INTRODUCTION:

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 thereto or in the production or testing of bio logicals, and including categories mentioned in Schedule I, of the BMW rules, 2016 In India, The waste generation rate ranges between 0.5 and 2.0kg/bed/day. In which only about 10 - 25% of biomedical waste is hazardous and remaining 75 - 95% is non hazardous and the hazardous part of waste includes chemical, Glassware and microbiological items. This is highly toxic, infectious and can cause a serious threatening condition if not managed in a scientific manner.

According to CPCB annual report of 2016 total quantity of Bio medical waste generation in the country is approximately 517 tonnes per day (TPD) besides, as per a joint report by associated chambers of commerce and industry of India &velocity in 2018, the total quantity of medical waste generated in India is 550 TPD and these figures are likely to increase close to 777.5 TPD by 2022. To overcome with these programs of social reform increase in generation of BMW, 199 common bio medical treatment facilities (CBWTFs) are in operation & 23 are under construction (CPCB) 2017.

NEED OF THE STUDY:

Biomedical waste is one of the major cause of wide range of health hazards, which should be taken seriously in concern, to reduce the incidence of such injury and illnesses. It is necessary for health care workers to take concern and adequate knowledge about biomedical waste management. India’s fight against its piles of garbage intensified in 2020 a year that will be known in history as the year of COVID19 pandemic, with the corona virus outbreak which is still ranging one of the other major fallout's has been the surge in hazardous biomedical waste.

Though India already had Bio medical waste management rules from ’2016’, the CPCB guidelines were repeated to ensure that the waste generated specifically during testing of people &treatment of COVID 19 patients is disposed off in a scientific manner.

The basic principle of BMWM is segregation at source and waste reduction, besides, a lot of research and development need to be in the field of developing environment friendly medical device and BMW disposal system for a greener and cleaner environment. A major issue related to current bio-medical waste management in many hospitals is that the implementation of Bio waste regulation is unsatisfactory as some hospitals are disposing of waste in a improper and in a inadequate manner.

RESEARCH STATEMENT:

“A study to assess the effectiveness of structure teaching programme on knowledge regarding biomedical waste management among nursing students of selected nursing college Rudrapur, U. S. Nagar, Uttarakhand”

OBJECTIVES:

1- To assess the level of pre test knowledge regarding Biomedical Waste management

2- To assess the effectiveness of Structured Teaching Programme on biomedical waste management.

3- To assess the level of post test knowledge regarding Biomedical Waste management

4- To find out the association between knowledge and selective demographic variable regarding BMW management.

OPERATIONAL DEFINITION:

Assess:

It refers to the level of knowledge regarding BMW management of nursing students

Effectiveness:

The effectiveness is a capability of producing a desired result or the ability to produce desired output among students after administering structured knowledge questionnaire regarding bio medical waste management

Knowledge:

Knowledge refers to the information regarding biomedical waste management which can be measured by the correct responses obtained from the nursing students to the structured knowledge questionnaire related to concept, storage, disposal, treatment of biomedical waste management

Structured teaching programme:

Structured teaching programme means systematically developed instructional programme using instructional aids designed to provide information on biomedical waste management.

Biomedical waste management:

Biomedical waste management means the segregation; collection, transport, disposal and monitoring of biomedical waste materials. Nursing students – Students who are enrolled in B.Sc nursing programme in selected nursing college.

Hypothesis:

H1: There will be significant difference between knowledge score of nursing students before and after implication of structured teaching programme in biomedical waste management

H2: There will be significant association between pre test knowledge score of biomedical waste management with their selected socio demographic variable.

RESEARCH METHODOLOGY:

· Research approach: Quantitative research approach

· Research design: Pre – experimental, one group pre test, post test descriptive research design

· Population of the study: The target population of this study was B.sc Nursing year students

· Sample: In this study sample consists of B.sc Nursing2^ND year students

· Sample size: sample size was 30, B.sc Nursing 2^ND year students

· Sampling technique: Non probability purposive sampling technique was used

· Data collecting tools/Instruments:

· Tool I: Structured knowledge questionnaire to assess the socio-demographic data.

· Tool II: Structured knowledge questionnaire to assess the knowledge regarding Bio waste management

RESULT AND DISCUSSION:

Section I:

Distribution of demographic characteristics of nursing students. (n=30):

This section deals with the analysis of demographic characteristics of nursing students.

Figure 1: Distribution of students based on age

Figure Reveals that majority 15(50%) of participant comes under the age of (20-22), followed by 14(46.6%) comes under (17-19), 1(3.3%) comes under the age of (23-25).

Figure 2: Distribution of students based on gender

Figure shows that 25(83.3%) are females, 5(16.6%) are males.

Table: 1- Frequency and percentage distribution of sample based on religion.

Socio
Demographic variable	Frequency (f)	Percentage (%)
Hindu	23	76.60%
Muslim	5	16.60%
Sikh	2	6.60%

Table indicate that most of the participants 23(76.6%) were Hindu, 5(16.6%) Muslims, 2(6.6%) Sikh religion

Figure 3: Distribution of students based

Figure implies that 15(50%) belongs to rural area, 15(50%) belongs to urban area.

Table:2- frequency and percentage distribution of samples based on education qualification.

Socio-Demographic variable	Frequency (f)	Percentage (%)
Education qualification of father
Graduate/post graduate	15	50%
Higher secondary	11	36.60%
Secondary education	3	10%
Primary education	1	3.30%
Education qualification of mother
Graduate /Post graduate	8	26.60%
Higher secondary	7	23.30%
Secondary education	7	23.30%
Primary education	8	26.6%s

Table indicates that majority of student’s father 15 (50%) are graduate/post graduate, 11(36.6%) higher secondary, (3-10%) secondary education, 1(3.3%) primary education and majority of student’s mother (26%) are graduate /post graduate, 7(23.3%) higher secondary, 7(23.3%) secondary education, 8(26.6%) primary education.

Table:3- frequency and percentage distribution of samples based on education qualification.

Socio-Demographic variable	Frequency (f)	Percentage (%)
Any family member work as a health care worker
Yes	10	33.30%
No	20	66.60%
Do you have any knowledge regarding BMW
Yes	29	96.6%
No	01	3.33%
Level of knowledge
Poor	1	3.33%
Shallow	29	96.60%

Table-3 shows that 10(33.3%) student’s Family member work as a health care worker. Majority of participant 29(96.6%) have previous knowledge regarding BMW management. Majority of participants 29(96.6%) have shallow level of knowledge and 1(3.33%) have poor knowledge.

Table-4 revealed that for majority of participant’s 28(93.3%) have source of information by books, and 1(3.33%) participant got information from mass media, and for 1(3.33%) the source of information from health care workers.

Table:4- frequency and percentage distribution of samples based on source of knowledge.

Socio-Demographic variable	Frequency (f)	Percentage (%)
Sources of knowledge
Mass media	1	3.33%
Books	28	93.30%
Health care workers	1	3.33%

SECTION II

Table no 2: frequency and percentage distribution of samples based on pre-test of level of knowledge regarding biomedical waste management (n=30)

Qs. no	Knowledge questionnaire on bio medical waste management	Response of the nursing students on Bio medical management
		Yes		No
		f	%	f	%
1	Full form of BMWM	30	100%	0	0%
2	Introduction of BMW	28	93.33%	2	6.67%
3	Correct sequence of biomedical waste management	24	80%	6	20%
4	Symbol of biohazard	27	90%	3	10%
5	Transportation of medical waste	9	30%	21	70%
6	Rules of biomedical waste	10	33.33%	20	66.67%
7	Amendments of rules	11	36.66%	19	63.33%
8	Category of biomedical waste	5	16.66%	25	83.33%
9	Types of containers	26	86.66%	4	13.33%
10	Types of non-chlorinate bages	7	23.33%	23	76.66%
11	Color code for broken glass	12	40%	18	60%
12	Timing of storage	7	23.33%	23	76.66%
13	Emptying of BMW container	14	46.66%	16	53.33%
14	Disinfectant used in white container	8	26.66%	22	73.33%
15	Segregation of biomedical waste	7	23.33%	23	76.66%
16	Disposal of anatomical waste	9	30%	21	70%
17	Disposal of sharp needle	7	23.33%	23	76.66%
18	Disposal of damage /expired medicines	12	40%	18	60%
19	Color bag for Covid -19 waste	3	10%	27	90%
20	Disposal of infected IV lines	5	16.66%	25	83.33%
21	Disposal of glassware	18	60%	12	40%
22	Biohazard sharp container	15	50%	15	50%
23	Incineration	7	23.33%	23	76.66%
24	Autoclaving method	26	86.66%	4	13.33%
25	E-waste	6	20%	24	80%

Interpretation of data:

Full form of BMWM - 30(100%) of the nursing students gave correct response for meaning of BMWM.

Introduction of biomedical waste - 28(93.33%) of nursing students gave correct response for introduction of biomedical waste

Correct sequence of biomedical waste management -24(80%) of nursing students gave correct response for correct sequence of BMWM.

Symbols of biohazard - 27(90%) of nursing students gave correct response for symbols of biohazard.

Transportation of medical waste regulation- 9(30%) of nursing student gave correct response of transportation of medical waste regulation.

Rules of biomedical waste management- 10(33.33%) of nursing student gave correct response for rules of biomedical waste management.

Amendment of rules- 11(36.66%) of nursing student gave correct response for amendment of rules.

Categories of BMW -5(16.66%) of nursing student gave correct response for categories of BMW.

Type of container -26(86.66%) of nursing students gave correct response for types of container.

Types of non-chlorinated plastic bags - 7(23.33%) of nursing students gave correct response for types of non-chlorinated plastic bags.

Color code of broken glasses - 12(40%) of nursing students gave correct response for color code of broken glasses.

Timing of storage -7(23.33%) of nursing students gave correct responses for timing of storage.

Emptying of BMW container-14(46.66%) of nursing students gave correct response regarding emptying of BMW container.

Disinfectant used in white container - 8(26.66%) of nursing students gave correct response for disinfectant used in white container.

Segregation of biomedical waste -7(23.33%) of nursing students gave correct responses for segregation of biomedical waste.

Disposal of anatomical waste -9(30%) nursing students gave correct responses for disposal of anatomical waste.

Disposal of sharp needle -7(23.33%) nursing students gave correct response for disposal of sharp needle.

Disposal of damaged/expired medicines-12(40%) nursing students gave correct response for disposal of damaged /expired medicines.

Color bags for covid-19 waste - 3(10%) nursing student gave response regarding color bags for covid-19 waste.

Disposal of infected IV lines -5(16.66%) nursing students gave correct response for disposal of infected IV lines.

Disposal of glassware -18(60%) nursing students gave correct response of disposal of glassware.

Biohazard sharp container -15(50%) nursing students gave correct response regarding biohazard sharp container.

Incineration-7(23.33%) nursing students gave correct response regarding incineration.

Autoclave method - 26(86.66%) students gave correct response regarding autoclaving.

E-Waste -6(20%) nursing students gave correct response regarding E-waste.

Table no:5- frequency and percentage distribution of samples based on post-test of level of knowledge regarding biomedical waste management (n=30)

Qs. No.	Knowledge questionnaire on bio medical waste management	Response of the nursing students on Bio medical management
		Yes		No
		f	%	f	%
1	Full form of BMWM	30	100%	0	0%
2	Introduction of BMW	28	93.33%	2	6.66%
3	Correct sequence of biomedical waste management	22	73.33%	8	26.66%
4	Symbol of biohazard	30	100%	0	0%
5	Transportation of medical waste	12	40%	18	60%
6	Rules of biomedical waste	18	60%	12	40%
7	Amendments of rules	28	93.33%	2	6.66%
8	Category of biomedical waste	23	76.66%	7	23.33%
9	Types of container	22	73.33%	8	26.66%
10	Types of non-chlorinate	19	63.33%	11	36.66%
11	Color code for broken glass	18	60%	12	40%
12	Timing of storage	19	63.33%	11	36.66%
13	Emptying of BMW container	24	80%	6	20%
14	Disinfectant used in white container	16	53.33%	14	46.66%
15	Segregation of biomedical waste	12	40%	18	60%
16	Disposal of anatomical waste	24	80%	6	20%
17	Disposal of sharp needle	21	70%	9	30%
18	Disposal of damage /expired medicines	9	30%	21	70%
19	Color bag for Covid -19 waste	3	10%	27	90%
20	Disposal of infected IV lines	14	46.66%	16	53.33%
21	Disposal of glassware	16	53.33%	14	46.66%
22	Biohazard sharp container	11	36.66%	19	63.33%
23	Incineration	12	40%	18	60%
24	Autoclaving method	21	70%	9	30%
25	E-waste	13	43.33%	17	56.66%

Interpretation of data:

Full form of BMWM - 30 (100%) of the nursing students gave correct response for meaning of BMWM.

Introduction of biomedical waste - 28(93.33%) of nursing students gave correct response for introduction of biomedical waste

Correct sequence of biomedical waste management -22(73.33%) of nursing students gave correct response for correct sequence of BMWM.

Symbols of biohazard - 30(100%) of nursing students gave correct response for symbols of biohazard.

Transportation of medical waste regulation-12(40%) of nursing student gave correct response of transportation of medical waste regulation.

Rules of biomedical waste management -18(60%) of nursing student gave correct response for rules of biomedical waste management.

Amendment of rules -28(93.33%) of nursing student gave correct response for amendment of rules.

Categories of BMW -23(76.66%) of nursing student gave correct response for categories of BMW.

Type of container -22(73.33%) of nursing students gave correct response for types of container.

Types of non-chlorinated plastic bags - 19(63.33%) of nursing students gave correct response for types of non- chlorinated plastic bags.

Color code of broken glasses - 18(60%) of nursing students gave correct response for color code of broken glasses.

Timing of storage -19(63.33%) of nursing students gave correct responses for timing of storage.

Emptying of BMW container-24(80%) of nursing students gave correct response regarding emptying of BMW container.

Disinfectant used in white container - 16(53.33%) of nursing students gave correct response for disinfectant used in white container.

Segregation of biomedical waste -12(40%) of nursing students gave correct responses for segregation of biomedical waste.

Disposal of anatomical waste -24(80%) nursing students gave correct responses for disposal of anatomical waste.

Disposal of sharp needle -21(70%) nursing students gave correct response for disposal of sharp needle.

Disposal of damaged /expired medicines- 9(30%) nursing students gave correct response for disposal of damaged/expired medicines.

Color bags for covid-19 waste - 3(10%) nursing student gave response regarding color bags for covid-19 waste.

Disposal of infected IV lines -14(46.66%) nursing students gave correct response for disposal of infected IV lines.

Disposal of glassware -16(53.33%) nursing students gave correct response of disposal of glassware.

Biohazard sharp container -11(36.66%) nursing students gave correct response regarding biohazard sharp container.

Incineration-12(40%) nursing students gave correct response regarding incineration.

Autoclave method - 21(70%) students gave correct response regarding autoclaving.

E-waste -13(43.33%) nursing students gave correct response regarding E-waste.

Section III

Table:6- Evaluation of effectiveness of standard teaching programme in terms of pretest and post test knowledge score regarding biomedical waste management: (n=30)

Knowledge

Mean

Standard

deviation

Mean

difference

‘t’ value

P<0.00001

95%CI

Pre test

11.1

2.37

4.4

6.98

10.3 to11.9

14.3 to 16.7

Post test

15.5

3.37

Significant level at 0.05*

Interpretation of data:

Table no 4 shows that the mean post-test knowledge score (15.5%) is significantly greater than the mean pre-test knowledge score (11.1%) of students [t =6.98, p=<0.05] hence it is evident that the structured teaching programme is effective module for improving the knowledge of nursing students regarding biomedical waste management.

H1: there is a significant difference between the pre-test knowledge and post test knowledge of nursing students regarding BMW management. hypothesis was tested at 0.05 levels. the t value of mean difference between pre-test and post -test scores was (t=6.98,p<0.05) hence the research hypothesis is accepted and null hypothesis is rejected.

Section IV

Table:7-Association between selected socio demographic variables with pretest knowledge score (n=30)

S. no.

Socio-demographic variables

Pretest knowledge score

Chi-square

Median and its below (11)

Median & its above (11)

Age

17-19

20-22

23-25

X^2=2.19

^Df=2

^{P
value=0.33}

Gender

Male

Female

X^2=3.47

^Df=1

^{P value
=0.06}

Religion

Hindu

Muslim

Christian

Sikh

X^2=4.08

^Df=3

^{P
value=0.12}

Area of residence

Rural

Urban

X^2=3.58

^Df=1

^{P
value=0.05}

Educational qualification of father

Graduate/post graduate

Higher secondary

Secondary educational

Primary educational

X^2=2.36

^Df=3

^{P value
=0.14}

Educational qualification of mother

Graduate/post graduate

Higher secondary

Secondary educational

Primary educational

X^2=0.31

^Df=3

^{P value=
0.95}

Any member work as a health care

Yes

X^{2= 0.28}

^{Df= 1}

^{P value=
0.59}

Any knowledge regarding BMW

Yes

X^{2= 0.59}

^Df=1

^{P value=0.43}

Level of knowledge

Poor

Shallow

X^2=o.59

^Df=1

^{P value=0.43}

Sources of knowledge

Mass media

Books

Health care worker

X^2=3.70

^Df=2

^{P value=0.15}