CHAPTER ONE

INTRODUCTION

1.1 Background

Clinical waste problems have evolved as the medical and health care service evolved. Clinical waste must be given serious attention and properly defined as an individual waste stream. Control of clinical waste under the law should be reinforced (1). Waste generated in the health care setting, that has been in contact with blood and other body fluids is classified as clinical waste and must be incinerated. Examples include soiled dressing, swabs, wound drainage tubes and bags, urine, drainage bags, sputum, incontinence pan, and used gloves (2)

WHO(3) found out that, around 80% of clinical waste are nonhazardous if properly handled, 15% are infections and the remaining 5% is made up of sharps (1%), toxic chemical and pharmaceutical waste (30%),  radioactive waste (1%) (3). Evidence from epidemiological studies indicates that needle stick injuries from needles used on an infected patient have a risk of HBV(30%), HCV(1.8%), and HIV(0.3%) IHCWS(4).

According to (1) the main method of clinical waste management in Cameroon is incineration and it has some merits, as well as demerits such as high maintenance cost and potential pollution risk. It is established that health care waste collected and handling systems including containers and bins for segregated waste are generally in a poor state. Clinical waste management problems are not only problems faced in Cameroon, but also in Africa as a whole and it’s an important public health concern worldwide.

In addition to the poor designated incinerators and poor state of containers and bins used in the management, the study established that little attention is given to clinical waste management and this is due to the lack of an integrated approach to policymaking at the higher levels of decision making. This is needed for legislation to allow for a more defined role and responsibilities for health care personnel responsible for the handling and disposal of the waste stream at the point of generating in the health care facilities.

Overall, there is a need to formulate more sustainable health care waste management legislation (5). Therefore clinical waste is properly managed and the nurse as a member of a health care team has a vital role in clinical waste management, Pruss et al(6).

The purpose of this research to ensure that CW is properly managed by assessing nurses’ knowledge, describing the various procedure of CW and determine the risk associated to poorly managed of  CW, this is due to the fact that improper management and lead to many hazards, occupational, environmental and public health hazards(6).

1.2 Problem Statement

Despite the fact that other researches had been carried out, the proportion of nurses with adequate knowledge is unknown in the LRH,BRH, and SHF(1).

If clinical waste is not properly handled, it can cause environmental, occupational, and public health hazards,

• Occupational health hazards such as needle stick injury which can either be due to recapping wrongly and unsafe collection and disposal of sharp waste and which can lead to spreading of diseases such as AIDS, Hepatitis B, and C
• An environmental hazard such as air pollution, or, tanks along the stream bed causing water pollution and unscientific landfilling causing soil pollution Heath & Taylor(2).

In addition to health hazards, due to lack of plan and policies in most hospitals to organize a flow chart of clinical waste management, nurses give little or no attention to what is needed or done, as such contributing to the poor management of hospital waste in our institution today, some do it as a result of laziness and others due to lack of knowledge that is, do not know the possible health hazards that can result.  And also the lack of facilities is also a great problem because the various hospital waste is to be disposed of in different colored containers depending on the hospital policies(6).

1.3 Justification

Improving techniques on clinical waste management might reduce health hazards and occupational hazards as such will help control nosocomial diseases, reduces the risk of HIV/AIDS, sepsis from needles that are infected, prevent illegal repacking and reused of the contaminated needles, cut the cycle of infection and prevent long term health hazards like cancer from the environmental release of toxin substance such as mercury, WHO(7).

Also improving health facilities related to hospital waste management might or reduce health hazards, such as providing different colours of waste bags for the various types of related waste depending on the institution,

Improving nurse’s knowledge on hospital waste management and related health hazards might widen the scope of nurses knowledge and act as a piece of work to improve or facilitate e another research study (8).

1.4 Research Goal

Our goal is to improve nurses knowledge on hospital waste, by producing fillies and posters that will aid nurses to understand, how hospital waste should be managed and related health hazards if not properly handled and also to reduce health hazards related to improper waste management by providing facilities, plans and policies to govern the proper management of hospital waste

1.5 General Objective

To determine nurse’s ability and knowledge in the management of CW and related health hazards

1.5.1 Specific Objectives

1. To determine the proportion of nurses with adequate knowledge on CWM in LRH, BRH, and SHF.
2. To identify possible human risks due to poor management of CW
3. To identify possible ways to reduce human risk, because of poor management of CW.

1.6 Research Questions

1. What is the proportion of nurses with adequate knowledge on CWM, in LRH, BRH, and SHF in 2013?
2. What are the human risks associated with poor management of CW?
3. What are the possible ways to reduce these human risks?