An Experimental Study to Evaluate Effectiveness of Bio-medical Waste Management Training Program on Knowledge Level regarding BMW Management among Nursing student of selected Nursing College in
Uttar Pradesh
Kusum Lata1, Nasima2, Altmash2, Ujjwal2, Nishu2, Shainki2, Sahil2, Mohd Abid2,
Vaseem2, Surat Ram Kudi1*
1Nursing Tutor, CON, AIIMS, Jammu, India.
2BSc. Nursing 4th Year Student, Ch. Kehar Singh Educational Trust Baraut, Baghpat U.P, India.
*Corresponding Author E-mail: srjat789@gmail.com
ABSTRACT:
Background: Medical waste states to all waste produced
in healthcare or in diagnostic activities and classify medical waste into two
type of medical waste which include municipal or general waste which occupy 75%
to 90 % of total waste produced in healthcare facilities and special waste
which occupy the rest of 10 to 20% of hospital wastes. The knowledge of
healthcare providers is very important to the best practice of waste management
this help them, community, and environment to be safe from hazardous.
Aim of study: This study aimed to evaluate effectiveness of Bio-medical
waste management training program on knowledge level regarding BMW
management among nursing student of selected nursing college in Uttar Pradesh. Methods:
A quasi-experimental study design was adopted to conduct this study. 120
nursing students were recruited from selected nursing college in U.P. Structured knowledge questionnaire on bio medical waste management
was used to evaluate the knowledge of the participants. SPSS v.21 was used to
analyze the finding of the study. Paired t-test will be used to compare the
pre-test and post-test knowledge mean score. Independent t-test will be used to
compare the pre-test and post-test knowledge mean score between control and
experimental group. Results:
Mean knowledge score of
the participants of the experimental group at baseline was 12.17±0.57,
immediately after intervention was 20.00±0.50 and follow up was 19.85±0.59
while mean knowledge score of the participants of the experimental group at baseline
was 12.12±0.46, immediately after intervention was 12.23±0.66 and follow up was
19.85±0.59. In experimental group 78.3% increased their knowledge level to
adequate level while 21.7% had moderately adequate knowledge level immediately
after intervention and in follow up 55% had adequate knowledge level and 45%
had moderately adequate knowledge level. There was statistical difference
between experimental and control group post-test 1 immediately after STP
administration with t value 7.04 at p<0.001 and post-test 2(follow up test)
with t value 6.01 at p<0.001.
Conclusion: Structured teaching program on Bio-medical waste management
was effective. Training program should be organized regularly for nursing
students to update their knowledge regarding Bio medical waste management and
to improve their skills.
KEYWORDS: Experimental Study, Bio-medical Waste Management Training Program, Knowledge Level, BMW Management, Nursing Student, Uttar Pradesh.
INTRODUCTION:
Medical waste is identified as a by-product of healthcare such as blood, body parts, sharps, chemicals medicines, radioactive elements and medical devices. It is classified into four: generated, infectious, hazardous and radioactive.1 Of the total amount of waste generated by health-care activities, about 85% is general, non-hazardous waste. The remaining 15% is considered hazardous material that may be infectious, toxic or radioactive. Public health and environment are at risk due to unsuitable medical waste disposal procedures, inadequate of physical sources, and deficiency of lookup on clinical waste management.2
20% and 70% of medical waste originates from a hospital’s working room and that up to 90% of this waste is inappropriately sorted and dispatched for pricey and unnecessary hazardous waste processing.3 Waste minimization is most favourable way used in medical waste management which may promote sustainable program; this step is composed by reduction at source, reuse, recycle, and compositing of medical waste.4
The knowledge of healthcare providers is very important to the best practice of waste management this help them, community, and environment to be safe from hazardous. Though Health care workers practices involved in bio-medical waste management still they have inadequate knowledge which further lead to poor practice of waste management.5 Students had lacunae in terms of knowledge regarding Bio-medical waste management.6
Biomedical waste poses significant health and environmental hazards if not managed properly. Nursing students play a crucial role in healthcare and must have adequate knowledge of BMW management to ensure safe disposal practices, prevent infections, and comply with regulations. Studies have shown that nursing students often have inadequate knowledge about BMW management due to insufficient training in their curriculum. A training program can bridge this gap. This motivated the researchers to conduct this study.
HYPOTHESIS:
H1: There will be significant difference in knowledge level regarding BMW management between experimental and control group nursing students after administration of STP at p<0.05 level of significance.
H2: There will be significant association between knowledge level of experimental group & selected demographic variables of nursing students at P< 0.05 level of significance.
H3: There will be significant association between knowledge level of experimental group & selected demographic variables of nursing students at P< 0.05 level of significance.
METHODOLOGY:
A quasi-experimental study was conducted on nursing students of selected nursing college of Uttar Pradesh. A convenient sampling technique was used to conduct this study. A sample of 90 participants was decided based on the statistical analysis at α = 5% and power = 80%. Considering 10% attrition rate 120 participants were chosen, 60 for experimental group and 60 control group. All chosen participants were available during the study time so 120 participant data have been carried forward for statistical analysis. Students undergoing graduation or diploma courses, aged >18 years and can speak, read and write English were selected. Students who had history or been diagnosed with any kind of mental illness during the period of data collection were excluded from study.
DATA COLLECTION PROCEDURE:
Ethical permission has obtained from the institute ethical committee. Data has been taken from the participants who met inclusion criteria. Using convenient sampling technique, the subjects were recruited and allocated in control and experimental group. Informed consent form was taken from participants. Purpose of the study was told to them. Participants were assured that they can drop from the study anytime without having any fear.
Following this, data regarding socio demographic variables was filled. Pre-test was taken from the participants by self-administration of knowledge questionnaire from experimental and control group both. Following this training on Bio-medical Waste management was given to Experimental group participants. Training was about 1hour. On the same day post-test-1 was conducted by self-administration of knowledge questionnaire from both experimental and control group. Post test 2 was taken after 6weeks±7days of training program by self-administration of same knowledge questionnaire from both experimental and control group. It took 15-20 minutes to administer demographic tool and structured knowledge questions.
RESULTS:
Table 1: Demographic characteristics of nursing students of experimental and control group N=120
|
Demographic Characteristics |
Experimental Group n=60 |
Control Group n=60 |
|||
|
f |
% |
f |
% |
||
|
Age |
18-19 years |
25 |
41.7 |
25 |
41.7 |
|
20-21 years |
26 |
43.3 |
29 |
48.3 |
|
|
22-23 years |
9 |
15 |
6 |
10 |
|
|
Gender |
Male |
5 |
8.3 |
5 |
8.3 |
|
Female |
55 |
91.7 |
55 |
91.7 |
|
|
Area of Residence |
Metropolitan city |
4 |
6.7 |
3 |
5 |
|
Urban |
40 |
66.7 |
37 |
61.7 |
|
|
Rural |
16 |
26.7 |
20 |
33.3 |
|
|
Course |
B.Sc. Nursing |
39 |
65 |
43 |
71.7 |
|
GNM |
21 |
35 |
17 |
28.3 |
|
|
Previously attended program on BMW |
No |
8 |
13.3 |
4 |
6.7 |
|
Yes |
52 |
86.7 |
56 |
93.3 |
|
Table 2 Mean Knowledge Scores of experimental group and control group participants at Baseline, immediately after intervention and follow up.
|
Test |
Knowledge Scores (Mean±SD) |
|
|
Experimental Group (n=60) |
Control Group (n=60) |
|
|
Pre test |
12.12±0.46 |
|
|
Post test-1 |
||
|
Post test-2 |
||
Demographic characteristics are shown in Table 1. Table 2 depicts knowledge Scores of experimental and control groups. Mean knowledge score of the participants of the experimental group at baseline was 12.17±0.57, immediately after intervention was 20.00±0.50 and follow up was 19.85±0.59. Mean knowledge score of the participants of the control group at baseline was 12.12±0.46, immediately after intervention was 12.23±0.66 and follow up was 11.50±0.59.
Table 3 shows knowledge level of participants of experimental and control group at baseline, immediately after intervention and follow up. In experimental group More than half of the participants (55%) had moderately adequate knowledge level, 38.3% had adequate knowledge and 6.7% had Inadequate knowledge level before intervention. 78.3% increased their knowledge level to adequate level while 21.7% had moderately adequate knowledge level immediately after intervention and in follow up 55% had adequate knowledge level and 45% had moderately adequate knowledge level. No one had inadequate knowledge level after intervention in Experimental group. In control group Nearly two third of the participants (63.3%) had moderately adequate knowledge level, 21.7% had adequate knowledge and 15% had Inadequate knowledge level before intervention. 65% had moderately adequate level while 20% had adequate knowledge level and 15% had inadequate knowledge level immediately after intervention and in follow up 65% had moderately adequate knowledge level and 23.3% had adequate knowledge level and 11.7% had inadequate knowledge level.
Table 4 showing comparison of mean knowledge scores of with in experimental and control group pre and post-intervention. In experimental group there was statistically significant difference between pre-test and post-test 1 with t value 7.62 at <0.0001 level of significance, post-test 1 and post-test 2 with t value 4.13 at <0.0001 level of significance, and pre-test and post-test 2 with t value 4.12 at <0.0001 level of significance. In control group there was no statistically significant difference between pre-test and post-test 1, post-test 1 and post-test 2 and pre-test and post-test 2 at <0.05 level of significance.
Table 5 showing comparison of mean knowledge scores of experimental and control group pre and post-intervention using Independent t test. There was no statistically difference in baseline knowledge level between experimental and control group participants at p<0.05 level of significance. There was statistical difference between post-test 1 immediately after STP administration with t value 7.04 at p<0.001 and post-test 2 (follow up test) with t value 6.01 at p<0.001
Hence Null hypothesis H01 there will be no significant difference in knowledge level regarding BMW management between nursing students of experiment group and control group after intervention at p< 0.05 level of significance is rejected and H1 is accepted.
A statistical association has been found only between age and baseline knowledge level of experimental and control group both. Hence null hypothesis H02 and H03 is accepted.
Table 3: Knowledge level of participants of experimental and control group at baseline, immediately after intervention and follow up.
|
Knowledge level |
Experimental group (n=60) |
Control group (n=60) |
||||
|
Pretest |
Post-test 1 |
Post test 2 |
Pretest |
Post-test 1 |
Post test-2 |
|
|
Adequate knowledge (≥80%) |
23 (38.3%) |
47 (78.3%) |
33 (55%) |
13 (21.7%) |
12 (20%) |
14 (23.3%) |
|
Moderately adequate knowledge (60-79%) |
33 (55%) |
13 (21.7%) |
27 (45%) |
38 (63.3%) |
39 (65%) |
39 (65%) |
|
Inadequate knowledge (<60%) |
4 (6.7%) |
0 |
0 |
9 (15%) |
9 (15%) |
7 (11.7%) |
Table 4 Comparison of mean knowledge scores of with in experimental and control group pre and post-intervention using paired t test
|
Test |
Experimental Group (n=60) |
Control Group (n=60) |
||
|
t test |
p value |
t test |
p value |
|
|
Pre-test- Post test 1 |
7.62 |
<0.0001 * |
1.45 |
0.6 |
|
Post -test1-post-test 2 |
4.13 |
<0.0001 * |
1.09 |
0.2 |
|
Pre-test - post test 2 |
4.12 |
<0.0001 * |
1.18 |
0.2 |
*statistically significant at p<0.05
Table: 5 Comparison of mean knowledge scores of experimental and control group pre and post-intervention using Independent t test N=120
|
Pairwise test comparison |
Mean Difference |
SE difference |
Confidential Interval |
t test |
df |
p value |
|
|
Lower |
Upper |
||||||
|
Pre test |
1.05 |
0.9 |
0.67 |
2.76 |
1.21 |
118 |
0.2 |
|
Post-test 1 |
5.76 |
0.8 |
4.14 |
7.38 |
7.04 |
118 |
<0.001* |
|
Post test 2 |
4.35 |
0.8 |
2.68 |
6.01 |
5.17 |
118 |
<0.001* |
*statistically significant at p<0.05
DISCUSSION:
This study was conducted to assess the knowledge of the nursing students regarding Bio medical waste management and finding effectiveness of training program on knowledge. Prior to the intervention, a substantial knowledge gap was evident, suggesting that traditional curricula may not sufficient to improve nursing student knowledge regarding biomedical waste management. In this study experimental group and control group comprises 91.7% participants females. In experimental group 65% participants were pursuing BSc nursing, 35% participants were doing GNM and in control group 71.7% participants were pursuing BSc nursing, 28.3% participants were doing GNM.
Mean knowledge score of the participants of the experimental group at baseline was 12.17±0.57, immediately after intervention was 20.00±0.50 and follow up was 19.85±0.59 while mean knowledge score of the participants of the experimental group at baseline was 12.12±0.46, immediately after intervention was 12.23±0.66 and follow up was 19.85±0.59.
In experimental group more than half of the participants (55%) had moderately adequate knowledge level, 38.3% had adequate knowledge and 6.7% had Inadequate knowledge level before intervention. 78.3% increased their knowledge level to adequate level while 21.7% had moderately adequate knowledge level immediately after intervention and in follow up 55% had adequate knowledge level and 45% had moderately adequate knowledge level. No one had inadequate knowledge level after intervention in Experimental group. There was statistically significant difference between pre-test and post test 1 with t value 7.62 at <0.0001 level of significance, post test 1 and post test 2 with t value 4.13 at <0.0001 level of significance, and pre-test and post test 2 with t value 4.12 at <0.0001 level of significance. Sukhbir et.al found paired t-test was applied to the pre and post-test scores, and the difference in knowledge regarding BMW rules among pre- and post-test group was found statistically significant at p<0.0001.5 Kaur et.al conducted experimental study and found mean post-test knowledge scores (26.70) of subjects after administration of Self Instructional Module was found to be significantly (p<0.01) higher than their mean pretest knowledge score (17.52). In pretest, majority 26(52%) of subjects secured average knowledge scores followed by 17(34%) who were having good knowledge scores and 5 (10%) subjects who had poor knowledge scores. Only 2 (4%) subjects had very good knowledge scores. After administration of Self-Instructional Module, the level of knowledge scores of study subjects increased as the result of post-test shows 36(72%) achieved very good level of knowledge score followed by 14(28%) who attained good level of knowledge score. None of the subjects were found to be having average, poor or very poor level of knowledge scores.7 Shivashankar Appa found mean difference between pre-interventional (4.7±1.7) and post-interventional knowledge (post-test 1–8.8±1.3; post-test 2–7.3±1.4) regarding Bio-medical waste management. Similarly, a significant difference in mean between pre-interventional (5.9±1.4) and post-interventional practices (post-test 1–8.6±1.1; post-test 2–7.3±1.2) regarding BMW management.8
CONCLUSION:
Structured teaching program on Bio-medical waste management was effective. There was statistical difference between experimental and control group post test-1 immediately after STP administration. Regular training workshops, simulation-based learning, and assessments should be incorporated to reinforce best practices. Furthermore, aligning nursing education with national and international biomedical waste disposal guidelines will enhance compliance and improve patient safety. Further studies should be done to assess the clinical practices of the nursing students regarding biomedical waste management.
ACKNOWLEDGEMENT:
We are thankful to Prof. Mahendra Kumar to guide us through out the study period. We are grateful to the participants.
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Received on 21.02.2025 Revised on 18.08.2025 Accepted on 28.01.2026 Published on 30.04.2026 Available online from May 02, 2026 Int. J. Nursing Education and Research. 2026;14(2):116-120. DOI: 10.52711/2454-2660.2026.00023 ©A and V Publications All right reserved
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