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Apollo Hospitals International Limited, Ahmedabad

 

Few points for consideration for treatment and disposal:

  • The waste is mutilated and disinfected before its final disposal to prevent the re-use and infections.
  • Syringes are cut and chemically disinfected with 1% bleaching powder solution before the final disposal into sharps pit.
  • Infected plastics are also chemically disinfected or autoclaved, shredded and recycled and sent for final disposal into municipal dumps.
  • General waste is transported to municipal waste dumps for final disposal without any treatment.

Handling Accidents & Incidents

Healthcare organization should have structured procedures for dealing with accidents or incidents involving clinical waste which may put employees or others at risk. Employees should be able to report to Emergency Department Staff Clinic at earliest upon exposure or injury. Immediate first-aid measures must be made available in case of any injury and post-exposure prophylaxis be given to affected handlers on case to case basis. Any deviations in defined process or related incidents are to be promptly reported to Quality Assurance/Infection Control Dept where they are thoroughly investigated and root-cause-analysis is carried out to establish the exact cause. Accordingly, corrective and preventive actions are initiated to prevent recurrences in the future.

Personnel Protection and Safety

The waste handlers and other staff who are involved directly or indirectly in this process are adversely affected and their health and safety must be protected at all the times.

Following personal protective equipment (PPE) should be freely available for their use to prevent injuries and exposure. Appropriate cleaning, maintenance and checking of all the protective equipment must be ensured from time to time.

  • Disposable gloves & heavy-duty gloves when handling waste containers.
  • Industrial aprons / leg protectors: if the risk of bodily contact with waste sacks/containers.
  • Face shields/glasses to protect employees from potential splashing.
  • Sturdy industrial boots to protect the feet against the risk of heavy containers being accidentally dropped. The soles of such boots will also offer some protection in the storage area against spillage, sharps and where floors become slippery.
  • Helmets and strong industrial PPE in high risk areas.
  • Masks and respiratory protectors for protection against toxic dust.
  • Standard PPE (approved by BARC) for protection against radioactive wastes.

Protective immunization i.e. Hepatitis-B, Tetanus etc are highly recommended for all staff handling healthcare wastes. Washing facilities at storage and disposal facilities must be made available and handlers must be educated on correct hand washing practices for their safety. All the waste handlers are medically examined at specific time interval and training on occupational safety is imparted frequently. Work SoPs at all working areas are displayed as ready reference and to avoid any confusion. Beside PPE, spillage kits, mercury kits, HAZMAT kits, first aid kits and fire lighting equipment are provided to concerned staff.

Education & Training

Since training and awareness is the powerful tool to ensure optimal compliance to defined work-flows and to prevent any mishap, waste management training is imparted to all staff on joining itself and is an integral component of orientation program for all new employees. Focused group training sessions are also conducted at regular intervals by Infection Control Department on handling the waste & adhering to the established policy. Upon revision of any policy/ procedure, retraining is also conducted. Such trainings cover awareness about occupational risks involved in healthcare waste management, hazard recognition and measures to mitigate besides colorcoding, labelling, route marking, special problems related to disposal of sharps etc. They are also taught on modes of pathogen transmission, personal safety, cleaning and disinfection procedures, use of protective clothing/equipment and how-to-deal-with spillage and other incidents at work area. Trainings on hand hygiene, first aid, fire safety are mandatory to all staff. Mock Drills and practical demonstrations are also conducted periodically wherein staff can see and learn the correct practices.

Quality Assurance

Continuous monitoring of the established protocols and practices is of paramount importance in sustaining the efforts. At Apollo Hospitals, Infection Control Officer takes the onus of overseeing the biomedical waste management processes, with the help of House Keeping In-charge. Biomedical waste management has been one of the permanent agenda in monthly Infection Control Committee Meetings. Needle stick injuries and all waste related incidents are reviewed in these meetings besides hospital acquired infections and hand hygiene compliance. Periodic process audits are carried out by Quality Assurance Department to see the
adherence and compliance to SoPs and reports deviations, if any, to Infection Control Committee. Cross departmental audits are also done wherein seniors
staff of one area audits the process of segregation, labeling and transportation of another area/department. Department wise waste volume is closely pursued every month.

                                           Major (Dr) Sanjay Dalsania,
                                                         Chief Quality Officer,
                          Apollo Hospitals International Limited,
                                                                   Ahmedabad

                                                              Dr. Mahesh Patel,
                                   Quality and Patient Safety Officer,
                          Apollo Hospitals International Limited,
                                                                       Ahmedabad

 

 

 

 

 

 

 

 

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