A Comparative Study to assess the level of knowledge regarding Biomedical Waste Management among staff Nurses in selected hospital of Udaipur

 

Rohit Yadav^1*, Dashrath Menaria¹, Monika Bhatia¹, Rajendra Meghwal¹,

Roopchand Meena¹, Ms. Asha Chacko²

¹B.Sc.(N) IV, Mass College of Nursing, Udaipur

²Lecturer, Mass College of Nursing, Udaipur

 

ABSTRACT:

The study was conducted with an aim to assess level of knowledge regarding biomedical waste Management among staff Nurses in selected hospital of Udaipur. The research design selected for the study was non-experimental comparative research design with purposive sampling technique for the selection of samples. 40 nurses were selected from Choudhary Hospital and Udaipur Hospital. Background of study: "Bio Medical Waste " means any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining or in the production or testing of biological and Health Care facilities. Hospital are meant to ensure community Health. It is thus surprising that till recently not enough attention has been given to the proper disposal of hospital waste. Infectious waste can transmit various diseases to the staff as well as community and put those handling the waste to risk. However what is not commonly known is that 20% of all the waste is infectious and hazardous and other 80% is not infectious. Objectives: To assess the level of knowledge regarding the Bio medical waste management among Staff Nurses of selected Hospitals of Udaipur.To find out the association of level of knowledge with selected demographic variables. To compare the level of knowledge regarding Bio medical waste management among staff Nurses in selected Hospitals of Udaipur. Methodology: A non experimental comparative research design was used for the study. The sample size consisted of 40 nurses selected by purposive sampling technique. A knowledge questionnaire used to collect data from nurses regarding biomedical waste management. The obtained data was analyzed and interpreted using descriptive and inferential statistics. Result: There is no significance association between level of knowledge and socio demographic variable age, gender, religion education, socio economic status, working experience, area of work due to small sample size (N = 40) hence RH₁ is rejected. it is revealed that the calculated value of ‘t’ is -1.328 which is actually less than the P < 0.05 level (t₃₈ = 2.024) so it reveals that there is no significant difference between level of knowledge of staff nurse of Udaipur and choudhary hospital.

 

 

INTRODUCTION:

Background of the study:

"Bio Medical Waste " means any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining or in the production or testing of biological and Health Care facilities.

 

 

Hospital are meant to ensure community Health. It is thus surprising that till recently not enough attention has been given to the proper disposal of hospital waste. Infectious waste can transmit various diseases to the staff as well as community and put those handling the waste to risk. However what is not commonly known is that 20% of all the waste is infectious and hazardous and other 80% is not infectious. (Park k., 2002)

 

The small percentage can be hazardous which includes infected sharp and wastes with infection, radioactive or genotoxic waste when inadequately treated and managed can have adverse impact on the environment and on the public health through air, land and water pollution. Therefore institutionalizing effective waste management system in all health care facilities is a key prerequisite in improving efficiency and effectiveness of health care.

 

Nearly 66% of the rag pickers in India suffer from  injury or wound because of improper biomedical waste management. It is postulated that in Japan, the risk of HIV and hepatitis infection after Hypodermic needle prick is 0.3 and 3%. (swarnkar, 2006)

 

In one study it was absorbed that there were 700 injuries per 1000 nursing staff per week in India, out of which 60% were due to needle recapping or handing (NJI-Dec 2002)

 

In Government Hospital, the generated bio medical waste rate is 0.5 – 4kg /bed/day and in private hospitals generated waste rate is 0.5 -2 kg/bed/day and in nursing Homes 0.5-1kg / bed day (Swarnkar, 2006)

 

Risk of Infection is greater for pricks from hollow Hypodermic needles as compared to suturing Needles.The risk of Infection for HIV is 0.3%, for Hepatitis B virus is 30% and for Hepatitis C virus is 3% - 10% due to Improper Bio Medical waste Management (RAO, 2001)

 

REVIEW OF LITERATURE:

Mohd Shafee et al (2010):

Conducted a study to assess the knowledge, attitude and practices of Hospital staff regarding biomedical waste management, in Karimnagar town (Andhra Pradesh). 500 subjects from 47 private registered homes were selected by systematic random sampling. The data were collected by one to one interview using pre-tested pre designed performa. This hospital based cross – sectional study was performed from March to September 2009 and statistical analysis was done using chi square Test and percentage. Results revealed that Nurses had a statistically significantly better knowledge than the technical and housekeeping staff (P<0.001, x²=30.9). The study showed that 85% Nurses, 14% housekeeping and 12% technical staff had knowledge about biomedical waste management. It was found that 98% of the nurses and 79% of the house keeping staff had a positive attitude while only 59% of the technical staff had positive attitude towards biomedical waste management.

 

N Nirupama et al (2009). Conducted a study to assess knowledge, attitude and practices about bio medical waste management among nursing technical and housekeeping staff. The study was conducted in the 47 private hospitals and clinics in Karimnagar town of Andhra Pradesh. Samples were selected by Systematic Random sampling. Results Revealed that 95.8% of subjects had knowledge about the health hazards but only 1.6% of the study subjects had knowledge about the 10 categories of biomedical waste management. It was also found that 47.2% of Nurses, 26.4% of Technicians and 26% of housekeeping staff were housing positive attitude towards biomedical waste management. Study also reveals that 45.4% Nurses, 25.8% Technicians and 13.8% of Housekeeping staff are following biomedical waste management Rules. Results concluded that nurses had a significantly better knowledge and practices than the technical and house keeping staff. Regular training programme about efficient management of biomedical waste management are necessary to improve the present situation.

 

Sireegiri et al (2009) Conducted a study to assess the awareness about the biomedical waste management and universal precautions among the health care personnel. This is a cross sectional hospital based study in a tertiary level hospital. 134 samples were selected randomly. Information was obtained by both interview and observation methods. Results Revealed that only 8.5% of Doctors, 57.1% of paramedical and 11% of the class IV staff had adequate awareness on type and hazards of waste and only 53% of class IV. 11% of Doctors and 32% of Staff Nurses were able to tell about the methods / guidelines of segregation and collection of waste in colour coded bins. Researcher concluded that safe handling of biomedical waste management continues to be a matter of serious concern for health authorities.

 

P. Hanumantha Rao et al (2008): Conducted a study to assess the awareness about the medical waste management and universal precautions among the health care workers. The study was conducted in Hospitals Nursing Homes in urban as well as rural areas of country. Stratified cluster sampling techniques was used to select the sample. A Observation and Questionnaire method was used to collect the Data. Results revealed that awareness of bio medical waste management rules was better among Hospital staff in comparison with private medical practitioner and awareness was marginally higher among these in urban areas in comparison with in rural areas.

 

NEED FOR THE STUDY:

Study of bio medical waste is very important because 80% of all the waste generated in Hospital is non infectious, 15% is infectious dressings and anatomical waste, 5% is not infectious but Hazardous (Swarnkar 2006). So when this 20% infectious material of hospitals mixes with 80% of non infectious material in the municipal waste Dumpyard, all the 100% waste becomes hazardous and infectious.

 

Improper Disposal of Medical waste including open dumping and uncontrolled burning for instance increases the risk of spreading infection and of exposure to toxic emissions from incomplete combustions. The problems associated with medical waste disposal is aggravated due to rapid and uncontrolled growth of medical care facilities, increase of waste generation rate owing to marked increase in disposable medical care materials, illegal and unsafe method of recycling of waste due to increased cost of disposable medical care materials. This situation can cause a potential health Hazard (epidemic) to public at large, especially health care workers municipal employees and rag pickers involved in recycling of waste. (Shrinivas Chary, 1999)

 

According to a study carried out by WHO more than 50000 people die every day from Infectious Disease (WHO, 1996) and one of the cause for the increase in infectious disease is improper waste management. Body fluids and body incretion are constituents of bio medical waste which harbours most of the viruses, bacteria and parasites that causes infections. This passes via a number of human contacts, all of whom are potential recipients of the infections.

 

Besides HIV and Hepatitis-B virus Tuberculosis, pneumonia, Diarrhoea, tetanus whooping cough are other common diseases spread due to improper Bio medical waste management.

 

The general public health can also be adversely affected by Bio medical waste, improper practices of such as dumping of biomedical waste in municipal dustbins, open spaces, water bodies etc. levels to spread of diseases.

 

Harmful chemicals such as dioxins and furans can cause serious health hazards to animal and birds.

 

During our clinical posting in various hospital we witnessed many incidents of needle pricks and health hazards due to improper waste management. When going through various reviews it was found that improper biomedical waste management leads to great deal of health hazards, so we felt a need to assess the knowledge of the staff nurses regarding Biomedical waste management.

STATEMENT OF THE PROBLEM:

A comparative study to assess the level of knowledge regarding biomedical waste Management among staff Nurses in selected hospital of udaipur

 

OBJECTIVE OF THE STUDY:

1    To assess the level of knowledge regarding the Bio medical waste management among Staff Nurses of selected Hospitals of Udaipur.

2    To find out the association of level of knowledge with selected demographic variables.

3    To compare the level of knowledge regarding Bio medical waste management among staff Nurses in selected Hospitals of Udaipur.

 

MATERIAL AND METHODS:

Research Design:

In our research non- experimental – Comparative research design is used.

 

Sample:

In this study, the sample comprised of 40 staff nurses.

 

Sampling Techniques:

In our research we use the purposive sampling technique.

 

Samples selection criteria:

a)   Inclusive criteria:

1.     Nursing staff willing to participate in the study.

2.     Staff nurses who are working in general units.

 

b)   Exclusive criteria:

1)    Who had previously participated in similar studies.

 

Sample Size:

The sample size of present study was 40 staff nurses.

 

Description of the tool:

The final tool designed for the study consisted of two sections.

 

i)      Section – A: Socio – demographic variables:

This section consisted of a questionnaire to collect the base line data which consisted of seven items for obtaining information regarding, age, sex, religion, education, socio economic status, working experience and area of work.

 

ii)    Section – B: Questionaire to Assess the level knowledge of staff Nurses.:

The section B consisted of Structured Questionnaire to assess the knowledge level of staff nurses regarding biomedical waste management. It consisted of 24 items.

 

 

Data Collection Process:

Ethical consideration was fulfilled by taking written permission from the administrative authority of the Hospitals and by taking an informed consent from the nurses. The study was conducted from to the total sample of forty nurses selected. Data collection in Udaipur hospital was done on staff nurses and in choudhary hospital was done on staff nurses. The total time taken by the nurses to fill up the questionnaire was 20 minutes. The investigators terminated the data collection procedure by thanking the respondents for their co-operation and participation.

 

PLAN FOR DATA ANALYSIS:

Analysis of data was planned on the basis of objectives and hypothesis.

i)    Base – line data containing sample characteristics would be analyzed using frequency and percentage.

ii)   Chi- Square test would be used to find out association between level of knowledge and selected demographic variables.

iii)  Significant different between the 2 groups was planned to be calculated using student 't' test.

 

Organisation And Presentation of Data:

The findings were organised and presented under the following sections.

 

SECTION I – Socio demographic characteristics of nurses.

SECTION II- Association of level of knowledge with selected socio demographic variable.

SECTION III: Comparison of level of knowledge of both the groups.

 

RESULTS:

SECTION I – Socio demographic characteristics of nurses:

Among 40 nurse, 14 were from age group 22-23 years, 22 were males,36 belonged to hindu religion,37of them were GNM,26 of them earned < 10000/-,16 had work experience of 1-5 years and 21 worked in general wards.

 

 

 

SECTION II- Association of level of knowledge with selected socio demographic variable.

Table 2: Association of level of knowledge with selected demographic variables.

Group	Poor Knowledge	Average Knowledge	Good Knowledge	Df	Chi-square
1)Age a) 20-21 yrs b) 22-23 yrs c) 24-25 yrs d) >26 yrs	0 0 0 0	5 9 5 2	1 5 3 5	6	5.66
2) Gender a) Male b) Female	0 0	12 9	10 9	2	0.076
3) Religion a) Hindu b) Muslim d) Sikh e) Others	0 0 0 0	19 1 0 1	17 0 0 2	6	1.331
4) Education a) ANM b) GNM c) B.Sc. Nursing	0 0 0	1 17 2	0 37 0	4	3.24
5) Socio Economic Status a) >10,000 b) 10001-15001 c) 15001-20000 d) <20,000	0 0 0 0	14 5 1 2	12 4 1 1	6	0.13
6. Working experience a)< 1 yer b)1-5 yrs. c)5-10 yrs d)>10 yrs	0 0 0 0	7 7 5 2	1 9 7 2	6	4.954
7. Area of Work a)General Ward b)ICU c)Operation Theatre d)Post operative ward	0 0 0 0	11 6 3 1	10 3 3 3	6	2.31

 

There is no significance association between level of knowledge and socio demographic variable age, gender, religion education, socio economic status, working experience, area of work due to small sample size (N = 40) hence RH₁ is rejected.

 

SECTION III Comparison of level of knowledge of staff nurse of Both the hospitals:

Table – 3 comparison of level of knowledge of staff nurses of Udaipur and choudhary hospital

S. N.	Group – I	Group II
1.	12	10
2.	20	9
3.	20	14	t38 = 2.024
4.	9	20
5.	17	17
6.	18	18
7.	9	20
8.	9	19
9.	18	15
10.	23	20
11.	14	12
12.	10	12
13.	17	15
14.	11	18
15.	12	18
16.	11	12
17.	9	18
18.	13	14
19.	18	21
20.	19	21

 

From Table 3. it is revealed that the calculated value of ‘t’ is -1.328 which is actually less than the P < 0.05 level (t₃₈ = 2.024) so it reveals that there is no significant difference between level of knowledge of staff nurse of Udaipur and choudhary hospital.

 

DISCUSSION:

Association of level of knowledge with selected socio demographic variable:

Mohd Shafee et al (2010). Conducted a study to assess the knowledge, attitude and practices of hospital staff. Results revealed that nurses had a statistically significantly better knowledge than the technical and housekeeping staff (P<0.001 x²=30.9).

 

In our study no association was found p≤0.05 level as the sample size was small so R_H1 was rejected.

 

Comparison of level of knowledge of two groups:

P Hanumantha Rao et al (2008). Conducted a study to assess the awareness about the medical waste management and universal precautions among the health care workers. The results revealed that awareness of Bio medical waste management rules was better among hospital staff in comparison with private, medical practitioner and awareness was marginally higher among those in urban areas in comparison with in rural areas.

 

CONCLUSION:

Present study attempted to assess the level of knowledge between two groups. The sample size of this study were 4O. Study was conducted in "Udaipur Hospital situated in Udaipur City near Gulab Bagh CHOUDHARY Hospital" situated in Hiran Magri Sec – 4 Udaipur. Udaipur Hospital is 100 bedded Hospital and Choudhary Hospital is 150 bedded Hospital. Results revealed that there is significance association between level of knowledge and socio demographic variables. Results also revealed that there was no significance difference between two groups the calculated value of t is – 1.328 which is actually less tha p ≤0.005 level (t₃₈=2.024).

 

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Received on 02.02.2019          Modified on 28.02.2019

Accepted on 21.03.2019     © A&V Publications all right reserved