Ashtari Ali, Sadegh Tabrizi Jafar, Rezapour Ramin, Rashidian Maleki Mohammad, Azami-Aghdash Saber
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Public Health. 2020 Sep;49(9):1611-1621. doi: 10.18502/ijph.v49i9.4074.
Given the importance of proper management of Health Care Waste Management (HCWM), comprehensive information on interventions in this field is necessary. Therefore, we aimed to systematically review and meta-analysis of characteristics and results of interventions in the field of HCWM.
The required data were gathered through searching the keywords such as waste management, biomedical waste, hospitals waste, health care waste, infectious waste, medical waste, Waste Disposal Facilities, Garbage, Waste Disposal Facilities, Hazardous Waste Sites in PubMed, Scopus, EMBASE, Google scholar, Cochrane library, Science Direct, web of knowledge, SID and MagIran and hand searching in journals, reference by reference, and search in Gray literatures between 2000 and 2019. CMA software: 2 (Comprehensive Meta-Analysis) was used to perform the meta-analysis.
Twenty-seven interventions were evaluated. Most of the studies were conducted after 2010, in the form of pre and post study, without control group, and in hospital. Interventions were divided into two categories: educational interventions (19 studies) and multifaceted managerial interventions (8 studies). The most studied outcome (in 11 studies) was KAP (knowledge, attitude and practice). The mean standard difference of interventions on KAP was estimated 3.04 (2.54-3.54) which was significant statistically (<0.05). Also, interventions were considerably effective in improving the indicators of waste production amount, waste management costs and overall waste management performance.
Despite positive effect of interventions, due to the methodological deficiencies of published studies and high heterogeneity in results of studies, caution should be exercised in interpreting and using the results of the studies.
鉴于妥善管理医疗保健废物管理(HCWM)的重要性,有必要获取该领域干预措施的全面信息。因此,我们旨在对HCWM领域干预措施的特征和结果进行系统评价和荟萃分析。
通过在PubMed、Scopus、EMBASE、谷歌学术、Cochrane图书馆、Science Direct、知识网络、SID和MagIran中搜索“废物管理”、“生物医学废物”、“医院废物”、“医疗保健废物”、“传染性废物”、“医疗废物”、“废物处理设施”、“垃圾”、“危险废物场地”等关键词,并逐篇查阅期刊参考文献以及搜索2000年至2019年期间的灰色文献来收集所需数据。使用CMA软件2(综合荟萃分析)进行荟萃分析。
共评估了27项干预措施。大多数研究在2010年之后进行,采用前后对照研究形式,无对照组,且在医院开展。干预措施分为两类:教育干预(19项研究)和多方面管理干预(8项研究)。研究最多的结果(11项研究)是知识、态度和实践(KAP)。干预措施对KAP的平均标准差值估计为3.04(2.54 - 3.54),具有统计学显著性(<0.05)。此外,干预措施在改善废物产生量、废物管理成本和整体废物管理绩效指标方面相当有效。
尽管干预措施有积极效果,但由于已发表研究的方法学缺陷以及研究结果的高度异质性,在解释和使用研究结果时应谨慎。