SEMINAR

ON

INFECTION PREVENTION ( INCLUDING

HIV) AND STANDARD SAFETY
MEASURES, BIO – MEDICAL WASTE
MANAGEMENT.

SUBMITTED TO: SUBMITTED BY:

MRS.DR. PADMAVATHI NAGARAJAN T.BIDESHWORI

ASSISTANT PROFESSOR M.SC NSG. 1ST YEAR

COLLEGE OF NURSING, JIPMER C.O.N. , JIPMER
INTRODUCTION: Infection is one of the leading causes of preventable deaths in hospitals every year. The
Center for Disease Control and Prevention estimates that there are approximately 2 million preventable infections in
hospitals every year, leading to 90,000 unnecessary deaths. The importance of keeping hospitals clean and infection-
free is greater now than ever, as information regarding the patient safety and effectiveness of prevention efforts
continues to grow. Regardless of the work area, preventing the transmission of organism is a concern of all nurses.
One way in which nurses accomplish this goal is by asepsis. Asepsis means to make free from disease producing
micro-organisms.

INFECTION PREVENTION AND CONTROL-Infection prevention and control is the discipline

concerned with preventing nosocomial or healthcare-associated infection. As such, it is practical (rather than an
academic) sub-discipline of epidemiology. It is an essential (though often under – recognized and under – supported)
part of the infrastructure of healthcare. Infection control and hospital epidemiology are akin to public health practice,
practiced within the confines of a particular health- care delivery system rather than directed at society as a whole.

DEFINITION OF INFECTION:An infection is the entry and multiplication of an infectious agent in the
tissues of the host. Infectious agent may be bacteria, viruses, fungus, spirochete or other microorganisms capable of
producing infection under favourable circumstances of host, and the environment.

TYPES OR CLASSIFICATION OF INFECTION:

 PRIMARY INFECTION : Initial infection with an organism to a host constitutes

primary infection.
 SECONDARY INFECTION: When in a host whose resistance is lowered by pre-
existing infections ,a new organism may set up a new infection.
 LOCAL INFECTION: Infection that is limited to defined area or single organ with
symptoms that resemble inflammation.
 SYSTEMIC INFECTION: Infection that spreads to whole body resulting in
septicemia.
 ACUTE INFECTION: Acute infection appears suddenly or lasts for a short time.
 CHRONIC INFECTION: May occur slowly over a long period and may last months
to years.
 NOSOCOMIAL INFECTION: These encompass all types of infections acquired by
patients while being cared for in acute care institution and those acquired by health
care personnel and visitors. Based on the source of infection, these can be classified
as:
 Exogenous infections – it is an infection caused by microorganisms from other person.
 Endogenous infections – it is an infection caused by the patient’s own normal
microorganisms becoming altered and over growing or being transferred from one
body site to another.
 IATROGENIC INFECTION: Infections resulting due to therapeutic and diagnostic
procedures.

CHAIN OF INFECTION

The presence of pathogen does not mean that an infection will begin. Development of an
infection occurs in a cycle that depends on the presence of all the following:-

1) An infectious agent or pathogen.

2) A reservoir or source for pathogen growth.
3) A portal of exit from the reservoir.
4) A mode of transmission.
5) A portal of entry to host.
6) A susceptible host.

An infection will not develop if this chain remains intact. Nurses follow infection
prevention and control practices to maintain the chain so that infection will not develop.
Fig

1. Infectious agent :
 The spread of infection requires an infectious agent – a pathogen that has the potential
to cause infection. The pathogen may be viral, bacterial, fungal or parasitic.
2. Reservoir:
 The infectious agent needs a reservoir where it can live, grow and reproduce.
 Reservoirs are warm, moist places.
 Humans, animals or the inanimate environment (eg. Water, food, soil and soiled
medical equipment ) are potential reservoirs.
 Human reservoirs include individuals with an acute infectious disease, and those who
are in the incubation period of the disease and asymptomatic carriers.
3. Portal of exit:
 Transfer requires a route for the infectious agent to exit the reservoir.
 An infectious agent can exit the reservoir and enter the host through various body
systems (eg. Respiratory, gastrointestinal, genitourinary tracts, skin lesions) and
through mucous membranes.
 4. Modes of transmission:
 Contact transmission:
-Direct transmission: direct physical transfer between and infected person and a
susceptible host.
-Indirect transmission: personal contact of a susceptible host with a contaminated
inanimate object.
 Droplet transmission: it involves contact of the conjunctivae or mucous membranes of
the nose or mouth of a susceptible host with large particle droplets that contain an
infectious agent.
 Airborne transmission: small particle residue of evaporated droplets may remain
suspended in the air for long periods of time or dust particles may contain an
infectious agent.
 Vehicle transmission: food, water or medication contaminated with an infectious agent
can act as a vehicle for transmission when consumed.
 Vector borne transmission: vectors such as insects may harbor an infectious agent and
transfer it to humans through bites(e.g. west Nile Virus).
5. Portal of entry :
 An infectious agent can exit the reservoir and enter the host through various body
systems (eg. Respiratory, gastrointestinal, genitourinary tracts, skin lesion) and
through mucous membranes.

6.Susceptible host:

 Susceptibility depends on the individual’s degree of resistance and virulence of

organisms.
 The transmission of infection also requires a susceptible host.
 Susceptibility to an infectious agent varies among individuals.
 Factors that influence a person’s susceptibility include age, general physical, mental
and emotional health, duration of exposure to the agent and the immune status.
Who is at risk of infection?
 Staff: Service providers are at significant risk of infection because they are exposed to
potentially infectious blood and other body fluids on daily basis.
 Clients: clients are at risk of post procedure infection , when service providers do not
follow aseptic technique.
 Community: Improperly disposed of medical waste-including contaminated dressings,
tissue and sharps.
 Some infections can be spread by staff to their family members or others in the
community.

INFECTION PREVENTION AND CONTROL (ICP)

ICP is a scientific approach and practical solution designed to prevent harm caused by
infection to patients and health workers.

Everyone who works at a health care facility is at risk of infection, every healthcare worker
has a role to play in practicing appropriate infection prevention.

BREAKING THE CHAIN OF INFECTION

As health professionals, we cannot provide health care services without some exposure to
potentially infectious materials, but we can prevent transmission in many cases. The only
way to prevent infectious is to break the chain of infection . The nurse must follow
certain principles and procedures to prevent infection and control its spread:
 CHAIN 1 BREAKING OF INFECTION
1) Rapid and accurate identification of organisms:
 Routinely send blood cultures, urine culture, skin swabs, throat swabs, tracheal
aspirate cultures.
 Send endotracheal tube tip, urinary catheter tip and central line tip for culture after
removal.
2) Control or elimination of infectious agents including:
 Proper cleaning by water and mechanical action with or without detergents.
 Disinfection
 Sterilization of contaminated objects. Sterilization and disinfection are physical
processes, involving the use of heat, radiation, chemical processes, etc. which use
various solutions or gases.
 CHAIN 2 (MEASURES FOR CONTROL OR ELIMINATION OF RESERVOIRS
OF INFECTION)
1. Employee Health
 Immunization of health personnel’s, eg. Hepatitis B vaccination.
 Regular check up for early detection of any communicable disease.
 Restriction from work of patient contact when infected with communicable disease.
2. Environmental cleaning
 Cleaning with hospital approved cleaner disinfectant, eg. Phenol
 Thorough cleaning of bed and bedside equipments before admitting new
admission.
 Separate mops should be used for cleaning the unit.
 Damp dusting should be done.
 Avoid brooming.
 Drains should be patent.
3. Handling of linen
 Keep the bed sheets dry and clean.
 Change sheets every day
 Don’t shake blankets and linen in ICU area
 Don’t throw them on floor
 Soiled linen counting should be done in separate place.
4. Visitors control
 Traffic should be restricted except for doctors, nurses and supportive staff.
 Allow only 1 attendant (3 to 4 hours).
 Keep the doors and windows closed.
 Instruct the attendants about hand washing , disposal of waste, hygienic preparation
of baby’s feed,etc.
5. Pest control
 Measures to be taken to avoid their entry into the unit, i.e. by proper cleaning,
sealing and draining.
 Patient diet should be kept in covered containers.
 Pesticide sprays should be used weekly.
 CHAIN 3 (PORTAL OF EXIT)
 Practice aseptic precautions.
 Avoid talking directly into the client’s face to prevent droplet infections.
 Wearing of mask is important once the nurse herself has infection or deals with
client’s suffering from infection.
 Careful handling of waste like urine, faces, blood and emesis is important.
 Disposable gloves should be worn to prevent direct contact with waste or infected
materials.
 CHAIN 4 (MODE OF TRANSMISSION)
 Airborne precautions
 Private room, well ventilated, door closed, should be there for patient with
respiratory bacterial or viral infection eg. TB, influenza.
 Place client in a private room that has negative air pressure, 6-12 air changes/ hour.
 Wear mask when entering the room of a client who is known or suspected of
having primary tuberculosis.
 Susceptible people should not enter the room of a client who has measles or
chickenpox. If they must enter then they should wear a respirator.
 Limit movement of client outside the room to essential purpose. Place surgical
mask during transport.
 Droplet precaution
 Place client in private room.
 Wear a mask if working within 3 feet of the client.
 Limit movement of client outside the room to essential purposes.
 Place surgical mask during transport.
 Contact precaution
 Wear gown when entering room if there is a possibility of contact with infected
surfaces or items or if the client is incontinent or has diarrhoea, colostomy or
wound drainage not cover by a dressing.
 Remove gown in the client’s room.
 Limit movement if client outside the room.
 Practice use of non-critical client care equipment to a single client to client with the
same infected microorganisms.
 CHAIN 5 (PORTAL OF ENTRY)
 Maintain integrity of skin and mucous membrane.
 Proper positioning of tubings, etc. may prevent injuries and skin breakdown.
 Dispose of contaminated syringes and needles properly to prevent accidental
injuries to hospital personnel as well as clients.
 Ensure personal hygiene of clients regularly.
 Care should be taken while collecting and handling specimen.
 CHAIN 6 (PROTECTING SUSCEPTIBLE HOST)
 Protecting normal defence mechanisms by
 Regular oral hygiene.
 Maintaining an adequate intake.
 Encouraging deep breathing and coughing exercises.
 Encouraging proper immunization of children and adult clients.
 Maintaining healing process involves
 Promotion of intake of a well balance diet containing essential protein, vitamins,
fats, and carbohydrate.
 Promotion of the client’s comforts and sleep.
 Helping the client to identify method to relieve stress.

STANDARD SAFETY MEASURES

With increased awareness of contamination from blood-borne pathogens (eg. Hepatitis B

virus, HIV), came the realization that “definite precautions should be taken to prevent the
infections”. The center for disease control and prevention (CDC) revised the guidelines for
isolation precaution in hospitals have now been adopted by many health care facilities.
These guidelines have been designed to reduce the link of transmission of blood born
pathogen and pathogens from moist body surfaces. These guidelines apply to-

 Blood
 All body fluids, secretions and excretion except sweat, regardless of whether or not
they contain visible blood.
 Non intact skin.
 Mucous membrane.
 STANDARD PRECAUIONS IN MEDICAL ASEPSIS AND SURGICAL ASEPSIS

 Hand washing
 Gowning
 Gloving
 Mask / protective eye wear / cap
 Disposing of contaminated equipment
 Double bagging
 Shoe cover
a) HANDWASHING
The most important and most basic technique in preventing and controlling transmission
of infection is hand hygiene.
 5 moments for hand hygiene:
 Before touching a patient.
 Before performing clean/ aseptic procedures.
 After body fluid exposure/risk.
 After touching a patient, and
 After touching the patient environment.
 THE 3 TYPES OF HANDWASHING
1) Handwashing with plain soap and running water : Removes transient microorganisms and
soil( such as dirt, blood, feces and crumbs from food. Handwashing with plain soap and
water for 10-15 seconds and rinsing in water is sufficient .
2) Handwashing with antiseptic soap and running water : Removes transient organisms and
soil and kills or inhibits the growth of resident microorganisms. Usually practice before
invasive procedures or contact with immune-compromised clients at high risk of
infection.
3) Alcohol Handrub: kills or inhibits the growth of transient and resident microorganisms
but does not remove microorganisms or soil. Usually practice when handwashing is not
possible or practical, but only if your is not visibly soiled or dirty.
 STEPS OF HANDWASHING
1. Palm to palm
2. Right palm over left dorsum and left palm over right dorsum.
3. Palm to palm fingers interlaced.
4. Backs of fingers to opposing palms with fingers interlocked.
5. Rotational rubbing of right thumb clasped in left palm, then vice versa.
6. Rotational rubbing backwards and forwards with clasped fingers of hand in left
palm then vice versa.
7. Rinse both hands properly with water.

b) GOWNING
Gown is one of the personal protective equipment , for gowning move your arm
through the sleeves and tie at the neck and back. Remove the gown carefully ,roll the
lengthwise so that the side that was towards your body is outer most and the
contaminated side is within. Then roll down the gown from top to bottom and discard
it.
C) GLOVING

Gloves provide a barrier against potentially infectious microorganisms that can be

found in blood, other body fluids and waste. Gloves act as a barrier that protects
healthcare workers and clients.
c) MASK/ PROTECTIVE EYE WEAR/CAP
The device should be changed after 20-30 minutes or if it becomes moist.
Mask should not be reused or dangled.
c) DISPOSING OF CONTAMINATED EQUIPMENT
The steps of Instrument processing reduces the risk of transmitting infections from
used instruments and other items to health care workers and clients:
 DECONTAMINATION:
The first step in processing instruments and other items for reuse, decontamination
kills viruses and microorganisms, making these items safer to handle by the staff
who perform cleaning and further processing.
The decontaminate solution : To decontaminate items, use a 0.5% chlorine
solution or a solution made from another acceptable disinfectant.
 CLEANING
Cleaning refers to scrubbing with a brush, detergent, and water to remove blood ,
other body fluids, organic material, tissue and dirt.
 STERILIZATION
Sterilization protects clients by eliminating all micro -organisms (bacteria, viruses,
fungi, and parasites), including bacterial endospores, from instruments and other
items.
METHODS OF STERILIZATION
a) Boiling
Boiling at 100 degree for 10 min kills most of pathogens.The articles should be clean
and free of organic matter.
b) Fumigation or gas sterilization
It is used to sterilize medical devices, instruments and equipment by using gaseous
agents.
c) Sterilization by ionizing radiation
Gamma radiations are used for sterilization of plastic items like disposable syringes,
catheters and sharp instruments.
 DISINFECTION
It is the process of application of a disinfectant for a sufficient length of time in
adequate quantity and strength so as to kill the specific organisms of infectious
diseases except spores.
d) DOUBLE BAGGING
A single bag is adequate if the contaminated articles can be placed in the bag without
contamination of the outside of the bag.

ASEPSIS

Asepsis is the absence of pathogenic microorganisms. The aseptic techniques refer to

practices that keep a client as free from pathogens as much as possible.

Components of aseptic technique

Aseptic technique refers to the practices performed immediately before and during a
clinical procedure to reduce postoperative infection. These include:
  Surgical scrub
 Using barriers /surgical attire/ personal protective equipment
 Client preparation preparing a client for surgical procedure)
 Maintaining a sterile field
 Using safe operative technique (making small incisions, avoiding trauma to tissue
and surrounding structures).
 Maintaining a safer environment in the surgical/ procedure area.
THE INFECTIOUS PROCESS

If the infection is localized, proper care is required to control the spread and minimize
the illness. An infection that affects the entire body instead of just a single organ or
part is systemic and can be fatal. The course of an infection influences the level of
nursing care provided.

COURSE OF INFECTION BY STAGE [DISEASE CYCLE]

 INCUBATION PERIOD –Interval between entrance of pathogen in to the body

and appearance of first sign or symptoms (chickenpox -2-3weeks)
 PRODROMAL STAGE – Interval from onset of nonspecific signs and symptoms
malaise, low grade fever, fatigue) to more specific symptoms.
 ILLNESS STAGES- Interval when client manifest signs and symptoms specific to
type of infection (common cold manifested by sore throat, sinus congestion, etc.).
 CONVALESCENCE- Interval when acute symptoms of infection disappear
(Length of recovery depends on severity infection and client’s general state of
health).

NURSING PROCESS IN INFECTION CONTROL

1) ASSESSMENT:
The nurse assesses the client’s defence mechanism, susceptibility and knowledge of
infection. By knowing the factors of susceptibility or risk of infection, the nurse is better able
to plan preventive therapy that includes aseptic technique.
2) NURSING DIAGNOSIS
During resentment the nurse gathers objective findings such as open incision or a reduced
caloric intake and subjective data such as client’s complaint of tenderness over a surgical
normal site. The diagnoses must have the appropriate etiological factors for the nurse to
establish an appropriate and well through – out – plan.

3) PLANNING
The clients care plan is based on the each nursing diagnosis and related factor’s .
Interventions are selected in collaboration with the client, the family and others in the health
care team. Planning is done to achieve the goals and outcomes.
4) IMPLEMENTATION

By recognizing and assessing client’s risk factors and implementing appropriate measures,
the client can reduce the infection. It aims at health promotion and acute care measures.

5) EVALUATION
To evaluate whether your client has achieved the expect outcome and has remained free of
infection. Maintain high standard of medical and surgical asepsis and constantly monitor the
sign on infection.
BIOMEDICAL WASTE MANAGEMENT

INTRODUCTION:

According to Bio-Medical Waste management and Handling Rules 1998 of India, Bio
Medical waste means any waste which is generated during the diagnosis, testing, treatment
or immunization of human being or animals or in research activities. In simple words,
biomedical waste is the waste generated by the medical and health institute or agencies. It
has been estimated that up to 85% to 90% of the waste generated in hospitals is non-
infectious (free with any body fluids, which is similar to domestic waste). It is the remaining
10% to 20% of waste that is of concern because it is hazardous and infectious. In addition,
waste that is un-segregated and not treated in the right manner would cause environmental
pollution affecting the health of the community.
DEFINITION:
Biomedical waste is the waste that is generated during:-
• Diagnosis, treatment or prevention of a disease.
• Biomedical research.
• Production and testing of biochemicals.
SOURCES OF BIO-MEDICAL WASTE

1)Hospital and health care centers

2)Clinics/offices
3)Medical research centres and laboratories

4)Animal ‘s institutions

5)Blood banks and collection centers

6)Biotechnological institutes and production units .

RISK GROUPS

1)Direct care givers nurses, doctors

2)Support service staff technicians, lab assistants, etc.

3)Hospital care taker staff

4)Workers of waste disposal management

5)Patient and visitors.

CLASSIFICATION OF BIOMEDICAL WASTE

Approximately 75-90% of the biomedical waste is non -hazardous and as harmless as any
other municipal waste.

The remaining 10-25% is hazardous and can be injurious to humans or animals and
deleterious to environment.
SCHEDULE I

CATEGORIES OF BIO-MEDICAL WASTE

Waste Category No. Waste Category [Type] Treatment and Disposal

Category Human Anatomical Waste Incineration/deep burial

No.1
(human tissues, organs, body
parts )
Category Animal Waste Incineration/deep burial
No.2 (animal tissues, organs, body
parts
carcasses, bleeding parts, fluid,
blood
and experimental animals used
in
research, waste generated by
veterinary
hospitals, colleges, discharge
from
hospitals, animal houses)
Category Microbiology & local autoclaving/micro-
No.3 Biotechnology waving/incineration
Wastes
(Wastes from laboratory
cultures, stocks
or specimens of micro-
 organisms live or
attenuated vaccines, human
and animal
cell culture used in research
and
infectious agents from research
and
industrial laboratories, wastes
from
production of bio-logicals,
toxins,
dishses and devices used for
transfer of
cultures)
Category Waste sharps disinfecting (chemical
No.4 (needles, syringes, scalpels, treatment/autoclaving/
blades, glass microwaving and multilation
etc. that may cause puncture /shredding )
and cuts.
This includes both used and
unused
sharps)
Category Discarded Medicines and incineration/destruction and
No.5 Cytotoxic drugs drugs disposal in secured
(wastes comprising of out landfills
dated, contaminated and
discarded medicines)
Category Soiled Waste incineration
No.6 (Items contaminated with autoclaving/microwaving
blood, and
body fluids including cotton,
 dressings,
soiled plaster casts, lines
beddings, other material
contaminated with blood)
Category Solid Waste disinfection by chemical
No.7 (wastes generated from treatment, Autoclaving/
disposable items microwaving and
other than the waste sharps mutilation/shredding
such as tubing’s, catheters,
intravenous sets etc.)
Category Liquid Waste disinfection by chemical
No.8 (waste generated from treatment and discharge
laboratory and into drains.
washing, cleaning, house-
keeping and
disinfecting activities)
Category Incineration Ash disposal in municipal landfill
No.9 (ash from incineration of any
bio-
medical waste)
Category Chemical Waste Chemical treatment and
No.10 (Chemicals used in discharge into drains for
production of liquids and secured landfill
disinfection, as insecticides for
etc.) solids

DISPOSAL OF HOSPITAL WASTE

The government of India first enacted and environment (protection ) Act in1986 then
satisfied the biomedical waste management and handling rule 1998.

According to rules,it shall be duty of every occupier of an institute generating hospital or

biomedical waste. Two schedules;

schedule1-categories of biomedical waste in india

schedule2-colour coding and type of container for disposal of biomedical waste.

SAFE DISPOSAL METHODS OF BIOMEDICAL WASTE

1) Collection and segregation.
2) Transportation and storage.
3) Disposal techniques.
1) Collection and segregation – Hospital waste should be collected at the site of
generation only.Segregation(classification) aims to keep the harmly infected material
separate from the harmless and non- contagious waste. For this purpose, use of
specially coloured dustbin and plastic bag is mandatory.

SCHEDULE-II

COLOR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF

BIOMEDICAL WASTES
Color coding Type of Waste category Treatment options as per
container schedule 1
Yellow Plastic bag Cat. 1,2,3,6. Incineration/deep burial
Red Disinfected Cat. 3,6,7 Autoclaving/Microwaving
container/plastic /Chemical treatment
bag

Blue/White Plastic Cat. 4,7 Autoclaving/Microwaving

translucent bag/Puncture /Chemical treatment &
proof container Destruction/ Shredding
Black Plastic bag Cat. 5,9,10 Disposal in secured
landfill

Procedures and facts should be kept in mind during the collection and segregation of
biomedical waste-
 Bins and bags should bear the symbol of biomedical hazards.
 Never mix infectious waste with non-infectious waste.
 Needles should be destroyed with a needle cutter
 All sharps should be kept in puncture,proof box and properly labelled.
 Disposable items(syringes,IV bottles,etc) should be undertaken only when they
have been mutilated and chemically disinfected dipping in 1% hypochlorite
solution for 30minutes.
 Waste should not be spill outside . Non infectious waste can be dealt with as
normal household waste and does not require any special treatment.

2)Transportation and storage-

 Before taking the bag away,ensure that it is properly tied and labelled and there
is no possibility of spillage.
 Persons handling the waste bags should not touch the items of public use.
 A covered, bio hazard symbolized hand cart may be used to transport the waste
to the central storage area of the hospital.
 Do not throw the bags haphazardly as this may tear and the waste may spill out.
 Unauthorized people should not enter in the storage area.
 As per rules, biomedical waste cannot be stored more than 24 to 48 hours.
  Always use closed transportation from the site of central storage to final
disposal site.

DISPOSAL TECHNIQUES

1) Chemical Disinfection : Solid waste as plastic,rubber and metallic item, IV sets,blood

bags, gloves, catheters, urobag, syringe, needles etc. must be disinfected before they are sent
for final disposal(landfill).Chemical disinfection is also most appropriate method to treat ,the
liquid waste such as blood, urine, stools or hospital sewage.

2) Thermal Measures (wet and dry)

a) Autoclave ( wet thermal treatment): It is effective method of sterilization for microbiology

and biotechnology waste. But cannot be used for human anatomical waste.

b) Hydroclave ( Dry thermal treatment): In this method, shredded infectious waste is exposed
to high temperature, high pressure steam like autoclaving. It dries 80% liquid of waste and
waste is reduced to 20% -30% in weight.

3 ) Microwave irradiation: This technique is also effective in sterilizing the infected

disposable waste. Most microorganism are destroyed by the action of microwaves.

4) Incineration: It is a high temperature dry oxidation process that reduces organic,

incombustible matter. It also reduces the volume and weight of the waste.

Three types of incinerators:

a)Single chamber furnaces- These are simple and cheapest units.

b)Double chamber pyrolytic incinerators- Most suitable and commonly used process for
health care waste is first pyrolytic chamber, waste is destroyed through an oxygen deficient,
medium temperature.

c)Rotary- Kiln: It comprises a rotating oven and post combustion chamber. It is specially
used to burn chemical wastes( cytotoxic drugs and pharmaceuticals)

5) Inertization: In this process, cement and other substances are mixed with waste before
disposal. Mixing of cement reduces the risk of migrating toxic substances into surface water
or ground water.
6) Landfill: It is quite effective, provided practiced appropriately a sanitary landfill observing
certain rules can be acceptable choice for disposal of biomedical waste, particularly in
developing countries like India.

HOSPITAL WASTE SAFETY

Among all health care workers, nurses spend more and longer time in hospitals and usually
become the victim of hepatitis B or HIV infection because of not handling the waste properly
and lack of safety measures. So safety measures are necessary to protect the nurse's own
health.
AIMS OF SAFETY MEASURES:
 To prevent the transmission of disease from patient to patient, from patient to nurses,
health care workers and vice versa.
 To prevent injury to nurses while handling the waste.
 To prevent general exposure to harmful toxic of the cytotoxic , chemical biomedical
waste as much as possible.
MEASURES OF PROTECTION
1) Personal protective equipments (PPE)
2) General protective measures.
 Vaccinated against hepatitis B.
 Careful handling of sharps and needles.
 Avoid personal exposure to radiation.
 Care during dealing with HIV or hepatitis B positive cases.
3) Case of injury caused by infected sharps

a)Special precautions are needed if the sharps are infected with HIV or hepatitis B
cases.

b) In case if infectious solution is spilled on the body.

 Removed the soiled clothes and wash the parts with plenty of water.
 Apply any non-irritant antiseptic cream on that part.
 Consult the physician.
-Post exposure prophylaxis with antiretroviral drugs( combination of 2-3drugs)
is advisable to nurses or healthcare workers, within two hours of exposure.
4) Other measures of safety
 Nurses need to well equipped with latest information, skills and practice in managing
and handling the biomedical waste.
 There should be continuous system of evaluation about hospital waste management by
the nursing supervisors for the nurses.

CONCLUSION

Biomedical wastes are one of the major causes of infection in the hospital settings. So it’s
the responsibility of the hospital authority along with the health care team workers to collect,
segregate, transport and store and dispose it off to safeguard the people from hospital
acquired infection.

JOURNAL REFERENCE

ABSTRACT

K.V. Radha

A case study of Biomedical Waste Management in Hospitals.

Biomedical waste is receiving greater attention due to recent regulations of the biomedical
wastes ( management and handling rules, 1998). Inadequate management of biomedical
waste can be associated with risks to health care workers, patients, communities and their
environment. The study was conducted to assess the quantities and proportions of different
constituents of wastes, handling ,treatment and disposal methods in different health care
settings. Questionnaire was obtained from WHO, with the aim of assessing the processing
systems of BWM disposal. Hazards associated with with poor BMW and shortcomings in
the existing system were identified.

BIBLIOGRAPHY
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