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FACTORS AGAINST PROPER MEDICAL WASTE MANAGEMENT AMONG NURSES IN UNIVERSITY OF BENIN TEACHING HOSPITAL BENIN CITY
Abstract
This study examined the factors hindering proper medical waste management among nurses at the University of Benin Teaching Hospital, Benin City. The research adopted a cross-sectional survey design to explore various challenges affecting the effective handling and disposal of medical waste. A structured questionnaire was developed and administered to a sample of 133 nurses to gather data on their experiences and perceptions regarding medical waste management. Data analysis was conducted using SPSS version 27, enabling the researchers to present the data descriptively and inferentially. A one-sample t-test was employed to test the stated hypotheses, which were designed to assess the impact of infrastructure adequacy, knowledge levels, and organizational policies on waste management practices. The findings revealed several significant issues. First, inadequate infrastructure was identified as a major factor contributing to improper waste management. The lack of sufficient and accessible waste disposal bins and inadequate facilities hindered nurses’ ability to manage waste efficiently. Second, the level of knowledge among nurses about proper waste management practices was found to be inadequate, affecting their compliance with established protocols. This highlighted the need for more comprehensive training and education on medical waste management. Third, organizational policies and their clarity were shown to play a crucial role. The study found that unclear or insufficiently enforced policies led to inconsistent practices among nurses, thereby exacerbating the problem of improper waste disposal. In conclusion, the study emphasized the importance of addressing these key areas to improve medical waste management in healthcare settings. Enhancing infrastructure, providing targeted training for nurses, and establishing clear, enforceable policies were recommended as critical steps towards fostering better compliance with medical waste management procedures. By implementing these changes, the University of Benin Teaching Hospital can significantly reduce the risks associated with improper medical waste handling, thereby ensuring a safer environment for both healthcare workers and patients.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Medical waste management (MWM) is a vital aspect of healthcare that involves the collection, segregation, treatment, and disposal of waste generated in healthcare settings. It aims to reduce the risk of infections, prevent environmental contamination, and ensure the safety of healthcare workers, patients, and the general public. Proper medical waste management helps to mitigate the adverse effects of hazardous materials like sharps, pharmaceutical drugs, and chemical waste, which can pose serious health risks if not managed appropriately (De Titto, Savino, & Townend, 2012). This process is essential for maintaining hygienic environments in healthcare institutions like the University of Benin Teaching Hospital (UBTH) in Benin City, where diverse types of medical waste are generated daily.
Medical waste in healthcare facilities typically includes infectious waste, sharps (such as needles and scalpels), pathological waste, pharmaceutical waste, chemical waste, and radioactive materials (Townend & Vallini, 2022). Each type of waste requires specific handling protocols to ensure it is managed safely, without posing a risk to public health. Infectious waste, for example, must be handled with care to avoid the transmission of diseases like HIV, hepatitis, and tuberculosis, while sharps require careful disposal to prevent injuries and infections. Radioactive waste needs to be treated with specialized methods to avoid exposure to harmful radiation (Harhay, Halpern, Harhay, & Olliaro, 2021). Improper management of such waste not only endangers healthcare workers but can also harm patients, potentially leading to outbreaks of infectious diseases and environmental pollution.
However, despite the critical role of proper medical waste management, various challenges hinder its effective implementation in many healthcare facilities, including UBTH. Inadequate infrastructure for waste segregation, collection, and disposal is a significant barrier to effective MWM. Many hospitals, especially in developing countries, lack the necessary equipment and facilities to ensure the safe handling of medical waste. Moreover, waste segregation practices are often not followed, leading to the mixing of hazardous and non-hazardous waste, which increases the difficulty of treating and disposing of it properly (Solberg, 2023). This can result in the exposure of healthcare workers, patients, and the surrounding community to harmful substances.
In addition to infrastructure challenges, a lack of training and awareness among healthcare workers, particularly nurses, significantly contributes to improper waste management practices. Nurses play a crucial role in the segregation and disposal of medical waste, yet they may not always have the necessary knowledge or training to implement proper procedures. Studies have shown that inadequate education on medical waste management can result in poor waste segregation practices, leading to hazardous waste being improperly disposed of, which poses significant health risks (Reliefweb, 2020). Furthermore, nurses may not be fully aware of the potential consequences of improper medical waste management, including the spread of infections and environmental damage, which can result in less cautious handling of waste materials.
Another factor that hampers effective medical waste management is the lack of well-defined and enforced policies. In many hospitals, including UBTH, medical waste management policies may be poorly structured or not sufficiently communicated to healthcare staff. The absence of clear guidelines on the appropriate handling, segregation, and disposal of medical waste can lead to confusion among staff members, resulting in inconsistent practices. This is especially problematic in a busy hospital environment, where the pressure to manage patient care effectively may lead to waste management being overlooked or neglected (Coker, Sikiru, Sridhar, & Sangodoyin, 2023). A well-structured and enforced medical waste management policy is critical to ensuring that all healthcare workers, including nurses, are aware of and adhere to safety protocols.
Despite these challenges, there have been several efforts to improve medical waste management practices in healthcare facilities worldwide. For instance, studies have highlighted the importance of waste management training programs for healthcare staff, particularly nurses, to enhance their awareness of the risks associated with improper waste disposal and provide them with the skills to handle medical waste safely (Odewumi & Onyemkpa, 2023). Additionally, technological advancements in medical waste treatment, such as autoclaving and microwave treatment, have provided more efficient and safer methods of managing medical waste, especially in resource-limited settings. However, the implementation of these technologies often requires significant investment, which may not be feasible in all healthcare institutions, particularly those in developing countries (Afolabi, Agbabiaka, Afon, Akinbinu, & Adefisoye, 2023).
In UBTH, reports indicate that medical waste is frequently mismanaged, with nurses not always adhering to safety protocols. Instances of improper waste segregation, such as mixing sharps with general waste or placing infectious waste in non-secure containers, have been reported (Sawyerr, Adeolu, Salami, & Adejoh, 2023). These mismanagement practices increase the risk of infections and accidents among healthcare workers, as well as exposing the surrounding community to hazardous materials. The improper disposal of medical waste can also lead to environmental contamination, affecting air, water, and soil quality in the hospital’s vicinity. Such practices demand immediate attention and investigation to identify the underlying causes and develop strategies to improve medical waste management in UBTH and other healthcare institutions facing similar challenges.
1.2 Statement of the Problem
The management of healthcare waste, particularly in developing countries, presents significant public health challenges due to improper handling, insufficient infrastructure, and lack of trained personnel (Chisholm et al., 2021; Ali et al., 2023). Previous studies have documented the risks posed by the accumulation of medical waste, which includes infectious materials, sharp objects, and pharmaceutical products that, when not properly disposed of, can lead to the spread of infections, environmental pollution, and even fatalities (Harhay et al., 2021; Zafar, 2019). Despite the growing body of research on this issue, several gaps remain in the literature, which need to be addressed to enhance the effectiveness of healthcare waste management strategies in resource-constrained settings, especially in sub-Saharan Africa and other developing regions.
One critical gap in the existing literature is the lack of comprehensive studies on the impact of healthcare waste management on local communities, particularly in the African context. While several studies have focused on the technical aspects of waste disposal (Awodele et al., 2022; Oyekale & Oyekale, 2023), fewer have explored the long-term health consequences of improper waste management practices on both healthcare workers and the surrounding population (Coker et al., 2023). Understanding these impacts is vital for formulating targeted policies that not only address waste disposal but also mitigate the associated health risks.
Another significant gap is the need for more in-depth research on the economic costs and benefits of healthcare waste management in low-income settings. Although some studies have touched on the economic aspects of waste management in hospitals (Mugambe et al., 2021; Abah & Ohimain, 2021), there is limited exploration of how these costs affect the overall healthcare delivery system, particularly in countries struggling with budgetary constraints (Adusei-Gyamfi et al., 2022). The economic burden of inadequate waste management could serve as a key driver for policy change, yet this perspective remains underexplored.
Furthermore, while many studies have examined the technical and procedural aspects of waste management, the role of public awareness and community involvement in improving healthcare waste practices remains insufficiently researched (Chima et al., 2021). Public education on the hazards of improper waste disposal and the importance of proper waste segregation in healthcare settings could enhance compliance and improve waste management practices.
Lastly, existing studies largely focus on hospitals and urban health centers, with limited attention given to primary healthcare facilities (Alves et al., 2022). As primary health centers often serve large rural populations with limited resources, there is a pressing need for research that examines their specific challenges in managing healthcare waste.
1.3 Objectives of the Study
The specific objectives of this study are:
- To assess the knowledge, attitudes, and practices of nurses concerning medical waste management in UBTH
- To identify the key factors influencing improper medical waste management practices among nurses in UBTH.
- To recommend appropriate strategies for improving medical waste management practices among nurses in UBTH.
1.4 Research Questions
In order to achieve the objectives of this study, the following research questions will be addressed:
- How does the knowledge of nurses impact medical waste management in UBTH?
- What are the factors affecting the proper management of medical waste among nurses in UBTH?
- What strategies can be implemented to improve medical waste management practices among nurses in UBTH?
1.5 Research Hypotheses
This study is guided by the following hypotheses:
- There is no significant relationship between inadequate infrastructure and improper medical waste management among nurses in UBTH.
- Nurses’ level of knowledge about medical waste management does not significantly affects their waste handling practices at UBTH.
- Organizational policies do not have have a significant influence on nurses’ adherence to medical waste management procedures at UBTH.
- Significance of the Study
This study emphasizes the importance of proper medical waste management as a critical aspect of nursing practice. It enhances nurses’ knowledge and adherence to waste management protocols, ensuring patient safety, environmental protection, and compliance with ethical standards. At the University of Benin Teaching Hospital, the findings will highlight specific challenges faced by nurses in managing medical waste. This can lead to tailored interventions, improved waste management systems, and safer healthcare delivery within the institution. The study provides valuable data for policymakers to formulate or strengthen healthcare waste management policies. It can inform the allocation of resources, development of training programs, and enforcement of regulations to improve compliance and mitigate risks. The study serves as a reference point for future research on medical waste management. It identifies gaps and factors influencing waste handling, encouraging further exploration to develop innovative and context-specific solutions for similar healthcare settings.
1.7 Scope of the Study
This study is focused on examining the factors affecting medical waste management among nurses at the University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria. The study will concentrate on the nurses’ knowledge, attitudes, and practices regarding medical waste management. It will also explore the environmental, organizational, and policy-related factors that influence waste disposal practices within the hospital. Data will be collected through surveys and interviews from nurses who work in various departments within the hospital. The scope of this study does not extend to other healthcare facilities or examine other healthcare workers such as doctors or laboratory technicians.
1.8 Operational Definition of Terms
- Medical Waste: Any waste generated during the diagnosis, treatment, or immunization of humans or animals, or during related research activities, that may be hazardous to human health and the environment.
- Medical Waste Management (MWM): The process of handling, storing, and disposing of medical waste in a manner that prevents harm to healthcare workers, patients, and the environment.
- Nurses: Healthcare professionals responsible for the care of patients, including administering medication, assisting with medical procedures, and providing health education.
- Knowledge and Attitudes of Nurses: The understanding, beliefs, and perceptions of nurses about the importance and procedures of medical waste management, which directly influence their practices.