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Fundamentals of Healthcare Waste Management

October 5, 2021

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Fundamentals of Healthcare Waste Management

Fundamentals of Healthcare Waste Management. Healthcare waste management requires a very detailed list of strategies that enable a facility to comply with all local, state, and federal laws and guidelines. Generators of medical waste are responsible in a concept called “cradle to grave,” requiring them to be accountable from the moment of waste generation to the final destruction and disposal. Laying the groundwork with a healthcare waste management (HCW) plan for excellence in dealing with the management of medical waste is critical for compliance.

Establishing Management/Supervisory Structure

Healthcare waste management falls on the responsibility of supervisors and managers and requires that all personnel be committed to education, training, risks, and knowledge of local, state, and federal laws/guidelines. Creating a complete document that includes all aspects of HCW, including specific and detailed responsibilities, on-going training, employee awareness, and regular review of standards is a high priority step. Depending upon the healthcare facility size, representatives should be assigned as contacts for regional and national support. Members of the management team overseeing HCW should include both medical and technical individuals and have specific information regarding safe management. Teams should be created as support factors to monitor, review, and report to management regarding HCW. Organizational policies should include full training for all new employees as a requirement for hiring.

Development of Risk Analysis and Risks of HCW

A regular risk analysis should be conducted to ensure that the healthcare facility is complying with safety standards for HCW, including employee training. It should be understood that all staff members and anyone associated with the healthcare facility is potentially at risk for infection or injury if there is a breach to HCW safety. Those that are at most risk can include: all members of the medical staff, both in/out patients that are receiving health-care at the facilities as well as visitors to the healthcare facility, staff that is associated with any support service such as transportation, waste disposal/handing. Review of compliance with all local, state, and federal compliancy laws to ensure that individuals outside of the healthcare facility are not exposed to HCW along with risk response in case of a breach. Procedures established to minimize all HCW risks with required treatment options for health-care workers, the general population, and exposures to the environment. Identifying the potential risks for occupational, public, and indirect environmental risks in the case of mishandling or breach.

Defining and Classifying HCW

Healthcare waste includes both at risk and non-risk waste. About 75% of HCW generated by the healthcare industry falls into the non-risk category, with 25% in the risk category. Defining each type of HCW and classifying it for the purpose of handling, recycling, treatment, and disposal will help to ensure the lack of transmission for risk HCW and the proper ecological disposal of non-risk HCW.

Non-Risk HCW categories include: Recyclable waste, biodegradable waste, and other non-risk waste. At risk HCW categories include: healthcare and biomedical waste requiring special attention, human anatomical waste, sharps, pharmaceutical waste, cytotoxic pharmaceutical waste, blood and body fluids waste, waste that have come into contact with blood and body fluids, infectious waste, contaminated waste from patients or animals confirmed with hazardous communicable diseases; carcasses, litter and bedding from animals that may have been exposed to communicable diseases, any equipment or discarded personal protection that is contaminated with blood, feces from patients or animals that have hazardous communicable diseases, secretions from patients with dangerous communicable diseases, all microbiological cultures generated in an medical laboratories including devices, dishes, inoculate and culture mixtures from medical analysis; other hazardous wastes such as liquid, solid, or gas chemicals, waste with high concentration of heavy metals, chemical wastes from disinfecting or cleaning procedures, pressurized containers, and radioactive wastes.

Confirmed HCWM Minimum Observation

A healthcare facility should have a well-defined identification of all HCW from the moment of generation through to the final disposal process. The stream of identification should be documented and reviewed on a continual basis and should include: generation, segregation collection, on-site transportation, storage on-site, offsite transportation (where applicable), on-site treatment (where applicable), and final disposal. Each step should comply with all local, state, and federal laws/guidelines, and have all documentation in case of review/audit.

HCWM Category Waste Guidance

Creating specific handling, storage, transportation, and disposal of each of the categories of HCWM waste.

For non-hazardous HCW, research into areas that involve recycling or in the case of food, composting to assist in ecological efforts.

For hazardous HCW, each category should be analyzed with detailed procedures in place for all of the at risk HCW types: human anatomical waste, sharps, pharmaceutical waste, cytotoxic pharmaceutical waste, body fluids and blood waste, infectious waste, highly infectious waste, other wastes from healthcare, and radioactive waste.

Develop both Awareness and Protection Measures for Healthcare Management Staff and the Environment

This is a broad perspective that incorporates awareness of HCW risk of all types and steps required for the protection of all staff/volunteers at the healthcare facility and the protection of the environment. This mandate involves education of HCW risks, daily actions taken to assist in avoiding a risk breach, and emergency conditions in case of a breach.

The measures can include but are not limited to:

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