Factors Contributing to Sharp Waste Disposal at Health Care Facility Among Diabetic Patients in North-East Peninsular Malaysia.

BACKGROUND: Type 2 diabetic patients are major users of medical sharps in the community. Proper sharp disposal practice among them, however, was reported to be low. The current study was aimed to determine the factors contributing to sharp waste disposal at a health care facility among Type 2 diabetic patients. METHODS: In this cross-sectional study, Type 2 diabetic patients who were on insulin therapy attending health clinics were randomly selected and interviewed using a validated questionnaire. Binary logistic regression analysis was applied. RESULTS: Out of 304 respondents, only 11.5% of them brought their used sharps to be disposed at health care facilities. Previous advice on sharp disposal from health care providers, knowledge score, and duration of diabetes were significant contributing factors for sharp waste disposal at health care facilities: (Adj. OR 6.31; 95% CI: 2.63, 15.12; p < 0.001), (Adj. OR 1.05; 95% CI: 1.03, 1.08; p < 0.001), and (Adj. OR 2.51; 95% CI: 1.06, 5.93; p = 0.036), respectively. CONCLUSION: Continuous education and a locally adapted safe sharp disposal option must be available to increase awareness and facilitate diabetic patients adopting proper sharp disposal behavior.

Strategies and challenges for safe injection practice in developing countries.

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Management of "SHARPS" wastes in Manila hospitals (Part 1)

BACKGROUND: Sharps waste is a special kind of health care waste that needs to undergo certain processes before its final disposal. These processes are guided by international policies, national laws and memoranda, the implementation of which is under the jurisdiction of certain agencies. OBJECTIVES: This study was designed to document the health care sector's adherence to proper waste management practices, especially for hazardous sharps waste. It specifically documented the adherence to government regulations of six tertiary hospitals in the Manila and Pasay City areas. The study was undertaken to identify if these six hospitals adhere to the guidelines set by the World Health Organization as adapted by the Department of Health (DOH) and Department of Environment and Natural Resources (DENR). The first specific objective is to document if these hospitals are complying with the documentary requirements of such regulations as required by law. The second specific objective is to document the presence of facilities and resources in the hospital that will ensure proper implementation of regulations regarding sharps waste disposal. METHODS: The study was conducted in six tertiary hospitals, three of which are government/public and three are private hospitals. An observation checklist was constructed to identify in a detailed manner if the said hospitals were adhering to the standards set by the government. This checklist was validated by photographs for documentation. Specific areas, people and equipment of interest were earmarked for observation. Nurses stations and the laboratory for example, were singled out due to the high volume of sharps waste produced and temporarily stored in these areas. Chart reviews were also done to check if permits and policies were in place to oversee proper hospital waste management. Results. The study showed that all six hospitals were not strictly adhering to all the prescribed requirements by the Department of Environment and Natural Resources and the Department of Health. CONCLUSION: Even with rules and policies in place, it has been documented that all of the study hospitals have not been adhering to documentary requirements. Furthermore, the facilities and resources needed for waste management in the hospital are not available. Recommendation: The responsible agencies should closely monitor the sharps waste management practices of hospitals to ensure safety and protect the health of health care workers, patients, their companions and visitors.