A case study to review compliance to biomedical waste management rules in a tertiary care hospital

Abstract

Background: Every healthcare establishment is known to produce several tonnes of waste. Over a period of time to cater to the needs and demands of the growing population has resulted in rapid mushrooming of hospitals, both in the government and private sector. Improper management of waste generated in health care facilities causes a direct health impact on the community, the health care workers and the environment. Such waste requires management & specific treatment prior to its final disposal. The objectives were to observe compliance of protocols in handling, transport & storage of Biomedical Waste in a tertiary care hospital and to assess compliance to occupational safety measures used by the health care staff.Methods: A validated checklist with 41 parameters to check compliance to various functions carried out at source of generation, handling, transport & storage by a Health Care Worker for BMW management was prepared. It was an observational study that made use of complete enumeration method to select all study sites. A total of 67 sites were visited and observed. A total of 4 visits were made to each area to assess the compliance to rules.Results: Out of 64 wards that were observed for compliance to BMW handling and Management rule 2011, 42.18% disinfected the biomedical waste bins daily. Mixing of contents in the red bag, yellow bag and black bag was found to be 20.31%, 12.5% and 10.93% respectively. None of the wards observed cutting of gloves and saline bottles prior to disposal.Conclusions: The tertiary care hospital where the study was carried out was compliant with most rules with respect to BMW management. Segregation, mutilation and disinfection practices were not performed strictly at all waste generating sites. Due to patient overload and lack of staffing mutilation and disinfection practices were overlooked at many sites. Day to day collection of waste from all sites was not carried out due to which record books were not properly maintained. False reporting was noted on records at various sites.