ABSTRACT
The management of medical waste is of importance due to its
infectious and hazardous nature that can cause risks on the environment and
public health. The study was conducted to evaluate the medical waste management
practices, to determine the amount of waste generated and to prepare an
Environmental Action Plan (EAP) for the Aninwaah Medical Center, Emena, Kumasi.
The survey was conducted at the Aninwaah Medical Center since its waste
management practices were not so clear to some staff. To examine the medical
waste management practices, the study employed a range of methods including
questionnaires survey which targeted 100 randomly selected health care workers
and ancillary staff, formal interviews with facility managers, field
observations and literature reviews. Compliance with EPA-Ghana guidelines and
other recommended used as standards to assess the hospital waste management
practices. The waste management practices were analysed for a week to capture
the daily management practices. It was observed that medical waste generation
rate at the Aninwaah Medical Centre ranged from 0.126-0.157kg/patient/day.
About 95% of the waste generated was general/non-infectious waste and sharps.
The audit also revealed that segregation procedures the wastes generated were
not constantly followed. The hospital workers are not given the proper training
and insufficient protection. It was revealed that there are no laws in Ghana on
how medical wastes are managed. In view of that, hospitals are not obliged to
strictly follow any laws or procedure in the management of medical waste.
CHAPTER ONE
INTRODUCTION
1.1 Background Information
Hospitals play a pivotal role in protecting people's health
and are a necessary part of our society. As such they must be examples of
economic, environmental and social responsibility (Serb C, 2008). The amount of
medical waste is increasing constantly throughout the world, raising the issue
of its safe and economic disposal as a grave concern (DenBos and Izadpanah,
2002). This is because waste from Healthcare Facilities (HCFs), arising
principally from hospitals and clinics, is potentially dangerous since it can
spread diseases because of the infectious nature of the wastes, and/or cause
injury through the mismanagement of clinical solid/liquid waste (Abd El-Salam,
2010; Al-Khatib and Sato, 2009).
Until recently, medical waste management was not generally
considered an issue. In the 1980s and 1990s, concerns about exposure to Human
Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) led to questions about
potential risks inherent in medical waste. In 1983, a premier meeting organised
by the World Health Organization (WHO) was held at Bergen, Norway to discuss
medical waste management issues (Lee et al, 1996).
Medical waste is generally described as any solid/liquid
waste that is generated in the course of diagnosis, treatment, or immunization
of human beings, or animals, in research pertaining to, or in the production or
testing of biological materials (EPA, 2005; OSHA, 1991). Though not all medical
wastes are hazardous some waste from healthcare or medical facilities are high risk, hazardous and can affect
human health as well as pollute the environment. In a working environment where
poor health care waste management practices are the norm, exposure to
infectious wastes due to blood borne pathogens could predispose healthcare
workers, patients, and clients to infections (Johannessen et. al. 2000; Sawalem
et. al., 2009; Pruss et. al., 1999; Akter, 2000).
Although great strides have been made in the field of
healthcare system over the years, the health of the public, patients and
professionals alike are affected by poor waste management practices (Shinee et.
al, 2008).
Hospitals undertaking an environmental audit are conducting a
type of internal investigation to assess the hospital's compliance with the
broad scope of environmental regulations which govern health care entities. An
environmental audit provides hospital management with a concentrated opportunity
to evaluate whether the facility has a system in place to achieve and maintain
compliance while detecting and correcting non-compliance (Riesel, 1986).
The audit forces hospital management to regard the hospital's
various units as a whole, which is necessary in several regulatory contexts.
For example, whether a hospital is required to hold certain air permits may
depend on the level of emissions from facilities such as boilers, generators or
backup generators used in the event of power outage.
1.2 Statement of
the Problem
A hospital management team's confidence is enhanced when the
hospital's balance sheet fairly states the financial position of the hospital
after the financial statement has been audited by an independent certified
public accountant. The hospital management team should have similar confidence that the hospital is operating
in compliance with Environmental Protection Agency (USEPA) and state
environmental regulations if the hospital has undergone a periodic review of
the hospital's environmental operations. While independent financial audits are
part of a hospital's business cycle, environmental audits are not a regular
practice.
Hospital preparedness for the USEPA inspection or inquiry is
enhanced where the hospital has in place an audit protocol, a practice of
conducting environmental audits. These audits, like financial internal control
audits, detect systemic weaknesses in the hospital's procedures which presently
may have led to no problems but are at risk to lead to a troubled future.
Environmental audits provide the hospital (which shores up internal control
weaknesses to guard against fraud) the opportunity to improve procedures,
conduct employee training or acquire updated equipment to lessen the risk of an
environmental violation.
The Aninwaah Medical Center and some hospitals in Ghana are
not exceptions of this problem hence it is prudent for the medical waste
problems and situations to be looked at and to find possible remedial measures
to them.
1.3 Objectives of
the Study
The objectives of the study are to:
* identify the types and quantities of waste generated at the
hospital;
* assess the current medical waste management system;
* prescribe suitable treatment options for waste identified;
* integrate the Protocols recommended for managing hospital
waste by the EPA, EU, and WHO into their management system; and
* prepare a detailed Environmental Action Plan (EAP) for the
hospital.
What are the types and quantities of waste generated at the
hospital?
What is the current medical waste management system operated
by the hospital?
Is the hospital operating a suitable treatment options for
its wastes?
Has the hospital integrated the protocols recommended for
managing hospital waste by the EPA, EU, and WHO into their management system?
and
Does the hospital have a comprehensive Environmental Action
Plan (EAP)?
1.5 Significance
of the Study
This study
will be a significant endeavour in promoting good work environment in the hospital and motivation of
its employees. This study will also be beneficial to management and corporate
bodies when they employ effective hospital waste management in their
workplace. By understanding the needs of the workers and benefits of quality
healthcare delivery, the management and public can be assured of an advantage.
Moreover, this research will provide recommendations on how to evaluate the
performance of any health institution in accordance to protocols for
environment.
Moreover, this study will be helpful to the health
practitioners in training
and informing them in the area of waste management, objectives, and
strategies. It will also serve as a future reference for researchers on the
subject. And importantly, this research will educate the public in deciding on
whether the healthcare facility is really fulfilling its responsibility to the
community or it is just showing off to promote its business, hence the need for
this environmental audit.
This study will be limited to a general medical hospital type
which has a capacity of less than 100 beds. A general environmental
evaluation/audit will be conducted. All options of design recommendations and
modifications will be limited to environmental and economic evaluation
components merely with objective of pollution reduction along with
environmental improvement. The study will be conducted at the Aninwaah Medical
Center, Emena, Kumasi near KNUST. The study will be concentrated on the waste
generated at the facility (pathological waste, sharps, needles etc).
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Item Type: Ghanaian Topic | Size: 94 pages | Chapters: 1-5
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