Anaesthetic agent usage and wastage during caesarean deliveries done with spinal anaesthesia in a labour ward theatre: a concern for the financial implication

Background: Local anaesthesia usage and wastage are common in the operation rooms. The wastage is often not given due considerations. Budgetary allocation for drugs is an identifiable area for cost-cutting and savings. Hence, the need to minimize wastage Objectives: To assess and estimate the amount of local anaesthesia usage and wastage in the labour ward theatre. Also, to analyze the financial implications of the wastages and suggest appropriate steps to reduce the wastages. Methodology: A prospective observational study conducted in the labour ward theatre of a tertiary care hospital. The amount of local anaesthesia administered to the patient during spinal anaesthesia prior to caesarean section was considered the dose used. The wastage was considered as the amount of local anaesthetic agents left unutilized in the syringes, ampules or vials after completion of each caesarean delivery. An estimation of the cost of wasted local anaesthetic agents was made. Result: The local anaesthetic agents being used in significant quantities were hyperbaric bupivacaine, plain lidocaine and lidocaine with adrenaline. The wastage was found more during the use of hyperbaric bupivacaine as the cost of its wastage formed the bulk (N75,000.00/ $210.10) of the estimated total cost of wasted local anaesthetic agents during the study period which was N88, 100.00 ($246.77). Conclusion: There were appropriate uses of the local anaesthesia with respect to the choice and doses for caesarean deliveries but there were wastages often ignored as infinitesimal. In the long run, the wastages become significant and the financial implication scale up the burden of health bills. Effective waste reduction strategies have input in the overall reduction of financial burden associated with health care. Emphasis should be t ailored towards awareness of these wastages among resident doctors and their prudent use of local anaesthesia

Gestion des déchets hospitaliers et du matériel biomédical au CHU de Brazzaville

Introduction ­ but.Les déchets hospitaliers et biomédicaux représentent un réel risque sanitaire et environnemental. Le but du travail est de décrire la gestion des déchets biomédicaux dans un hôpital de Brazzaville et ainsi contribuer à l'amélioration du mode de traitement des déchets biomédicaux au sein des structures sanitaires à Brazzaville. Méthodologie. Il s'agit d'une étude transversale, observationnelle et prospective qui s'est déroulée au sein de Centre Hospitalier et Universitaire de Brazzaville au cours de la période allant de février a juillet 2017. Un interrogatoire a été réalisé à l'aide d'un questionnaire soumis aux agents exerçant dans les 09 départements pour évaluer les variables suivantes : typologie des déchets, le tri des déchets, le mode d'élimination, les accidents de manipulation, ainsi que le statut vaccinal de la personne. Résultats. Pour les 78 agents interrogés et en ce qui concerne les déchets tranchants, les plus fréquents étaient les seringues (83,22 %) et les lames (82,05 %). En ce qui concerne les déchets infectieux, les plus fréquents étaient les tubes (33,33 %) et en ce qui concerne les déchets assimilables aux ordures ménagères, il s'agissait avant tout de bouteilles vides (93,58 %). Il y a eu une réponse positive pour 55,12 % des agents en ce qui concerne le tri des déchets, pour 84,61 % en ce qui concerne l'incinération des déchets infectieux et pour 92,3 % en ce qui concerne l'enfouissement des déchets ménagers et assimilés. Les accidents étaient liés aux piqures pour 62,8 des répondants et parmi les répondants, seuls 21,79 avaient un statut vaccinal à jour contre le tétanos. Conclusion. Il y a une gestion inadéquate des déchets hospitaliers avec des effets potentiels néfastes sur la santé du personnel hospitalier et sur l'environnement

Threats posed by stockpiles of expired pharmaceuticals in low- and middle-income countries: a Ugandan perspective

In some low- and middle-income countries, the national stores and public-sector health facilities contain large stocks of pharmaceuticals that are past their expiry dates. In low-income countries like Uganda, many such stockpiles are the result of donations. If not adequately monitored or regulated, expired pharmaceuticals may be repackaged and sold as counterfeits or be dumped without any thought of the potential environmental damage. The rates of pharmaceutical expiry in the supply chain need to be reduced and the disposal of expired pharmaceuticals needs to be made both timely and safe. Many low- and middle-income countries need to: (i)strengthen public systems for medicines' management, to improve inventory control and the reliability of procurement forecasts; (ii) reduce stress on central medical stores, through liberalization and reimbursement schemes; (iii) strengthen the regulation of drug donations; (iv) explore the salvage of officially expired pharmaceuticals, through re-analysis and possible shelf-life extension; (v) strengthen the enforcement of regulations on safe drug disposal; (vi) invest in an infrastructure for such disposal, perhaps based on ultra-high-temperature incinerators; and (vii) include user accountability for expired pharmaceuticals within the routine accountability regimes followed by the public health sector

The disposal pattern of domestic medical and pharmaceutical waste in Uyo Metropolis, Southern Nigeria

Abstract: The evaluation of waste treatment practices is an important step in the design interventions to improve the health status of municipalities. Objectives: The purpose of this study was to evaluate national practices in the treatment (disposal) of medical and pharmaceutical waste by households in the Uyo metropolis in Nigeria; and to provide a Informal education on appropriate practices for the community. Methods: The city was delimited into three zones A, B and C equivalent respectively to residential districts High income, middle income and low income. In total, 140 households were selected at random in the zones (40 households each of zones A and B and 60 of zone C). The sampling unit was the head or the representative of each household. A self-administered self-administered questionnaire was used to assess practices for the disposal of domestic medical and pharmaceutical wastes. The chi-square test was assessed differences in disposal practices between the three zones. A p value less than 0.05 was considered significant. Results: The majority of households disposed of medical and pharmaceutical waste with garbage. The rates of households involved in this practice ranged from 85% to 96.67% for medical waste and 73.34% to 82.5% for pharmaceutical waste. Only a small proportion eliminated medical waste by burning or burying them. Disposal by incineration was not practiced at all in the population studied. There was no significant difference in waste disposal practices between the three areas. Conclusion: The waste was not sorted before disposal. The recommended methods were not followed for the disposal of medical and pharmaceutical waste. Disposal of medical waste domestic products, especially sharps, does not meet the international standard

Medical Waste Disposal at a Hospital in Mpumalanga Province; South Africa: Implications for Training of Healthcare Professionals

Background. Healthcare professionals (HCPs) produce various types of waste in the course of rendering healthcare services. Each classification of waste must be disposed of according to the prescribed guidelines. Incorrect disposal of waste may pose a danger to employees; patients and the environment. HCPs must have adequate knowledge of the disposal of medical waste.Objectives. To determine the knowledge and practices of HCPs with regard to medical waste disposal at a hospital in Mpumalanga Province; South Africa.Methods. A quantitative cross-sectional research approach was used. The study respondents included nurses; medical doctors; dental health staff and allied health staff. Data were collected through self-administered questionnaires and analysed using IBM SPSS version 22.0.Results. A high proportion of HCPs did not have adequate knowledge regarding the disposal of medical waste; but nevertheless disposed of medical waste appropriately. While the knowledge and practices of HCPs with regard to medical waste disposal were not associated with age; gender or years of experience; there was an association between professional category and knowledge and practices.Conclusions. Disposal of medical waste is the responsibility of all HCPs. All categories of HCPs should receive regular training to improve their knowledge regarding disposal of medical waste and to minimise the risks associated with improper waste management. This will further increase compliance with the guidelines on disposal of medical waste

Healthcare Waste Management in Clinics in a Rural Health District in KwaZulu-Natal

The handling of healthcare waste (HCW) was investigated in 30 rural healthcare facilities in KwaZulu-Natal. Using a semi-structured questionnaire; interviews were carried out with the person in charge of the facility and observations were made to establish current practices in sorting; handling and disposal of HCW. It was found that improper sorting and management of HCW occurred on most sites with implications for cost; infection control and education. It is imperative therefore that improved HCW management measures be implemented and that healthcare facility staff receive appropriate and repeated training to ensure minimising risk

Medical Waste Management at the University of Port Harcourt Teaching Hospital

Background: The generation and handling of wastes from medically related procedures poses a potential health hazard to health workers and non health workers alike; and this has far reaching consequences for the public in areas where such wastes are disposed of carelessly. Aim: To investigate the medical waste management procedure at the University of Port Harcourt Teaching Hospital (UPTH) and assess the knowledge of; attitudes to and practice of waste management by staff of the Hospital. Methods: A stratified random sampling method was used for this descriptive cross sectional study; using a structured questionnaire that was pre-tested; as the instrument of data collection. The respondents were directly involved with medical waste generation; handling and disposal. Data collected was analysed using Statistical Package for Social Sciences for windows software; version 12.0. Results: There was a high level of awareness among UPTH health workers of the different waste types and their hazardous nature. A majority of the respondents showed favourable attitudes towards the importance of guidelines on medical waste management and training in; and use of personal protective equipment. Also the staff avoided certain aspects of their jobs they considered risky. The study also showed that the procedure of medical wastes management i.e. generation; segregation; storage; treatment; and final disposal at the UPTH was inadequate. Conclusion: The knowledge; attitude; and practice of the UPTH members of staff regarding management of medical wastes appeared satisfactory. The procedure of wastes management at the hospital appeared inadequate. We recommend that health education on medical wastes management be aggressively pursued as a policy