Kumar Ramesh, Somrongthong Ratana, Shaikh Babar Tasneem
Fellow at College of Public Health Sciences, Chulalongkorn University Thailand, Bangkok, Thailand.
Department of Health Systems and Policy, Health Services Academy, Islamabad, Pakistan.
BMC Health Serv Res. 2015 Feb 28;15:81. doi: 10.1186/s12913-015-0758-7.
Infectious waste management has always remained a neglected public health problem in the developing countries, resulting in high burden of environmental pollution affecting general masses. Health workers are the key personnel who are responsible for the management of infectious waste at any hospital, however, their proper training and education is must for an optimal performance. This interventional study was conducted to assess the effectiveness of Intensive healthcare waste management (IHWM) training model at two tertiary care hospitals of Rawalpindi city, Pakistan.
This study was quasi-experimental pre and post design with control and intervention groups. Out of 275 health care workers enrolled for the study, 138 workers were assigned for intervention group for 3 months trainings, hands-on practicum and reminders on infectious waste management; whereas 137 workers were assigned to the control hospital where routine activities on infectious health care waste management were performed. Pre and post intervention assessment was done for knowledge, attitude and practices (KAP); and was statistically analyzed. Bivariate and multivariate analysis, independent, paired and unpaired t-test, chi-square with p values, and mean of the responses were calculated. Overall the response rate was 92% at the end of intervention.
During the baseline survey, 275 healthcare workers (HCW) included doctors, nurses, paramedics and sanitary workers, and after 3 months of intervention, 255 were reached out to complete the questionnaire. With regard to KAP at baseline, there were no significant differences between two groups at baseline, except for gender and department. However, in the post intervention survey, statistically significance difference (<0.05) between intervention and control group's knowledge, attitude and practices was found. Moreover, within the control group no statistically significant difference was reported (>0.05) after 3 months.
Study results suggest that IHWM training could be an effective intervention for improving knowledge, attitudes and practices among health workers regarding infectious waste management. Such training should become a regular feature of all hospitals for reducing the hazards attached with infectious wastes.
在发展中国家，医疗废物管理一直是一个被忽视的公共卫生问题，导致环境污染负担沉重，影响广大民众。医护人员是任何医院医疗废物管理的关键人员，然而，对他们进行适当的培训和教育是实现最佳绩效所必需的。本干预性研究旨在评估强化医疗废物管理（IHWM）培训模式在巴基斯坦拉瓦尔品第市两家三级护理医院的效果。
本研究采用类实验性前后设计，设有对照组和干预组。在参与研究的275名医护人员中，138名被分配到干预组，接受为期3个月的培训、实际操作练习以及关于医疗废物管理的提醒；而137名被分配到对照医院，在那里进行医疗废物管理的常规活动。在干预前后对知识、态度和实践（KAP）进行评估，并进行统计分析。计算双变量和多变量分析、独立、配对和非配对t检验、带p值的卡方检验以及反应均值。总体而言，干预结束时的反应率为92%。
在基线调查期间，275名医护人员（包括医生、护士、医护辅助人员和卫生工作者）参与，经过3个月的干预后，联系到255人完成问卷。关于基线时的KAP，除性别和科室外，两组之间在基线时没有显著差异。然而，在干预后调查中，发现干预组和对照组在知识、态度和实践方面存在统计学显著差异（<0.05）。此外，在对照组中，3个月后未报告有统计学显著差异（>0.05）。
研究结果表明，IHWM培训可能是一种有效的干预措施，可提高医护人员在医疗废物管理方面的知识、态度和实践。这种培训应成为所有医院的常规项目，以减少医疗废物带来的危害。
