Infrastructure Challenges in the Management of healthcare risk waste (HCRW)
Samantha Immelman, Compass’ National Sales Manager, was one of the guest speakers at the Council for the Scientific and Industrial Research (CSIR) conference held in October in Gauteng. Her presentation highlighted the challenges which healthcare risk waste (HCRW) service providers experience with regards to the infrastructure on a healthcare facility.
- Vehicle Access
- Insufficient access for delivery
- Insufficient access for collection
- increased manual handling
- full containers being transported through hospital premises and over long distances
- Insufficient dedicated loading / offloading zones
- Insufficient turning and reversing space
- Sluice Rooms
- Insufficient in size
- No dedicated employee to manage and oversee internal transportation of the full containers from sluice room to the CSA
- Overcrowding of clean and full containers leaving little or no space in the sluice room
- Confined space creates a risk to healthcare workers working in the area
- Insufficient warehouse space means increased delivery frequency which is costly
- Central Storage Area (CSA)
- Not built large enough to contain the amount of HCRW generated by the hospital, resulting in more collections which negatively impacts on costs.
- CSA's not built in accordance with requirements i.e. no wash basin, ventilation, air conditioner, etc.
- Spill Kits
- Not provided for each CSA area to deal with a HCRW spill should it occur.
- Internal Transportation
- Trolleys are not provided for internal transportation of HCRW from sluice rooms to the CSA.
- Challenges include poor maintenance on the trolleys, insufficient ramps or lifts are not always operational.
- OHS concerns for staff
- Sharps Waste
- Brackets should be installed so sharps containers are located as close to point of care as possible. This reduces NSI and helps with correct segregation.
- All sharps containers should be placed into brackets either on the walls and/ or trolleys.
- Maintenance and repair of brackets limited and, in turn, sharps containers are placed onto table tops, counters or tied to a trolley which is high risk.
- Anatomical Waste
- Fridges and freezers for the storage of anatomical waste should be mandatory at hospitals and clinics and should be big enough to hold the waste generated before collection. If not, this puts unnecessary pressure on the generator, the service provider and requires additional transportation which increases costs and carbon emissions.
- Pharmaceutical Waste
- Insufficient space in the pharmacy is allocated to hold the containers which need to be separated into Schedule 0 – 4 (and then further into six different types) and Schedule 5 and 6.
- Infectious Waste
- Single use and reusable box sets are available for the containment of infectious waste, these are adequately sized for the waste and for internal movement by the healthcare workers. Implementing various size wheelie bins (up to 770L) is impractical for stacking, moving and transporting and the space wasted in the vehicle requires more frequent service by your HCRW service provider, thereby increasing costs.
- Poor IT Infrastructure
- Individuals accountable to manage and oversee the HCRW are not provided with computers with internet connection and are, therefore, unable to log onto waste portals to access invoices, safe disposal certificates, permits and other information essential for internal and external HCRW audits.
Fortunately, more new builds are sufficiently providing for intermediate storage and internal transportation of HCRW. The real challenge is with existing hospitals where occupancy has increased and new wards built with no regard to increase the CSA to counter for the increased HCRW generated. Hospital expansions are taking space from parking areas, negatively impacting on HCRW vehicles delivering stock and collecting containers. This also requires more frequent collections which directly impacts on costs.
When doing a new build or an expansion to an existing hospital, why not contact a Compass sales executive. With over 9 000 customers and 21 years’ experience, Compass is able to provide invaluable input when it comes to infrastructure and its impact on HCRW management.