scholarly journals REVIEWING CLINICAL WASTE MANAGEMENT UNDER THE LEGISLATIVE FRAMEWORK IN PAKISTAN: PRACTICES AND CHALLENGES

2021 ◽  
Vol 3 (2) ◽  
pp. 69-76
Author(s):  
Um e Hani ◽  
Ilyas Hussain Sarfaraz

The waste generated at healthcare facilities has two distinct categories: hazardous and non-hazardous waste. 10- 15% of the total waste generated at hospitals is hazardous which is termed as clinical waste. This review article has reported and reviewed the practices of clinical waste management in Pakistan’s major cities. Researches demonstrated that about 1.35 Kg / bed waste has been produced by the tertiary health care facilities in Pakistan. Studies for review process are selected through an iterative process. More than 100 research articles, National legislations, international protocols and newspaper reports are consulted and reviewed to extract the data of interest. Clinical waste management in Pakistan is the responsibility of the individual health care facility producing it under Hospital Waste Management Rules, 2005. Due to lack of proper checks and weak implementation of legislations many gaps have been identified in this review article like lack of segregation, inappropriate vehicles for transportation, poor storage and no advanced pollution control treatment strategies. Most of the hospitals lack documented waste management plan. Staff was mostly untrained and under educated. International standards for safe hazardous waste disposal are not being followed resulting in spread of diseases like hepatitis and AIDS. Cases of poor recycling and reuse of used clinical instruments is also documented. However, the condition is much satisfactory in big cities. There is an understanding to focus on the proper implementation of clinical waste management rules with strict checks. Establishment of incineration facility at major hospitals with proper maintenance, safe transportation to secure landfills and utilization of proper SOPs are suggested improvements towards safe management of clinical waste.

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.


Author(s):  
Elena Grossman ◽  
Michelle Hathaway ◽  
Amber Khan ◽  
Apostolis Sambanis ◽  
Samuel Dorevitch

Abstract Objectives: Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it. Methods: An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided. Results: Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications. Conclusions: Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.


2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.


Author(s):  
Mayadhar Panda ◽  
Sikata Nanda

Background: As a part of “Swachh Bharat Abhiyaan” campaign, the Ministry of Health and Family welfare, Govt. of India had launched “Kayakalp” in 2015, an initiative to promote cleanliness and enhance the quality of public health facilities. Our aim was to study the situational analysis of the health institution using Kayakalp tool; to assess the level of cleanliness, hygiene and infection control practices in the facility and to assess the status of Bio-medical waste management in the health care facility and to suggest remedial measures based on the study finding.Methods: It is a hospital based snapshot study done during a period of one year from April 2016 to March 2017. Kayakalp assessment tool was used for analysis.Results: The total scores for upkeep maintenance obtained in 2016-17 was 69 and for the year 2017-18 was 81. There was an increase of total score in the year 2017-18 and it was found to be statistically significant. On assessment in the year 2016-17, for BMW the total score obtained was 58 and in the year 2017-18 it was 81. There was a statistically significant increase in the scores (p=0.001) obtained in the year (2017-18).Conclusions: Improvements in Biomedical waste management can be made by increasing the knowledge, awareness and practices of the health care providers as well as the beneficiaries with regular periodic monitoring. 


2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.


2008 ◽  
Vol 2 (S1) ◽  
pp. S51-S57 ◽  
Author(s):  
John L. Hick ◽  
Kristi L. Koenig ◽  
Donna Barbisch ◽  
Tareg A. Bey

ABSTRACTFacility-based health care personnel often lack emergency management training and experience, making it a challenge to efficiently assess evolving incidents and rapidly mobilize appropriate resources. We propose the CO-S-TR model, a simple conceptual tool for hospital incident command personnel to prioritize initial incident actions to adequately address key components of surge capacity. There are 3 major categories in the tool, each with 4 subelements. “CO” stands for command, control, communications, and coordination and ensures that an incident management structure is implemented. “S” considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations. “TR” comprises tracking, triage, treatment, and transportation: basic patient care and patient movement functions. This comprehensive yet simple approach is designed to be implemented in the immediate aftermath of an incident, and complements the incident command system by aiding effective incident assessment and surge capacity responses at the health care facility level. (Disaster Med Public Health Preparedness. 2008;2(Suppl 1):S51–S57)


2011 ◽  
Vol 23 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Masayoshi Kanoh ◽  
◽  
Yukio Oida ◽  
Yu Nomura ◽  
Atsushi Araki ◽  
...  

We have developed a Robot Assisted Activity (RAA) program for recreational use in health care facilities for elderly people. The RAA program has been evaluated in such a facility to assess its usefulness. The program applies a standard classroom model, starting with homeroom and including lessons in the Japanese language, music, gymnastics, arithmetic, and other subjects. At the end of the program, there is a graduation ceremony. We use a video camera to record each scene. Each behavior and utterance of the participants is then analyzed. In addition, immediately upon completion of the RAA program, specialists conduct a Focus Group Interview (FGI) in which they collect comments, opinions, and requests from the participants. Ten elderly people participate in the program, two men and eight women (81.0±3.7 years old). All are residents at a health care facility in Aichi Prefecture, Japan. TheMMSE (MiniMental State Examination) score indicating the level of dementia is 24.1±3.0 points. Two participants are judged to be in a moderate stage of cognitive decline (21 points or less), six are in a mild stage (22-26 points), and the remaining two are normal. On the Geriatric Depression Scale (GDS), in which a score of 13.3±4.2 points indicates a state of depression, seven participants are judged to be depressive (11 points or more). The results of our study show that all participants have a favorable impression of the robot and nearly all have a positive opinion of the RAA program. This suggests that the program can be used for emotional and recreational therapy at health care facilities for the elderly. However, in spite of the overall success of the RAA program, we seldom observe interaction between participants and the robot.


2017 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Adita Puspitasari Swastya Putri ◽  
Kurnia Dwi Artanti ◽  
Dwiono Mudjianto

Hospital Acquired Infections (HAIs) is an infection acquired during a patient undergoing treatment proedur and medical measures in health care facilities within ≥ 48 hours or within ≤ 30 days and infection was observed after the patients leaving the health care facility. The one of Hais what often happens is Surgical Site Infection (SSI) so that SSI surveillance is needed for prevention and control of infection. Bundle prevention is an instrument used for data collection the incidence of SSI in Hospital X Surabaya. This study aims to look at the picture of existence, charging and completeness of bundle SSI prevention on patients sectio caesarea in Hospital X Surabaya. The study design used is cross sectional with a total sample of 47 patients were taken by simple random sampling on patients sectio caesarea in January-June 2016. The result showed that 64% of patient records status is not accompanied by SSI prevention bundle with charging and completeness of the data that is still below the predetermined standard that is equal to 80%. Although SSI surveillance is in conformity with the guidelines infection surveillance but there are still some shortcomings in terms of the accuracy of the data so that the information obtained is still not able to be reported as well.Keywords: surveillance, SSI, hospital


Author(s):  
Vinita Shukla ◽  
Pratibha Gupta

Background: Population is increasing rapidly so with the limited resources government alone cannot cater the health of whole population. Private health sector is equally important for the improvement of health of the people. In view of these facts the present study was planned to assess the utilization of health care services (both public and private) and to assess the reasons for visiting that particular health facility (public or private).Methods: Study was cross sectional for 1 year period. Total sample size was 1024. In the present study only rural area was taken. By using multistage stratified random sampling 6 villages were selected and sample came out as 516. Data was analyzed by stata software version -12 for windows and chi square test.Results: 50% respondents visited public, 38% private and 10% visited others (charitable, pharmacies etc.). 62% respondents belonged to lower socio economic status preferred public health care facility. The main reason for visiting public health facility was free services and for private was got cure earlier from that heath facility. Majority of people visited any health facility for illness. (344 out of 516) and 50% of them visited for respiratory diseases. For chronic illness majority (60%) preferred public health care facility.Conclusions: Both public and private health care facilities should be made well equipped and affordable so that people can make choices and not forced to choose particular health facility.


2020 ◽  
Author(s):  
Corinna Vossius ◽  
Hege Ersdal ◽  
Jan Terje Kvaløy ◽  
Paschal M ◽  
Estomih Md ◽  
...  

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams and an increase in newborns weighing more than 4000 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.


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