ORIGINAL ARTICLE Knowledge and Attitude of Nurses Regarding Healthcare Waste Management Practices in a Tertiary care HospitalsofLahore TANZEEL UL RAHMAN1, SAJID HAMEED2, SHAHJEHAN3, SADAF AYYAZ4, RANA M AKHTAR KHAN5 ABSTRACT Background: Healthcare waste is considered infectious and hazardous. It requires specific handling prior to its disposal and poses a stern dangers to ecological, occupational and public health if not managed with caution. Hazardous waste management is a concern for every health care organization and for every healthcare professional. As nurses are the primary members of healthcare team and during provision of care to the patients they are the primary people dealing with the healthcare waste. Aim: Toassess knowledge and attitude of nurses regarding healthcare waste management practices. Methodology:A quantitative descriptive cross-sectional Study design was used. Data was collected by a self-administered modified questionnaire, containing 20 questions, from 50 staff nurses of Shalamar Hospital Lahore, using a convenience sampling. The study was carried for the period of October 2011 to December 2011. The collected data was then analyzed and frequencies and percentages were calculated. Result and conclusion: Study revealed that that most of the nurses were not having satisfactory knowledge regarding healthcare waste management practices. Majority of staff nurses were conscious of the measures for safe collection and final disposal of health care and were having positive attitude toward healthcare waste management practices. Keywords: Attitude, knowledge, waste management practice INTRODUCTION Health care waste is produced by the health care infectious waste, pathological waste, sharps, establishments during their functioning(Ilyas, 2004). pharmaceutical waste, geotaxis waste, chemical ThemanagementofHealthcare w a s t e hasbecomea waste and radioactive waste. The non-risk waste major public health and humanitarian issue globally comprises of other types of garbage like foodstuff today (Sharma & Chauhan, 2008). With the passage leftovers, cardboards and packages (Ilyas, 2004) of time there have been fabulousinnovations in the Derisory and improper management of health care system. However, we cannot deny from healthcare waste may results inseverepublic health the fact that the health care organizations, which treat consequences and pose asubstantialinfluence on the the ill and maintain our health, are also posing a environment(Lee, Ellenbecker, & Moure-Ersaso, serious danger to our wellbeing. The health care 2004).NegligenceconcerningHealthcare facilitiesthatprovidesvarioushealthcareserviceswhich wastemanagement can considerably includesdiagnostic,curative,rehabilitationandpreventiv contributestoenvironmentalpollution and e.In process of provision of these henceaffectsthehealth of individuals (Oweis, Al- services,theyalsoproducewastesbothfrommedicaland Widyan, & Al-Limoon, 2005).Poor waste management non-medicalactivities(Chaerul, Tanaka, & Shekdar, practices pose a higher risk to the health of public, 2008). patients and to the health of health care professionals Hospital waste is a special type of waste as well and contribute to the environmental carrying a high potential of infection and injury. degradation(Jang, Lee, Yoon, & Kim, 2006). Hospital waste includes hazardous or risk waste and Knowledge and attitude regarding healthcare non-risk waste. The different types of risk wastes are: waste management practices, among various ------------------------------------------------------------------------ members of healthcare team of developing countries 1Nursing Instructor, Shalamar Nursing College, Lahore, Pakistan. 2Assistant Professor Community Medicine, Avicenna Medical is deficient(Hageman, 2002; Uysal & Tinmaz, 2004). College, Lahore Studies from Pakistan states that about2kgofhealth 3Assistant Professor .of Urology, Shalmar Medical & Dental care waste/bed/dayisproducedoutofwhich0.1-0.5 kg College and Hospital, Lahore waste/bed/dayis calculated as hazardous (Rasheed, 4Hospital Pharmacist, Aziz bhattishaheedHospital,Gujrat 5Professor of Community Medicine, Avicenna Medical College, Iqbal, Baig, & Mufti, 2005). Many infectious diseases Lahore including Human immunodeficiency virus (HIV), Correspondence to Mr. TanzeeulRahman Email: hepatitis B and C and many more can spread through [email protected]. +923214114167 improper dealing of health care waste (Ahmed, 2004). 739P J M H S Vol. 11, NO. 2, APR – JUN 2017 TanzeelUlRahman, SajidHameed, Shahjehan et al Awareness regarding hospital waste RESULTS AND DISCUSSION management in terms of its segregation, collection, storage, transportation and disposal is lacking in Fifty five percent nurses were able to define nurses who are involved in patient care primarily healthcare waste management. 50% staff nurses (Shafee, Kasturwar, & Nirupama, 2010). Health care were aware about the hospital waste management workers especially nurses have avitalchance to policy of the hospital. 55% staff nurses knew about manage the environmental effects of their practice. health care waste management plan of hospital while Their efforts may seem small, but each step builds a 40% nurses have attended any prior training program base of sound behavior and thinking that are or workshop on healthcare waste management while necessary for the success of the whole. 60% nurses have not attended any prior training Thispaperisan attemptto provide withareviewof program or workshop on healthcare waste knowledge and attitude regarding health care waste management. Only 22% nurses said that the hospital management practices of nurses, who are provide continuing educational programs or considered as the integral part of health care and are workshops on healthcare waste management while the focal members of health care team dealing with 78% nurses said that hospital do not provide any health care waste. continuing education program on healthcare waste management. 58% nurses have knowledge about the METHODOLOGY incineration process.Only 30% nurses were aware that infectious waste should be labeled with This quantitative descriptive cross-sectional study biohazard symbol while 60% nurses were not aware was carried out to identify the knowledge and attitude of this fact. 84% nurses know about the protective of nurses regarding healthcare waste management measures while handling the waste. 78% nurses said practices.Study population of this research includes that waste is carried via secure puncture proof bags staff nurses of Shalamar teaching hospital. The study while 22% were not aware. was conducted in Shalamar nursing college while From the above percentages it can be inferred data was collected from the nurses of Shalamar that most of the nurses working in hospital do not hospital, Lahore.The research was carried for the have satisfactory knowledge regarding healthcare period of three months from October 2011 to waste management practices that contradicts with a December 2011. Sample for this study was selected study conducted in Agra by (Sharma, 2010) which by mean of convenience sampling method. A sample states that nurses have satisfactory knowledge, it can of 50 staff nurses was selected out of total strength of be because of the fact that most of the study 100 staff nurses of Shalamar hospital from the participants in our study responded that they have morning, evening and night shifts on the bases of never attended any continual education or refresher availability of the nurses in clinical units of Shalamar session on healthcare waste management practices. hospital. Staff nurses having more than 1 year of Eighty two percent nurses were disagreeing that safe clinical experience were included in the study while management of healthcare waste is not an issue at head nurses, nursing assistants and nursing students all. 72% nurses were Disagree that safe were excluded from the study. The data for the study management of health care waste is the was collected by using the self-administered and responsibility of government only. 68% nurses are specially designed and modified questionnaire.The Disagree that safe management of healthcare waste questionnaire was very simple in nature; it consisted efforts by hospital increases financial burden on of 20 questions. It was having questions for hospital management hence it is not needed. 88% knowledge and attitude assessment about healthcare nurses are Disagree that safe management of waste.Data collection was completed in 1 month. The healthcare waste is an extra burden of work. 98% respondents were cooperatives and took interest in nurses like to attend a program or workshop on filling the questionnaire. Data was analyzed by using healthcare waste Management. 66% nurses make SPSS18, frequencies and percentages of the sure for color coding the waste for disposal. 60% responses of participants were calculated. nurses agree that maintaining documentation for Ethical Consideration: Written Consent from waste disposal is necessary in clinical units. 86% participants was taken before including them in study. nurses take protective measures while handling the The data collected from the nurses has been kept healthcare waste. Seventy percent nurses said that purely confidential and only used for statistical waste is carried from the point of generation to the analysis about study. Autonomy and beneficence of final disposal site via polythene bags. 84% nurses the participants were considered. show positive attitude toward waste segregation and 90% nurses