::: Bio-Medical Waste Management : Training on Waste Management
 Training on Waste Management

Training of bio- waste medical management - Phase-I
Training of trainers (TOT) [medical officers and staff nurses designated]

         Professors/Associate professors
         Assistant professors
         Tutors/senior residents    
Para-medical persons
          Lab technicians                 
          Theatre technicians          
          Female/Male nursing assistants      
          Hospital workers [basal sanitary workers/sweepers

Training should on the following aspects:

Segregation of Waste ` ·
Segregation of waste means separating and placing the Hospital Waste / Bio-Medical Waste and General waste in the different colour coded bins as per rules bins as per rules (given in picture).

Disinfection of Segregated Waste
Disinfection is a process of destroying micro-organisms that can cause potential danger by transmitting infections. It is an essential part in Bio-Medical Waste Management.

Mode of Disinfection
Disinfection can be done in two ways i.e., Chemical and Mechanical wherever essential.
In the Chemical disinfection process, generally chlorine based chemical disinfectants like Sodium Hypochlorite Solution, bleach, etc. are used.
In the Mechanical disinfection process, devices like autoclave or microwave are used.

Red Bin
There are three types of Red Bins - Twin Bin, 25 Liters Red Bin (big), end 15 Liters Red Bin (small)
Clearly demarcate plastic end non-plastic wastes.
Put the plastic waste such as syringes, I.V tubes, ryles tube, catheters, etc. In the Twin Bin provided which has 1% freshly prepared Sodium 1-lypdchlerite hypochlorite Solution in it. The plastic waste should be immersed at least for 30 minutes in the Twin Bin for disinfection process. After disinfecting the plastic waste, shift it to the specially designed pictured Red color bag with big bio-hazard symbol inside the red bin (25 liters - big).

Non-plastic waste (used cotton, gauze, soiled bandages) should be placed in red bin with small bio-hazard symbol inside the small red bin (15 liters - small).

Blue Bin
Bid-Medical Waste such as sharps including ampoules, vials, broken glasses, suture, slides, etc. should be placed in the Blue Bin. Needles and suture lancets should be managed by using needle destroyer.

Needle Management with Needle Destroyer
HIV & HBV transmission can be largely minimized by adhering strict needle management plan by using the Needle Destroyer Instrument. When the needle is inserted in the hole provided in the needle destroyer a high temperature electric arc is passed which burns the needle. The used needles should be destroyed immediately to reduce minimum handling of sharps.

Yellow Bin
Bio-Medical waste such as anatomical waste, placenta, tissues, body parts, etc. should be placed in the Yellow Bins.

Black Bin
In the Black Bin, all expired drugs and cytotoxic drugs, etc. should be placed.

Green Bin
General Waste such as food items, plastic covers, needle covers and infected plaster of Paris, etc should be placed in the green bins.

Monitoring and Record Maintenance 
Health Care Units and Hospitals should maintain the records for the Bio-Medical Waste generated and disposed from their premises.
Bio- Medical Waste Management Registers includes four types.
1. Registers for Daily Collection of Bio·-Medical Waste at the source.
2. Register of Source wise collection of Bio-Medical Waste for the day.
3. Monthly consolidation registers for collection of Bio- Medical Waste.
4. Register for needle stick injuries.

Transportation and Storage
 After weighing the segregated Bio—Medical Waste and registering its details in the wards/OP/ Lab/ Theaters,. etc. it should be transported to the respective Colour Bins kept in the Trolleys.
 The waste collected in the trolleys should be transported and stored in the Health Care Waste Storage Room in the Hospital for the disposal to the Common Treatment Facility.
 Care should be taken that no Bio-Medical Waste should be spilled during transportation.

Treatment and Disposal
The segregated Bio-Medical Waste collected from the Hospital should be transported to the Common Treatment Facility for further final disposal.
Common Treatment Facility (CTF) or Common Bio-Medical Waste Treatment Facility is referred to a place or establishment where the Bio-Medical Waste collected from the Hospitals is treated and disposed in accordance to the Bio-Medical Waste (Management and Handling) Rules.

Technology used for Treatment and Disposal of Waste
Based on the kind of segregated waste various treatment technologies are used for final disposal.
  • Autoclave
  • Incineration
  • Sharp Pits
  • Secured Land Fill
  • Autoclave is the process in which Erie waste is treated under high pressure and temperature of about 12odegrees centigrade for a minimum period of 30 minutes thereby destroying all forms of  fungus, bacteria and micro-organism including  virus.
  • The disinfected Bio-Medical Waste collected in Red bag is autoclaved.
  • The autoclaved waste is safe and sterile.

 It is a process of burning the anatomical waste such as human tissues, organs, placenta and the waste collected in yellow bag without disinfection, body parts in high temperature to destroy the waste. The final residue is ash.
Secured Land Fill
Secured Land Fill is one which has containment measures such as liners and a leach ate collection system so that materials placed in the landfill will not migrate into the surrounding soil, air and water.
The ash from the incinerators and the waste from black bags which includes cytotoxic drugs and expired drugs will be disposed to a secured landfill.

Deep Burial
· Deep Burial is an alternate technology opted for disposing small quantities of Bio-Medical Waste.
. A separate pit is dug and used to dispose Bio-Medical Waste which can decompose naturally.

Protective Gears
 Health Care Providers should use the Protective Gears like Apron, Gloves and Mask Wherever essential to reduce the cross contamination and the risk of transmitting infection from person to person in Hospital.

Health Care Staff are exposed to high risk of infections like HBV, HIV and Tetanus. It is recommended that all the Health Care Staff should be vaccinated. However, no vaccine exists to prevent HIV infection.
 Post Exposure Prophylaxis (PEP) - Needle Stick Injuries
Place the injured part under running water and allow the bleeding from the site of injury.
Wash the wounds with soap.
Apply antiseptic cream and cover the wound with the dressing.
Report the incident immediately to the doctor/ nurse concerned to receive the PEP drugs.
Needle Stick Injuries should be registered in the prescribed Annexure.

Essential Practices for Health Care Providers
It is sensed, Bio-Medical Waste Practices lead to some injuries and infections when handled without necessary precautions. The Health Care Staff such as Sanitary Workers /Hospital Workers, Nurse / Para Medical Staff & Doctors are to be sensitized for effective management of Bio-Medical Waste.

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