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Medical waste bins are a potential source of microbial contamination in the hospital environment, while there is no clear guidance for the management of them. We aimed to assess the impact of medical waste bins on patient's environment. This experimental study simulated microbial contamination by performing medical procedures on a patient model with fluorescent lotion. The waste bin was set as initially empty or two-thirds filled with waste, open or with a lid. The percentage of fluorescent-contaminated area in designated patient's environments was analyzed by 2 independent observers. Among a total of 120 experiments, the sides of the bins were more contaminated in open-occupied bins compared to open-empty bins and in open-occupied bins compared to lid-occupied bins (median 1.9175% vs 0.0916% [ P =.001] and 1.9175% vs 0.0899% [ P =.003], respectively). The top of the bedside equipment trolley for preparing medical procedures was more contaminated in lid-occupied bins than open-occupied bins (median 0.0080% vs 0.0040%, P =.013). In addition to reducing contamination of the bin itself, the manually operated lid had a potential risk of contributing to microbial transmission by contaminating the equipment trolley. Medical waste bins should be kept no more than two-thirds full, and caution should be taken when using the manually operated lid, to avoid cross-contamination. • The guidance on medical waste bins, potential source of pathogen, is needed. • Two-thirds filled waste bins were more contaminated than empty bins. • Open waste bins were more contaminated than lidded bins. • Equipment trolley was more contaminated in bins with manually operated lids. • Occupied waste bin and manually operated lid may be sources of contact transmission. [ABSTRACT FROM AUTHOR]

Background: Medications including unused ones, might lead to financial and environmental costs. Not only they could have economic impact but also, harm the population safety. However, the nature and extent of leftover and unused medications in Saudi families and its economic impact remain unknown. Objectives: The aim of this study is to assess the potential economic cost of the unused medications in Saudi households. Method : A cross-sectional, observational study was conducted using a snowball method for recruiting the families. Descriptive data were collected face to face using a structured questionnaire. Result: A total of 116 family included in the study, 536 unused medications were found in their houses during the study period (December 2021- April 2022). Approximately, 42 % (227) of unused medications were stopped due to symptoms improvement. A total of 56 types of unused medications with different dosage forms were found at houses because of receiving excess medication in the packet (17%, 90) and purchased for emergency (14% 78) use. The total cost was SR 26249. ($ 6995.60) for the unused medications which found at 116 households. Of the total 41(34%) of the total households with unused medication have unused medication range between 1-99SR. The stoke of left over medication worth of above 500 SR for around six (5%) of the families. Conclusion: A significant number of unused medications were found at family's. The study also identified that there were different reasons for unused medications that can be prevented. The unused medications result in relatively high economic impact. Educational interventions are highly needed for families on unused medications. [ABSTRACT FROM AUTHOR]

This column discusses the Anatomy Act 1977 (NSW) and its regulatory environment. The column begins with examining the history of anatomy regulation in the United Kingdom and Australia. It then goes on to analyse the history of the current anatomy regulation in New South Wales, pointing out areas for reform. [ABSTRACT FROM AUTHOR]

Government of India has provided Indian Public Health Standards to improve rural health care services and health status, but still rural laboratory is a cause of concern. This study is performed to understand the laboratory facility-level gaps that need to be addressed to improve the public primary health centres (PHCs) present in rural areas. The laboratory assessment is performed for governance, financing, resources and services, and results are validated with the PHC laboratory performance. The current assessment shows critical gaps in the facilities regarding governance, services, resources and financing required for the laboratory services at the rural primary health care level. Governance and services need to be strengthened the most, followed with sustained availability of resources and financing. Poor health status in rural areas necessitates public health response based on health systems. Therefore, health system preparedness in the form of laboratory services is essential in primary health care facilities. [ABSTRACT FROM AUTHOR]

The healthcare industry is a major contributor to greenhouse gas emissions. Within the hospital, operating rooms are responsible for the largest proportion of emissions due to high resource utilization and waste generation. Our aim was to generate estimates of greenhouse gas emissions avoided and cost implications following implementation of a recycling program across operating rooms at our freestanding children's hospital. Data were collected from three commonly performed pediatric surgical procedures: circumcision, laparoscopic inguinal hernia repair, and laparoscopic gastrostomy tube placement. Five cases of each procedure were observed. Recyclable paper and plastic waste was weighed. Emission equivalencies were determined using the Environmental Protection Agency Greenhouse Gas Equivalencies Calculator. Institutional cost of waste disposal was $66.25 United States Dollars (USD)/ton for recyclable waste and $67.00 USD/ton for solid waste. The proportion of recyclable waste ranged from 23.3% for circumcision to 29.5% for laparoscopic gastrostomy tube placement. The amount of waste redirected from landfill to a recycling stream could result in annual avoidance of 58,500 to 91,500 kg carbon dioxide equivalent emissions, or 6583 to 10,296 gallons of gasoline. Establishing a recycling program would not require additional cost and could lead to modest cost savings (range $15 to 24 USD/year). Incorporation of recycling into operating rooms has the potential to reduce greenhouse gas emissions without increased cost. Clinicians and hospital administrators should consider operating room recycling programs as they work towards improved environmental stewardship. Level VI – evidence form a single descriptive or qualitative study. [ABSTRACT FROM AUTHOR]

Background: The reverse logistics of medicines consists of the logistical procedure of collection, transport, storage, treatment and final disposal of postconsumer or expired waste. Medicines can be toxic to the environment and affect the health of citizens of the territory. Community pharmacies, as a health facility, play a key role in this process. Objectives: Define the spatial analysis and cases of reverse logistics of medicines in community pharmacies in Brazil. Methods: This is a cross-sectional study, and the research covered the medicines collected by 400 community pharmacies in the period from 2020 to 2022. To obtain the data, the medicines were collected, weighed, segregated and the weight released on a dedicated waste management platform. All regions of Brazil subject to georeferencing were processed using the free software Geographic Information System (QGIS). Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher's exact test were used to compare variables. The accepted significance level was 5%. Results: Of the five existing regions in Brazil, only three had records of reverse medication logistics. 4,519.74 Kg of products were collected, and the North region of Brazil was responsible for 69.1% of the collection. In the spatial analysis, it was possible to perceive a difference between the areas of concentration of the RDL, that is, locations where collections were carried out in the period from 2020 to 2022. Conclusion: The present study preliminarily analyzed the reverse logistics of medicines in Brazil. The data obtained can contribute to the knowledge of this area and to the strengthening of the process. Thus, these places must exercise a task force for the educational process of the population about the risks of incorrect disposal of medicines and that this could harm the environment, economic aspects of society, food and the entire context that involves health and well-being of citizens. [ABSTRACT FROM AUTHOR]

Background: Objectives of quality principles in the clinical setting present nursing with opportunities for quality patient care but at lower environmental footprint. This affects patients, hospital personnel, and community because choices reduce climate change and thus support an innovative nursing role. Purpose: This article aims to support nursing knowledge to include environment in decisions regarding patient care and reusable versus disposable incontinence underpads (IUPs). Methods: A life cycle analysis was conducted, including soiling, reusable cycles before removal, supply chains, laundry use, and end-of-life environmental impact. Results: The selection of reusable IUPs versus disposables reduced total natural resource energy consumption by 71%, greenhouse gas emissions by 61%, blue water consumption by 57%, and solid waste by 97%. Conclusions: The nursing community can use this information in its health care organizations regarding IUP to advocate for decisions to select reusable IUPs that benefit our environment (air, water, and land). [ABSTRACT FROM AUTHOR]

• An educational brochure improves disposal rates of unused opioids after upper extremity surgery. • Recruiting hand therapists in brochure distribution further increases opioid disposal rates. • Brochure administration is more effective when coupled an active discussion of opioid use. • Older age is associated with higher rates of opioid disposal. Opioids often remain unused after upper extremity surgery, and leftover prescriptions are frequently diverted. When administered in a hand surgery clinic, an educational brochure outlining a simple method of opioid disposal has been shown to improve disposal rates after surgery. To understand whether administration of an opioid disposal educational brochure in a hand therapy clinic would increase opioid disposal rates, compared to a hand surgery clinic. Prospective cohort study. Patients who presented to a hand therapy clinic postoperatively were recruited to participate in this prospective cohort study. An educational brochure outlining a simple method of opioid disposal was made available at the hand therapy and surgery clinics. A questionnaire was later issued to obtain: location of brochure receipt, demographic information, pre- and post-operative opioid use history, and opioid disposal patterns. Chi-square tests and multivariable binary logistic regression assessed associations between medication disposal and explanatory variables. Patients who received the brochure were significantly more likely to dispose of excess opioid medication, compared to those who did not receive the brochure (57.1% vs 10.8%, p <.001). Patients who received the brochure at the hand therapy clinic were significantly more likely to dispose of excess opioids (86.4%) compared to those who received the brochure at the surgery clinic (25.0%). Older age was predictive of increased disposal (p =.028*). There were no significant associations between gender, length of follow-up, or surgery type with the incidence of opioid disposal. Recruiting both hand therapists and surgeons in the distribution of a simple, educational brochure on opioid disposal can increase disposal rates. Patients who received the brochure from the hand therapist were more likely to dispose of excess opioids. The longstanding patient-therapist relationship creates an opportunity for educational initiatives and discussion of stigmatized topics, such as opioid use. [ABSTRACT FROM AUTHOR]

The article provides a review of the cause, impact, and remedies of ecopharmacovigilance or pharmaceuticals contaminating the environment. Topics discussed include sources of pharmaceutical waste, the problem of incorrect disposal of pharmaceutical waste, and how to integrate ecopharmacovigilance into existing pharmacovigilance systems.

• Medical waste severely contaminate the landfilled sites and adjacent sites. • Collected soil sample containing more quantity of heavy metals and alkaline soil. • J. integerrima showed remarkable metal absorption potential in greenhouse study. • POD activity of J. integerrima was found as dose dependent. • 8 week of greenhouse study it effectively absorbed significant amount of metals. An improper disposal of hazardous medical waste in soil cause severe soil pollution and is becoming challenging to handle by eco-friendly way. Fortunately, the selective plant based treatment on medical waste polluted soil can be a feasible approach. Thus, the metal removal competence of Jatropha integerrima was analyzed in this research on medical waste polluted soil. The soil characteristics like pH, Ag, As, Cd, Cr, Hg, Pb, Zn, and Mg were analyzed by typical digital pH meter and acid digestion method. The greenhouse experiment was performed with J. integerrima on test soil sample. The plant pigments and peroxidises (POD) activity was recorded in these study respective standard methods. Soil has alkaline pH and tested heavy metal contents were beyond the permissible limits. The J. integerrima based phytoremediation study revealed that the soil alkaline pH was considerably minimized as close to neutral. Metal quantities such as Ag: 3.0 ± 0.11, As: 4.46 ± 0.21, Cd: 38.41 ± 1.65, Cr: 36.02 ± 1.3, Hg: 3.25 ± 0.14, Pb: 38.34 ± 1.32, Zn: 45.91 ± 2.28, and Mg: 29.02 ± 1.52 mg Kg−1 were reduced from 100 m soil and they accumulated in plant biomass. The real-field experiment will be performed to assess this plant potential and it will be the future perspective of this study. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Though global health care delivery systems have been under inevitable pressure and risks from the ongoing coronavirus disease (COVID-19) pandemic, our natural human environment is also increasingly threatened. The reason is that efforts to contain the pandemic have resulted in a vast generation of medical waste from disused personal protective equipment, such as facemasks, face-shields, hand-gloves, hand-sanitisers, and related single-use products. Unprofessional management of medical waste can result in environmental contagion. This article, adopting an analytical approach, argues that COVID-19 waste represents a mode of contagion, and hence demands special regulatory attention, management, and disposal procedures at all levels of governance. The article offers an epidemiological perspective on COVID-19 waste and its place in medical waste. It provides insights into the best practices for managing COVID-19 waste and examines how global objectives and frameworks visibly support COVID-19 medical waste management globally. [ABSTRACT FROM AUTHOR]

T-Spherical fuzzy sets provide a robust framework for handling uncertainty in real-world decision-making. This paper addresses the construction of T-Spherical fuzzy Heronian mean averaging aggregation operators using novel Hamacher operations. The study mathematically verifies the properties of these operators and develops new distance measures such as Hamming, Euclidean and Jaccard for quantifying dissimilarity between T-Spherical fuzzy numbers. Furthermore, the TOPSIS method is implemented using the proposed operators and distance measures to solve a practical decision-making problem in selecting the best transportation firm for medical waste disposal. A sensitivity analysis is made to assesses the efficacy of the proposed operators, while a comparison study with existing methods is exhibited to establish their efficiency. • Novel Hamacher operational laws for T-spherical fuzzy (T-SF) numbers. • New distance measures: Hamming, Euclidean, Jaccard and T-SF Heronian mean averaging operators. • TOPSIS method using proposed operators and distance measures. • Effective handling of complexities and uncertainties. • Example: selecting best transportation firm. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nosileftiki is the property of Hellenic Nurses' Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Studies have shown that severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) is a highly infectious disease, with global deaths rising to about 360,438 as of 28 May 2020. Different countries have used various approaches such as lockdown, social distancing, maintenance of personal hygiene, and increased establishment of testing and isolation centers to manage the pandemic. Poor biomedical waste (BMW) management, treatment, and disposal techniques, especially SARS-CoV-2 infected BMW, may threaten the environmental and public health in most developing countries and, by extension, impact the economic status of individuals and the nation at large. This may increase the potential for the transmission of air/blood body fluid-borne pathogens, increase the growth of microorganisms, risk of mutagenesis, and upsurge of more virulent strain. In contrast, uncontrolled substandard burning could increase the potential spread of nosocomial infection and environmental exposure to toxic organic compounds, heavy metals, radioactive, and genotoxic bio-aerosols which might be present in the gaseous, liquid, and solid by-products. The paucity of understanding of pathophysiology and management of the SARS-CoV-2 pandemic has also necessitated the need to put in place appropriate disposal techniques to cater for the sudden increase in the global demand for personal protective equipment (PPE) and pharmaceutical drugs to manage the pandemic and to reduce the risk of preventable infection by the waste. Therefore, there is a need for adequate sensitization, awareness, and environmental monitoring of the impacts of improper handling of SARS-CoV-2 infected BMWs. Hence, this review aimed to address the issues relating to the improper management of increased SARS-CoV-2 infected BMW in low middle-income countries (LMICs). [ABSTRACT FROM AUTHOR]

BACKGROUND: Every day, more than 190 people in the United States die from opioid overdose. Unused opioid medications pose a risk to the patient and the community as they increase the potential for abuse or misuse. A contributing factor is lack of education on the proper disposal methods of unused opioid medications. PURPOSE: The purpose of this quasi-experimental nursing study was to examine whether providing education on proper disposal of opioid medications would increase the proportion of patients who properly dispose of unused opioids. METHODS: The study site's mandatory orthopaedic preoperative class was used for consenting patients. The control group did not receive targeted education on opioid disposal, whereas the intervention group did receive targeted education. A total of 86 patients were consented during Months 1 and 2 of the study. Forty-one patients were in the control group and 45 were in the intervention group. Demographic variables such as age, gender, and marital status were collected to determine whether certain demographic factors had an influence over whether or not opioids would be disposed of properly. FINDINGS: Those in the intervention group who attended the class were slightly younger than those in the control group (68.2 ± 9.9 years vs. 70.3 ± 10.6 years, p =.5098), primarily male (57.5% vs. 35.0%, p =.0436), and more likely to live with a significant other (94.7% vs. 74.4%, p =.0249). Of those who had medication left over, 62.5% disposed of their unused opioid prescription in the intervention group compared with 40.7% in the control group (p =.1208). In the intervention group, 86.7% of the individuals with leftover medication disposed of it correctly compared with 63.5% in the control group (p =.3478). CONCLUSION: Those who received education on appropriate opioid disposal were more likely to dispose of it in general as well as dispose of it correctly. Although not statistically significant, the findings from this study are clinically significant in that they provide direction on the importance of standardized and focused patient education on proper opioid disposal. [ABSTRACT FROM AUTHOR]

• Carbon from medical waste combined with ZnIn 2 S 4 photocatalyst was successfully synthesized. • Carbon from medical waste on ZnIn 2 S 4 photocatalyst significantly enhances the photocatalytic activities. • ZISC-0.5 photocatalyst exhibits nanothorn particles with carbon at the outer. • The hydrogen amount generated by ZISC-0.5 photocatalyst reaches 86.9 μmol for 5 h light irradiation. • The in-situ generated H + ions play important role for HER or hydrogenation of azobenzene in ZISC-0.5 photocatalytic system. The COVID-19 pandemic has caused a massive increase of medical waste with the approximate amount of 16,000 tons/day in the worldwide. The generation of such huge medical waste will be serious health and environment issues if the medical waste disposal is not well-treated. Despite the fact that air and water pollutions decrease significantly during the pandemic, the era of post-pandemic could bring back these issues with even worse polluted condition. Therefore, alternative solutions to overcome the medical waste and pollution issues are urgently needed. In this study, medical waste was treated to obtain carbon combined with ZnIn 2 S 4 photocatalyst for photocatalytic hydrogen evolution reaction (HER) and hydrogenation reaction of azobenzene at mild condition under solar light irradiation. It was found that with the carbon amount of 0.5 wt%, ZISC-0.5 exhibits the most optimum photocatalytic performances. The amount of generated hydrogen by ZISC-0.5 achieves 86.9 μmol for 5 h light irradiation. On the other hand, the conversion from azobenzene to aniline by ZISC-0.5 was occurred within 2 h photoreaction as confirmed by UV–Vis spectroscopy and GCMS– analysis. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Drug take-back programs (TBPs) provide the opportunity to safely dispose of unused or expired medications (UEMs), potentially reducing the risk of environmental harm and morbidity. Data on patient perceptions and participation are limited, especially in underserved Asian populations.Objective: This study aimed to evaluate medication disposal perceptions and behaviors through a free mail-in medication disposal program among patients in a Chinatown community pharmacy.Methods: An institutional review board-approved Web-based survey was developed in English and Mandarin. Student pharmacists tabled at a Chinatown community pharmacy in Boston, Massachusetts. The patients were educated about safe medication disposal practices and invited to take the anonymous survey assessing medication disposal needs, practices, and beliefs accessed in person by using a quick response code. On survey completion, the patients were offered a disposal envelope. Envelope tracking numbers were used to evaluate medication disposal over a 9-month follow-up period.Results: Sixty-two patients of Asian descent completed the survey, and 42 (67.7%) accepted an envelope. Forty-seven patients (75.8%) reported having access to UEMs. More than half indicated that TBPs were important to alleviate the risk of medication and environmental consequences despite low previous use (6.5%). Most patients felt more aware of TBPs (72.6%), an increased sense of the importance of TBPs (74.2%), and intent to participate in TBPs (69.4%), including using the envelope (75.8%). Three (4.8%) patients disposed of medications using the study-provided envelope during the 9-month follow-up.Conclusion: Patient education about TBPs and their importance may be effective in increasing TBP awareness in a population with low TBP use. Free disposal envelopes did not seem to be highly used within 9 months of receipt despite interest and access to UEMs. Future research should continue offering programs at no charge, evaluating barriers to free TBP use, and implementing follow-up procedures to increase envelope use. [ABSTRACT FROM AUTHOR]

• The evidences obtained show issues about waste disposal in operating theatres, focused on waste types and on surgery phases of production. • The observational tool can be an easy instrument to check the process of waste segregation. • The summary of evidence can guide hospital managers in an organizational re-engineering to optimize waste management and save resources. Each day operating theatres produce lots of waste. The wrong segregation represents both an environmental and economic problem, which is reflected in increased disposal cost and in a loss of resources. To examine waste segregation by medical and nonmedical healthcare personnel in an Italian hospital's operating theatres. We used an observational tool, according to the local regulations and validated by a panel of experts. Fifty-seven percent of waste were disposed of incorrectly, of these 71% could have been recycled and 1% recovered. The preoperative phase had the greatest production of waste (48%) and the highest percentage of incorrect differentiation (72%). Sixty-six percent of waste handled as "undifferentiated" could have been recycled. Waste managed as hazardous that could have been recycled, reused or otherwise segregated stood at 54%. Hazardous waste was managed incorrectly in 5% of the disposals. The lack of a variety of bins for waste segregation and improper classification by personnel appear to be the cause of the incorrect segregation, which should be error free. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medical waste with pathogenic bacteria is infectious and toxic, which could cause significant harm to the environment and human health without being adequately disposed of. Pyrolysis-incineration coupled technology can realize the rapid and efficient treatment of medical waste while reducing the generation of pollutants. Whereas, the NaClO disinfection treatment, which is a necessary process prior to transfer and disposal of medical waste, has not been sufficiently described in terms of its effect on the pyrolysis yield and components characteristics of medical waste. This study clarified the influence mechanism of NaClO disinfection treatment on the yields, components, and combustion characteristics of pyrolysis products derived from typical medical waste (cotton swab sticks, masks, and latex gloves). The results showed that NaClO disinfection treatment induced depolymerization of the internal structure of the polymer and increased pyrolysis tar and syngas at 400 °C. In addition, NaClO disinfection treatment reduced syngas quality, which was attributed to generating more CO 2 and inhibiting alkynes gas production under medium-low pyrolysis temperatures. Furthermore, the condensation or cyclization of light components into heavy components in the tar increased the average double-bond equivalents and oxygen content, which was detrimental to tar ignition and combustion. Moreover, the combustion performance of char was improved because there was a tendency for the conversion of graphitic carbon to fatty carbon in the char. These findings elucidate the feasibility of pyrolysis-incineration coupled technology for the fast and effective treatment of medical waste. [Display omitted] • NaClO leads to oxidation of raw materials and an increase ash content. • Disinfection treatment increases oxygenated gases and inhibits alkyne components. • NaCl produced by NaClO increases the heavy components and DBE of tar. • Disinfection treatment converted graphitic carbon to fatty carbon in the char. • Disinfection treatment affects pyrolysis behavior and combustion characteristics. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Special handling is needed for the treatment of the management of solid medical waste, especially the hazardous and toxic wastes (B3) at the hospital so that the expected effects of this medical solid waste can be minimized. At the West Pasaman Regional General Hospital, the management of solid medical waste is carried out using a third party. In 2018, The hospital cooperated with PT Noor Annisa Kemikal with the number of the cooperation agreement Number 660/431 / RSUD-2018 and Number 0302 / NAK / PSM / II / 18 on 01-02-2018 and in 2019, with PT Andalas Bumi Lestari with the Agreement Number of Hazardous and Toxic Waste Treatment Services Number 445/003 / PKS / RSUD-2019 and Number 003.22 / ABL-PKS / II / 2019. In the implementation of management by third parties, the Hospital has to provide a quite large amount of budget for services for the management of solid medical waste by a third party. In order to make the existing budget effective and minimize the Budget absorption, the efforts taken are internal management systems so that some solid medical waste (especially Infusion Tubes) does not need to be handled by the third party and by utilizing existing technological equipment instead. Based on existing data, the West Pasaman Regional General Hospital undertakes efforts to process solid medical waste carried out internally by the Hospital itself by using a sterilization system using the existing technology, namely sterilizers. It is expected that the use of Sterilization technology can yield budget effectiveness approximately IDR. 168,890,000. - per year. This is done specifically for infusion tubes with a large density and considered the safest to be sterilized and recycled. [ABSTRACT FROM AUTHOR]

The problem of opioid diversion and its contribution to the opioid epidemic are well known nationally, existing even within hospice care. Proper disposal of opioids may be a critical factor in reducing diversion. In 2014, Ohio implemented legislation requiring a hospice employee to destroy or witness disposal of all unused opioids within a patient's plan of care. The purpose of this study was to determine the impact of Ohio Revised Code 3712.062 on hospice programs' policies and procedures to prevent opioid diversion in the home. Directors of Ohio-licensed hospices were surveyed to assess the percentage of programs with a written policy in place for disposal of opioids and to calculate a compliance score based on responses to survey questions assessing compliance with legislation components. Fifty-two surveys were completed (39.4%). All survey respondents reported having a written policy in place. A 95.5% average compliance score was calculated, with the largest disparity occurring with timing of opioid disposal. While Ohio Revised Code 3712.062 requires opioid disposal at the time of patient's death or when no longer needed by the patient, only 84% of respondents report disposing opioids upon discontinuation. Overall, a high compliance rate was seen among hospice programs indicating such regulation is manageable to meet. Background [ABSTRACT FROM AUTHOR]

Background: Health care generates a large amount of healthcare waste (HCW), which is complex to manage because of its variety and potential to create health and safety hazards if improperly handled. It is essential that healthcare workers have appropriate knowledge of and adhere to proper disposal methods for each category of HCW. Aim: The aim of this study was to assess the knowledge, attitudes and practices of staff working at a district hospital about HCW management, and measure associations between these variables. Setting: The setting for this study was a district hospital in KwaZulu-Natal province. Methods: This was an observational descriptive study among 241 professional and non-professional staff. Data were collected using a questionnaire and analysed using the Statistical Package for the Social Sciences. Results: Knowledge of HCW management was generally inadequate, with 42.7% of the participants scoring ‘poor’ overall. Just over half of the participants reported a good attitude towards the appropriate disposal of HCW but only 53.9% demonstrated good HCW management practices. There was a significant (p < 0.05) relationship between knowledge and practice and between attitudes and practices (p < 0.05). Conclusion: Appropriate training and supervision in HCW management as well as relevant and ongoing in-service training is needed to ensure appropriate knowledge, attitudes and safe practice among all members of staff. As poor practices have been reported on a number of occasions from different hospitals in South Africa, relevant training must also be introduced or improved at undergraduate level. [ABSTRACT FROM AUTHOR]

Healthcare services create medical waste that may be dangerous to healthcare personnel, patients, the general public, and the environment. Medical waste disposal method selection is among the most important decisions that must be made by healthcare organizations, and such a problem has a number of contradictory criteria and alternatives. On the other hand, decision experts may have considerable uncertainty while evaluating these alternatives. In this paper, new fuzzy multi-criteria decision-making (MCDM) methodologies are provided for assessing the medical waste disposal alternatives. The CRiteria Importance Through Intercriteria Correlation (CRITIC) is used for obtaining criterion weights in an objective manner, and the Weighted Aggregated Sum Product ASsessment (WASPAS) approach is utilized to rank the alternatives. For modeling the uncertainty in the nature of the problem, the proposed methodology is developed in single and interval-valued spherical fuzzy environments. Single-valued spherical fuzzy sets enable users to model the membership, non-membership, and hesitancy parameters independently. On the other hand, interval-valued spherical fuzzy sets provide increased fuzziness modeling capacity. The step-by-step solution of the proposed methodologies are followed by sensitivity and comparative analyses, and a discussion. This study contributes to the work of both academics and practitioners in the healthcare industry, as well as other sectors facing similar types of decision-making problems. • CRITIC-WASPAS method is extended with single and interval-valued spherical fuzzy sets. • The proposed methodology provides extensive fuzziness modeling capacity. • The CRITIC phase enables calculating criteria weights in an objective manner. • Medical waste disposal alternatives are prioritized with the WASPAS technique. • Sensitivity analyses for decision expert, criterion, and threshold parameter weights are provided. [ABSTRACT FROM AUTHOR]

Copyright of Nosileftiki is the property of Hellenic Nurses' Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Nowadays there is a growing concern in the treatment of solid medical waste due to the increase in waste generation that has been accelerated by the pandemic. This accentuated the problems of medical waste management, related to separation, storage, and transportation. In addition, current medical waste treatments are not globally accepted, since most of them generate pollutants, or simply not all treatment technologies are applied correctly. This review analyzes the basis for proper management, and the main existing technologies and developments carried out so far. An exhaustive comparison between them allows for distinguishing the pros, cons, scales, and applicability of each one. This is complemented with a TRL analysis to describe their degree of development. Furthermore, some waste-to-energy (WtE) alternatives are discussed since they represent an appealing option that can positively affect the environment and the economy of existing technologies. Finally, some tools and technology selection criteria shown in the literature are presented, along with some discussion of their economics. This paper exposes a theoretical approach based on the literature on the current situation of solid medical waste treatment and provides the basis for decision-making to implement some existing technologies. Likewise, it presents the limitations in the current system that are the kick for future research. [Display omitted] • The recent sharp increase of medical waste raises the urgent need to a proper management. • High thermal technologies or their combination push power plants. • Analytical decision methodologies applied to select the most convenient technology. • Costs of medical waste recovery and recycling represent the main bottleneck. [ABSTRACT FROM AUTHOR]

Medical wastes include all solid and liquid wastes that are produced during the treatment, diagnosis, and immunisation of animals and humans. A significant proportion of medical waste is infectious, hazardous, radioactive, and contains potentially toxic elements (PTEs) (i.e., heavy metal (loids)). PTEs, including arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), are mostly present in plastic, syringes, rubber, adhesive plaster, battery wastes of medical facilities in elemental form, as well as oxides, chlorides, and sulfates. Incineration and sterilisation are the most common technologies adopted for the safe management and disposal of medical wastes, which are primarily aimed at eliminating deadly pathogens. The ash materials derived from the incineration of hazardous medical wastes are generally disposed of in landfills after the solidification/stabilisation (S/S) process. In contrast, the ash materials derived from nonhazardous wastes are applied to the soil as a source of nutrients and soil amendment. The release of PTEs from medical waste ash material from landfill sites and soil application can result in ecotoxicity. The present study is a review paper that aims to critically review the dynamisms of PTEs in various environmental media after medical waste disposal, the environmental and health implications of their poor management, and the common misconceptions regarding medical waste. [Display omitted] • Safe management of hazardous medical wastes is a major global challenge. • A significant proportion of medical waste is infectious, hazardous and radioactive. • Potentially toxic elements (PTEs) in medical waste occur mostly as oxides. • Incinerated medical waste ash application can release PTEs to environment. • Chemical stabilisation is effective in preventing PTEs release into the environment. [ABSTRACT FROM AUTHOR]

AIM: To determine the period prevalence of needlestick injury (NSI) at the Massey University Veterinary Teaching Hospital (VTH) and to identify handling and disposal practices that may contribute to the risk of NSI. METHODS: Observations of personnel were conducted in the equine (EVH) and companion animal (CAH) clinics of the VTH during scheduled clinical activities over 9- and 10-day periods, respectively. The number and type of NSI incidents, needle uncapping, capping and disposal events were recorded for veterinarians, nurses and other personnel (visitors and students). The number of needle-related practices, as a proportion of observations, were compared between CAH and EVH, and veterinarians, nurses and others using χ2tests. RESULTS: Needlestick injury was not observed during 190 and 163 needle handling and disposal observations in the CAH and EVH, respectively. Uncapping of needles by mouth was observed and was practised more by veterinarians (15/119; 13%) than nurses (2/42; 5%) and others (6/193; 3%) (p=0.001). Two-handed needle recapping after use was observed 265/354 times, and the one handed scooping technique was rarely observed (8/352). In the case of needle disposal, EVH workers used a container that was not purpose built for disposal more than CAH staff (p=0.02), or placed them in a pocket more frequently (p=0.003). Needle disposal containers were available on adjacent bench tops for 65/190 (34%) CAH observations, but no EVH observations. For 51/163 (31%) EVH observations the needle disposal containers were located on the ground, whereas none were observed there in the CAH. No approved sharps containers were observed in the immediate EVH and CAH work areas for 47/163 (28.8%) and 1/191 (0.5%) needle-handling activities, respectively. CONCLUSIONS: Unsafe needle-handling practices must be reduced by policies and training programmes to encourage safe needle-related practices, and ensuring that approved sharps containers are available in close proximity to where needles are used. [ABSTRACT FROM PUBLISHER]