Effectiveness of Structured Teaching Program on Knowledge RegardingBiomedical Waste Management among House Keeping Staff

INTRODUCTION

Biomedical waste (BMW) means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to in the production or testing of biological, including categories mentioned in schedule 1 of BMW (management and handling) (second amendment) Rules,2OOO by ministry of environment and forests notification. Most medical waste is incinerated, a practice that short-lived because of environmental considerations. The burning of solid and regulated medical waste generated by health care creates many problems. Medical waste incinerators emit toxic air pollutants and toxic ash residues that are the major source of dioxins in the environment. The toxic ash residues sent to landfills for disposal have the potential to leach in to ground water medical waste has been identified by US Environment agency as the third largest known source of dioxin air emission of about 10% of mercury emissions to the environment from human activities.¹

“The environment ministry” released the new bio-medical waste management rules, 2016 which will bring in a wider and more comprehensive regime for bio waste management .The new biomedical waste management rules will change the way country used to manage the waste earlier. Under the new regime, the coverage has increased and also provides for pre-treatment of lab waste, blood samples etc. It mandates bar codesystem for proper control. It has simplified categorization and authorization. Thus, it will make a big difference to clean India mission.² 

Health care waste refers to all the waste generated by a health care establishment. It is estimated that 10-25% of health care waste is hazardous, with the potential for creating a variety of health problems. Bio-medical waste (BMW) collection and proper disposal has become a significant concern for both the medical and the general community. Since the implementation of the Biomedical Waste Management and Handling Rules (1998), every concerned health personnel is expected to have proper knowledge, practice, and capacity to guide others for waste collection and management, and proper handling techniques.³

OBJECTIVES  

1.  To assess the existing knowledge and practice of biomedical waste Management among housekeeping staff. 
2. To assess the post-test knowledge and practice of biomedical waste Management among housekeeping staff. 
3. To assess the effectiveness of structured teaching programme regarding the knowledge and practice of biomedical waste management among housekeeping staff. 
4. To associate the post-test knowledge and practice score of biomedical waste management among housekeeping staff with selected demographicvariables.

MATERIAL AND METHODS

Pre- experimental ones group pre-test and posttest design was used to study effectiveness of STP. Forty housekeeping staff in RRMCH hospital was recruited by non-probability convenience sampling method. Necessary administrative permission was obtained from concerned hospital authority. Oral consent was obtained from all subjects. Demographic proforma and structured interview schedule was used to elicit the baseline data and structured questionnaires, practice checklist were used to elicit the knowledge and practice of housekeeping staffs. Ethical clearance was obtained from ethical committee. Content validity of the tool was established by split of method. The obtained score was 0.95 & it was found to reliable. Pre-testing of the tools were done. A pilot study was conducted to see the feasibility. The data analysis was done manualy.

RESULTS

I. Level of knowledge of House Keeping Staff regarding biomedical waste management

Table-1 shows that among the 40 respondents; majority of samples 27 (67.5%) had inadequate level of knowledge and only 13 (3.3%) were having moderately level of knowledgeregarding biomedical waste management in the pre-test. In post testamong; majority of samples 15(37.5%) had moderate level of knowledge only 25(62.5%) were having adequate level of knowledge regarding BMW in the post-test.

II. Level of Practice of House Keeping Staff regarding biomedical waste management

In pre-test all the samples i.e. 75% had poor practice of biomedical waste management whereas in the post-test 62.5% of the samples reached the a good practice level 37.5% showed moderate practice and no one remained with poor practice of biomedical waste management. This shows an improvement in practice level after STP (Table 2)

III. Effectiveness of STP on knowledge regarding BMW among HKW.

The post-test mean knowledge score (23.2 , SD=3.86) was found higher than pre-test mean knowledge score (mean =9.3, SD= 3.89).The paired ‘t’ test implies that the difference in the pre-test and post-test value was found to be statistical highly significant at 0.05 level of significance (t(tab) Value = 0.681) with a paired ‘t’ test value of 16.58. This shows a statistical significant enhancement in knowledge score and indicating the positive impact of structured teaching program. (Table 3)

IV. Effectiveness of STP on practice scores regarding BMW among HKW.

The findings in the above Table 4 reveal that the posttest mean practice score (mean =9.72 and SD=0.96) was found higher than pre-test mean practice score (mean =4.6 and SD=1.23). The statistical paired‘t’ test implies that the difference in the pre-test and post- test value was to be statistically higher significant at 0.05 level of significance (t(tab) value=0.681) with a obtained paired‘t’ test value of 17.5. This shows a statistical significant enhancement in practice score and indicating the positive impact of structured teaching program. 

DISCUSSION

Structured teaching programme was found to be an effective educative method for improving the knowledge of housekeeping staffs who are working in the hospital regarding biomedical waste management. These findings were similar to other studies, which shown that housekeeping staffs having good knowledge and practice on biomedical waste management. In the present study results revealed that there was significant association found at 0.05 level between pre-test knowledge and practice of housekeeping staffs and their selected demographic variables.The present study emphasizes on enhancements regarding knowledge and practice of biomedical waste management. In order to equip the nurse further about the biomedical waste management, the curriculum of nursing education at graduate level should incorporate the aspect of biomedical waste management in a broader sense which helps the housekeeping staff to get the knowledge on biomedical waste management.This study also emphasizes continuing education, seminar conferences on BMW management for student nurses.

The findings of the research are fruitful only when incorporated into practice. It is the responsibility of nurses to make the housekeeping staff to aware about the biomedical waste management. For this the nurses need to have adequate knowledge regarding the biomedical waste management and should have skills to assess the risk group developing major health problems and to encourage them to improve their knowledge.

CONCLUSION

The study concluded that the structured teaching program on biomedical waste management carried out was effective in improving the knowledge of housekeeping staff as evidenced by the significant change between pre-test and post-test knowledge score. The nurse administrators must initiate teaching on such topic for more number of housekeeping staff to have exposure of concepts. The housekeeping staff being the key members of biomedical waste management are responsible for the duties assigned to them.