Section C Training hospital staff
Who requires training? • Doctors • Administrators • Nurses • Technicians • Ward boys C1
Trainers Initially • Hospital personnel • Outside agency Ongoing training • Hospital Infection Control Committee • Medical Superintendent • Nursing Supervisor • Sanitary Supervisor C2
Training sessions • Teaching • Discussion • Feedback • Ongoing training Training module: • Vernacular medium • Easy to understand • Include equipments and slides • Demonstration C3
Training session one Inputs from trainees: • About the present system • The need of managing waste • Their role and intervention Introducing concepts of waste management C4
Sensitisation – the need for managing waste Dangers to the patients • Many patients immuno-compromised Dangers to the community • Spread of infection through waste • Access of waste to the animals • Problems due to incinerators • Spread of infection through recycling trade C5
Dangers to healthcare workers • Hours spent at the workplace • High rate of needle-stick injuries • Exposure to mercury/chemicals • Dangers due to improper spill handling • Dangers due to on-site incinerators. C6
What are sharps? Anything capable of causing cuts and punctures: • Needles • Blades • Scalpels • Lancets • Sutures • I.V. catheters • Glass C7
Categories of staff exposed to needle-stick C8
Incidents leading to pricks C9
Sero-conversion following exposure Pathogen Sero-conversion Time of rate conversion ----------- ------------------- ------------ • HIV 0.3% 6 months • HBV 30% 2-6months • HCV 10% 7 weeks C10
Mercury products in hospitals Product Alternative ---------------------------- ----------------- • Thermometers Digital, expansion or aneroid • Sphygmomanometers Electronic vacuum gauge, expansion/ aneroid • Esophageal Dilators, Products w/Miller • Abbott & Cantor tubes Tungsten tubing • Dental amalgams Gold, ceramic, porcelain C11
Symptoms of mercury poisoning • Impairment of peripheral vision • Disturbance in sensations • Lack of coordination of movements • Impairment of speech or hearing • Muscle weakness • Skin rashes • Mood swings, mental disturbance • Abnormal brain development; impaired memory, attention and learning C12
Mercury effects • Damage to the brain, the kidneys and developing foetus. Effects on brain functioning may result in irritability, shyness, tremors, changes in vision or hearing and memory problems. • In addition, short-term exposure to high levels of metallic mercury vapours may cause effects including lung damage, nausea, vomiting, diarrhea, increases in blood pressure or heart rate, skin rashes, and eye irritation. C13
Where is glutaraldehyde used? • Endoscopy units • Theatres • ICU • Labour wards • Infection control • Dental units C14
Glutaraldehyde and you! • Irritates skin, eyes, throat and lungs, causes sensitisation of skin and respiratory tract • Can cause allergic reaction, like asthma • Skin sensitisation and contact dermatitis • Headache, shortness of breath, chest pain, discomfort, cough and fatigue C15
Cytotoxic drugs • Ability to kill or arrest the growth of living cells • Used for treatment of cancerous cells • Harmful to normal cells specially the actively dividing cells • Exposure happens mainly through inhalation of droplets or dusts. Can be absorbed through the skin, or by swallowing food/beverages contaminated with CDs. • Risks for exposure are during the preparation and administration of the drugs, handling of body fluids from patients being treated with cytotoxic drugs C16
Cytotoxic drugs-health effects • Short term effects:skin injury, lightheadedness, dizziness, nausea, headache, and allergic reactions • Long term effects:Some anti-neoplastics can cause cancer, they may also cause birth defect (teratogens) and miscarriages, as well as chromosomal damage (mutagens) C17
Other aspects Dangers to rag pickers • Sorting of mixed hospital waste • Needle-stick injuries Healthcare institutions Bio-Medical waste (Management and Handling rules) 1998: • Fine & Penalties • Shared responsibility C18
Used gloves being sold in open market
Access of waste to animals
Problems with incinerator Poor operation Ash
Threat to rag pickers
