THAI NGUYEN UNIVERSITY
THAI NGUYEN UNIVERSITY OF AGRICULTURE AND FORESTRY
Thai Nguyen City, Thai Nguyen Province
HOSPITAL WASTE MANAGEMENT PRACTICES IN LAO CAI CITY:
AN INPUT TO POLICY ENHANCEMENT
In Partial Fulfilment of the
Bachelor in Environmental Science and Management
Of the Advance Education Program
Under the Supervision of
DR. HOANG VAN HUNG
BY:
CAMILLE T. DE JESUS
JANUARY 2014
1
CERTIFICATION
This
Research
Paper
entitled
“HOSPITAL
WASTE
MANAGEMENT
PRACTICES IN LAO CAI CITY: AN INPUT TO POLICY ENHANCEMENT” prepared
and submitted by Camille Tibay de Jesus,in partial fulfillment of the requirements for
the undergraduatestudy of Bachelor of Science in Environmental Science and
Management and is therefore base on her original work and cannot be used by any
other institution without prior consent.
Dr.Hoang Van Hung
Thesis Adviser
2
Thai Nguyen University of Agriculture and Forestry
Degree Program
Bachelor of Environmental Science and Management
Student Name
Camille T. de Jesus
Student ID
DTN1054140233
Thesis Title
Hospital Waste Management Practices In Lao Cai City:
An Input To Policy Enhancement
Supervisor
Dr. Hoang Van Hung
Abstract: This study was conducted in order to determine and assess the
hospital waste management in Lao Cai Province specifically the hospital waste
management in Lao Cai General Hospital. A total of 51 questionnaires had
been distributed to the hospital personnel. It covers critical aspects of waste
segregation, recycling and treatment of the waste. It also examines the level of
knowledge and awareness of the hospital personnel towards the hospital waste
management in Lao Cai General Hospital. In order to evaluate the hospital
waste management practices in Lao Cai General Hospital, face to face
interview had been made and with the use of survey questionnaire to assess the
knowledge of hospital utility, nurses and hospital practitioner. The study
reveals that most of the respondents were 31 – 40 years old and dominated by
female. In terms of educational attainment they obtain vocational/ technical
education. Majority of the respondents are also technicians and most of them
served for six (6) to ten (10) years. It shows that the demographic
characteristics of the respondents played an important role in delivering health
services of the Lao Cai General Hospital. The study confirms that most of the
respondents are all “highly aware”. In terms of recycling the respondents were
“aware” in good recycling process that can save money and energy. While in
terms of treatment, the respondents were “aware” that there are many ways to
treat the hospital waste and there should be proper treatment in different kind
of hospital waste. The researcher firmly proposed that the administration of the
Lao Cai General Hospital will conduct a quarterly orientation to its members
in managing the hospital waste. In that case, all of them will become highly
aware in performing their responsibilities in managing the hospital waste.
Hospital Waste Management, Classification of Hospital
Keywords:
Waste, Awareness on Hospital Waste, Demographic
Characteristics
Number of Pages
Forty – five (45)
Date of Submission
January 23, 2015
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ACKNOWLEDGMENT
The researcher wishes to extend her most sincere thanks to gratitude to the
following people, without them, this study could not be reality.
Thai Nguyen University of Agriculture and Forestry, her Alma Mater that
served as guide to her success in facing all the challenges to attain her goal;
Dr. Tran Van Dien, University Rector of Thai Nguyen State University of
Agriculture and Forestry, for the support given to the professional growth of the
students;
Dr. Hoang Van Hung, her thesis adviser, and Fansipan University or
formerly known as Lao Cai Community College for their immeasurable support that
made this study possible;
To Lao Cai General Hospital and their staff, for allowing the researcher to
conduct the study in their health institution and for the necessary information needed
in this study;
Advanced Education Program,Dr. Duong Van Thao, Coordinator of
Advanced Education Program, and both former and present staff, for their
understanding, support and this once in a lifetime opportunity to study abroad with
international environment;
Dr. Nguyen The Hung, Vice Rector of Thai Nguyen University of Agriculture
and Forestry, for his generosity, advice and support;
Dr. Olivia P. Magpily and Mr. Nestor Magpily,for beingher second parents,
for their care, moral support and guidance;
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Angelica Christine A. Acaylar, Shekinah R. Tibay and Shelah Marie D.
Recide, for being a good sister, friend and whose always there to support her in
various ways.
Nguyen Manh Ha, Luu Thi Cuc, Do Van Hai and Do Thi Hien, and other
Fansipan (Lao Cai) family for their valuable help;
Bonifacio B. Natag-oy, Marcia B. Buhungan, Paul Angel Erlindo P.
Candole, Paul Ezekiel M. Losaria, and Lester O. Tegui-in, her fellow Filipino
student whose been with the researcher all through their study, for their boundless
support and encouragement to pursue this study;
Mr. Ramil F. de Jesus and Mrs. Josefina T. de Jesus, her loving parents, for
their unending love, patience, support and inspiration that gave strength to the author;
Jinelle and Mervin Jommel, her sibling, for their inspiration and endless
support;
GOD, the LORD ALMIGHTY, who grants courage, patients and knowledge
to the author;
The author’s sincerest gratitude is also extended to all the people who helped
her in any respect to make this research a possible one.
CTDJ
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TABLE OF CONTENTS
LIST OF TABLES.................................................................................................. 9
PART I. INTRODUCTION ................................................................................... 1
1.2. Objectives of the Research ........................................................................... 3
1.3. Research Questions and Hypothesis ............................................................ 3
1.4. Scope and Limitation of the Research ......................................................... 4
1.5. Definitions .................................................................................................... 5
PART II. LITERATURE REVIEW ....................................................................... 7
2.1. Hospital Waste Management ....................................................................... 7
2.2. Classification of Hospital Waste ................................................................ 12
2.3. Awareness on Hospital Waste Management .............................................. 13
2.4. Demographic Characteristics of Respondents ........................................... 15
PART III. METHODS .......................................................................................... 17
3.1. General Information ................................................................................... 17
3.2. Research Design ......................................................................................... 17
3.3. Statistical Analysis ..................................................................................... 18
PART IV. RESULTS ........................................................................................... 20
4.1. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Age .................................................................... 20
4.2. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Gender ............................................................... 21
4.3. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Educational Level.............................................. 22
6
4.4. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Job Category...................................................... 23
4.5. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Duration of Services .......................................... 24
4.6. The Percentage Level of the Times of Disposal of Hospital of Their Waste
Material ............................................................................................................. 25
4.7. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Segregation ......................................................................................... 25
4.8. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Recycling ............................................................................................ 27
4.9. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Treatment ............................................................................................ 28
4.10. The Significant Difference Between the Demographic Characteristics and the
Level of Awareness on the Hospital Waste Management Among the Respondents
........................................................................................................................... 30
PART V. DISCUSSION AND CONCLUSION .................................................. 32
5.1. Discussion .................................................................................................. 32
5.1.1. Demographic characteristics ................................................................... 32
5.1.2. Classification of Medical Waste ............................................................. 32
5.1.2 The Times of Disposal of Hospital Waste ............................................... 33
5.1.4. The Level of Awareness on Hospital Waste Management ..................... 34
5.2. Conclusion.................................................................................................. 35
5.2.1 The significant difference between the demographic characteristics and the
level of awareness on the hospital waste management ..................................... 35
7
5.2.2. The proposed enhanced policy on hospital waste management ............. 35
REFERENCES ..................................................................................................... 37
APPENDICES
1.
8
LIST OF TABLES
Table 4.1. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Age .......................................................... 21
Table 4.2. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Gender..................................................... 21
Table 4.3. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Educational Level ................................... 22
Table 4.4. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Job Category ........................................... 23
Table 4.5. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Duration of Services ............................... 24
Table 4.6. The Percentage Level of the Times of Disposal of Hospital of Their Waste
Material ................................................................................................... 25
Table 4.7. Level of Awareness on Hospital Waste Management Among Respondents
in Terms of Segregation.......................................................................... 26
Table 4.8. Level of Awareness on Hospital Waste Management Among Respondents
in Terms of Recycling ............................................................................ 27
Table 4.9. Level of Awareness on Hospital Waste Management Among Respondents
in Terms of Treatment ............................................................................ 29
Table 4.10. The Significant Difference Between the Demographic Characteristics and
the Level of Awareness on the Hospital Waste Management Among the
Respondents ............................................................................................ 31
2.
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PART I. INTRODUCTION
1.1. Background and Rationale
Vietnam’s economy is expanding rapidly over the past decades. Through that
time it is not only the economy that is developing but also the health sector. Prior to its
development, the country is generating almost 15 million tons of waste per year and
approximately about 21,000 tons per year are being produced by the hospitals. 1 The
waste generation of health sector is not as high as the municipal solid waste generation
though it still poses a great threat to public health and the environment.
Lao Cai Province as situated at mountainous Northwest of Vietnam has its land
total area of 6,383.9 km2 and approximately 602,300 total population as of 2008. The
province is also bordering the Yunnan Province in China. Lao Cai General Hospital
officially opened to the public to serve its local people especially the ethnic minority
people, the largest and most modern hospital in the province. 2
As a newly launch general hospital in the province and the life connecting
institution, there are questions that make the researcher become interested to assess the
hospital waste management practices. Even though not all the waste in the hospital is
categorized as hazardous or toxic still there is a need to take proper hospital waste
management most especially the medical worker who are exposed on it. Hence, if the
hospital waste is not properly managed there will be serious threats in health and in the
environment as well. Individuals can be infected in various ways.
1
Effective waste management for Vietnam / Waste Viet (2010).Waste management in Vietnam. Retrieved from:
http://www.waste-viet.com/en/waste-management-vt/ (accessed on 08/01/2014)
2
Lao Cai Province gets largest-ever hospital (2013). Viet Nam News. Retrieved from:
http://vietnamnews.vn/society/238132/lao-cai-province-gets-largest-ever-hospital.html (accessed on
07/31/14)
1
Moreover, efficient policy and regulation of the hospital especially when it
comes to proper hospital waste management they will not only provide good service to
the patients and the household within the vicinity of the hospital but also it is an
environmentally step to minimize the waste and prevent the risks that may occur.
However, the awareness of the individual in terms of hospital waste
management plays a vital role in the efficiency and effectiveness of its policy and
regulation to an environmental-friendly hospital. In this regard, the researcher believe
that this study will open the mind of the respondents to a more and better place to live
in with a minimal impact to the environment that will enhance the policy on waste
management of Lao Cai General Hospital.
The arising issues of improving and enhancing the hospital waste management
receive attention from the different field of study around the world. Hospital waste is a
small portion of solid waste and yet it poses great risk on the environment and public
health. But annually they generate tons of hospital waste each year both hazardous and
non-hazardous waste.
The study is conducted in order to determine and assess the hospital waste
management in Lao Cai Province specifically the hospital waste management in Lao
Cai General Hospital. The study covers the critical aspects of waste segregation,
recycling and treatment of the waste. It also examines the level of knowledge and
awareness of the hospital personnel towards the hospital waste management in Lao
CaiGeneral Hospital.
2
The quantity of hospital waste that has been generated is alarmingly increasing and
it is also a potential source of pathogenic micro-organisms that demands suitable handling
that is indeed a fail-safe. Exposure to hospital waste may result to disease or injury.
As reported by the Vietnamese Ministry of Health, there are approximately
1,050 hospitals and more than 10,000 commune health stations and biomedical
research institutes, centers of preventive medicine, pharmaceutical manufacturing
facility, are the facility that emit big amount of medical waste, particularly solid waste
that generated more than 400 tons per year (Ministry of Health, 2007).
1.2. Objectives of the Research
The main purpose of the study is to survey the doctors, nurses, health staff and
workers by means of questionnaires and interviews with the following objectives:
-
To determine and assess the level of knowledge and awareness of the
respondents in hospital waste management.
-
To enumerate the types of medical waste that is being generated by the
hospital.
-
To provide recommendations for the improvement of the hospital waste
management policy.
1.3. Research Questions and Hypothesis
1.3.1. Research Questions
The following are the research questions:
1. What is the level of demographic characteristics of the respondents in Lao
Cai General Hospital age, gender, educational level, job category and duration of
services?
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2. What are the classifications of hospital waste in the Lao Cai General
Hospital?
3. How do the hospital wastes managed by the Lao Cai General Hospital?
4. What is the level of awareness on hospital waste management among
respondents?
5. Is there a significant difference between the demographic characteristics and
the level of awareness on the hospital waste management among the respondents?
6. What is the proposed enhanced policy on hospital waste management?
1.3.2. Hypothesis
-
Null Hypothesis
There is no significant difference between the demographic characteristics and
the level of awareness on the hospital waste management among the respondents.
-
Alternative Hypothesis
There is no significant difference between the demographic characteristics and
the level of awareness on the hospital waste management among the respondents.
1.4. Scope and Limitation of the Research
This thesis is limited to the hospital waste management of Lao Cai General
Hospital in Lao Cai, Vietnam. It is limited further to five (5) areas of investigation namely
: 1. the demographic characteristics of the respondents in Lao Cai General Hospital in
terms of age, gender, educational level, job category and duration of services; 2. the
classifications of hospital waste in the Lao Cai General Hospital; 3. the hospital wastes
management by the Lao Cai General Hospital; 4. the level of awareness on hospital waste
management among respondents; and 5. If the demographic characteristics has significant
4
difference on the level of awareness on the hospital waste management among the
respondents.
The investigation focuses on the hospital waste management of Lao Cai
General Hospital. This study is limited to the self-appraisal of the respondents on their
demographic characteristics and the hospital waste management of Lao Cai General.
1.5. Definitions
The following terms were defined according to how they were used in the
study:
Age. This refers to the actual age of the respondents at Lao Cai General
Hospital.
Classifications of hospital waste. It pertains to the medical waste such as
infectious waste, hazardous chemical waste, radioactive waste, tank pressure and
usual or general waste.
Duration of services. This is refers to the number of working years served of
the respondents at Lao Cai General Hospital.
Educational level. It pertains to the education attained by the respondents in
the educational institution.
Gender. It refers to the sex role of the respondents as to male and female.
Hospital wastes management. It pertains to the waste disposal practices of
Lao Cai General Hospital such as segregation, recycling and treatment.
Job category. It refers to work performed by the respondents at Lao Cai
General Hospital as to utility, technician, administrative employee, hospital attendant,
nurse and physician.
5
Lao Cai General Hospital. It pertains to the location of the study conducted.
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PART II. LITERATURE REVIEW
This chapter presents a review made by the researcher on what has been written
and published about hospital waste management which are relevant to the study. A
review of the various literatures and studies which have important bearing on the
subject under the investigation brought out some enlightening facts which enable the
researcher to gain deeper insight into the present problem.
2.1. Hospital Waste Management
Healthy and safety environment is a right place to live in by the individual
created by God. A place where children can play without any harmed and a place
where people can perform social, political, religious and economic activities.
Good healthcare waste management in a hospital depends on a dedicated waste
management team, good administration, careful planning, sound organization,
underpinning legislation, adequate financing, and full participation by trained staff
(World Health Organization (WHO), 2005).
According to Langridge et.al, (2006) maintaining the health and safety of the
environment is an essential part of carrying out an individual care and support. Care
providers have a duty to care for those individual they support and to make accurate
and objective assessments of any risks that may compromise their safety and security.
Employers also have a legal duty to minimise health and safety risks to workers.
Everyone have a responsibility to minimise the adhering to organisational policies and
procedures and demonstrating safe working practices at all times.
7
However, all working environments are different and will pose different threats
or hazards. The first step when carrying out a risk assessment is to identify the hazard
that has the potential to cause significant harm.
Ananth et.al., (2010) cited that the most authentic definition from the WHO
characterizes healthcare waste (HCW) as those wastes generated from hospitals,
medical centers, healthcare establishments and research facilities in diagnosis,
treatment, immunization and associated research.
Moreover, Manyel and Lyasenga (2010) stated that hospital waste management
includes all activities involved in waste generation, segregation, transportation,
storage, treatment and final disposal of all types of waste generated in healthcare
facilities, stages of which require special mention. This will ensure that inputs (funds,
equipment and facilities), activities and outputs (safe workplaces, healthy
environment, health workers) for the safe handling and disposal of healthcare waste
are in place.
In the study conducted by Soncuya et.al., (1997) on hospital waste management
in Metro Manila. The results showed that hazardous medical wastes were not properly
handled. A large volume of infectious wastes is disposed in burial pits located at
hospital sites, and in municipal landfills. Majority of the hospitals is not practicing
treatment procedures prior to the disposal of their infectious waste and does not adhere
to color- coding system required by MMDA Ordinance No. 16. These practices pose
significant risks to humans, including direct contact and contamination of surface
water or groundwater.
Furthermore, the results of a WHO (2002) assessment conducted in 22
developing countries showed that the proportion of health-care facilities that do not
8
use proper waste disposal methods ranges from 18% to 64%. Improvements in healthcare waste management rely on the following key elements: building a comprehensive
system, addressing responsibilities, resource allocation, handling and disposal. This is
a long-term process, sustained by gradual improvements; raising awareness of the risks
related to health-care waste, and of safe and sound practices; selecting safe and
environmentally-friendly management options, to protect people from hazards when
collecting, handling, storing, transporting, treating or disposing of waste. Government
commitment and support is needed for universal, long-term improvement, although
immediate action can be taken locally.
However, Sarkar et.al., (2006) in a study entitled “ Hospital Waste Management
in Slyhet City”, it was observed that existing hospital waste collection, and handling
and disposal practices of all the hospitals in Sylhet involved transport of wastes by
ward boys, maid nurses and other employees from the point of generation to initial
storage. Wastes are normally collected from small bowl or plastic bins provided for
each bed and stored either in a large size plastic bag or bucket. These plastic bags or
wastes from buckets are then put in a pushcart and carried to the nearest municipal
bins for dumping without any segregation or treatment.
While, Bhatia et. al., (2004) cited that health care institutions dump their
infectious waste along with the rest of the non- infectious waste, in the municipal
garbage systems, posing a serious risks to public health as well as a risk of scavenging.
Thus, poor management of healthcare waste poses a severe threat to public health and
may also damage the environment.
However, Mohankumar et.al., (2011) cited that there are of two types,
infectious wastes and non- infectious wastes. Infectious Hospital Waste are human
9
anatomical or surgical waste, animal waste, pathological waste including tissues,
organs, blood and body fluids, microbiological cultures, Cotton, Swabs etc., used
Syringes, I.V. tubes, Blood bags and other items contaminated with blood and body
fluids, items such as plaster, casts and bandages, when contaminated by blood and pus,
waste from isolation wards. The amount of infectious waste is near about 15% to 20 %
of the total wastes generated from the health care establishment. On the other hand, the
Non- Infectious Hospital Wastes are non-infectious waste which is broadly classified
as kitchen waste and office wastes. It is similar to household waste. Non- infectious
wastes constitute nearly about 80% to 85% of the total wastes generated from a health
care unit. In absence of proper segregation, the non- infectious waste becomes
infectious and poses environmental threat to the society.
According to Chary (2001) 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 methods of recycling of waste due to increased cost of
disposable medical care materials. This situation can cause a potential health hazard to
public at large, especially health care workers, municipal employees and rag pickers
involved recycling of waste.
Furthermore, Santappa and Kumar (2002) says that waste handlers and the
community that lives in the proximity are at risk of contacting communicable disease
arising due to improper handling of hospital wastes. Skin contact, injection and inhalation
are possible routes of exposures which could cause chronic effects and acute problem.
Containers and plastic materials, likely to be salvaged by scavengers may spread
communicable disease in case they are not properly sterilized before recycling or reuse.
10
However, Gupta (2006) observed that the personnel working under the occupier
were trained to take adequate precautionary measures in handling these bio hazardous
waste materials, the process of segregation, collection, transport, storage and final
disposal of infectious waste was done in compliance with the standard procedures, the
final disposal was by incineration in accordance to Environment Product Act Rules
1998, the non-infectious waste was collected separately in different containers and
treated as general waste, and on an average about 520 kg of non- infectious and 101 kg
of infectious waste is generated per day about 2.31 kg per day per bed, gross weight
comprising both infectious and non-infectious waste. This hospital also extends its
facility to the neighboring clinics and hospitals by treating their produced waste for
incineration.
However, Pandit et.al., (2007) stated that among other health workers in
hospitals, nurses play a key role in the management of health care waste, they need to
segregate the waste and store it in the correct bins at the point of generation, in order
for them to fulfil this function efficiently, it is important that they have adequate
knowledge about the importance of segregation and how to distinguish the different
containers and bins for the various types of health care waste, the health hazard of
hospital waste, proper technique and methods of handling the waste, and practice of
safety measures can go a long way toward the safe disposal of hazardous hospital
waste and protect them, their patients, as well as the communities and the
environment.
Moreover, Shivalli and Sanklapur (2014) cited that proper management of such
waste is not only a legal, but also a social responsibility of the hospitals. Segregation at
the site of waste generation is the first and foremost important step in healthcare waste
11
management. It is emphasized as a means of ensuring that hazardous healthcare risk
waste and healthcare general waste are separated and stored in appropriate containers.
While, according to Khajuria and Kumar (2007) the lack of segregation
between HW and non-HW, an absence of rules and regulations applying to the
collection of waste and the on-site transport to a temporary storage location, a lack of
proper waste treatment, disposal of MW along with municipal garbage, insufficient
training of personnel, insufficient personal protective equipment (PPE) and lack of
knowledge about the proper use of such equipment are among the factors contributing
to poor health care waste management.
2.2. Classification of Hospital Waste
Health care wastes are in the form of solid and liquid wastes generated by
hospitals, medical or research laboratories, clinics, offices of physicians and dentists,
veterinarians, and funeral homes. These wastes represent a relatively small portion of
the total solid waste stream, and are simple to identify, to separate, and to treat
properly (DOH Manual, 2004).
Furthermore, Dinesh et.al., (2010) stated that health care waste can be
categorized into two broad categories as hazardous wastes and non-hazardous
wastes. Nonhazardous waste include non-infected plastic, packaging material,
paper etc. Bio hazardous waste is divided into two categories as (a) Infectious
wastes like sharps, non-sharps, plastic disposables, liquid waste, etc. and (b) Noninfectious wastes like radioactive waste, discarded glass, chemical waste, cytotoxic
waste and incinerated waste.
12
However, according to Dwivedi et.al, (2009) some hospitals or pathological
laboratory wastes may contain toxic chemicals, like mercury, xylene and formalin.
Dinesh et.al., (2010) added that although 75-90% of the hospital waste is nonhazardous and harmless as any of the other municipal waste, the remaining 10-25% is
hazardous to humans or animals and deleterious to environment.
Hazardous waste is responsible for spreading infectious and epidemic diseases.
Thus, generators of such waste products should take special care in handling and
disposing of this kind of waste. Improper management of waste generated in health
care facilities cause a direct health impact on the community, the health care workers
and on the environment (WHO, 2004).
2.3. Awareness on Hospital Waste Management
According to Mohankumar et.al., (2011) in India, BIO MEDICAL WASTE
MANAGEMENT RULES, 1998 (Amended in 2000 and 2003) Under the
Environmental Protection Act, the bio medical waste management rules were
introduced. These rules are directly relevant to the health sector. The salient features of
these rules are as follows:
Bio medical wastes means waste that is generated during the diagnosis,
treatment or immunizations of human beings or animals or in research activities
pertaining there to or in the production or testing of biological.
Moreover, it is the duty of every occupier of an institution generating bio
medical waste which includes a hospital, nursing home, clinic, dispensary, veterinary
institution, animal house, pathological laboratory and blood bank by whatever name
called to take all steps to ensure that such waste is handled without any adverse effect
13
to human health and the environment, policies, legislation and regulations policy
framework, March 2007.
Mohanmar et.al., (2011) cited that the Ministry of Health and Social Welfare
(2006) hospital waste management includes all activities involved in waste generation,
segregation, transportation, storage, treatment and final disposal of all types of waste
generated in the hospital facilities, stages of which require special attention. This will
ensure that inputs activities and outputs for the safe handling and disposal of
healthcare waste are in place.
However, according to Kaplowitz (2009) limited environmental awareness and
college campus culture are barriers to campus greening. A survey was conducted at
Michigan State University found that university members believed recycling was
important but they had limited knowledge regarding what they could recycle and place
on campus where they could recycle.
Furthermore, Shivalli and Sanklapur (2014) cited that nurses’ knowledge and
healthcare waste management practices were not satisfactory. There is a need of
refresher trainings at optimum intervals to ensure sustainability and further
improvement. Educating patients and their entourages and display of segregation
information board in local language are recommended.
Adequate knowledge about the health hazard of hospital waste, proper
technique, and methods of handling the waste could go a long way toward the safe
disposal of hazardous hospital waste and protect the community. With this milieu,
this study was undertaken to appraise nurses with respect to healthcare waste
management by both quantitative and qualitative research methods.
14
2.4. Demographic Characteristics of Respondents
Jessor and Jessor (2010) cited that at any age group, whether teenager or adults,
good health is not a result of fate or luck. Nor it is a matter of medical care, health
today and the future depends a great deal on health patterns and practices.
In the study of Omar et.al., (2012), it shows that the analytical results of testing
the level of knowledge and awareness. The result shows not much and almost same
mean among the hospitals with p-value of 0.112. It means that the level of knowledge
and awareness of clinical waste management among respondents in the three case
studies are almost similar. There are significant different of mean knowledge and
awareness score in gender. The result indicated that male respondents are having
higher level of knowledge and awareness of clinical waste management in the
hospitals compared to female respondents. The level of knowledge and awareness of
clinical waste management in the three case studies at all age categories are similar.
The level of education are categorized from Malaysian High Certificate level, Diploma
level and Degree and higher education level. There are significant different between
the score level and the education level with p-value <0.001. Post hoc tests comparison
confirmed that respondents that have Degree and higher education level have higher
knowledge and awareness in clinical waste management and handling in the hospitals.
The result indicated that there is significant different between the variables with pvalue of 0.005. It is shown that respondents with service of duration below 3 years
have higher knowledge and awareness in correct handling and management of clinical
waste compared respondents having higher length of working time.
However, Fronda (2007) found out that majority of the respondents did not
practice waste segregation properly which was further confirmed by the presence of
15
bin contamination in most of the trash receptacles. It was likewise observed that all
janitors and garbage collectors were not practicing proper waste collection and
disposal. This study concludes that the respondents were generally noncompliant to the
strategies of the system.
In the study by Ehrampoush and Baghiani Moghadam (2005) on the
knowledge, attitude and practice of Medical Sciences students in Iran in respect to the
disposal of solid waste, two hundred thirty seven students were included in this crosssectional study. The mean grade of knowledge of men and women was 13.53 and
12.38, of 20, respectively. The difference between the knowledge of males and
females was significant (P< 0.016). On the whole the knowledge of the students was
not appropriate. About 66% of students did not have any action in segregation and
recycling of solid wastes. It is concluded that all students must take part in formal and
informal education classes to promote their knowledge in this regard.
16
PART III. METHODS
This chapter presents the research design, experimental procedures, data
gathering and statistical analysis used in conducting the study.
3.1. General Information
In order to evaluate the hospital waste management practices in Lao Cai
General Hospital. Face to face interview had been made and with the used of survey
questionnaire to assess the knowledge of hospital utility, nurses and hospital
practitioner.
The study was conducted from the month of September until November of 2014
at Lao Cai General Hospital, Lao Cai, Vietnam.
A total of 51 questionnaires had been distributed to the hospital personnel such
as utility, technician, administrative employees, hospital attendant, nurses and
physician serve as respondents during the conduct of this study.
3.2. Research Design
The survey research was used to examine and evaluate hospital waste
management and to identify the level of awareness among the respondents. Aside from
the interview and physical observations, the study also used questionnaire as a tool to
collect data and information from the hospitals personnel.
A site survey was carried out at the study location as to observe and examine
the current practices of hospital waste management. The research was administered by
using survey questionnaires to identify the significant difference between the
demographic characteristics and the level of awareness on hospital waste management
17
among respondents. Fifty-one (51) questionnaires had been distributed to the
respondents.
A simple random sampling technique was applied in determining the number of
respondents at the locations was done to answer the questionnaires. An observational
checklist was used to record the findings from the surveys.
The questionnaires was sent out to the utility, technician, administrative
employees, hospital attendant, nurses and physician from Lao Cai Hospital. The
questionnaire was divided into two parts.
Part one covers the demographic
information such as age group, gender, education level, job category and duration of
services. Part two covers the questions regarding the level of awareness on hospital
waste management in Lao Cai General Hospital.
Structured interviews were conducted to obtain information on the
hospital waste management at the study locations. Section one covers the general
information of the hospitals including total number of employees in the hospital,
total number of beds and total number of inpatients and outpatients per day. Section
two covers the clinical waste management information gathered from the concession
companies if there is any.
3.3. Statistical Analysis
The data collected were extracted from the questionnaires and it was tabulated
in Microsoft Excel spread sheets to assure that there will be no bias and to determine
the accuracy of interpretation among distributed questionnaires, the Likert-scale form
was used for tabulation. The formats of the five-level Likert-scale used in the
questionnaire were as follows:
18
1 - Not Aware
2 - Fairly Aware
3 - Aware
4 - Moderately Aware
5 - Highly Aware
The author did not provide a sub-scale of 1-5 in the level “aware” to make the
questionnaires simple to avoid confusion on the respondents who will answer the
same. Moreover, it is not part of the research proposal and it would entail a separate
study to make it at this juncture.
After all of the questionnaires were completed, each item was analysed
separately or in some cases item responses was summed up to create a score for a
group of items. In order to interpret each response the Likert-scale was used in the
computation. Weighted mean is the average of means of all groups wherein every
quantity to be average has a corresponding weight. These weights represent the
significance of each quantity to the average of the population. In order to compute the
weighted mean, each value must be multiplied by its weight. Products should then be
added to obtain the total value. The total weight should also be computed by adding all
the weights. The total value will then divided by the total weight. (Likert, Rensis 1932).
19
PART IV. RESULTS
This chapter presents the results and analysis of data gathered on hospital waste
management practices in Lao Cai City: an input to policy enhancement.
The presentation of the major findings follows the order of the questions
enumerated in the statement of the problem namely: percentage level of demographic
characteristics of the respondents in Lao Cai General Hospital in terms of age, gender,
educational level, job category and duration of services; percentage level of the times
of disposal of hospital of their waste material; level of awareness on hospital waste
management among respondents in terms of segregation, recycling and treatment; and
the significant difference between the demographic characteristics and the level of
awareness on the hospital waste management among the respondents.
4.1. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Age
Table 4.1 presents the percentage of demographic characteristics of the
respondents in Lao Cai General Hospital in terms of age.
As shown from table 4.1, the age group of 21 – 30 years old, 31 – 40 years old,
41 – 50 years old, 51 – 60 years old and 61 and above got a frequency of 13, 20, 12, 6,
and 0; percentage of 25. 49, 39.22, 23.53, 11.76 and 0, respectively.
20
Table 4.1. Percentage of Demographic Characteristics of the Respondents in Lao
Cai General Hospital in Terms of Age
Age Group
Frequency Percentage
21 – 30 years old
13
25.49
31 – 40 years old
20
39.22
41 – 50 years old
12
23.53
51 -60 years old
6
11.76
61 and above
0
0.00
Total
51
100
It is observed that the age group of 31 – 40 years old was the dominant among
the other age group with a frequency of 20 and percentage of 39.22.
4.2. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Gender
Table 4.2 presents the percentage of demographic characteristics of the
respondents in Lao Cai General Hospital in terms of gender.
Table 4.2. Percentage of Demographic Characteristics of the Respondents in Lao
Cai General Hospital in Terms of Gender
Gender
Frequency Percentage
Male
24
47.06
Female
27
52.94
Total
51
100
21
As shown from table 4.2, the male and female got a frequency of 24 and 27;
percentage of 47.06 and 52.94, respectively.
It is observed that the female was the dominant between the categories of
gender with a frequency of 27 and percentage of 52.94.
4.3. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Educational Level
Table 4.3 presents the percentage of demographic characteristics of the
respondents in Lao Cai General Hospital in terms of educational level.
Table 4.3. Percentage of Demographic Characteristics of the Respondents in Lao
Cai General Hospital in Terms of Educational Level
Educational Level
Frequency Percentage
Vocational/Technical
23
45.10
BS graduate
10
19.61
Post Graduate
13
25.49
Others
5
9.80
51
100
Total
As shown from table 4.3, the educational level of vocational/technical, BS
graduate, post graduate and others got a frequency of 23, 10, 13, and 5; percentage of
45.10, 19.61, 25.49 and 9.80, respectively.
It is observed that the vocational/technical was the dominant among the other
educational level with a frequency of 23 and percentage of 45.10.
22
4.4. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Job Category
Table 4.4 presents the percentage of demographic characteristics of the
respondents in Lao Cai General Hospital in terms of job category.
Table 4.4. Percentage of Demographic Characteristics of the Respondents
in Lao Cai General Hospital in Terms of Job Category
Job Category
Frequency Percentage
Utility
5
9.80
Technician
16
31.37
4
7.84
Hospital attendant
5
9.80
Nurse
7
13.73
Physician
14
27.45
Total
51
100
Administrative
Employee
As shown from table 4.4, the job category of utility, technician, administrative
employee, hospital attendant, nurse, and physician got a frequency of 5, 16, 4, 5, 7,
and 14; percentage of 9.80, 31.37, 7.84, 9.80, 13.73 and 27.45, respectively.
It is observed that the job category of technician was the dominant among the
other job category with a frequency of 16 and percentage of 31.37.
23
4.5. Percentage of Demographic Characteristics of the Respondents in Lao Cai
General Hospital in Terms of Duration of Services
Table 4.5 presents the percentage of demographic characteristics of the
respondents in Lao Cai General Hospital in terms of duration of services.
As shown from table 4.5, the duration of service of 0 – 5 years, 6 – 10 years, 11
– 15 years, 16 – 20 years and 21 and above got a frequency of 11, 16, 13, 7, and 4;
percentage of 21.57, 31.37, 25.49, 13.73 and 7.84, respectively.
Table 4.5. Percentage of Demographic Characteristics of the Respondents in Lao
Cai General Hospital in Terms of Duration of Services
Duration of
Frequency Percentage
Services
0 – 5 years
11
21.57
6 – 10 years
16
31.37
11 – 15 years
13
25.49
16 – 20 years
7
13.73
21 and above
4
7.84
Total
51
100
It is observed that the duration of service of 6 – 10 years was the dominant
among the other age group with a frequency of 16 and percentage of 31.37.
24
4.6. The Percentage Level of the Times of Disposal of Hospital of Their Waste
Material
Table 4.6 presents the percentage level of the times of disposal of hospital of
their waste material.
Table 4.6. The Percentage Level of the Times of Disposal of Hospital of Their
Waste Material
Time
Frequency Percentage
Everyday
51
100
Weekly
0
0
Monthly
0
0
Total
51
100
As shown from table 4.6, the everyday, weekly and monthly disposal of
hospital waste material got a frequency of 51, 0, and 0; percentage of 100, 0, and 0,
respectively.
It is observed that the hospital disposed their waste material every day with a
frequency of 51 and percentage of 100.
4.7. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Segregation
Table 4.7 presents the level of awareness on hospital waste management among
respondents in terms of segregation.
25
Table 4.7. Level of Awareness on Hospital Waste Management Among
Respondents in Terms of Segregation
Statement
Mean
SD
Interpretation
1. The hospital segregates the waste
according to their proper category.
4.31
0.47
Highly Aware
2. The hospital practice proper waste
segregation.
4.22
0.46
Highly Aware
3. Waste bins are classified for easier waste
segregation.
4.22
0.54
Highly Aware
4. Every waste bin/container/plastic has
appropriate label that indicate what level of
biohazard.
4.31
0.58
Highly Aware
5. There should be separate container for
sharp items such as needles, test tubes,
syringes, broken glass, etc.
4.20
0.57
Highly Aware
6. There should be separate container for
bio-degradable waste like, papers, etc.
4.22
0.61
Highly Aware
7.There should be a separate container for
non-biodegradable waste like plastic
4.22
0.58
Highly Aware
4.24
0.54
Highly Aware
Overall Computed
As seen from Table 4.7, the respondents “highly aware” that the hospital
segregates the waste according to their proper category; practice proper waste
segregation; waste bins are classified for easier waste segregation; every waste
bin/container/plastic has appropriate label that indicate what level of biohazard; should
be separated container for sharp items; should be separated container for biodegradable waste; should be separated container for non-biodegradable; got a mean
score of 4.31, 4.22, 4.22, 4.31, 4.20, 4.22, and 4.22; and standard deviation of 0.47,
0.46, 0.54, 0.58, 0.57, 0.61 and 0.58, respectively.
26
The standard deviation of 0.54 implied that the ratings given by the respondents
about the segregation of hospital waste material were on the same level.
The overall computed mean of 4.24 indicated that the respondents “Highly
Aware” of the segregation of hospital waste material.
4.8. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Recycling
Table 4.8 presents the level of awareness on hospital waste management among
respondents in terms of recycling.
Table 4.8. Level of Awareness on Hospital Waste Management Among
Respondents in Terms of Recycling
Statement
Mean
SD
Interpretation
4.20
0.63 Highly Aware
4.22
0.58 Highly Aware
4.27
0.57 Highly Aware
4. Recycling reduces materials for disposal.
4.22
0.61 Highly Aware
5. Good recycling process can save money and energy.
4.16
0.67
4.25
0.63 Highly Aware
4.22
0.59 Highly Aware
1. This process saves resources as well as the public
health and the environment.
2. The recycling process is difficult due to waste
diversity.
3. Recycling process reduces the impact of hospital
waste in the environment.
Aware
6. If not handled properly it may pose great risk to
the public health and the environment.
Overall Computed
27
As seen from Table 4.8, the respondents “highly aware” that hospital’s
recycling process saves resources as well as the public health and the environment;
difficult due to waste diversity; reduces the impact of hospital waste in the
environment; reduces materials for disposal; and the statement if not handled properly
it may pose great risk to the public health and the environment got a mean score of
4.20, 4.22, 4.27, 4.22, and 4.25; and standard deviation of 0.63, 0.58, 0.57, 0.61, and
0.63, respectively. While the statement good recycling process can save money and
energy got a mean score of 4.16 and standard deviation of 0.67 and interpreted as
“Aware”.
The standard deviation of 0.59 implied that the ratings given by the respondents
about the recycling of hospital waste material were on the same level.
The overall computed mean of 4.22 indicated that the respondents “Highly
Aware” of the recycling of hospital waste material.
4.9. Level of Awareness on Hospital Waste Management Among Respondents in
Terms of Treatment
Table 4.9 presents the level of awareness on hospital waste management among
respondents in terms of treatment.
As seen from Table 4.9, the respondents “aware” that hospital’s treatment to
their waste have many ways; and it should be proper way; got the same mean score of
4.18; and standard deviation of 0.59. While the statement treatment is used to
minimize the risk it pose to public health and in the environment; provides safer
transportation and disposal of the waste; and Incineration is one common practice for
28
hospital waste treatment got a mean score of 4.27, 4.22 and 4.22; and standard
deviation of 0.57, 0.58 and 0.58, respectively, and interpreted as “Highly Aware”.
Table 4.9. Level of Awareness on Hospital Waste Management Among
Respondents in Terms of Treatment
Statement
Mean
SD
Interpretation
4.18
0.59
Aware
4.18
0.59
Aware
4.27
0.57
Highly Aware
4.22
0.58
Highly Aware
4.22
0.58
Highly Aware
4.21
0.56
Highly Aware
1. There are many ways to treat
hospital waste.
2. There should be proper treatment in
different kind of hospital waste.
3. Treatment is used to minimize the
risk it pose to public health and in the
environment .
4.
Treatment
provides
safer
transportation and disposal of the
waste.
5.
Incineration
is
one
common
practice for hospital waste treatment.
Overall Computed
The standard deviation of 0.56 implied that the ratings given by the respondents
about the treatment of hospital waste material were on the same level.
The overall computed mean of 4.21 indicated that the respondents “Highly
Aware” of the treatment of hospital waste material.
29
4.10. The Significant Difference Between the Demographic Characteristics and
the Level of Awareness on the Hospital Waste Management Among the
Respondents
Table 4.10 presents the significant difference between the demographic
characteristics and the level of awareness on the hospital waste management among
the respondents.
It can be seen from the table that the category age group have critical x² value
of 26.296 was greater than the
computed x² value of 6.476 at 0.05 level of
significance less than the p-value of 0.98 and degree of freedom of 16; the category
gender have critical x² value of 9.488 was greater than the computed x² value of
2.6804 at 0.05 level of significance less than the p-value of 0.61 and degree of freedom
of 4; the category educational level have critical x² value of 21.026 was greater than
the computed x² value of 11.563 at 0.05 level of significance less than the p-value of
0.48 and degree of freedom of 12; the job category have critical x² value of 31.41 was
greater than the computed x² value of 10.424 at 0.05 level of significance less than the
p-value of 0.96 and degree of freedom of 20; and the category duration of services
have critical x² value of 26.296 was greater than the computed x² value of 3.974 at
0.05 level of significance less than the p-value of 1.00 and degree of freedom of 16. As
observed from the table, the age group, gender, educational level, job category, and
duration of services were interpreted as “not significant”.
30
Table 4.10. The Significant Difference Between the Demographic Characteristics
and the Level of Awareness on the Hospital Waste Management Among the
Respondents
Critical
Categories
Computed
Level of
df
x²- value
x²-Value
Significance
p-value
Interpretation
Age Group
26.296
16
6.476
0.05
0.98
Not Significant
Gender
9.488
4
2.6804
0.05
0.61
Not Significant
21.026
12
11.563
.0.05
0.48
Not Significant
31.41
20
10.424
0.05
0.96
Not Significant
26.296
16
3.974
0.05
1.00
Not Significant
Educational
Level
Job
Category
Duration of
Services
It can be concluded that there is “no significance difference” between the
demographic characteristics and the level of awareness on the hospital waste
management among the respondents. The demographic characteristics of the
respondent have no significant relation on their awareness of the hospital waste
management. Therefore age, gender, educational level, job category and duration of
service of the respondent have no significant relation in their awareness of the hospital
waste management among them.
31
PART V. DISCUSSION AND CONCLUSION
This chapter presents the discussion and conclusion of the study.
5.1. Discussion
5.1.1. Demographic characteristics
The demographic characteristics of the respondents in terms of age concluded
that most of the respondents were 31 – 40 years old. In terms of gender, it is
dominated by female respondents. Most of the respondents attained vocational/
technical educational level. Moreover, in terms of job category, most of the
respondents are technician and in terms of duration of services the respondents served
for six (6) to ten (10) years at Lao Cai General Hospital. It shows that the demographic
characteristics of the respondents played an important role in delivering health services
of the Lao Cai General Hospital.
5.1.2. Classification of Medical Waste
The classification of medical waste that is being generated by the hospital based
on the documents given by the hospital management are infectious waste, hazardous
chemical wastes, radioactive waste, tank pressure and the usual/general waste.
Infectious waste is classified into four: sharp waste (class a), infectious waste that is
not sharp (class b), waste with high infection (class c) and waste from surgery (class
d). Hazardous chemical waste are pharmaceutical overdue, they may contain heavy
metals such as mercury and lead, chemical substances that is used in medicine,
cytotoxic substances such as secretions from patients and cytotoxic drug. Radioactive
waste from diagnosis and treatment may be in form of solid, liquid and gas. Tank
32
pressure includes pitcher oxygen, carbon dioxide, gas cylinders, aerosol bottle which is
prone to scorching fire. Usual/general waste are waste that does not contain infection,
sensitive chemical element, radioactive and explosive such as leaves and rubbish from
external sector and waste from administrative task like papers, newspapers, plastic
bags and film bags.
The usual/general waste has the highest waste generation in the hospital with
the total amount of 95,562 kilograms. The wastes are classified into two, domestic
waste with 93,300 kilograms and recycle waste with 2,262 kilograms.
However, class B or the infectious waste which is not sharp such as the waste
leaches blood, biological fluid absorbed by the body and the waste arising from the
isolation ward and class C or the wastes with high infection are the waste that are
generated in the laboratory such as swabs and containers and adhesive specimens of
infectious waste are the common medical waste in Lao Cai General Hospital.
The findings of the study on the classification of medical waste are almost the
same as the classifications enumerated by the study of Dinesh et. al. (2010) and the
classifications enumerated by the Philippines’ Department of Health Manual.
5.1.2 The Times of Disposal of Hospital Waste
It is evident that “everyday” in terms of the times of disposal of hospital waste
material is regularly done at the Lao Cai General Hospital. According to the Medical
Waste Management Report document from the hospital, the waste storage does not
exceed 24 hours and there is daily incineration of waste. The report also provides that
the medical waste management is being handled by the Office of Faculty of Infection
33
Control and three (3) personnel form such office are assigned for the management of
the medical waste.
5.1.4. The Level of Awareness on Hospital Waste Management
It is concluded that the level of awareness on hospital waste management by the
utility, technician, administrative employees, hospital attendant, nurses and physician
are all “ highly aware”. It means that the hospital management has regular orientation
on the medical institution component. However, in terms of recycling the respondents
were “aware” in good recycling process that can save money and energy. While in
terms of treatment, the respondents were “aware” that there are many ways to treat
the hospital waste and there should be proper treatment in different kind of hospital
waste. Therefore, though the respondent’s level of awareness is highly aware, policy
enhancement in recycling and treating the hospital waste be considered. According to
World Health Organization assessment conducted in 2002 in 22 developing showed
that the proportion of health-care facilities that do not use proper waste disposal
method ranges from 18 % to 64 %. In addition to the public health risks, if not
managed it will be a hazards to health workers, waste handlers, scavengers and even to
children who may come into contact with contaminated waste.
34
5.2. Conclusion
5.2.1 The significant difference between the demographic characteristics and the
level of awareness on the hospital waste management
Based on the result of the study conducted, there is no significant difference
between the demographic characteristics and the level of awareness on the hospital
waste management among the respondents, therefore, the hypothesis is “accepted”.
This implies that the demographic characteristics of the respondent have no significant
relation on their awareness of the hospital waste management.
This finding negates the finding of the study of Omar, D. et. al. which
concluded that there is significant diffirence between the set of demographic
characteristics studied and the level of awareness on clinical waste management and
handling in the hospitals. Likewise, the study of Ehrampoush, et. al., (2005) confirms
that there is the difference between the knowledge of males and females was
significant.
5.2.2. The proposed enhanced policy on hospital waste management
The researcher firmly proposed that the administration of the Lao Cai General
Hospital will conduct a quarterly orientation to its members in managing the hospital
waste. In that case, all of them will become highly aware in performing their
responsibilities in managing the hospital waste. Include the patients and their relatives
in the awareness campaign by distributing leaflets or flyers regarding waste
segregation and disposal to them and by posting salient features of the hospital waste
management policy on the bulletin boards or conspicuous places within the hospital
premises.
35
Considering the key elements in improving health-care waste management such
as building a comprehensive system, addressing responsibilities, resource allocation,
handling and disposal though it is a long term process but it sustained by gradual
improvements; raising awareness of the risks related health-care waste and of safe and
sound practices; and selecting safe and environmentally-friendly management options,
to protect people from hazards when collecting, handling, storing, transporting,
treating or disposing of waste.
36
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42
APPENDIX 1
Survey Questionnaire
Name: ____________________________________________(Optional)
Part I. A. Demographic Information of the respondents
Please put a check mark (√ ) in a box
which corresponds to your
answer. Please answer honestly and legibly.
Age group
21 – 30 years old
31 – 40 years old
41 – 50 years old
51 -60 years old
61 and above
Gender:
- male
- female
Educational level:
Vocational/Technical
BS graduate
Post Graduate
Others, please specify __________________
Job Category:
Utility
Technician
Administrative Employee
Hospital attendant
Nurse
Physician
Duration of Services:
0 – 5 years
6 – 10 years
11 – 15 years
16 – 20 years
21 and above
Part II. Awareness on the hospital waste management
Direction: Below are items indicating the level of awareness on Hospital
shown below.
5
4
3
-
Highly Aware
Moderately Aware
Aware
2
1
-
Fairly Aware
Not Aware
43
Segregation
1.
2.
3.
4.
5.
6.
7.
5
4
3
2
1
The hospital segregates the waste according to their
proper category
The hospital practice proper waste segregation
Waste bins are classified for easier waste segregation
Every waste bin/container/plastic has appropriate label
that indicate what level of biohazard
There should be separate container for sharp items such
as needles, test tubes, syringes, broken glass, etc.
There should be separate container for bio-degradable
waste like, papers, etc.
There should be a separate container for nonbiodegradable waste like plastic
Recycling
1.
2.
3.
4.
5.
6.
This process saves resources as well as the public health
and the environment
The recycling process is difficult due to waste diversity.
Recycling process reduces the impact of hospital waste
in the environment.
Recycling reduces materials for disposal
Good recycling process can save money and energy
If not handled properly it may pose great risk to the
public health and the environment
Treatment
1.
2.
3.
4.
5.
There are many ways to treat hospital waste
There should be proper treatment in different kind of
hospital waste
Treatment is used to minimize the risk it pose to public
health and in the environment
Treatment provides safer transportation and disposal of
the waste
Incineration is one common practice for hospital waste
treatment
How often the hospital does dispose their hospital waste material?
Everyday
Weekly
Monthly
Others, please specify __________________
44
APPENDIX 2
The oral interview and dissemination of the questionnaires.
45