Knowledge, attitudes and practices of healthcare workers about healthcare waste management at a district hospital in KwaZulu-Natal

Figures & data

Table 1: Number of relevant staff members working at district hospital and sample selected

Health worker category	Population	Sample
Doctors	27	26
Medical technologists	12	12
Dentists	4	4
Paramedics (physio, OT, speech therapists and clinical psychologists)	26	25
Nurses	361	187
Porters	15	15
Cleaners	44	40
Ward attendants	21	20
Total	510	329

Table 2: Respondents’ information

Employment designation	Total population	Number selected	Number of questionnaires returned	Percent
Medical doctor	27	26	26	100
Dentist	4	4	2	50
Nurse	361	187	187	100
Allied healthcare professionals (physiologists, occupational therapists, speech therapists, and clinical psychologists)	26	25	0	0
Medical technologist	12	12	5	42
Non-professional workers (porters/cleaners/ward attendants)	80	75	21	28
Total	510	329	241	73

Table 3: Overall knowledge of healthcare workers about healthcare waste

Designation	Knowledge
	Excellent	Good	Poor
	(> 81%)	(52–81%)	(> 52%)
Other professional healthcare workers (n = 33)	0 (0%)	11 (32.3%)	22 (67.7%)
Nurses (n = 187)	29 (15.3 %)	89 (47.7%)	69 (36.9%)
Non-professionals (n = 21)	1 (5.9%)	8 (35.3%)	12 (58.8%)
Total	30/241 (12.4%)	108/241 (44.8%	103/241 (42.7%)

Table 4: Overall attitude of healthcare workers about healthcare waste

Designation	Possible responses	Q46: Segregating waste at source increases the risk of injury to waste handlers		Q47: Containing sharp objects does not help the safe management of hospital waste		Q48: Hepatitis-B immunisation prevents its transmission within the hospital		Q49: Reporting needle-stick injury is an extra burden on work
		No.	%	No.	%	No.	%	No.	%
Other professionals (n = 33)	Strongly agree	4	12.1	1	3.0	6	8.2	2	6.1
	Agree	8	24.2	1	3.0	13	39.4	2	6.1
	Disagree	6	18.2	5	15.2	3	9.1	10	30.3
	Strongly disagree	9	27.3	21	63.7	6	18.2	14	42.4
	Don’t know	1	3.0	1	3.0	1	3.0	1	3
	Unanswered	5	15.2	4	12.1	4	12.1	4	12.1
Nurses (n = 187)	Strongly agree	34	18.2	16	8.6	25	13.4	13	7
	Agree	63	33.7	28	15	22	11.8	21	11.2
	Disagree	24	12.8	69	36.9	83	44.4	66	35.3
	Strongly disagree	29	15.5	41	21.9	26	13.9	58	31.0
	Don’t know	7	3.7	6	3.2	3	1.6	3	1.6
	Unanswered	30	16.1	27	14.4	28	15	26	13.9
Non-professionals (n = 21)	Strongly agree	1	4.8	0	0	3	14.3	2	9.5
	Agree	6	28.6	5	23.8	7	33.3	7	33.3
	Disagree	4	19.0	4	19.0	1	4.8	2	9.5
	Strongly disagree	0	0	1	4.8	0	0	2	9.5
	Don’t know	3	14.3	5	23.8	4	19.0	2	9.5
	Unanswered	7	33.3	6	28.6	6	28.6	6	28.6

Table 5: Healthcare workers’ practices in dealing with healthcare waste

Designation	Practice
	Excellent	Good	Poor
	(> 77%)	(52–76%)	(< 52%)
Other professionals (n = 33)	0 (0%)	13 (38.7%)	20 (61.3%)
Nurses (n = 187)	1 (0.6 %)	102 (54.5%)	84 (44.9%)
Non-professionals (n =21)	0 (0%)	15 (70.6%)	6 (29.4%)
Total	1/241 (0.6%)	130/241 (53.9)%	110/241 (45.5%)

Table

	Yes	No	I don’t know
5. Are you able to identify the nature of medical waste? 6. If yes what criteria do you use to identify medical waste? Please state them below:
7. Do you identify the need to sort medical waste during collection?
8. Do you know the reason behind sorting (separation of) medical waste? i. ii. iii. 9. If yes give 3 reasons why waste should be sorted at site:
10. Are you aware of risks in dealing with medical waste? 11. If yes – name 3 risks associated with medical waste: i. ii. iii.
12. Do you know adequate disposal procedures for liquid waste? 13. If yes, give a brief explanation of the procedure you use or know of below: 14. Have you ever received any formal training on medical waste handling? 15. If yes, kindly tick the form(s) of training you received below: A. Formal lecture B. seminar C. workshop D Case scenario E. Others (please state below)
16. Do you know adequate disposal procedures for expired blood units and by-product waste? 17. If yes briefly describe what you will do with it below:
18. Do you know adequate disposal procedures for human tissue remains? 19. If yes, briefly state the disposal approach you use:
20. Do you have appropriate knowledge of the colour coding of medical waste disposal bags/containers? 21. If yes, state the categories of waste that goes into each of these colours: i. RED—————————————— ii. ORANGE————————————- iii. YELLOW————————————- iv. BLACK OR DARK GREEN——————— v. BLUE—————————————–
22 Do you know adequate disposal procedures for expired medicines?
23 Do you believe that throwing blood waste into domestic waste is an adequate disposal procedure? 24 Do you receive any form of supervision on the way you handle wastes?
25 Do you believe that throwing expired medicine into domestic waste is an adequate disposal procedure?

Table

	Yes	No	I don’t know
5. Are you able to identify the nature of medical waste? 6. If yes what criteria do you use to identify medical waste? Please state them below: 7. Do you identify the need to sort medical waste during collection? 8. Do you know the reason behind sorting (separation of) medical waste? 9. If yes give 3 reasons why waste should be sorted at site: 10. Are you aware of risks in dealing with medical waste? 11. If yes – name 3 risks associated with medical waste: 12. Do you know adequate disposal procedures for liquid waste? 13. If yes, give a brief explanation of the procedure you use or know of below: 14. Have you ever received any formal training on medical waste handling? 15. If yes, kindly tick the form(s) of training you received below: A. Formal lecture B. seminar C. workshop D Case scenario E. Others (please state below) 16. Do you know adequate disposal procedures for expired blood units and by-product waste? 17. If yes briefly describe what you will do with it below: 18. Do you know adequate disposal procedures for human tissue remains? 19. If yes, briefly state the disposal approach you use: 20. Do you have appropriate knowledge of the colour coding of medical waste disposal bags/containers? 21. If yes, state the categories of waste that goes into each of these colours: i. RED—————————————— ii. ORANGE————————————- iii. YELLOW————————————- iv. BLACK OR DARK GREEN——————— v. BLUE—————————————– 22 Do you know adequate disposal procedures for expired medicines? 23 Do you believe that throwing blood waste into domestic waste is an adequate disposal procedure? 24 Do you receive any form of supervision on the way you handle wastes?

Table

	Yes	No	I don’t know
26 Do you sort medical waste during collection?
27 Do you separate sharp waste from blunt waste?
28 Do you move medical waste using trolleys?
29 Do you clean the waste trolley directly after each collection?
30 Do you use personal protection tools (e.g. gloves, safety goggles, face mask) ever or when handling medical waste? 31 Do you think the number of people employed to handle waste in the hospital is adequate?
31 Do you think the number of people employed to handle waste in the hospital is adequate?
32 Do you collect liquid waste in bags that prevent leakage?
33 Do you collect blood waste in bags that prevent leakage?
34 Do you collect human tissue remains in separate bags to prevent leakage?
35 Do you collect liquid waste together with other waste?
36 Do you collect blood waste together with other waste in ordinary bags?
37 Do you collect human tissue remains together with other wastes in ordinary bags?
38 Do you collect expired medicines together with other wastes?
39 Do you dispose of liquid waste into the sewage system after processing?
Does the hospital have furnaces for internal destruction of medical waste?
40 Are hospital visitors exposed to medical waste?
41 Do you gather medical wastes in open areas within the hospital for temporary storage before being transferred outside the hospital?
42 Does the hospital have standard stores for temporary storage of medical wastes?
43 Does the hospital depend on the city cleaning authority (e.g. DSW) in moving and disposing of medical waste outside hospital?
44 Does the hospital dispose of medical waste outside using its own vehicles?

Table

	Agree	Strongly agree	Disagree	Strongly disagree	Don’t know
45 Segregation of waste at source increases the risk of injury to waste handlers
46 Containment of sharps does not help in safe management of hospital waste
47 Hepatitis B immunisation prevents transmission of hospital-acquired infections
48 Reporting of needle-stick injury is an extra burden on work