Handling Bio-medical waste

One of the main functions of housekeeping in hospitals is infection control and proper handling of bio-medical waste. Safety against fire, prevention of cross contamination, odour control and pest control are all a part of waste disposal procedures. A carefully planned programme of waste disposal will safeguard not only personnel and patients but also the community. Housekeeping is responsible to ensure an infection free and safe environment:

The following steps have to be taken by housekeeping team to ensure a proper and effective waste management.

1. Thorough knowledge of processes and procedures of bio-medical waste management.
2. Following of colour codes and proper segregation of waste.
3. Proper training in managing the waste as well as in handling emergency situations like spillage of the waste.
4. Usage of proper personnel protective equipment at all times.
5. Collection and transportation of waste to the storage area as per norms.
6. Storage of clinical waste as per norms.
7. Disposal of clinical waste as per Pollution Control Board’s specifications.
8. Cleaning and disinfection of storage bins and storage area.

Segregation of waste at source

Bio-medical waste should not be mixed with other waste. Segregation at source is done by doctors, nurses and paramedical staff. They are segregated into different colour coded containers, which are labeled with the bio-hazard symbol indicating the nature of waste. These containers contain self-printed dustbin covers to enable the staff to segregate the waste without any confusion. Bins should be easy to use.

Collection and transportation of waste

A separate team of housekeeping staff is identified for collecting the segregated waste at all points in closed trolleys to the common storage area identified at the rear end of the hospital. The clearance is done thrice a day. When the covers are three-fourths full, they are tagged appropriately. The person responsible for collection of the biomedical waste carries a checklist to maintain the records such as name of user, department, type of waste and signature of the user department. Permanent marker pens are used to mark on the dustbin cover denoting the area from where it is generated so that the user can be traced back if the waste is not segregated properly.

Storage of waste

The collected segregated waste is stored in designated compartments containing big puncture proof drums. All the wastes as per the category are weighed and entered in the checklist. The drums should be strong enough to withstand any possible damage that may occur during loading, transportation or unloading . No untreated biomedical waste is kept beyond 24 hours in any premises. All the compartments are tiled to enable proper washing after every shift.

Transportation, treatment and disposal of waste at the common facility

The transportation, treatment and disposable of waste are carried out by the contractor identified by the Pollution Control Board. A responsible person shall always accompany the vehicle to supervise the collection and transportation of biomedical waste.

Training

Training of doctors, nurses, and paramedical staff is a very important part of setting up a biomedical waste management system. Unless the staff is trained on all aspects handling and managing waste, it is impossible to implement the system of waste management. Bio-medical waste segregation boards should be made available at all key locations of the hospital.

Challenges faced

1. Awareneof staff on biomedical waste management
2. Needle stick injury
3. Proper segregation of waste

Work instruction for bio-medical waste collection

1. Put on appropriate mask, cap, apron and gloves.
2. Place the respective colour coded covers in the large waste collection drum.
3. Place the drum required for the task into the trolley.
4. Move to the concerned area of waste collection. Remove the respective dustbin covers. Tie the top of all bin covers securely with plastic tags / rubber band and mark the respective area on the dustbins with marker pen.
5. Place all secured dustbin covers in the respective colour coded drums.
6. Clean all surface of dustbins with disinfectant solution.
7. Place new dustbin covers according to the respective colour coding. The stationery waste bags are transported to the garbage collection area through garbage chute available in higher floors.
8. Filled sharp containers are replaced with new sharp containers at various locations. Needle cutter boxes are removed when they are three fourth filled and replaced with new ones. They are taken to the common area and handed over to the contractor.
9. The needle cutter equipment are replaced with the new ones on completion of cutting 50,000 needles in the work area. The schedules for replacing the needle cutter equipment in identified locations are done in adherence to the manufacture’s guidelines. This schedule is followed strictly to ensure employee safety and to avoid contamination incidents.
10. The schedule for replacing the needle cutter equipments is reviewed bi-annually to ensure the compliance towards the manufacturer’s guidelines.
11. Infectious waste is transported to the common garbage area in closed trolleys.
12. Transfer the tied waste bags into the drums of different compartments.
13. Clean and wipe dry all equipment on completion of the assigned task.
14. All collected waste bags, sharp container and needle cutter boxes as stored in designated area are transported and treated by the appointed Pollution Control Board Vendor.
15. Check list maintained by the housekeeping staff is checked by the supervisor.
16. The clearance is done as per the zones.
17. At the end of every clearance, the four respective rooms – infectious waste, clinical waste, sharps and food & stationery – where the wastes are stored as per specified norms, are cleaned in the following procedure:
    1. Put on rubber shoes, safety mask, rubber gloves and apron.
    2. Arrange the required cleaning material for the task.
    3. Remove all the waste drums from the compartments.
    4. Clean the floor from corner to corner towards the door.
    5. Collect the waste in dustbins.
    6. Wash the ceiling walls and floor with cleaning agent and then with disinfectant solution.
    7. Wash all the bins with disinfectant solution and replace the bins to the respective compartments.
    8. Wash all the trolleys with disinfectant solution and place the respective drums after cleaning.

Caution

1. Do not compact the waste with your hands.
2. Use applicable colour coded covers.
3. Always wear safety gears like gloves, mask, apron, and cap before handling waste.
4. Thorough cleaning of compartments is done with hosepipe.