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基于对外科部门医护人员知识与实践评估制定废物管理方案。

Development of a waste management protocol based on assessment of knowledge and practice of healthcare personnel in surgical departments.

作者信息

Mostafa Gehan M A, Shazly Mona M, Sherief Wafaa I

机构信息

Nursing Administration Department, Faculty Of Nursing, Helwan University, 10th Nasar City, Cairo, Egypt.

出版信息

Waste Manag. 2009 Jan;29(1):430-9. doi: 10.1016/j.wasman.2007.12.009. Epub 2008 Mar 7.

Abstract

BACKGROUND

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. Hence, waste management protocols must be convenient and sensible.

AIM OF STUDY

To assess the knowledge and practice related to waste management among doctors, nurses, and housekeepers in the surgical departments at Al-Mansoura University Hospital, and to design and validate a waste management protocol for the health team in these settings.

SUBJECTS AND METHODS

This cross-sectional study was carried out in the eight surgical departments at Al-Mansoura University Hospital. All health care personnel and their assistants were included: 38 doctors, 106 nurses, and 56 housekeepers. Two groups of jury were included for experts' opinions validation of the developed protocol, one from academia (30 members) and the other from service providers (30 members). Data were collected using a self-administered knowledge questionnaire for nurses and doctors, and an interview questionnaire for housekeepers. Observation checklists were used for assessment of performance. The researchers developed the first draft of the waste management protocol according to the results of the analysis of the data collected in the assessment phase. Then, the protocol was presented to the jury group for validation, and then was implemented.

RESULTS

Only 27.4% of the nurses, 32.1% of the housekeepers, and 36.8% of the doctors had satisfactory knowledge. Concerning practice, 18.9% of the nurses, 7.1% of the housekeepers, and none of the doctors had adequate practice. Nurses' knowledge score had a statistically significant weak positive correlation with the attendance of training courses (r=0.23, p<0.05). Validation of the developed protocol was done, and the percent of agreement ranged between 60.0% and 96.7% for the service group, and 60.0% and 90.0% for the academia group.

CONCLUSION AND RECOMMENDATIONS

The majority of the doctors, nurses, and housekeepers have unsatisfactory knowledge and inadequate practice related to health care waste management. The knowledge among nurses is positively affected by attendance of training programs. Based on the findings, a protocol for healthcare waste management was developed and validated. It is recommended to implement the developed waste management protocol for the surgical departments in the designed hospital, with establishment of waste management audits.

摘要

背景

医院良好的医疗废物管理依赖于专业的废物管理团队、良好的管理、精心的规划、合理的组织、相关立法的支撑、充足的资金以及训练有素的工作人员的充分参与。因此,废物管理方案必须方便且合理。

研究目的

评估曼苏拉大学医院外科部门医生、护士和勤杂工对废物管理的知识和实践情况,并为这些部门的医疗团队设计和验证一份废物管理方案。

研究对象与方法

这项横断面研究在曼苏拉大学医院的八个外科部门开展。纳入了所有医护人员及其助手:38名医生、106名护士和56名勤杂工。还纳入了两组评审团以对所制定方案进行专家意见验证,一组来自学术界(30名成员),另一组来自服务提供商(30名成员)。通过为护士和医生设计的自填式知识问卷以及为勤杂工设计的访谈问卷收集数据。使用观察清单评估实践情况。研究人员根据评估阶段收集的数据的分析结果制定了废物管理方案的初稿。然后,将该方案提交给评审团进行验证,之后予以实施。

结果

只有27.4%的护士、32.1%的勤杂工和36.8%的医生具备令人满意的知识。在实践方面,18.9%的护士、7.1%的勤杂工具备充分的实践,而医生中无人具备充分实践。护士的知识得分与参加培训课程的情况存在统计学上显著的弱正相关(r = 0.23,p < 0.05)。已对所制定的方案进行了验证,服务组的一致率在60.0%至96.7%之间,学术界组的一致率在60.0%至90.0%之间。

结论与建议

大多数医生、护士和勤杂工在医疗废物管理方面知识不令人满意且实践不足。护士的知识受到参加培训项目的积极影响。基于这些发现,制定并验证了一份医疗废物管理方案。建议在所设计的医院为外科部门实施所制定的废物管理方案,并建立废物管理审计制度。

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