بررسی وضعیت مدیریت پسماند بیمارستانی با استفاده از ابزار ارزیابی سریع منحصربه‌فرد (I-RAT).

نوع مقاله: مقالات پژوهشى اصیل کمی و کیفی

نویسندگان

1 دانشجوی کارشناسی ارشد دانشکده بهداشت دانشگاه علوم پزشکی تهران

2 دکترای بهداشت محیط، دانشکده بهداشت، گروه مهندسی بهداشت محیط، دانشگاه علوم پزشکی تهران.

3 دانشجوی دکترای بهداشت محیط، دانشکده بهداشت، دانشگاه علوم پزشکی تهران.

چکیده

زمینه‌ و ‌هدف: رشد جمعیت و افزایش نیاز بشر به بهداشت ‌و درمان، سبب گسترش امکانات گوناگون و به دنبال آن، افزایش تولید پسماندهای پزشکی شده است. بنابراین، این مطالعه با به‌ کارگیری ابزارIRAT در سال1393 به‌عنوان بخشی از استراتژیWHO، به بررسی وضعیت مدیریت پسماند بیمارستان شریعتی ‌تهران به دلیل مدیریت ‌ضعیف پسماند پزشکی پرداخته است.
 
مواد و روش‌ها: این مطالعه توصیفی با تکمیل70 پرسش از مسئولان بهداشت محیط و پسماند انجام شد و پس از بازرسی محلی از روش اجرای قوانین مدیریت ‌پسماند، در ابزارIRAT ثبت گردید. همچنین، انواع پسماند تولیدی بخش‌ها به مدت یک ماه توزین و شد
 
یافته ‌ها: در مدت یک ماه توزین به‌طور میانگین، 68/1911  کیلوگرم پسماند تولید شد که از این مقدار، سرانه پسماند عفونی314/0±91/1، شبه‌خانگی254/0±11/2، شیمیایی/دارویی027/0±1/0 و نوک‌تیز و برنده 032/0±08/0  کیلوگرم/تخت/روز است. طبق نتایج، در حدود 18درصد کیسه‌ها و سفتی باکس بخش‌ها با بیش از ظرفیت ¾ جمع‌آوری و تنها تعداد ۳4 بخش (72درصد)، برچسب‌زنی منظم کیسه‌های پسماند را انجام می‌دادند؛ همچنین، مدیر بیمارستان بودجه‌ای جداگانه یا برنامه‌ریزی‌ای برای پوشش هزینه‌ها در مدیریت پسماند پیش‌بینی نکرده بود.
 
نتیجه ‌گیری: طبق آنالیزIRAT، نمره نهایی کسب‌شده بیمارستان در شرایط ضعیف بوده (71/50درصد) که شامل 9/75 درصد تفکیک، 9/78 درصد جمع‌آوری، 8/77 درصد انتقال و ذخیره‌سازی و 7/81 درصد تصفیه و دفع است. میزان پسماند عفونی تولیدی نیز (27/47درصد) بیش از مقدار توصیه‌شده توسط سازمان بهداشت جهانی است. بنابراین، آموزش‌های بیشتر و مداوم در زمینه جداسازی و کاهش پسماند در مبدأ تولید، جلوگیری از عفونی و مخاطره‌آمیز شدن همه زائدات به‌منظور کاهش تولید پسماندهای خطرناک و اقدامات قانونی برای الزام مسئولان مراکز بهداشتی- درمانی در اجرای قوانین مدیریت پسماند ضروری به نظر می‌رسد.

کلیدواژه‌ها


عنوان مقاله [English]

A Survey on the status of hospital waste management using rapid assessment tool unique (I-RAT).

نویسندگان [English]

  • Najmeh Bayat 1
  • Mahmood Alimohammadi 2
  • Ramin Nabizadeh Nodehi 2
  • Mohammad Hadi Dehghani 2
  • Kamyar Yaghmaeian 2
  • Masoud Binesh Berahmand 3
  • Mahmood Shams 3
1 MSc of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences.
2 PhD of Environmental Health, School of Public Health, Department of Environmental Health, Tehran University of Medical Sciences.
3 PhD Student of Environmental Health, School of Public Health, Department of Environmental Health, Tehran University of Medical Sciences.
چکیده [English]

Background & objective: Parallel to the growth of Population  and increasing healthcare needs ,the production of medical wastes is constantly increasing . Owing to the poor healthcare waste management ,this study  surveys the state of waste management in  Shariati Hospital of Tehran using IRAT in 2015 as part of WHO's strategy.
 
Matrial&Methods:This descriptive study recorded 70 questions asked from environmental health and waste authorities  after inspection the implementation waste management law using the IRAT tool . The waste products for sectors  were weighed for one month.
 
Results:The average weighing  was 1911.68 kg waste production, which included 1.910.314 of infectious waste rate, 2.110.254 of domestic, 0.10.027  of  Chemical/Pharmaceutical and 0.080.032 kg/b/d of sharp particles. According to the results, 18% of the  bags and safety boxes with the capacity of more than 3/4 were collected with only 34 parts (72%) regular label waste bags. In addition, the  hospital manager did not anticipate a specific budget  to cover the costs of waste management.
 
Conclusion:According to the IRAT analysis, the final score for the hospital was poor  i.e. 50.71% which included 75.9% for separation, 78.9% for collection, 77.8% for transmission and storage and 81.7% for the treatment and disposal. The infectious waste rate ,that is 47.27%, seems more than that  recommended by WHO. So it is necessary to have more educational programs  in the field of waste separation for  reducing the source of infections and hazardous wastes. Legal measures should be done to make the authorities of health centers  implement the waste management rules.

کلیدواژه‌ها [English]

  • Hospital
  • Individualized Rapid Assessment Tool
  • Wastet management
 

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