HOSPITAL SAFETY MEDICAL WASTE DISPOSAL Ahmed alassf

HOSPITAL SAFETY & MEDICAL WASTE DISPOSAL Ahmed alassf Muwayed Al-Khnaini

Abstract Introduction Identifying Risk Factors in the Hospital (waste , environment , technology , people, system) Focus on medical waste & different type How we dispose these waste

Abstract Our goal in this research are to focus on very important issue in medical field. A lot of people does not realize the sensitivity and important of this issue. But the big problem is that some of the people who works in the medical field (staff) do not consider the dangerous of carelessness in this issue. Finally, we hope to be part of the persons who contributed to awareness of the importance for this subject.

Scope & definition What is healthcare safety? Q Is it a matter of checking the resistivity of the electrical wiring system? Or is it focusing on infection control? Or is it ensuring proper water and air quality within the hospital environment? So what does safety mean? Or in other words, when can we say that a certain hospitals is safe? . Let us say that a hospital is safe so, long as it complies with all of the internationally recognized safety standards.

Identifying Risk Factors in the Hospital There is unlimited number of risk factors. we try to categorize these factors in five main sources of risk that exist in hospital, waste, environment, technology, people and system. Let us also keep in mind that these sources of risk are not necessarily mutually exclusive, i. e. , they may interact to cause compound risk

A. Waste is a general term which refers to material which is produced as-a byproduct or remainder of a certain process not all waste is harmful For instance, biodegradable waste is harmless so long as it is disposed of in a sanitary way.

NO Hazardous Waste Descreiption Where? 1 Infectious waste Contain pathogens Common infected items are lab cultures, swabs, dinnerware, …etc Labs, isolation wards, operating rooms. . . etc. 2 Pathological waste Human tissue or fluids such as blood or urine. OR, pathology labs. . . etc. 3 Pharmaceutical waste Drugs which expired or not Consume fully, Drug containers Pharmacies, patient wards. ICU. OR, . . . etc. 4 Radio-pharmaceutical waste Radioactive substance (inject in blood &out with urine) Nuclear medicine. Dept 5 Chemical waste Medical gases, used or expired lab Reagents, film developer OR's, Labs, dark rooms 6 Heavy metal waste Lead-acid batteries, mercury from broken thermometers Portablequip ICU, OR 7 Skin penetrating hard objects waste Sharps, needles, broken glass Anywhere in hospital

B. Environment refer to the ambient conditions in certain space. temperature, pressure, humidity, air quality, building design and material, electrical supply and water supply.

NO Environmental Factor Precaution & Hazardous Effect 1 Ambient Climate 2 Air quality 3 Water quality 4 Electrical Supply stability in varying loads, ability to absorb excess charges , its ability to fail safely 5 Building Design It has direct effects on infection control, fire control, and personal safety such as emergency exits and hazardous area access limitation 6 Other OR temperature must be in the lower twenties (? C) OR pressure must be positive OR humidity must be set at such a value bacteria and dust, should be minimized By using HEPA filters , (UV) ultraviolet radiation lamps at OR entrances Difference between Drinking water quality & water used in hemodialysis we must concern the purity of water (particulates, ionic level) Audio noise, vibration, and electromagnetic waves.

C. Technology is responsible for producing healthcare hazards through undesirable byproducts or secondary effects which occur simultaneously with the use of technology itself. Technology Inherent Hazard Electrical Supply Electric shock Medical gases Tank explosion - fire Electro surgery device Burning and scarring of surrounding tissues Gamma Camera Ionizing radiation Ventilation system Infection spread'

D. People The Institute of Medicine (IQM) has recently published a report which shocked both healthcare policymakers and citizens. the report stated that at Least (44. 000) Americans die annually from medical error , (70% ) which are preventable. great percentage of these medical errors are purely human errors. So , become obvious that without highly qualified people, it is impossible to maintain a safe environment.

E. System The system is the collection of Policies, procedures and practices in the workplace. The system also includes P 3 factors dictated by governmental and accredited organizations. it is essential for any given healthcare facility, regardless of its size and location, to have a safety committee.

Safety committee policies * The safety committee sets standards on what constitutes a hazardous effect. * Hazards are ranked and classified according to health risk level. * The committee must approve sites to host hazardous equipment prior to installation. * Training of users and technicians on new equipment must include safe operation , emergency actions and essential ppm. * All health care employees must immediately report any signs of hazardous conditions to designated committee members.

Procedures * Election of committee members. * Meeting calendar for the committee. * Voting on disputed issues. * Documentation Of findings. * Survey procedures ( suddenly visits, …) * Warning signs and labels: size, color, disposal methods, …etc.

Risk factor Waste QA # Use biodegradable or environmentally friendly reagents. QC # Dispose of waste safely and efficiently Environment # Design the building according to safety standards. # Maintain building regularly. Technology # Purchase medical equipment which is approved by # Perform routine maintenance internationally recognized bodies. and calibration( PPM). # Use technology within the context of safely. People # Hire highly qualified personnel. # Train personnel regularly and effectively. System # Set your objectives in accordance with safety. Monitor adherence documenting performance & Correction

Medical Waste refers to material which is produced as-a byproduct or remainder of a certain process not all waste is harmful For instance, biodegradable waste is harmless so long as it is disposed of in a sanitary way. How does hospital waste affect us? Infectious waste can cause diseases like Hepatitis, AIDS, etc. When waste containing plastics are burnt, Dioxin is produced, which can cause Cancer, birth defects, hearing defects.

DIFFERENT TYPES OF WASTE 1. Biohazard Waste: defined as materials of biological origin that are capable of producing an infectious disease in humans and includes at a minimum blood, body fluids. *Biohazard Sharps Waste consists of discarded items such as derived from human patient diagnosis, care, or treatment. These items include hypodermic needles, glass containers. *Biohazard Non-Sharps Waste Blood, blood products, and body fluids classified as infectious.

2. Chemical and Hazardous Waste Is any chemical material for disposal and includes both hazardous and non-hazardous chemicals. like lead acid batteries and aerosol cans. 3. Radioactive Waste Radioactive waste is any material with detectable radioactivity above background levels.

4. Universal Waste a. Batteries b. Mercury containing lamps c. Mercury containing items (thermostats, switches, manometers, etc). d. Electronic items (circuit boards, computer monitors) 5. General waste is anything which does not fit into other waste categories.

Waste Streams a. Facilities Management/Engineering * fluorescent bulbs. * Waste batteries. * Lithium, Mercury and Silver. * Used TV monitors. b. Laboratory/Histology/Pathology * Waste solvents from tissue processing (Example: Formalin). * Waste tissue stains containing Mercury. * Discarded or waste diagnostic test reagents.

c. Pharmacy * Waste solvents (Examples: Acetone, Ethyl Alcohol, Phenol). * Outdated or discarded pharmaceuticals. d. Radiology * Discarded X-ray film. * Radioactive isotopes being decayed on-site.

Solution for waste disposal Incinerators: a solution or a threat? Incineration is treatment method for medical waste for two important reasons. First, incineration is best method of eliminating any infectious organisms in medical waste. Second, incineration has been economical for hospitals because it substantially reduces the volume to be disposed of in landfill. Waste is burnt at very high temperatures, that produce emissions full of acidic gases, heavy metals and toxic organisms, so Incinerators affect on pollution.

Non-incineration Technologies The technologies will be categorized based on the fundamental processes used to decontaminate waste. The three basic processes are: 1. Thermal processes. 2. Chemical processes. 3. Irradiative processes.

1 -THERMAL PROCESSES That use thermal energy to destroy pathogens in the waste. This category is further subdivided into low-heat, medium-heat, and high-heat thermal processes. This classification depends on physical and chemical mechanisms of the waste. AUTOCLAVES: consists of a metal chamber sealed by a charging door and surrounded by a steam jacket. The removal of air from the chamber is essential to ensure penetration of heat into the waste. Types of Waste Treated cultures and stocks, sharps, materials contaminated with blood and limited amounts of fluids.

Autoclaves advantages: * Autoclaves are available in a wide range of sizes, capable of treating from a few pounds to several tons per hour. * Costs are relatively low compared with other technologies. Disadvantages: * If hazardous chemicals such as phenol, or mercury are in the waste, these toxic contaminants are released into the air. * If the technology does not include a way of drying the waste, the resulting treated waste will be heavier because of condensed steam.

2. CHEMICAL PROCESSES Chemical processes employ disinfectants such as dissolved chlorine dioxide, bleach, peracetic acid, or dry inorganic chemicals. Types of Waste Treated Cultures and stocks, sharps, isolation and surgery wastes, laboratory waste. Chemical advantages: * Well-automated and easy to use. * No combustion byproducts are produced.

Disadvantages: * Chemical hazards are a potential problem with chemical-based systems. * Noise levels can be very high. 3. IRRADIATIVE PROCESSES Irradiation-based technologies involve electron beams or UV irradiation. These technologies require shielding to prevent occupational exposures. Types of Waste Treated Soft wastes (bandages, drapes, bedding, …etc. )

Irradiative advantages: * The technology is well-automated and requires little operator time. * This technology is noiseless & low operating cost. Disadvantages: * Personnel must be protected from radiation exposure. * Any large, hard metal object in the waste can damage any shredder or grinder.

FACTORS TO CONSIDER IN SELECTING A TECHNOLOGY * Capacity & Cost. * Types of waste treated. * Space requirements. * Reduction of waste volume and mass. * Noise and odor. * Community and staff acceptance.

The End