Technicians and 13.8% of

Housekeeping staff are practicing / following BMW management rules (P<0.05, significant).6
 A study was conducted to assess the knowledge of bio medical waste management

among nursing personnel at G T P Hospital Delhi. 30 samples were randomly selected and

data collection was done using a structured questionnaire. The findings showed that 66.6% of

the staff nurses aware about the generation of bio medical waste and 77.5% aware about the

categorization and segregation.92.22% of the staff nurses aware about the transport and

66.66%aware about the treatment and final disposal of bio medical waste and 70% aware

about the needle disposal.99.66% of the nursing personnel desired the hospital authority to do

more regarding the awareness of bio medical waste management.7

A Cross Sectional study was conducted on development of a waste management

protocol based on knowledge and practice of health personnel at Almansoura university

hospital Egypt. 200 samples were taken for the study and data collection was done using a

self administered questionnaire for nurses and doctors and an interview questionnaire for

house keepers. Observation checklist was used for assessment of the performance. The result

was only 27.4% of the nurses, 32.1% of housekeepers and 36.8% of the doctors had

satisfactory knowledge. Concerning practice, 18.9%of the nurses, 7.I % of the house keepers,

and none of the doctors had adequate practice. Nurses knowledge score had a statistically

significant weak positive correlation with the attendance of training courses(r==0.23,

p<0.05). The majority of the doctors, nurses, and housekeepers have unsatisfactory

knowledge and inadequate practice related to health care waste management. The knowledge

among nurses is positively affected by attendance of training programs. Based on the

findings, a protocol for healthcare waste management was developed and validated. It is

recommended to implement the developed waste management protocol for the surgical

departments in the designed hospital, with establishment of waste management audits.8

 A study on biomedical waste management awareness and practices in the districts of

Madhya Pradesh. The aim was to assess the awareness and existing practices regarding

biomedical waste and its management. It was carried out both rural and urban health care

facilities of smaller district from January to June 2008. Medical, paramedical, non medical

personnel working at the current position for at least 6 months were included the study

participants to assess the awareness. The results showed that awareness regarding biomedical

waste management was highest among doctors followed by paramedical staff and least

among non medical staff. The study concluded that regular orientation and reorientation

training programs should be organized for hospital staff and strict implementation of

guidelines of biomedical waste management to protect themselves and hospital visitors.9

A study was conducted to assess knowledge, attitude, and practices of doctors, nurses,

laboratory technicians, and sanitary staff regarding biomedical waste management. This was

a cross-sectional study. The study was conducted among hospitals (bed capacity >100) of

Allahabad city. Medical personnel included were doctors (75), nurses (60), laboratory

technicians (78), and sanitary staff (70). Results shows that Doctors, nurses, and laboratory

technicians have better knowledge than sanitary staff regarding biomedical waste

management. Regarding practices related to biomedical waste management, sanitary staffs

were ignorant on all the counts. The study concludes that importance of training regarding

biomedical waste management needs emphasis; lack of proper and complete knowledge

about biomedical waste management impacts practices of appropriate waste disposal.10

A study was undertaken to assess the Biomedical waste(BMW) management

practices in a tertiary care, teaching hospital of Ludhiana, Punjab. A 10% sample was

selected randomly from each of the 3 categories of staff comprising 476 doctors, 378

nurses and 142 paramedical staff, on rolls. A semi-structured questionnaire was used to
obtain information from respondents. The study showed gaps in the knowledge of all three

categories of respondents. The knowledge of the existence of the BMW Management

Rules 1998 was better in doctors than in the nurses or the paramedical staff, but

knowledge of the practical aspects of BMW management was better in nurses and

paramedical staff. The BMW management practices in the hospital were satisfactory,

except for a deficiency in supply of needle-cutters in 40.9% wards. 11

CHAPTER III
 CHAPTER III

RESEARCH METHODOLOGY

A research methodology defines as the steps, procedures and strategies for gathering

and analyzing the data in a research investigation.

This chapter deals with the methodology adopted for assessing the effect of mindful

breathing on menopausal symptoms. It includes the description of the research approach,

research design, setting of the study, sample and sampling technique, development of the data

collection tools, procedure for data collection and the plan for data analysis.

Research approach

The present study aims at assessing the knowledge of nurses regarding biomedical waste

management hence the investigator has adopted the evaluative approach.

Research design

The Research Design is the plan, structure, and strategy of investigation of answering

the research question. It is the overall plan.

In the present study the investigator selected the non experimental descriptive design.

The purpose of this design is to observe, describe and document aspects of the situation as it

occurs. In this study the level of knowledge is assessed.

 Setting of the study

‘Setting’ refers to ‘the areas where the study is conducted.’16

The setting for this study was the selected areas of Dr. D. Y. Patil Hospital.

The rationale for selection of these areas is their geographical proximity, economy in

terms of time; easy transportation facilities, administrative approval, cooperation, and

fulfilled criteria of sampling technique which helped in maintaining the homogeneity.

Population

Population refers to a total category of persons or objects that meets the criteria for

the study established by the researcher, any set of persons, objects or measurements having

an observable characteristics in common.

Population in this study comprises of staff nurses working in Dr DY Patil Hospital,

Pune.

Sample

Sample refers to the representative unit of population under study.

Sample for this study consists of staff nurses working in selected areas of Dr DY Patil

Hospital, Pune.

Sample size

Sample size is the number of subjects needed in sample.

The sample size for this study was 30.

 Sampling technique

Sampling is the process of selecting representative units of the population under

study.

Purposive Sampling Technique indicates the selection by design by choice, not by

chance. In Purposive Sampling a sample is chosen which is thought to be typical of the

universe with regard to the characteristics under investigation.

A Non Probability Purposive Sampling Technique was used for this study. It is also known as

judgmental sampling is a type of non probability sampling in which the subjects are selected

because they are identified as knowledgeable regarding the subjects under investigation.

Sampling criteria

Inclusion criteria

Staff nurses who are working in Dr DY Patil Hospital, Pune.

Nurses who are willing to participate in the study

Exclusion criteria

Nurses with higher qualification than B.Sc nursing

Nurses who are not willing to participate in the study

Data collection technique and tool

The various techniques of data gathering involves the use of appropriate recording

forms. These are called as tools or instruments of data collection. Information gathered

through the tools provides the description of characteristics of individual’s institutions or

other phenomenon under study. The characteristics may help to explain differences in

behavioral patterns and performances of the objects under study.

Data collection techniques are described as being both objective and systematic.

Objective means that data must not be influenced by anyone who collects the data. Whereas

systematic means the data must be collected in the same way by everyone who is involved in

data collection process.

The present study aimed at assessing the level of knowledge among staff nurses

regarding biomedical waste management. Thus a structured questionnaire was developed.

Development of tool

The tools of data collection translate the research objectives into specific questions/

items, the responses which will provide the data required to achieve the research objectives.

In order to achieve this purpose, each question must convey to the respondent the idea or

group of ideas required by the research objectives, and each item must obtain a response

which can be analyzed for fulfilling the research objectives. An instrument in research refers

to the tool or equipment used for data collection or may take the form of questionnaire or

interview schedule.

An instrument selected for research should be as far as possible the vehicle that would

best obtain data for drawing conclusions, which are pertinent to the study. Based on the

objectives of the study, a structured questionnaire was developed. It is considered to be an

appropriate instrument.

For the selection of the items and tool, the following aspects are taken into

consideration:

 An extensive review of literature was done in the area related to biomedical waste
 management.

 Opinions and suggestions were taken from the experts, which helped in determining the

important areas to be included.

Description of the tool

Section I

This includes information regarding the demographic profile of the respondents. The items

included; age, gender, educational qualification, years of experience.

Section II

This section includes the structured questionnaire regarding biomedical waste management. It

consists of 20 multiple choice type questions. Knowledge levels were scored as;

Poor: 0-5

Good: 6-10

Average: 11-15

Excellent: 16-20

Validity

Validity refers to the degree to which an instrument measures what it is supposed to

measure. Content validity is concerned with the sampling adequacy of the content area being

measured. Content validity is of special relevance to individuals designing a test to measure

knowledge in a specific content area. The content validity of an instrument is based on

judgment. Experts in the content area may be called on to analyze the items.

Reliability

The reliability of an instrument that yields Quantitative Data is a major concern for
assessing its quality and adequacy. Essentially the reliability of an instrument is the degree of
consistency with which it measures the attribute it is supposed to be measuring. The
reliability of a measuring tool can be assessed in several different ways.

Reliability was assessed using test re-test method for knowledge section and inter-
rated method of reliability for practice section.

The test re-test reliability was used for Structured Questionnaire. The researcher
administered the same Structured Questionnaire test to 10 staff nurses working in Dr.D.Y.
Patil hospital on two occasions with an interval of 30 minutes and then compared the scores
obtained. The comparison procedure was performed objectively by computing a reliability
coefficient, which is numerical index of the magnitude of the test’s reliability. For knowledge
section, reliability was assessed using test-retest method. Pearson’s correlation coefficient
was found to be 0.98.

Pilot study

The pilot study is a small-scale dress rehearsal that proceeds as if it were the actual

study except for the fact, that the subjects who will participate in the actual study are not

used. The primary objective of the pilot study is to test as many elements of the research

proposal as possible in order to correct any part that does not work properly. It is advisable to

carry out the pilot study in order to minimize the possibilities of major difficulties. The pilot

study was conducted in Bhosari Hospital from 10/10/15 to 15/10/15 on a selected sample of

10 staff nurses.
CHAPTER IV
 CHAPTER IV

ANALYSIS AND INTERPRETATION OF DATA

The analysis is defined as the categorizing, ordering, manipulating and summarizing of

data to obtain answers to research questions. The purpose of analysis is to reduce the data to

intelligible and interpretable from so that the relation of research problems can be studied and

tested.

This chapter presents the analysis and interpretation of the data collected to assess the

knowledge regarding biomedical waste management among staff nurses. The data was

analyzed according to objectives of study, which were:

 To assess the knowledge level regarding biomedical waste management among staff

nurses in selected areas of Dr. D. Y Patil Hospital, Pune.

 To determine the association between level of knowledge regarding biomedical waste

management and the selected demographic variables.

Organisation of the data

The collected data was tabulated, analyzed, organized and presented under the

following headings:

Section I: Description of samples (staff nurses) based on personal characteristics.

Section II: Analysis of data related to the knowledge level regarding biomedical

waste management among staff nurses.

Section III: Analysis of data related to association between level of knowledge

regarding biomedical waste management and the selected demographic

variables.
 Section I

Description of samples (staff nurses) based on personal characteristics

Table 1: Description of samples (staff nurses) based on personal characteristics in terms

of frequency and percentages

N=30

Demographic Freq %
variable
Age
21-25 years 9 30.0%
26-30 years 11 36.7%
31-35 years 4 13.3%
36-40 years 6 20.0%
Gender
Male 5 16.7%
Female 25 83.3%
Education
GNM 6 20.0%
PB B.Sc 16 53.3%
B.Sc. Nursing 8 26.7%
Years of experience
0-2 years 11 36.7%
3-5 years 14 46.7%
6-9 years 3 10.0%
More than 9 years 2 6.7%
 Age

36-40
years
20.0% 21-25 years
30.0%
31-35 years
13.3%

26-30 years
36.7%

Fig No:1 - Description of sample according to age by percentage

30% of the staff nurses had age 21-25 years, 36.7% of them had age 26-30 years, 13.3% of

them had age 31-35 years and 20% of them had age 36-4 years.
 Gender

Male
16.7%

Female
83.3%

Fig No:2 - Description of sample according to gender by percentage

83.3% of them were females and 16.7% of them were males.

 Fig No: 3 - Description of sample according to qualification by percentage

20% of them were GNM, 53.3% of them were PB-B.Sc Nursing and 26.7% of them had

B.Sc. Nursing.
 Years of experience
More than 9
years
6-9 years 6.7%
10.0%
0-2 years
36.7%

3-5 years
46.7%

Fig No: 4 - Description of sample according to years of experience by percentage

36.7% of them had 0-2 years of experience, 46.7% of them had 3-5 years of experience, 10%

of them had 6-9 years of experience and 6.7% of them had more than 9 years of experience.
 Section II

Analysis of data related to the knowledge level regarding biomedical waste management

among staff nurses

Table 2: Knowledge level regarding biomedical waste management among staff nurses

N=30

Knowledge Freq %

Poor (Score 0-6) 8 26.7%

Average (Score 7-13) 15 50.0%

Good (Score 14-20) 7 23.3%

Half (50%) of the staff nurses had average knowledge (Score 7-13), 26.7% of them had poor

knowledge (Score 0-6) and 23.3% of them had good knowledge (score 14-20) regarding

biomedical waste management.

 Knowledge level regarding biomedical waste
management among staff nurses
Good Poor
(Score 14-20) (Score 0-6)
23.3% 26.7%

Average
(Score 7-13)
50.0%
Table 3:Item analysis-Knowledge level regarding biomedical waste management among

staff nurses.

N=30

Item Freq %
1 The following are personal protective measures EXCEPT 18 60.0%
2 In which colour container are needles and blades disposed 16 53.3%
3 Plastic syringe will be discarded in what colour bin 14 46.7%
4 Cotton dressing soiled with blood goes in which colour code 14 46.7%
5 General and domestic waste is put in what colour bag 15 50.0%
6 Which of these is NOT a waste disposal method 18 60.0%
7 Disease caused during hospitalization are called 13 43.3%
Hospital infection control concerns which of the following
8 personnel 9 30.0%
9 Duration to re-autoclave dressing drum is 21 70.0%
10 IV set can be used for how many days 9 30.0%
11 Blood stain on the floor should be cleaned using 18 60.0%
12 Sharps container should be 13 43.3%
13 While handling biomedical waste staff must ware 10 33.3%
14 Biomedical waste management is the responsibility of 20 66.7%
15 Sharps container is 12 40.0%
16 Recapping of used needles is 12 40.0%
17 1% Hypo chloride solution equals to 16 53.3%
What is the concentration of savlon solution used for cleaning in
18 hospital 10 33.3%
Following are the stages of biomedical waste management
19 EXCEPT 16 53.3%
20 Human anatomical waste is discarded in which colour container 13 43.3%

60.0% of the staff nurses knew the personal protective measures. 53.3% of them were aware

of the colour of the container in which are needles and blades disposed. 46.7% of them knew

Plastic syringe will be discarded in what colour bin. 46.7% of them knew Cotton dressing
soiled with blood goes in which colour code.50% of them knew General and domestic waste

is put in what colour bag. 60% of them knew the waste disposal methods. 43.3% of them

knew what the disease caused during hospitalization are called. 30% of them knew Hospital

infection control concerns personnel. 70% of them knew Duration to re-autoclave dressing

drum. 30% of them knew IV set can be used for how many days. 60% of them knew what

should be used for cleaning Blood stain on the floor. 43.3% of them knew how the Sharps

container should be. 33.3% of them knew while handling biomedical waste what staff must

ware. 66.7% of them knew whose responsibility is biomedical waste management. 40% of

them knew the texture of Sharps container. 40% of them knew Recapping of used needles is

done or not. 53.3% of them knew how much is 1% Hypo chloride solution. 33.3% of them

knew What is the concentration of savlon solution used for cleaning in hospital. 53.3% of

them knew the stages of biomedical waste management. 43.3% of them knew in which colour

container Human anatomical waste is discarded.

 Section III

Analysis of data related to association between level of knowledge regarding biomedical

waste management and the selected demographic variables.

Association between level of knowledge regarding biomedical waste management and the

selected demographic variables was assessed using Fisher’s exact test. The summary of

Fisher’s exact test is tabulated below:

Table 4: Association between level of knowledge regarding biomedical waste

management and the selected demographic variables
N=30
Demographic variable Poor Average Good p-value
Age 21-25 years 5 4 0
26-30 years 3 8 0
0.001
31-35 years 0 1 3
36-40 years 0 2 4
Gender Male 0 4 1
0.387
Female 8 11 6
Education GNM 4 2 0
PB B.Sc Nursing 4 7 5 0.071
B.Sc. Nursing 0 6 2
Years of 0-2 years 7 4 0
experience 3-5 years 1 10 3
0.001
6-9 years 0 1 2
More than 9 years 0 0 2

Since p-values corresponding to age and years of experience are small (less than 0.05), age

and years of experience of staff nurses were found to have significant association with

knowledge regarding biomedical waste management.

 CHAPTER V

FINDINGS, DISCUSSION, SUMMARY AND CONCLUSION

The present study was designed to assess the knowledge regarding biomedical waste

management among staff nurses in selected areas of Dr. D Y Patil Hospital, Pune.

The present study design was Non Experimental in nature. The study population

consisted of the of staff nurses working in Dr D Y Patil Hospital, Pune.

Total 30 samples were taken with a non-probability purposive sampling technique.

For collection of the data, a structured questionnaire was used to assess the knowledge

regarding biomedical waste management among staff nurses.

Findings

The findings of the study have been discussed with reference to the objectives with
the findings of the study.

The objectives of the study were,

 To assess the knowledge level regarding biomedical waste management among staff

nurses in selected areas of Dr. D. Y Patil Hospital, Pune.

 To determine the association between level of knowledge regarding biomedical waste

management and the selected demographic variables.

Section I:Description of samples (staff nurses) based on personal characteristics-

 30% of the staff nurses had age 21-25 years, 36.7% of them had age 26-30 years,

13.3% of them had age 31-35 years and 20% of them had age 36-4 years.

 83.3% of them were females and 16.7% of them were males.

 20% of them were GNM, 53.3% of them were PB B.Sc and 26.7% of them had

B.Sc. Nursing.
  36.7% of them had 0-2 years of experience, 46.7% of them had 3-5 years of

experience, 10% of them had 6-9 years of experience and 6.7% of them had more

than 9 years of experience.

Section II: Analysis of data related to the knowledge level regarding biomedical

waste management among staff nurses-

 Half (50%) of the staff nurses had average knowledge (Score 7-13), 26.7% of them

had poor knowledge (Score 0-6) and 23.3% of them had good knowledge (score 14-

20) regarding biomedical waste management.

 60.0% of the staff nurses knew the personal protective measures. 53.3% of them were

aware of the colour of the container in which are needles and blades disposed. 46.7%

of them knew Plastic syringe will be discarded in what colour bin. 46.7% of them

knew Cotton dressing soiled with blood goes in which colour code.50% of them knew

General and domestic waste is put in what colour bag. 60% of them knew the waste

disposal methods. 43.3% of them knew what the disease caused during hospitalization

are called. 30% of them knew Hospital infection control concerns personnel. 70% of

them knew Duration to re-autoclave dressing drum. 30% of them knew IV set can be

used for how many days. 60% of them knew what should be used for cleaning Blood

stain on the floor. 43.3% of them knew how the Sharps container should be. 33.3% of

them knew while handling biomedical waste what staff must ware. 66.7% of them

knew whose responsibility is biomedical waste management. 40% of them knew the

texture of Sharps container. 40% of them knew Recapping of used needles is done or

not. 53.3% of them knew how much is 1% Hypo chloride solution. 33.3% of them

knew What is the concentration of savlon solution used for cleaning in hospital.

53.3% of them knew the stages of biomedical waste management. 43.3% of them

knew in which colour container Human anatomical waste is discarded.

 Section III: Analysis of data related to association between level of knowledge

regarding biomedical waste management and the selected demographic variables-

 Association between level of knowledge regarding biomedical waste management

and the selected demographic variables was assessed using Fisher’s exact test.

 Since p-values corresponding to age and years of experience are small (less than

0.05), age and years of experience of staff nurses were found to have significant

association with knowledge regarding biomedical waste management.

Discussion
The findings of the study have been discussed with reference to the objectives stated
in chapter 1 and with findings of other studies.

 30% of the staff nurses had age 21-25 years, 36.7% of them had age 26-30 years,

13.3% of them had age 31-35 years and 20% of them had age 36-4 years.

 83.3% of them were females and 16.7% of them were males.

 20% of them were GNM, 53.3% of them were PB B.Sc Nursing and 26.7% of

them had B.Sc. Nursing.

 36.7% of them had 0-2 years of experience, 46.7% of them had 3-5 years of

experience, 10% of them had 6-9 years of experience and 6.7% of them had more

than 9 years of experience.

Half (50%) of the staff nurses had average knowledge (Score 7-13),

26.7% of them had poor knowledge (Score 0-6) and 23.3% of them had good

knowledge (score 14-20) regarding biomedical waste management.

60.0% of the staff nurses knew the personal protective measures. 53.3% of

them were aware of the colour of the container in which are needles and blades

disposed. 46.7% of them knew Plastic syringe will be discarded in what colour

bin. 46.7% of them knew Cotton dressing soiled with blood goes in which colour
code.50% of them knew General and domestic waste is put in what colour bag.

60% of them knew the waste disposal methods. 43.3% of them knew what the

disease caused during hospitalization are called. 30% of them knew Hospital

infection control concerns personnel. 70% of them knew Duration to re-autoclave

dressing drum. 30% of them knew IV set can be used for how many days. 60% of

them knew what should be used for cleaning Blood stain on the floor. 43.3% of

them knew how the Sharps container should be. 33.3% of them knew while

handling biomedical waste what staff must ware. 66.7% of them knew whose

responsibility is biomedical waste management. 40% of them knew the texture of

Sharps container. 40% of them knew Recapping of used needles is done or not.

53.3% of them knew how much is 1% Hypo chloride solution. 33.3% of them

knew What is the concentration of savlon solution used for cleaning in hospital.

53.3% of them knew the stages of biomedical waste management. 43.3% of them

knew in which colour container Human anatomical waste is discarded.

The association between level of knowledge regarding biomedical waste

management and the selected demographic variables was assessed using Fisher’s

exact test.

Since p-values corresponding to age and years of experience are small (less

than 0.05), age and years of experience of staff nurses were found to have

significant association with knowledge regarding biomedical waste management.

 Summary

The main aim of the study was to assess the knowledge regarding biomedical waste

management among staff nurses in selected areas of Dr. D Y Patil Hospital, Pune.

Objectives of the study were;

 To assess the knowledge level regarding biomedical waste management among staff

nurses in selected areas of Dr. D. Y Patil Hospital, Pune.

 To determine the association between level of knowledge regarding biomedical waste

management and the selected demographic variables

The researcher adopted the non experimental descriptive design. The sample comprised of 30

staff nurses from D Y Patil Hospital, Pune and were selected using non probability purposive

sampling technique. Data was collected using a structured questionnaire on items regarding

biomedical waste management. Descriptive and inferential statistics were employed and the

data was analyzed and interpreted.

 Conclusion

The study concluded that Half (50%) of the staff nurses had average knowledge (Score 7-13),

26.7% of them had poor knowledge (Score 0-6) and 23.3% of them had good knowledge

(score 14-20) regarding biomedical waste management.

60.0% of the staff nurses knew the personal protective measures. 53.3% of them were

aware of the colour of the container in which are needles and blades disposed. 46.7% of them

knew Plastic syringe will be discarded in what colour bin. 46.7% of them knew Cotton

dressing soiled with blood goes in which colour code.50% of them knew General and

domestic waste is put in what colour bag. 60% of them knew the waste disposal methods.

43.3% of them knew what the disease caused during hospitalization are called. 30% of them

knew Hospital infection control concerns personnel. The investigator concluded that in the

wake of increased demand on quality care and accreditation also in the best concern of the

clients there is a need to improve the knowledge level of staff nurses regarding biomedical

waste management. Staff training activity like continuing nursing education, workshops and

seminars on the concerned topic should be undertaken. Also periodic assessment through

competency matrix and evaluation is required.

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