Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Sağlık Çalışanlarının Tıbbi Atık Uygulama Durumlarının İncelenmesi
Examination of Medical Waste Application Situations of Health Workers
Münevver YÜCEDAĞa, Altun BAKSİb
aDicle Üniversitesi Diş Hekimliği Fakültesi,
bHemşirelik Bölümü, Cerrahi Hastalıkları Hemşireliği AD, Dicle Üniversitesi Atatürk Sağlık Yüksekokulu, Diyarbakır, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2019;11(1):52-67
doi: 10.5336/nurses.2018-61087
Article Language: TR
Full Text
ÖZET
 Amaç: Sağlık çalışanlarının tıbbi atıkların atılması, toplanması, taşınması ve depolanmasına ilişkin uygulama durumlarının incelenmesidir. Gereç ve Yöntemler: Araştırma tanımlayıcı tiptedir. Araştırma, Mart-Haziran 2017 tarihleri arasında yürütülmüştür. Araştırmanın örneklem büyüklüğü uygulama adımlarına göre değişmektedir. Araştırmanın örneklemini; sağlık çalışanlarının tıbbi atıkların atılmasına yönelik uygulama durumlarının incelenmesinde 205 (hemşire, doktor, stajyer hekim, temizlik ve dezenfeksiyon personeli) sağlık çalışanı, tıbbi atıkların atık torbasına toplanması ve taşınmaya hazırlanmasında 25 temizlik ve dezenfeksiyon personeli ve tıbbi atıkların depoya götürülmesi ve götürdükten sonraki işlemlerde üç temizlik ve dezenfeksiyon personeli oluşturmaktadır. Araştırma verileri; sosyodemografik ve tıbbi atık ile ilgili soruları içeren tanıtıcı bilgi formu ve tıbbi atık uygulama adımlarını içeren gözlem formu aracılığıyla toplanmıştır. Araştırmada, sağlık çalışanları ve temizlik ve dezenfeksiyon personeli 15 gün ara ile iki kez gözlenmiştir. Araştırma için etik kuruldan onay ve sağlık çalışanlarından izin alınmıştır. Araştırma verileri bilgisayar ortamında sayı-yüzde, ortalama, standart sapma ve ki-kare analizi ile değerlendirilmiştir. Bulgular: Araştırmaya katılan sağlık çalışanlarının %54,1'i ve temizlik ve dezenfeksiyon personelinin tamamı erkektir. Sağlık çalışanlarının yarısı iğneleri şırıngaları ile birlikte yarısı şırıngalardan ayırarak kesici-delici tıbbi atık kutusuna atmıştır. Dezenfeksiyon ve temizlik personelinin tıbbi atıkları toplamadan önce el yıkama oranı %12, bittikten sonra ellerini yıkama oranı ise %100 olarak bulunmuştur. Personelin tamamı tıbbi atık torbalarına eldivensiz dokunmamış ve %88'i tek kullanımlık eldiven kullanmıştır. Yine çalışanların özel kıyafet giyme, çizme giyme ve bone kullanma oranı %12'dir ve hiçbiri koruyucu gözlük kullanmamıştır. Sonuç: Araştırmaya katılan bireylerin bazı uygulamalarının yeterli olmadığı görülmektedir. Tıbbi atık yönetiminin eksiksiz yürütülebilmesi için bu uygulamaların iyileştirilmesi önemlidir. Bu doğrultuda nedenler araştırılarak uygun girişimler planlanmalıdır.

Anahtar Kelimeler: Tıbbi atık; sağlık çalışanı; atık yönetimi
ABSTRACT
 Objective: The aim of this course is to examine the health status of health workers in the disposal, collection, transportation and storage of medical wastes. Material and Methods: Research is descriptive. The research was carried out between March-June 2017. The sample of the research; 205 (nurses, doctors, trainees doctor, cleaning and disinfection personnel) healthcare professionals in the study of healthcare workers' application of medical waste disposal, 25 cleaning and disinfection personnel in the collection and transportation of medical waste into waste bags and three cleaning and disinfection personnel constitute the medical waste to be taken to the warehouse. Research data; the questionnaire including the questions about socio-demographic and medical waste was collected through an observation form including the steps of medical waste. In the research, health workers and cleaning and disinfection personnel were observed twice every fifteen days. Approval was obtained from the ethics committee for the research and permission was obtained from the participants. The data of the study were evaluated with the number-percentage, mean, standard deviation and chi square analysis in the computer environment. Results: Half of the health workers have taken half of the medical waste from the syringes with the needle syringes and threw them into the cut-piercing medical waste pail. The disinfection and cleaning personnel had a hand washing rate of 12% before the collection of medical wastes, and a wash rate of 100% after they were finished. All of the personnel were untouched to the medical waste bags without gloves and 88% of them used disposable gloves. Again, employees are wearing special clothing, boots, and a boned rate of 12%, and no one wears protective goggles. Conclusion: It seems that some applications of the individuals participating in the research are not enough. It is important to improve these practices so that medical waste management can be carried out completely. In this direction, appropriate initiatives should be planned by investigating the causes.

Keywords: Medical waste; medical staff; waste management
REFERENCES:
  1. Hossain MS, Santhanam A, Nik Norulaini NA, Omar AK. Clinical solid waste management practices and its impact on human health and environment-a review. Waste Manag. 2011; 31(4):754-66. [Crossref] [PubMed]
  2. Giusti L. A review of waste management practices and their impact on human health. Waste Manag. 2009;29(8):2227-39. [Crossref] [PubMed]
  3. Birpinar ME, Bilgili MS, Erdoğan T. Medical waste management in Turkey: a case study of Istanbul. Waste Manag. 2009;29(1):445-8. [Crossref] [PubMed]
  4. Windfeld ES, Brooks MS. Medical waste management-a review. J Environ Manag. 2015;163:98-108. [Crossref] [PubMed]
  5. Chartier Y, Emmanuel J, Pieper U, Prüss A, Rushbrook P, Stringer R, et al. World Health Organization. Safe management of wastes from healt-care activities. 2nd ed. Geneva: WHO; 2014. p.305.
  6. Çamözü E, Kitiş Y. [Determination of hospital cleaning Staff?s knowledge and applications abour collecting, transferring and stocking medical wates]. TAF Prev Med Bull. 2011; 10(6):631-40.
  7. Marthur V, Dwivedi S, Hassan M, Misra R. Knowledge, attitude, and practices about biomedical waste management among healthcare personnel: a cross-sectional study. Indian J Community Med. 2011;36(2): 143-5. [Crossref] [PubMed] [PMC]
  8. Terekli G, Özkan O, Bayın G. [Environmentally friendly hospitals: from hospital to green hospital]. Ankara Sağlık Hizmetleri Dergisi. 2013;12(2):37-54.
  9. Caniato M, Tudor T, Vaccari M. International governance structures for health-care waste management: a systematic review of scientific literature. J Environ Manag. 2015;153:93-107. [Crossref] [PubMed]
  10. Akbolat M, Işık O, Dede C, Çimen M. [Assessment of health professionals? knowledge levels about medical waste]. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2011;2(3): 131-40.
  11. Cheng YW, Sung FC, Yang Y, Lo YH, Chung YT, Li KC. Medical waste production at hospitals and associated factors. Waste Manag. 2009;29(1):440-4. [Crossref] [PubMed]
  12. Çevre ve Orman Bakanlığı, Çevre Yönetimi Genel Müdürlüğü. Tıbbi Atık 2010 Yılı Durum Raporu 2010. p.126.
  13. Resmi Gazete (25.01.2017, Sayı: 29959) sayılı Tıbbi Atıkların Kontrolü Yönetmeliği; 2017. p.1.
  14. Rahman S, Açık Y, Gülbayrak C, Erhan D, Nazlıer K, Deveci E. [Methods of collection, storage and disposal of medical waste by health institutions]. Fırat Sağlık Hizmetleri Dergisi. 2009;4(11):3-14.
  15. Yong Z, Gang X, Guanxing W, Tao Z, Dawei J. Medical waste management in China: a case study of nanjing. Waste Manag. 2009;29(4):1376-82. [Crossref] [PubMed]
  16. Sachan R, Patel ML, Nischal A. Assessment of the knowledge, attitude and practices regarding biomedical waste management amongst the medical and paramedical staff in tertiary health care centre. IJSRP. 2012;2(7): 1-6.
  17. Ozder A, Teker B, Eker HH, Altındis S, Kocaakman M, Karabay O. Medical waste management training for healthcare managers-a necessity? J Environ Health Sci Eng. 2013;11(1):20. [Crossref] [PubMed] [PMC]
  18. Centers for Disease Control and Prevention. Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Environmental Infection Control in Health-Care Facilities 2003. Atlanta: CDC; 2017. p.240.
  19. Hasçuhadar M, Kaya Z, Şerbetçioğlu S, Arslan T, Altınkaya S. [The awareness level among the employees working in Ankara Ataturk Training and Research Hospital about medical wastes]. Turkish Medical Journal. 2007;1:138-44.
  20. Erefe İ. [The nature of data collection tools]. Hemşirelikte Araştırma İlke Süreç ve Yöntemleri. 3. Baskı. İstanbul: Odak Ofset; 2004. p.169-88.
  21. Yoldaş Ö, Bulut A, Ertürk E, Çelik D, Karakaşoğlu Ü, Altındiş M. [Determination of exposure risk to infected blood and body fluids in health care workers]. Kocatepe Medical Journal. 2014;15(3):297-300.
  22. Altıok M, Kuyurtar F, Karaçorlu S, Ersöz G, Erdoğan S. [Healthcare workers experiences with sharps and needlestick injuries and precautions they took when injuring]. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2009;2(3):70-9.
  23. Kumar D, Jayswal D, Singh S. Knowledge, attitude & practices related to biomedical waste management among the nursing staff of a tertiary care rural hospital of gujarat, India. Natl J Community Med. 2016;7(5): 372-6.
  24. Aygun P. [Wounding tool injuries and preventive measures]. Antalya: 5. Ulusal Sterilizasyon Dezenfeksiyon Kongresi Kitabı; 2007. p.385-91.
  25. Güngör Özdemir E, Şengöz G. [The outcomes of the attitude and information level questionnaire-survey on sharps injuries in a 500-bed training and research hospital]. Med Bull Haseki. 2013;51(1):11-4. [Crossref]
  26. Mir MR, Ahamad J, Ashfaq A, Jan R. Knowledge, attitude and practices about biomedical waste management among nursing professionals of skıms medical college hospital bemina-a cross sectional study. IOSR Journal of Nursing and Health Science. 2013;1(5):47-8. [Crossref]
  27. Kaur S. A comparative study on knowledge and practices of nurses regarding biomedical waste management in select government hospitals. Nursing and Midwifery Research Journal. 2011;7(3):130-40.
  28. Anand P, Jain R, Dhyani A. Knowledge, attitude and practice of biomedical waste management among health care personnel in a teaching institution in Haryana, India. Int J Res Med Sci. 2016;4(10):4246-50. [Crossref]
  29. Terzi Ö, Aker S, Sünter TA, Peşken Y. [Hospital cleaning staffs and occupational infection risks: a study to assess knowledge and behaviour]. İnönü Üniversitesi Tıp Fakültesi Der gisi. 2009;16(1):7-12.

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