A.

FMMC WASTE MANAGEMENT

1. INTRODUCTION
The Hospital, as a health care institution, does generate waste whose disposal needs to be
managed so as to present, or at least, minimize the adverse impact it may have on our
environment. Thus, we have outlined the Institution’s waste management program to be
implemented and overseen by our health Care Management Committee. The management is
fully committed through the BOD’s Resolution, to support and sustain this program.

2. WASTE MINIMIZATION
The primordial efforts of the Hospital shall be addressed to the minimization of waste which
involves the elements of waste REDUCTION at source and RECYCLING. These definitely help
lessen the bulk of health care waste for disposal. We believe that the benefits of this
minimization of waste shall redound both to our hospital and to the waste receiving
environment.

With the establishment of this program, we shall undertake to establish a baseline data on the
extent of the waste generated. These data collated from our various units shall be noted and
recorded. The units will be arranged in a chart according to the volume of waste generated.

As a matter of principle, we shall train the employees involved in handling of hazardous waste
and enumerate the method of specific waste minimization. These employees shall be made
aware of and be updated on all the hazardous waste regulations.

3. REDUCTION AT SOURCE
Efforts shall be made to eliminate use of non-biodegradable materials and toxic materials. We
shall also make it a point to convince some suppliers to avoid packing materials of such nature.

4. RE-USE
We shall make a deliberate choice of products that will enable us to use them over and over for
the function they are intended for. We shall opt for these instead of disposal ones. Of course,
we shall subscribe to set standards of disinfection and sterilization of materials as well as
equipment use.

5. RECYCLING
We shall collect what are ordinarily included among our waste but can be re process into similar
or new use. In the hospital there are those items which can definitely be recycled such as plastic,
paper, card-board, glass and metal.

6. SEGREGATION OF WASTE
While segregation is a very important step in waste management, this requires consistency,
persistency and drive. This process will reduce the volume of waste that has to be managed. The
mixing of non-infectious waste with infectious or hazardous waste will make the combined

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 waste all infectious and hazardous. When we separate the wastes (as hazardous and non-
hazardous, biodegradable and non-biodegradable) we make easier our minimization because,
we reduce the extent of toxic substance release to the environment and we generate a solid
waste stream management more easily through recycling or composting.

7. COMPOSTING
A strategy we shall also adopt to minimize waste particularly for bio-degradable type is
composting. This will include the food discards in the kitchen and also in the wards and rooms
when visitors or companions bring food to the hospital. We also have those other waste in the
kitchen, cardboards, papers and yard waste. Our composting will be the simplest method we
can pursue and the rich compost will be used for the plants around the hospital.

8. IMPLEMENTATION
a. OUR WASTE HANDLING, STORAGE, AND COLLECTION PRIOR TO TRANSPORT
 At the waste source units, we provide bags in the labeled container bins intended to
facilitate segregation at source and different locations.
 We have constructed a storage area within the hospital grounds designed to keep
off rodents and other scavenging animals before the city garbage collection trucks
gather them for transport.
 Aside from impermeability, the storage has hard standing floor with good drainage
that makes it easy to clean and disinfect.
 It is easily accessible for the staff charged with handling the waste. It is also easily
accessible to the garbage collecting trucks plying the route.
 It protects the waste from the sun, strong winds, even flooding. It is also kept that
prevents access by unauthorized persons.

b. COLLECTION AND TRANSPORT

 Waste are collected frequently as required during the day and transported/brought
over to the central waste storage area.
 The bags in the labeled container bins are replaced immediately with new ones of
the same type the moment they are taken out of the container bins. These bags are
readily available.
 The waste within the premises is transported through the use of trolley container
particularly for the purpose.
 We use large sealed bags to prevent spilling of waste as this is transported.
 The city government collects waste every day.

B. COMPOSITION AND FUNCTIONS OF HEALTH CARE WASTE MANAGEMENT COMMITTEE

Appropriate health care management practices depends largely on the administration and
organization, adequate legislative and financial support as well as the active participation by trained
and informed staff. The entire organizational structure and services of the health care facility must

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be responsible in proper segregation, storage, collection, treatment and disposal of health care
waste.

1. COMPOSITION
The Chief/Director of the Health Care Facility will have the overall responsibilities for ensuring
that health care waste are disposed of in accordance with the national policies and guidelines.

For departmentalize hospitals, the Chief/Director of the Health Care Facility is required to form a
waste management committee that comprises the following members.

CHAIRMAN : Teresita F. Coseng

Co- Chairman: Josielyn B. Justo RN, WMO

Members: Dr. Sherwin E. Feir, Infection Control Officer

Evangeline R. Alvarez RN, Chief Nurse
Hanneleth Binala, RMT
Elvira Soriano, Pharmacist
Dave Roy Guillermo, Radtech
Revelita Tomas, Financial Officer
Shierelle Paulino, Health Educator
Juan Jara, Hospital Maintenance Aide
Brenda Ancheta, Supply Officer
Michelle Quirod, Housekeeping Supervisor

The Chief/Director of the health care facility should formally appoint the members of the waste
management committee in writing, informing each of them of their duties and responsibilities.
The appointment of a Waste Management Officer with overall responsibilities for the
development of the waste management plan will also be responsible for the subsequent day
today operation and monitoring of waste disposal system. In smaller facilities, one or more
individual may fulfill two or more sets of responsibilities, but the same principles will apply.

2. FUNCTIONS OF THE COMMITTEES

a. Formulate a policy formalizing the commitment of the health care institution to proper
management of its waste with the goal of protecting health and the environment.
b. Establish baseline data and develop the facility’s health care waste management plan that
should include a minimization plan, training and written guidelines on waste management.
c. Implement the health care management plan; review and update the policy, plans, and
guidelines in annual basis.
d. Ensure adequate financial and human resources for the implementation of the health care
waste management plan.

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3. DUTIES AND RESPONSIBILITIES OF THE COMMITTEE MEMBERS
a. Chief/Director of Health Care Facility
 Form a waste management committee to develop a written waste management
plan for the health care facility.
 Designate a Waste Management Officer/Pollution control Officer to supervise and
coordinate the waste management plan.
 Keep an up to date management plan.
 Allocate sufficient financial and personnel resources to ensure efficient operation
of the plan. For example, The WMO should be complimented with sufficient staff
to ensure efficient implementations of the waste management plan.
 Ensure that monitoring procedure is incorporated in the plan. The efficiency and
effectiveness of the disposal system should be monitored so that the system can
be updated and improved when necessary.
 Appoint immediately a successor in the event of personnel leaving key positions in
the waste management committee or temporarily assign responsibility to another
staff member until a successor can formally appointed.
 Ensure adequate training for key staff members and designate the staff responsible
for coordinating and implementing training courses.
 Attend to complaints and legal matters regarding existing and unforeseen
problems arising from the implementation of the program.
 Establish good working relationship with other related agencies by proper referral,
consultation and cooperation concerning health care waste management.

4. Waste Management Officer

The WMO is responsible for day to day operation and monitoring of the waste management
system. It is therefore essential that he/she has direct access to all members of the health care
management committee. The WMO is directly responsible to the Chief of Hospital. He/she
should liaise with the Infection Control Officer, the Chief Pharmacist, and the Radiation Officer
in order to become familiar with the correct procedures for handling and disposing of
pathological, pharmaceutical, chemical and radioactive waste. The responsibilities of WMO
includes among others:
 The internal collection of waste and their transport, ensure availability of waste
bags, protective clothing and collection carts, and directly supervise collection
crews;
 Correct use of central storage facility, which should be kept locked but is accessible
to authorized staff at all times;
 Coordinate and monitor waste disposal operations, waste transport for both on -
site and off-site;
 For training, liaise with the Senior Nursing Officer and department heads
to ensure that nursing staff and medical assistants as well as doctors and other

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 qualified clinical staff are aware of their responsibilities for segregation and storage
of waste and;
 Ensure that written emergency procedures are available and that personnel are
aware of the action to be taken in the event of an emergency. Investigate and
review reported incidents concerning the handling of health care waste.

5. Department Heads
Department’s Heads are responsible for the segregation, storage, and disposal of waste
generated in their department. Among their responsibilities are:

 Ensures that all doctors, nurses, and clinical and non-clinical professional staff in
their departments are aware of the segregation and storage procedures and that all
personnel comply with the highest standards;
 Liaise with the WMO to monitor working practices for failure or mistakes;
 Ensure that key staff members in their departments are given training in waste
segregation and disposal procedures; and
 Encourage medical and nursing staff to be vigilant so as to ensure that hospital
attendants and ancillary staff follow correct procedures at all times.

6. Senior Nursing Officer

Responsible for the training of nursing staff, medical assistants, hospital attendants, and
ancillary staff in the correct procedures for segregation, storage, transport, and disposal of
waste. They should therefore:

 Liaise with the WMO and the advisers (Infection Control Officer, Chief of Pharmacist
and Radiation Officer) to maintain the highest standards;
 Participate in staff introduction, and continues training in, the handling and
disposal of waste; and
 Liaise with the Department Heads to ensure coordination of training activities, other
waste management issues specific to particular departments.

7. Infection Control Officer

The infection control Officer should liaise with the WMO on a continued basis and provide
advice concerning the control of infection and the standards of the waste disposal system. His
/her duties are:
 Identify training requirements according to staff grade and occupation;
 Organize and supervise staff training courses on safe waste management;
 Liaise with the Department Heads, senior Nursing Officer to coordinate training.

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 The Infection Control Officer also has the overall responsibility for chemical disinfection, sound
management of chemical stores, and chemical waste minimization.

8. Chief Pharmacist
The Chief Pharmacist is responsible for the sound management of pharmaceutical stores and for
pharmaceuticals waste minimization .His/her duties are:

 Liaise with the Department Heads, the WMO, the Senior Nursing officer and give advice,
in accordance with the national policy and guidelines, on the appropriate procedures for
pharmaceutical waste disposal;
 Coordinate continues monitoring of procedures for the disposal of pharmaceutical waste;
 Ensure that personnel involved in pharmaceutical waste handling and disposal receive
adequate training; and
 Has the special responsibility of ensuring the safe utilization of genotoxic products and the
safe management of genotoxic waste.

9. Radiation Officer
The duties and responsibilities of the radiation officer are the same as those of the
pharmaceutical officer but related to radioactive waste.

10. Supply Officer

The supply officer should liaise with the WMO to ensure a continuous supply of the items
required for waste management (plastic bags and containers of the right quality, spare parts for
on-site health care waste treatment equipment).These items should be ordered in reasonable
time to ensure that they are always available, but accumulation of excessive storage should be
avoided. The supply officer should also investigate the possibility of purchasing environmentally
friendly products.

11. Maintenance Aide

The maintenance aide of the facility is responsible in installing and maintaining waste storage
facilities and handling equipment that comply with the specifications of the national guidelines.
He is also accountable for the adequate operation and maintenance of any on-site waste
treatment equipment and is responsible for the staff involved in waste treatment, ensuring that
(a) Staff should receive training in the principles of waste disposal and are aware of their
responsibilities under the health care waste management plan and (b) Staff operating the on-
site waste treatment facilities are trained in their operation and maintenance.

12. Health Educator/Information Officer

The health educator and Information officer are responsible in organizing training and health
education activities for all staff in the correct procedure for segregation, storage, collection,
transport and disposal of health care waste.

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C. POLICY ON MEDICAL WASTE MANAGEMENT

1. INTRODUCTION
This policy describes a program designed to accomplish the safe management of hazardous
materials including infectious wastes, chemical wastes, pathologic al wastes, genotoxic waste of
the hospital. This program, in conjunction with the safety and fire protection policy, addresses
the health and safety concerns of patients, personnel, visitors, and the community.

2. POLICY DESCRIPTION
It is the policy of AOFMH to comply with laws that regulate hospital waste such as the Hospital
Licensure Law ( Republic Act 4226) and the Toxic Substances and Hazardous and Nuclear Waste
Control Act of 1990( Republic Act No. 6969 ) insuring that wastes are properly classified, stored
and disposed of accordingly.

3. REGULATIONS
a. To maintain and enforce a program which will monitor and control entry, use, storage, and
disposal of all hazardous materials.
b. To protect all hospital patients, personnel, and visitors as its first priority.
c. To protect property and environment and will ensure compliance to all statutory rules and
regulations.
d. To choose the least hazardous material possible in any procedure and to minimize the
volume of hazardous materials used.

4. OBJECTIVES:
a. To protect the AOFMH employees, personnel, patients, and visitors.
b. To protect the community and the environment from harm due to exposure to different
waste materials.
c. The hazardous waste policy will be in compliance with all local laws.
d. To the extent possible, the hazardous waste policy will minimize the generation of
hazardous waste and the cost of waste disposal.

5. RIGHTS AND RESPONSIBILITIES

a. Employees have the responsibility to follow, the hazardous material policy.
b. Employees have the responsibility to report any unsafe condition or use of hazardous
materials to their supervisor
c. Employees have the responsibility to promptly report accidents and spills that result in
chemical exposure of AOFMH patients or personnel.
d. All employees have the right to be informed about the potential hazards that they may be
exposed.

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6. TABLE FOR WASTE CATEGORIES AND SOURCES, COMPOSITION AND PROPER WAY OF
DISPOSAL

CATEGORIES OF WASTE AND COMPOSITION PROPER WAY OF DISPOSAL

THEIR SOURCES
1.General Waste Domestic type of waste from -Container for WET
-all areas packing materials, non- WASTE”Nabubulok”
-Emergency room infectious bedding, waste
-Wards water from laundries, non- -Container for DRY WASTE”Di
-Other services( laboratory, infectious. Nabubulok”
dietary, pharmacy, CSR,
nursery, radiology)

2.Pathological Waste Tissues, organs, fetuses, blood -Organs, tissues, fetuses-=put

-Wards and body fluids, animal in a specimen bottle and mix
-Laboratory carcasses, tissues from with 10% formalin solution,
-OR Laboratories together with all then give to relatives if not for
-Endoscopy room related swabs and dressing. biopsy and let them sign
whoever receives the
specimen.

-Blood and body fluids= mix

with chemical disinfectant
then flush in the toilet and
pour chemical disinfectant
again.

-Swabs and dressing= disinfect

with 1% sodium hypochlorite
for 30 minutes and then
dispose to container for
infectious waste.

3.Infectious Waste Soiled surgical dressings, Disinfect with 1% sodium

-Out- patient services swabs, cultures, and stocks of hypochlorite for 30 minutes
-Wards infectious agents from and then dispose to container
-Nursery, laboratory/surgery, gowns, for infectious waste.
-Radiology gloves, towels, waste from
-Laboratory patient in isolation wards.
-O.R

4.Sharps Waste Includes needles, syringes, -Needles, scalpels, blades-are

-Emergency room scalpels, blades, broken placed in a punctured proof

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 -Wards glasses and any other items container and when it is ¾
-Laboratory, Nursery which could cut or puncture. full, cover it and ask IW to put
-O.R them in the MRA for chemical
disinfection.

-Plunger and barrels- placed

them in a container and when
it is ¾ full cover it and ask IW
to put them I MRA for
chemical disinfection then
recycling

5.Pressurized Container Included are those used for Baygon cans- put them in the
-Wards treatment instructions or container for pressurized can
-Radiology demonstrati0on purposes, in the MRA for proper
-Pharmacy those containing inert gases disposal.
and other containers which
may explode if incinerated or
punctured.

6.Pharmaceutical Waste Pharmaceutical products, Expired drugs (syrup and

-Wards drugs, and chemical which tablet) flush in the toilet.
-Pharmacy have returned from wards,
are out of date or
contaminated.

7. Genotoxic waste Included are those for chemo -Placed chemo waste in a box,
-Chemo room treatment seal and label it properly and
transport it in the MRA.
Segregation of waste after 6
months and for proper
disposal of each kind.

7. REMINDERS ON PROPER WASTE HANDLING, COLLECTION AND DISPOSAL

 SHARPS should all be collected together, regardless of whether or not they are
contaminated. Containers should be punctured proof and fitted with covers.
 Bags and containers for infectious waste should be properly labeled and marked
with the international infectious substance symbol.
 Highly infectious and other hazardous waste, whenever possible, be treated
immediately.
 Appropriate containers or bag holder should be placed in all locations where
particular categories of waste may be generated.

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  Staff should never attempt to correct errors of segregation by removing items from
a bag or container after disposal. If general and hazardous waste are accidentally
mixed, the mixture should be classified as hazardous waste.
 Cytotoxic waste should be stored separately from other waste in a designated
secured location.
 Nursing and other clinical staff should ensure that waste bags are tightly closed or
sealed when they are about three-quarters full. Bags should not be close by
stapling.

8. RECOMMENDATIONS THAT SHOULD BE FOLLOWED BY HEALTH CARE PERSONNEL

DIRECTLY INVOLVED IN WASTE HANDLING AND COLLECTION.

 Waste should be collected every shift (or as frequently as required) and

transported to the designated central storage site.
 No bags should be removed unless they are labeled with their point of production
(hospital ward or department) and contents.
 The bags or containers should be replaced immediately with new ones.
 A supply of collection bags or containers should be readily available at all locations
where waste is produced.
 All waste bag seals should be in place and intact at the end of transportation.
 Workers transporting the waste should be equipped with appropriate personal
protective equipment including heavy duty gloves, mask, and boots.

9. REQUIREMENTS FOR STORAGE FACILITIES

 The storage area should have an impermeable, hard standing floor with good
drainage; it should be easy to clean and disinfect.
 There should be water supply for cleaning purposes.
 The storage area should allow easy access for staff in charge of handling the
waste.
 It should be possible to lock the storage area to prevent access by unauthorized
persons.
 Easy access for waste collection vehicle is essential.
 The storage area should be inaccessible to animals, insects and birds.
 There should be good lighting and adequate ventilation.
 The storage area should not be situated in the proximity of fresh food stores or
food preparation areas.

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  A supply of cleaning equipment, protective clothing, and waste bags or containers
should be located conveniently close to the storage area.
 Floors, walls, and ceilings of the storage area must be kept clean, which at a
minimum should include daily cleaning of floors.
 Biodegradable general and hazardous waste should not be stored longer than 2
days to minimize microbial growth and odors.

10. PROPER MANAGEMENT OF TEMPORARY STORAGE AREAS PRIOR TO HAULING FOR DISPOSAL

 We have constructed a storage area within the hospital grounds designed to keep off
rodents and other scavenging animals before the city garbage collection trucks gather
them for transport.
 Aside from impermeability, the storage has hard standing floor with good drainage that
makes it easy to clean and disinfect.
 It is easily accessible for the staff charged with handling the waste. It is also easily
accessible to the garbage collecting trucks plying the route.
 It protects the waste from the sun, strong winds, even flooding. It is also kept that
prevents access by unauthorized persons.
 There should be water supply for cleaning purposes.
 The storage area allows easy access for staff in charge in handling waste.

11. DILUTION OF WASTE DISINFECTANT

Flores Memorial Medical Center adapts the policy on waste disinfectant dilution from St. Paul
Hospital waste management.

a. Dilution of ZONROX to WATER

 Stock: ZONROX 25% in 3785 ml
 1%= 151 ml of ZONROX: 3684 ml of WATER

b. Computation:
3684 ml of water = 921 ml of water
4
151 ml of ZONROX = 37.75 to 38 ml of ZONROX
4
 37.75 to 38 ml of ZONROX is diluted in every 921 ml of WATER.

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D. POLICIES AND PROCEDURES ON SAFE REUSE OF ITEMS

It is the policy of AOFMH to minimize the volume of costly waste disposal stream by recycling and re
using on some items.

1. RE USE
Medical and other equipment used in the hospital establishment may be reused provided that
it is designed for the purpose and will withstand the sterilization process. After use, these
should be collected separately from non-reusable items, carefully washed and may then be
sterilized.

a. Cautery pen for gas sterilization

PROCEDURE:
 Wash thoroughly the cautery pen with soap and water.
 Dry it with a clean cloth.
 Pack the cautery pen using steri pouch and seal it.
 Proper labeling of the item.
 Send to Manila for gas sterilization
b. Medicine Glass
PROCEDURE:
 Washed thoroughly with soap and water
 Dry with a clean cloth
 Pack the medicine glass using steri pouch and seal
 Proper labeling of item
 Autoclave for 1 hour
 Ready for use

c. Paper – all departments were informed that the back part of coupon bond can be reuse as
scrap paper.

2. RECYCLE
Collecting of waste and processing it into something new.
a. IVF bottles – are use as Closed Tube Thoracostomy bottle.
PROCEDURE:
 Use personal protective equipment
 Remove the rubber stopper of the IV fluid.
 Disinfect with 1 percent sodium hypochlorite for 30 minutes
 Wash the IV bottle with soap and water.
 Dry by turning the bottle upside down.
 Cover the opening with a piece of paper and secure it with a rubber band.
 Place steri tape

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  Proper labeling of the bottle.
 Autoclave for 1 hour

b. Medicine vials- are use as specimen bottles.

PROCEDURE:
 Use Personal Protective Equipment.
 Remove the rubber stopper of the medicine vial.
 Disinfect with 1 percent sodium hypochlorite for 30 minutes
 Soak the vials into the basin with water and soap until the medicine label softens so
that it will be much easier to remove.
 Wash the bottles thoroughly with running water.
 Dry by turning the bottles upside down.
 Cover the vial with the rubber stopper then wrap it with a piece of paper.
 Place steri tape.
 Place it all in a large container
 Proper labeling of the container
 Autoclave for 1 hour and ready for use

c. Carton- use as splint.

PROCEDURE:
 Cut the carton according to desirable size for newborn, pedia and adult.
 Cover it with used clean paper.
 Secure it with a tape.

 There is a designated area for storage of materials for reuse and recycling.

E. PROPER PROTECTIVE EQUIPMENT

1. POLICY
It is the policy of AOFMH to protect the health care workers from infectious diseases by
providing Personal Protective Equipment (PPE).

2. GENERAL PRINCIPLES WHEN USING PPE:

a. Perform hand hygiene before handling and putting PPE.
b. Immediately remove and replace broken pieces of PPE.
c. Remove PPE directly after completing the procedure to avoid contaminating other surfaces
and area.
d. Properly discard all single use PPE immediately after use.
e. Perform hand hygiene immediately after removing and discarding any item of PPE.

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 3. TYPES OF PPE USE:
a. Gowns
b. Gloves
c. Mask
d. Caps
e. Closed footwear(Boots)
f. Eyewear

4. WHEN TO USE PPE:

a. NURSES:
 During surgical procedures.
 During wound dressing.
 Insertion and removal of catheters, NGT, etc.
 Induction of enema
 When in contact with patient with infectious diseases.
 When assisting chemotherapy.

b. MED TECH:
 When withdrawing blood from patients.
 During processing of different laboratory test.
 When cleaning test tubes and machines.

c. INSTITUTIONAL WORKERS:
 When cleaning rooms.
 When disposing the different waste generated by the hospital.
 When washing soiled linens.
 When washing medical equipment and instruments.

5. SCENARIOS OF PPE USE:

SCENARIO HAND GLOVES GOWNS MEDICAL EYEWEAR

HYGIENE MASK
Always before and after patient
contact, and after contaminated 
environment.
If direct contact with blood and body
fluids, secretions, excretions,  
mucous membranes, non-intact
skin.
If there is a risk of splashes onto the
healthcare worker’s body.   
If there is a risk of splashes onto the
body and face.     

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6. PERSONAL PROTECTIVE EQUIPMENT

Eye protector

Coverall

Gloves
N 95 Mask

Non-absorbent Boots

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F. PROPER HANDLING AND DISPOSAL OF MERCURY SPILL

1. Contents of Mercury Spill kit

a. 4-5 zip lock bags
b. Trash bag (2-6 mm thick)
c. Rubber or latex gloves
d. Paper towel
e. Cardboard paper
f. Syringe without needle
g. Masking or duct tape
h. Flashlight
i. Marker for labeling trash bag and zip lock
j. Small sealable container for waste mercury ( film canister)

2. Things to do when there is mercury spill:

a. EVACUATE AREA
Remove everyone from the area that has been contaminated and shut the door. Turn off
interior ventilation system to avoid dispersing mercury vapor throughout the facility.

b. PUT ON FACE MASK

In order to prevent breathing of mercury vapor wear a protective face mask.

c. PUT ON OLD CLOTHES

Change into old clothes and shoes that can be discarded if they become contaminated.

d. REMOVE JEWELRY
Remove all jewelry from hands and wrists so that the mercury cannot combine (amalgate )
with the precious metals.

e. WEAR GLOVES
Put on rubber or latex gloves. If there are any broken pieces of glass or sharp objects, pick
them up with care. Place all broken objects on a paper towel. Fold the paper towel and
place in a zip lock bag. Secure the bag and label it as containing items contaminated with
mercury. When labeling bags, do so as directed by your local health or fire department to
prevent confusion about contents.

f. INDENTIFY SURFACE
Wood, linoleum, tile and any other like surfaces can easily be cleaned. Carpet, curtains,
upholstery or other such surfaces cannot. These items should be thrown away according to
the method outlined below. (Carpets: only the affected portion needs to be cut or
removed.)

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 g. LOCATE MERCURY BEADS
Locate all mercury beads, and then carefully use the cardboard to gather them together.
Use slow sweeping motions to prevent accidentally spreading the mercury. Small and hand
–to-see beads can be located with the flashlight. Hold it at a low angle close to the floor in a
darkened room and look for additional glistening beads of mercury that may be sticking to
the surface. Mercury can move a surprisingly long distance on hard and flat surfaces. Be
sure to carefully inspect the entire room.

h. USE EYEDROPPER AND STICKY TAPE

Use an eyedropper or syringe (without a needle) to draw up the mercury beads. Slowly and
carefully transfer the mercury into an unbreakable plastic container with an airtight lid (such
as a plastic film canister). Place the container in a zip lock bag. Label the bag as containing
items contaminated with mercury.

i. LEAK PROOF BAG

Place all materials used during the clean-up, including gloves, into a leak proof plastic bag or
container. Seal and label it.

j. FINAL DISPOSAL
Contact your local hospital manager responsible for toxic clean-up to ensure that all
mercury contaminated waste now secured in labeled bags will be disposed properly.

k. OUTSIDE VENTILATION
Keep the affected area ventilated to the outside (with windows open and ventilation
running) for at least 24 hours after your successful clean-up. If sickness occurs, seek medical
attention quickly.

G. GENERAL POLICY FOR PREVENTION OF NEEDLE STICK INJURIES

 To prevent/ avoid needle stick injuries to health care workers and personnel, the following must
be observed:
1. DO NOT RECAP NEEDLES
Nurses and Med Techs must not recap needles in giving injections and in withdrawing blood to
avoid accidental pricking and possible infection of HIV, HEP A and B.

2. DO NOT RE-USE NEEDLES

Re-use of needles is prohibited especially in withdrawing blood/specimen because it is already
contaminated to avoid cross- infection. Do not re-use syringe in giving medication thru injection.
Since the hospital uses disposable syringe, it is to be followed strictly to use the syringe one time
only then dispose.

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 3. DONOT BEND DISPOSABLE NEEDLES
In proper disposal and segregation of syringe, Health care Worker should not attempt to bend
the needle to avoid accident pricking.

4. AVOID HAND TO HAND PASSAGE OF SHARPS

Health care workers must avoid hand to hand passage of sharp instruments by using a dish/
basin. This practice must not only be observed during operations but at all times.

5. CARE IN HANDLING SHARP DEVICES

Proper protective equipment is necessary in handling sharp devices. Using of instruments,
rather than fingers, to grasp needles, retract tissue, and load/ unload needles and scalpels.

 PROPER DISPOSAL AND TREATMENT OF SHARPS WASTE

1. Use separate container for sharps waste. Container must be punctured proof and fitted
with covers. Containers must be difficult to open or break and it is properly labeled.
Sharps waste includes needles, razors, blades and iv cannula.
2. Sharps use can be burn using the needles burner if available or directly place in into the
punctured proof container after use,
3. Use clamp in separating the needle from the barrel to prevent accidental pricking. In
every area where the container of sharp is available, clamp is present.
4. If the container of sharp waste is ¾ full, it must be immediately replace by another
punctured proof container.
5. IW on duty is responsible for the collection. Proper PPE is observed.
6. IW on duty is responsible for the disinfecting of the sharps waste to garbage holding
area.
7. The waste is disinfected using Sodium Hydrochlorite. The proportion of the disinfectant
is 151 ml of Sodium Hydrochlorite: 3684 ml of water. In every container with sharps
waste, disinfectant is placed for 30 minutes. After the procedure, proper drainage of the
container is made. Seal and label properly the container as ‘sharps’.
8. Every Friday the sharps waste is collected by the Municipal City Collection System.

H. WASTE MANAGEMENT PLAN

1. GOAL: To keep and maintain the cleanliness of the hospital premises.

1.1 SPECIFIC OBJECTIVES: To promote proper waste segregation.

Plan/Activities:

a. Patients should be informed of the proper waste disposal.

 In every room there should be waste disposal policy posted.
 Upon admission NOD should instruct the patient regarding proper waste disposal

18
  There should be centralized waste box for “nabubulok”,“di-nabubulok” and infectious
waste.
b. NOD should follow strictly instruction for proper waste segregation/disposal.
 Sharp waste – used needles, ampoules , butterflies, blades, scalpels, broken glass, and any
items that could cut and puncture.
 Infectious waste – used NGT, Foley catheter, IV catheters, endotracheal tube, soiled
surgical dressings, swabs, cultures, surgery gowns, gloves, towels, and waste from patient
in isolation wards.
 Nabubulok-fruits, vegetables, peelings, flowers, leaves, papers, cartons, boxes, newspapers
and left over foods.
 Di- nabubulok – bottles, styropor, plastic, candy wrappers

c. Institutional Worker (IW) on duty is responsible for the collection and proper disposal of
nabubulok , di-nabubulok , sharp and infectious waste.

d. Supervisor will monitor / supervises the strict implementation of the above guidelines.

1.2 SPECIFIC OBJECTIVES: To device a systematic and more effective ways of collecting waste
materials.

Plan/ Activities:

a. Institutional Worker (IW) on duty is responsible for daily collection of different waste materials
from every room and offices.

A.M. Shift (7am to 7 pm)

P.M. Shift (7pm to 7 am)

b. Waste should be collected on room to room basis and brought to the designated collection.
Storage/ transfer station for general waste existing within the hospital and accessible for
municipal collection service.

 Pathological and infectious waste collection shall be made by using a separate air tight
plastic/container with inner plastic bag lining and must not mixed either with any other type
of hospital waste and should be properly treated before disposal.
 Sharp waste should be collected using a puncture proof container and should be treated
and packed in a plastic bag properly labeled as “sharps” prior to disposal.

19
1.3 SPECIFIC OBJECTIVES: To avoid health hazards in the community

PLAN/ ACTIVITIES:

a. The transport of hospital waste such as pathological / infectious/sharps and other categories
of hospital waste thru the community should be carried out in such a way that it cannot harm
the public. Disposal is made with the use of Landfill.

2. WASTE MANAGEMENT PLAN

a. Project plan on Health Care Waste Management during the training seminar at Tuguegarao,
Cagayan on September 2009.

NAME OF HOSPITAL: DR. ADOLFO O. FLORES MEMORIAL HOSPITAL

LOCATION: #16 ABAUAG ST. VILLASIS SANTIAGO CITY
DATE PREPARED: SEPTEMBER 30, 2009

PROGRAM/ TARGET/ TIME FRAME BUDGETARY PERSON RESPONSIBLE

PROJECT ACTIVITY INDICATOR REQUIREMENT
 RE- OCT.26, 2009 1 HOUR MERIENDA C/0 JOSIE JUSTO
ECHOING/ ADMIN
LECTURE
JAN. 14, 2010 1 HOUR MERIENDA C/0 JOSIE JUSTO/
ADMIN EVANGELINE ALVAREZ

JAN. 18, 2010 1 HOUR MERIENDA C/0 JOSIE JUSTO/

ADMIN EVANGELINE ALVAREZ

 RE - FEB. 19, 2010 1 HOUR MERIENDA C/0 JOSIE JUSTO

ORIENTATIO ADMIN
N OF THE
POINT 1 HOUR MERIENDA C/0 JOSIE JUSTO
PERSON OF ADMIN
HCWM
COMMITTEE

a. ACTUAL FMMC WASTE MANAGEMENT PLAN

FREQUENCY
TYPE OF WASTE TYPE OF OF TREATMENT HOLDING COLLECTION DISPOSAL
STORAGE COLLECTION AREA
1. GENERAL WASTE Labeled 1x a day or as None Garbage INSTITUTIONAL Municipal
container needed shed/ WORKER City
for “nabu- compost Collection
bulok” fit system
and
“di- Recycling/
nabubulok Selling

20
2. SHARPS Punctured Disinfect for Materials INSTITUTIONAL Municipal
proof When 30 min. recovery WORKER City
container is ¾ using 1% area Collection
full hypochlorite

3. INFECTIOUS Labeled 2x a day or as Disinfect for Garbage INSTITUTIONAL Municipal

WASTE container need arise 30 minutes shed WORKER City
Collection

4. PATHOLOGI-CAL Labeled Every Friday Soaked with OR INSTITUTIONAL Burying

WASTE container of the week formalin washing WORKER
w/ area
formalin
(placenta)
Every after Soaked with Nurse
Container operation formalin Give to Burying
properly family
labeled members
(body
parts)
5. CHEMICAL Labeled 1x a week or none Materials INSTITUTIONAL Municipal
WASTE(busted container as needed recovery WORKER/ City
bulbs, used area WMO Collection
batteries, empty
cans, empty cans
of glue, empty
bottles of
disinfectant
empty bottles of
alcohol)
6. PHARMACEUTICAL Labeled Once a month none WMO Disposal by
WASTE container supplier/
septic tank
7. PRESSURIZED Labeled Once a week none Materials INSTITUTIONAL Municipal
CONTAINER container recovery WORKER City
area Collection
system

8. GENOTOXIC Labeled Every after Stored for 6 Materials NURSE/ IW/ Segregation
WASTE container chemotherapy months at recovery WMO after 6
materials area months and
recovery collected by
area, Municipal
properly City
labeled and
sealed

21
I. FLOWCHARTS
NON-INFECTIOUS WET WASTE

“NABUBULOK”

(Fruits, vegetables peelings, left over foods)

START

Put your waste on the labeled

container for “Nabubulok”

Collecting of waste by IW

Transporting of waste by IW to
Garbage Collecting Shed

Place the waste in the large

container for” Nabubulok”

Pack the plastic bag when it’s

three fourths full

Properly label the plastic bag as

“Nabubulok”

Collecting of waste by Municipal

Collection System/Composting

END

22
 NON- INFECTIOUS WASTE

DI-NABUBULOK (Dry waste)

(Cans, bottles, styropor, plastic, candy wrappers,)

START

Put your DRY waste on the

labeled Dry Garbage
Container

Collecting of waste by IW

Transporting of waste by IW to Garbage

Holding Area

Sorting of waste by IW according to each

kind

Y Is the
N
waste
recyclable
Put them in the large
Place them in the
? container for dry waste
storage holding
area.(others for
hospital use, others for Collecting of waste by
selling) Municipal/City Collection
System

END
END
23
 INFECTIOUS WASTE
(Used NGT, Foley catheter, IV catheter, endotracheal tube, soiled surgical dressing, swabs, used gloves,
waste from patient in isolation wards)

START

Put your infectious waste on the

labeled INFECTIOUS garbage container

Collecting of waste by IW

Disinfecting of waste by IW with

sodium hypochlorite

Transporting of waste to Garbage

Collecting Shed and put them in the
container for Infectious waste

Pack , seal and properly label the

container as “Infectious Waste”

Collecting of waste by
Municipal/City Collection
System

END

24
FLOWCHART: DISPOSAL OF EXPIRED DRUGS

START

PHARMACY AIDE:
Monthly listing of medicines
and supplies near expiry. ( 6
month- 1 month)

Submit to INVENTORY CLERK

INVENTORY CLERK:
1. EXPIRED DRUGS FROM
Pharmacy
2. Prepare listing for each
supplier
3. Seek approval for disposal
of expired drugs before
returning to the supplier.

1. When supplier collects

payments, return the
expired drugs.
2. Unreturned expired drugs
must be returned over to
“WASTE MANAGEMENT
OFFICER” for proper
disposal.

END

25
 SHARPS
(Needles and blades, ampoules, butterflies, scalpels, )

START

Put your sharps waste on the labeled

SHARPS garbage container

Burn needles using needle burner

by NOD/MIDWIVES/MEDTECHS

Put burned needles in puncture proof

container

Collecting of waste by IW to Materials

Recovery Area

Disinfecting of waste by IW for 30 minutes

using Sodium Hypochlorite

Drain, seal and label the container as

“SHARPS”

Collecting of waste by Municipal /City

Collection System

END

26
PHARMACEUTICAL WASTE
(Drugs that are expired)

Expired medicines:
 Tablets
 syrup

FLUSH IN THE TOILET followed

by disinfectant

WASTE TO THE SEPTIC TANK

END

27
 PATHOLOGICAL WASTE

START

Put your Pathological waste on the labeled

container

Mix with formalin by NOD /

Midwives

Y Is the waste N
for biopsy?

Send to laboratory
Is the
pathological
STOP waste placenta?
Place the placenta on the
container with formalin
Place the body part on
the container with
formalin

Burying of placenta

Give to family for

burying
END

STOP

28
 GENOTOXIC WASTE
(All materials and supplies used for chemo treatment)

START

Throw all chemotherapy waste

into the trashcan

Place chemotherapy waste into

the box after the procedure
properly labeled and sealed

Transport box into the Materials

Recovery Area

Segregation of waste after

6 months

Proper disposal of each

kind

Collection of waste by
Municipal City Collection
System

END

29
AEROSOL AND PRESSURIZED CONTAINER

START

Place the aerosol and pressurized

container on the labeled container

Collecting of waste by IW

Transporting of waste by IW to Material

Recovery area and put them in the container
for pressurized waste

Pack the container when it’s

three fourths full and label
properly.

Transporting of waste by IW to
garbage collecting shed

Collecting of waste by
Municipal/ City Collection
System

END

30
 CHEMICAL WASTE
(Busted bulbs, used batteries, empty cans of glue, empty bottles of disinfectants, empty bottles of
alcohol)

START

Put the waste on the labeled container at

the Waste Recovery Area by IW/Hospital
Maintenance Aide

Pack the container when

Three fourths full,
seal and properly label

Transporting of waste by IW to Garbage

Collecting Shed

Collecting of waste by Municipal

Collecting System

END

31
RADIOLOGICAL WASTE
(Fixer, Developer)

START

Waste is collected on a
designated container for
water, fixer and developer

Open the hose then drain

the waste in to the
drainage

END

32
FLOWCHART – WHAT TO DO IN CASE OF NEEDLE PRICK INJURIES

START

ACCIDENTAL PRICKING OF
NEEDLE

ENCOURAGE BLEEDING

WASH WITH SOAP UNDER

RUNNING WATER

PAINT WITH BETADINE AND

APPLY PRESSURE DRESSING

REFER TO HOUSE
PHYSICIAN FOR FURTHER
EVALUATION AND
MANAGEMENT

END

33