Running head: HEALTH CARE WASTE MANAGEMENT BY NURSES 1

Knowledge of nursing professionals regarding waste management in primary health care

Student Name: Jojo Thomas

ID number:

Unit code and title: Research in Nursing

Title of Assignment: Critical Review

Name of Unit Coordinator:

Due date: 28/02/2019

Word count: 1522

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Knowledge of nursing professionals regarding waste management in primary health care

Introduction

In the past decade, health care waste (HCW) production was significant. This journal is

about the knowledge of nursing professionals regarding the management of health care waste in

primary health care. A sound knowledge regarding waste management will help to reduce the

social impacts such as communicable disease, needlestick injuries, and other problems, which

may develop by improper management of this waste. The assessment of this knowledge is

critical in health care settings as these wastes are hazardous to the society, and the hospital

employees at the same time. Nowadays, hospital health care waste is increasing due to a large

number of patients ( Mhirdaui Sanches, Mekaro, Figueiredo, André,2018). The researcher's

purpose in this study was assessing the knowledge of nurses on health care waste management in

primary care. It conducted among 42 nurses; who work in primary health care units in a region

of Brazilian capital using a mixed methodology and different software to conclude the result.

This review of the selected journal will describe the methodology, strength, weakness, and

characteristics of the methodology and will discuss the philosophical principles of used paradigm.

Methodology and design

It is a descriptive and cross-sectional study conducted among 42 nurses using a joint

methodology in a primary health care setting in a region of the Brazilian capital. This method

had selected because it allowed the researchers to collect data and analyse that qualitatively and

quantitatively at the same time. The mixed methodology can answer a question from a different

angle and reduces the chances of gaps that may occur to the information collected (Ingham-

Broomfield, Becky 2016). The use of mixed methods can deliver a more in-depth understanding
HEALTH CARE WASTE MANAGEMENT BY NURSES 3

or a better idea about what is happening. It can include culture in the design by providing a

voice to those who participate in the behaviour being researched (Ingham-Broomfield, Becky

2016). A mixed methodology is expensive and time-consuming; the researchers should have

extensive knowledge regarding how to correlate the data obtained (Dastjerdi, 2016). The study

period was between June and September 2016. The authors have used SPSS 20.0 programme to

analyse the quantitative data and IRaMuTeQ (Interface de R pour less Analyses Multi-

dimensionnelles de Textes et de Questionnaires) software to process the report. This report

analysed on a descending hierarchical classification and grounded on the collective subject

discourse. The city has three regional health departments. Two out of three had selected for the

study, which included 63 basic health units 27 from the south unit and 36 from the east/south-

east zones. The data collected from 21basic health units and these stations served as a platform

to assemble the primary analysis units. The analysis units were randomly selected nursing

professionals, using a draw, from the set of workers available in the given unit when the data

collected. The authors describe that it was not possible to examine the totality of the workers.

Data Collection

Data collection carried out in a private room of the institutions by two trained researchers.

The authors have used semi-structured interviews which were previously script checked and

adapted form, Mendes. The interview structured into three sections, and it dealt with knowledge

and the daily practice of nursing professionals related to HCW management. The first section

was regarding the personal characteristics of the professionals who are involved. The second one

was open-ended questions regarding definition, separation, handling and destination of HCW.

Thirdly a questionnaire of multiple choice questions about the classification of the primary type

of HCW produced in their work settings. The average interview time was 40 minutes each, and
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these interviews were recorded and transferred to a printed form. The participants were given a

chance, at the end of each interview to modify their answers, but nothing changed. The

interview results double typed into Microsoft excel 2010 program to import to SPSS program for

more meaningful analysis. The reports of the participants are collected and processed through

IRaMuTeQ, and it was analyzed in a descending hierarchical classification (DHC). Identification

of keywords from the interview report was the next step, which supported the DHC and allowed

the text to divide into particular classes. Collective subject discourse (CSD) method was the

base of this analysis, and it allowed the researchers to divide the classes of groups which

presented similar vocabulary. CSD method allows authors to organise and process the qualitative

data in an easy way (Valongo Zani, Silva, & Parada, 2017). At this point, the keywords were

determined from the account of the participants to support the findings with the theoretical help

of CSD, which helped to divide the groups into different classes. The general performance

assessed using non-parametric statistical analyses and the comparison of both the professional

groups has done using Mann-Whitney test applied to the total score of each participant. The

authors kept the originality of the reports unchanged during transcription. Qualitative analysis

also conducted using IRaMuTeQ tool to match the quantitative data based on the DHC; the text

areas are identified and examined by collecting the most significant words and derived the

meaning associated with them. During the time of data processing, the corpus had divided into

two subgroups. The final result was justifying to the chosen framework.

Literature Review and Sampling Design

The citations of this literature are relevant to the topic that is the nurse`s knowledge

regarding waste management in the primary care setting. The target population was 42 nursing

professionals they were selected as 21 nurses and 21 technicians. The samples were selected
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using proportionate stratified random sampling. The inclusion criteria were this; the professional

should be employed in any of the selected BHUs for the past one year. The professionals

involved in administration duties were excluded. In a mixed method of the research, the sample

population can vary from a tiny number of people to a vast number of people (Ingham-

Broomfield, Becky 2016). Prior approval was obtained from the research ethics committee and

used alphanumeric identification system (NUR01 and TEC01) to maintain the secrecy of the

examined professionals. This investigation was carried out on a partnership basis of the Federal

University of Piaui, and the Ribeirao Preto College of Nursing at the University of Sao Paulo as

the part of a macro project named “Infection prevention and control in healthcare services”. If a

researcher conducts human research, it falls under bioethics (Ingham-Broomfield, Becky 2017).

Findings and the Recommendations

According to research reports, 32.3% of participants said that inappropriate disposal is

the first and foremost reason for the improper management of HCW. It develops due to

negligence, inattention, and sloppiness of some workers, and it may create cross-contamination

and infection. An inadequate transport facility also has a significant role in improper HCW

management. The second group professionals believe that correct disposal can reduce disease

and improve quality. This group professionals recognised the primary health care activities, as a

chief producer of HCW and responsible for the implementation of correct HCW management.

This group stressed the need for reaching a service level and correct destination of HCW to

prevent harm to others. This report reveals the need for diagnosis to develop an HCW

management plan. Class three had shown that only 30% of the employees know about the

problems associated with the improper disposal of HCW. Separation is significant in HCW

management. Inadequate separation leads to negative consequences, such as professional risk

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and cost management. Poor handling of HCW expose people of the community to infections,

toxic effects and injuries (Sapkota, Gupta, Mainali, Shrestha, 2015). As a cross-sectional study,

this study has some limitations; it had less time to assess the knowledge of the employees.

Cross-sectional research cannot adequately demonstrate changes over time, as in longitudinal

research (Connelly, 2016). If it were contained an observational step to examine HCW

produced, the result would be more attractive. The studies with this design need the support of

broad conclusions. The result of this study recommends the need to continue education for those

who work in primary health care, especially those who implement waste related policies where

outpatient care takes place. In the conclusion of the study, the researchers found that the

knowledge of the examined employees cannot meet the expected level of HCW management,

especially in the disposal. The authors found out some factors affecting the knowledge of the

employees and the hostile impact of less knowledge regarding proper waste management on the

nursing professionals and other workers. The researchers recommended the need for

investigative studies on other departments which produce HCW, such as dental.

Conclusion

The knowledge of the nurses about HCW management is vital in primary health care

because they are members of the health care team with the highest participation in the production

and disposal of HCW. The research conducted among selected nursing professionals using a

mixed methodology has described the knowledge level of primary health care nurses regarding

HCW management. The knowledge of nurses regarding HCW management did not meet the

expected level, mainly on the initial steps. Some socioeconomic and training variables such as

age, time since graduation, and experience can make an impact on this knowledge. The nursing

professionals who are interviewed have seen themselves as one of the primary producers of
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HCW. The findings illustrate that nursing professionals must adapt HCW management into their

daily practice. To achieve this goal, it is essential to strengthening the knowledge of these

nursing professionals. The researchers also recommend the development of new tools which

help to monitor the HCW management.

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References

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