Knowledge, Attitude, Practice of biomedical waste managementduring COVID 19 pandemic: A single centered study

Title of the project: Knowledge, Attitude, Practice of biomedical waste management

during COVID 19 pandemic: A single centred study

Type of study : Prospective single centred study

Aims & objectives :

Aim : To assess knowledge, attitude, practice of health care personals

regarding BMW management during COVID-19 pandemic

Objective :a)To assess safety precautions during handling the biomedical waste in the study centre

b) To assess the levels of knowledge, attitude and practice among doctors, nurses,

technicians and house keeping staff

Justification for study : According to Central Pollution Control Board report, India generates about 101 metric Tonnes per day of COVID-19 related biomedical waste.During the COVID-19 outbreak, many types of additional medical and hazardous waste are generated including infected mask, gloves, syringes, samples, drain bags,urine bags, body fluids, empty ampules etc. Disposal of biomedical waste including PPE kits worn by healthcare worker became a challenge during the ongoing pandemic. COVID-19 cases increased among individuals employed in garbage collection and disposal due to mismanagement of biomedical waste including PPE.Basic infection control practices are the only measures for containment. Thus, this study purpose to prevent general exposure to harmful effect of COVID-19 related biomedical waste.

Department involved: Department of Quality, Department of Hospital Infection control and management

Study period: January – April 2021

Sample size : 200 study sample including all health care personnel

Materials and methods:

Inclusion criteria and exclusion criteria

Inclusion criteria:

• All healthcare staff who are participating in the study

Exclusion criteria:

• Subjects who are not willing to participate in the study

Statistical methods: Descriptive statistics

Tools used : Structured questionnaire to assess the knowledge, attitude and

practice on biomedical waste management and safety precaution on handling

COVID-19 related biomedical waste.

Detailed description of procedure/processes: After obtaining approval from the

departmental dissertation committee and Institutional Ethics Committee, the

prospective single centred study will begin. The participants will be approached by

structured questionnaire related to the knowledge, attitude and practice of handling

the COVID-19 related biomedical waste will be provided to doctors, nurses,

technician and housekeeping staff to answer within stipulated time. The questions

on knowledge appraises the participant’s knowledge on attributes related to the

colour coding and their identification of biomedical hazard symbol, waste categories

and hospital policies for biomedical waste management. The question on attitude

were related to matters like is biomedical waste hazardous, waste management is a

team work and safe management of waste is an extra burden of work. The question

of practice appraises if the study respondents had undergone any training on

biomedical waste management, disposal of sharps in puncture proof container and

disinfection of sharps are carried out at the point of generation.

Outcome measures: Assessing how safely the staffs are handling the COVID-19

related biomedical waste

Potential risk : Minimal risk

Benefits : The present status of healthcare worker’s awareness with respect to

BMWM will aid the authorities to expand the programme or master plan for polish

up or upgrade the situation in future.

Ethical considerations and methods to address issues: IEC clearance will be taken

before the start of the study. Informed consent from participant and use of indirect

identifier to ensure confidentiality.

Budget and proposed funding source: Not applicable.

Review of literature:

In a study done by Divya Rao, M.R Dhakshaini, Ameet Kurthukoti and Vidhya G.Doddawad, titled “Biomedical waste management: A study on assessment of knowledge, attitude and practices among Health care professionals in a tertiary care teaching hospital†A cross sectional study was carried out using questionnaire as the study tool among the health care professionals in a tertiary care teaching hospital. The study demonstrated gaps in the knowledge amongst all the cadres of the study respondents. The knowledge in relation to BMW Management including the hospital BMW protocols was more desirable among doctors, but practical facets were better in nurses and the lab technicians. Knowledge, Attitude and Practice amongst the different cadres of staff members were found to be significant statistically. In another study done by Keshvi Chauhan, Summaiya Mullan, Yogita Mistry titled

“Practices and barriers for personal protective Equipment among Health care workers during COVID-19 pandemic management at tertiary care government hospital of south Gujarat, India†This was a cross-sectional study designed during the COVID-19 pandemic management in the South Gujarat region, to analyse the knowledge,attitude and practices of health care workers about their usage of personal protective equipment. A semi-structured questionnaire-based study was prepared, deriving pointers from previous experience of seasonal flu outbreaks.225 participants enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. As a result, analysis of the barriersrelated questions show good preparedness by the medical institution.Overall we found good knowledge, attitude and practice related to PPE during COVID-19 pandemic  management. There are few gaps found in the knowledge of donning of PPE (p-0.0075), N-95 mask related knowledge (p-0.01) and the attitude that PPE use causes discomfort while nursing patients.In an effectiveness study titled “Analysis of compliance and barriers for hand hygiene practices among health care workers during COVID-19 pandemic management in tertiary care hospital of India- an important step for second wave preparedness†done by Keshvi Chauhan, Yogita Mistry, Summaiya Mullan this study was planned for analysis of barriers and practices of hand hygiene among health care workers which determine the adherence of hand hygiene in medical practice. This was a cross-sectional study designed during COVID-19 pandemic management to analyze the barriers and knowledge, attitude and practices in health care workers for hand hygiene. Semi-structured questionnaires based

study based on previous experience of seasonal flu outbreak was make to know barriers as well as to analyze the knowledge, attitude and practices of Health care workers.The “Barriers†related questions’ analysis showed that hand hygiene facilities, with the supply of soap, hand rub, basins with adequate as well as clean water, are available at various places in the Hospital. In knowledge related questions, major gaps are found in 5 moments of hand hygiene and regarding aspects of alcohol-based hand-rub. Majority HCWs show a good attitude towards questions that hand hygiene is an important thing to do along with other works and they feel frustrated when others or they themselves omit hand hygiene. But the attitude toward hand hygiene when hands are not visibly soiled and when working with gloved hand showed a wrong attitude. There is a major gap in practices of hand hygiene. The majority feel hand hygiene is difficult due to work pressure, sometimes they forgot, they feel it difficult to adhere due to more steps during an emergency. Good preparedness by Government and Institute for supplying adequate hand hygiene facilities in the work area for health care workers. But there were few gaps found in knowledge and attituderelated questionnaires and major gaps in practices were found

15. References:

16. CPCB guidelines for handling, treatment and disposal of waste generated during

treatment/diagnosis/quarantine of COVID-19 patients 25th March 2020.

2. Analysis of Compliance and Barriers for Hand Hygiene Practices among Health

Care Workers during COVID-19 Pandemic Management in Tertiary Care Hospital

of India—An Important Step for Second Wave Preparedness Keshvi Chauhan,

Yogita Mistry, Summaiya Mullan

3. Divya Rao1

, M. R. Dhakshaini2

, Ameet Kurthukoti3 and Vidya G. Doddawad

Biomedical Waste Management: A Study on Assessment of Knowledge, Attitude

and Practices Among Health Care Professionals in a Tertiary Care Teaching

Hospital

4. Keshvi Chauhan

1*

, Summaiya Mullan

2

, Yogita Mistry Practices and Barriers for

Personal Protective Equipment among Health Care Workers during COVID-19

Pandemic Management at Tertiary Care Government Hospital of South Gujarat,