Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine

Figures & data

Table 1. Name, geographical location, type, number of beds, and number of employees of the hospitals under study.

Hospital	Geographic Location	Type	No. of Beds	No. of Employees
				Physicians	Nurses	Pharmacists	Waste Workers	Administrators, Technicians, Others	Total
Al-Shifa Medical Complex	Gaza	Internal medicine, surgery, maternity	619	635	394	23	152	283	1487
Nasser	Middle of Khan Younis	Internal medicine, surgery, maternity	322	330	295	18	77	49	769
EGH	East of Khan Younis	Internal medicine, surgery	246	164	221	11	50	335	781
Al-Aqsa	Deir-Elbalah	Internal medicine, surgery, maternity	129	116	94	4	42	306	562
Kamal Odwan	North Gaza	Internal medicine, surgery, maternity	119	99	75	4	40	92	310
Total			1435	1344	1079*	60*	361*	1065	3909

Notes. *Nurses, pharmacists, and waste workers constituted the study population with a total of 1500 individuals.

Table 2. Demographic characteristics of the intervention study sample (n = 69).

Variable	No.	%
Age
Less than 30	230	43.5
From 30 to 40	215	40.6
More than 40	84	15.9
Missing	1	.18
Gender
Male	298	56.2
Female	232	43.8
Qualification
Secondary school and less	82	15.5
High school diploma	161	30.4
Bachelor	250	47.2
Postgraduate	37	7.0
Profession
Pharmacist	46	8.7
Radiographer	21	4.0
Waste worker	91	17.2
Nurse	364	68.7
Others	8	1.5
Total experience
Less than 5 years	142	26.8
From 5 to 10 years	224	42.3
More than 10 years	164	30.9

Table 3. Knowledge of the pre-intervention study sample (n = 530) as regards to pharmaceutical waste management and impact of the educational program (n = 69).

	Pre-intervention Phase (n = 530)				Impact of Educational Program (n = 69)
	Answers (%)				Knowledge Score* as %
Question	Correct Complete	Correct Incomplete	Wrong/Don’t Know	Score* (%)	Pretest	Posttest	Follow-up	P value**
What is the definition of pharmaceutical waste?	5.3	91.6	3	51.1	52.1	66.6	81.1	<0.001
What are the reasons for pharmaceutical waste generation in pharmacies? n = 46	18.1	80.4	1.5	58.3	71.4	85.7	85.7	<0.001
What are the reasons for pharmaceutical waste generation at nursing floor? n = 364	6.7	91.8	1.5	52.6	53.8	71	77.3	<0.001
Does pharmaceutical waste cause any health hazards?	84.7	—	15.3	84.7	85.5	91.3	95.7	0.034
Does pharmaceutical waste cause any environmental hazards?	83	—	17	83	75.4	85.5	94.2	0.004
Is it important to wear PPE when handling pharmaceutical waste?	76.2	—	23.8	76.2	81.2	89.9	95.7	0.007
What are the steps of PWM? (one step at least)	75.5	—	24.5	75.5	75.4	81.2	92.8	0.006
What are the steps of PWM? (all steps)	21	53	26	47.5	42.7	60.8	71.9	<0.001
What is the importance of pharmaceutical waste segregation process?	24	34.7	41.3	41.4	33.3	50	75.3	<0.001
What are the pharmaceutical waste types that should be segregated from each other?	17.5	53.7	28.8	44.4	30.4	51.4	74.6	<0.001
What are the colors that should be used to segregate each type of pharmaceutical waste?	0.6	34.1	65.3	17.6	0	39.1	52.2	<0.001
Is it important to have a storage room for pharmaceutical waste in each hospital?	64	0	36	64	68.1	75.4	92.8	<0.001
What is the optimum collection frequency for generated pharmaceutical waste?	20.8	0	79.2	20.8	15.9	63.8	76.8	0.005
What are the specifications of the vehicle used for pharmaceutical waste transport?	0	8.8	91.2	4.9	7.9	51.4	73.2	<0.001
What are the treatment methods of pharmaceutical waste?	2.6	33	64.4	19.2	28.4	55.7	75.3	<0.001
Mean knowledge score	49.4 ± 25.2				48 ± 28	68 ± 17	81 ± 12	<0.001

Notes: *Scores ≥75% = satisfactory; scores 50% to <75% = fair; scores <50% = poor. **P value between pretest (n = 69) and follow-up test (n = 69).

Table 4. Practice of the pre-intervention study sample (n = 530) as regards to pharmaceutical waste management and impact of the educational program (n = 69).

	Pre-intervention Phase (n = 530)				Impact of Educational Program (n = 69)
	Answers (%)				Practice Score* as %
Practice	Yes	Sometimes	No	Score*	Pretest	Posttest	Follow-up	P value**
Following a specific system in PWM	19.6	29.2	51.1	34.2	23.1	22.4	78.2	<0.001
Adherence of PWM system to written guidelines	7.5	13	79.5	14	4.3	5.7	85.5	<0.001
Attending training workshops about PWM	17.5	0	82.5	17.5	17.5	100	100	<0.001
Pharmaceutical waste segregation at generation point	17.7	34.7	47.6	35.05	26	31.8	92	<0.001
Regular collection of PW	16.2	34	49.8	33.2	39.1	36.9	82.6	<0.001
Immediate replacement of full waste bags	60.2	27.7	12.1	74.05	72.4	69.5	90.5	0.001
Spill management	19.6	34.7	45.7	36.9	39.2	42	80.4	<0.001
In-site storage of PW in specially designed rooms	8.5	0	91.5	8.5	8.5	0	0
Using PPE while handling PW	60.6	36.8	2.6	79	79	89.8	95.6	0.001
Mean practice score	36.9 ± 24.7				34.3 ± 26	44.2 ± 35	78.3 ± 30

Notes: *Scores ≥75% = satisfactory; scores 50% to <75% = fair; scores <50% = poor. **P value between pretest (n = 69) and follow-up test (n = 69).