Azami-Aghdash Saber, Sayadzadeh Mahdi, Ashtari Ali, Derakhshani Naser, Sedaei Zahra, Rezapour Ramin
Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Heliyon. 2023 Jul 3;9(7):e17695. doi: 10.1016/j.heliyon.2023.e17695. eCollection 2023 Jul.
Hospital waste poses numerous concerns for both human health and the environment. Using an action research technique, this study attempts to improve waste management at the Farabi Hospital in Malekan city-Iran. In 2020, integrated (quantitative-qualitative) action research was done. For action research, the Simmons model was employed. First, a list of significant issues was found during the waste management process evaluation using a standard checklist and brainstorming with hospital officials and workers. The identified issues were prioritized using a prioritization matrix. Then, after consulting with hospital officials, 11 interventions were designed and implemented over six months. Finally, waste management performance was re-evaluated. Average knowledge of the participants about hospital waste management (HWM) standards was improved significantly (64 ± 13.8 before the training, 84.6 ± 20.6). General waste production was reduced by 27.7% in terms of garbage bags and 23.4% in terms of waste weight (95.5 kg-73.1 kg), respectively. Infectious waste output was reduced by 22.8% in the number of garbage bags and 32.1% in the weight of waste (57.5 kg-39 kg). The rate of compliance with HWM criteria was improved from 10 to 33 items. Although the interventions in this study improved the HWM to an acceptable level, more interventions and ongoing monitoring are required. The study's findings also show that an action research strategy might address a wide range of issues and weaknesses in hospitals and related facilities.
医院废弃物对人类健康和环境都构成了诸多问题。本研究采用行动研究技术,试图改善伊朗马莱坎市法拉比医院的废弃物管理。2020年,开展了综合(定量 - 定性)行动研究。对于行动研究,采用了西蒙斯模型。首先,在使用标准清单对废弃物管理过程进行评估,并与医院管理人员和工作人员进行头脑风暴的过程中,找出了一系列重要问题。使用优先级矩阵对识别出的问题进行了优先级排序。然后,在与医院管理人员协商后,设计并在六个月内实施了11项干预措施。最后,对废弃物管理绩效进行了重新评估。参与者对医院废弃物管理(HWM)标准的平均知识水平有了显著提高(培训前为64 ± 13.8,培训后为84.6 ± 20.6)。一般废弃物产量分别以垃圾袋数量计算减少了27.7%,以废弃物重量计算减少了23.4%(从95.5千克降至73.1千克)。传染性废弃物产量以垃圾袋数量计算减少了22.8%,以废弃物重量计算减少了32.1%(从57.5千克降至39千克)。符合HWM标准的项目数量从10项提高到了33项。尽管本研究中的干预措施将HWM改善到了可接受的水平,但仍需要更多的干预措施和持续监测。该研究结果还表明,行动研究策略可能解决医院及相关设施中广泛存在的各种问题和薄弱环节。