CHAPTER 1:

INTRODUCTION THE RESEARCH

1.1: Introduction to the chapter

A dissertation is an extended piece of writing of between ten and twenty thousand words on a topic set
by a department or one chosen by the student him or herself. It is usually divided into chapters and may
contain headings and sub-headings, and these are sometimes (though not always) numbered as in a
report. Dissertations answer a particular research question and can either report on an empirical study
or on a literature-based study.

This dissertation is important because it is the method of demonstrating that I can identify a topic of
concern to field, and read, understand, and incorporate the relevant literature into a new research
question to be investigated. Dissertation is important because it usually involves the student in a lot of
research work, and this enhances his/her research skills which makes them better at researching.

1.2: Background

Biomedical waste (BMW) is any waste produced during the diagnosis, treatment, or immunization of
human or animal research activities pertaining thereto or in the production or testing of biological or in
health camps. Globally biomedical waste has risen to the level of a major public health concern. When it
comes to disposing of medical waste, many hospitals have become chaotic, ineffective, and arbitrary. As
a result of the project, health care professionals and other healthcare workers have been inspired to
adopt acceptable biological waste management procedures into their everyday operations and
activities.

Video-assisted learning is the process of acquiring ultimate knowledge, skills, and abilities with the
intelligent use of audio-visual aids as teaching aids or is also defined as a strategic teaching approach to
the use of videos, both didactic and conceptual, for improve a student's understanding, cognitive skills,
or socio-emotional skills (Anon., 2021). Using videos in nursing classrooms provides a simple, innovative,
and intuitive way to engage today's nursing students. Video presentations can be easily adapted to
nursing courses at any level, whether it is a foundation course for undergraduates or a theoretical
foundation course for graduate students. Nursing students are the professional nurses of the future who
can contribute more in the field of treatment, educate and create awareness for these students, help
them learn more about proper disposal of biomedical waste management, will produce positive results
in future health and quality indicators of care. As the famous saying goes, right practice is the safest
investment in risk-free care and right practice comes from right education.

Due to environmental disturbances, several types of new diseases are now prevalent. Hospital waste
refers specifically to tools used to clean human organs, infections, fungal, bacterial, and viral infections,
and blood vessels. Therefore, we must address these disasters in an appropriate and controlled way. If
not properly disposed of, many diseases caused by fungi and bacteria can develop, affecting human
health and the environment.

These infections are not only harmful to humans but also flora and fauna. Inadequate biomedical waste
management will cause environmental pollution, unpleasant smell, growth, and multiplication of vectors
like insects, rodents and worms and may lead to the transmission of diseases like typhoid, cholera,
hepatitis, and AIDS through injuries from syringe and needles- contaminated with human.

Hypodermic needles, scalpels, blades, surgical cotton, gloves, bandages, clothing, abandoned
medications and bodily fluids, human tissues and organs, chemicals, etc. are only a few of the wastes
produced during the course of providing healthcare. The most environmentally hazardous healthcare by
products require extra attention and must be closely managed, including radioactive wastes, mercury-
containing devices, PVC plastics, and others ( Remy, 2001). Compared to other types of trash, waste
generated during medical procedures has a higher risk of infection and harm. Lack of information about
how to properly handle medical waste can have negative effects on one's health as well as the
environment.

The most serious issues with healthcare waste include the lack of effective waste management, a lack of
knowledge about the health risks posed by biological wastes, a lack of sufficient financial and human
resources, and poor waste disposal regulation. If effective and appropriate handling of these wastes is
not adopted, the hazardous impact of medical waste on the general people and the environment is
multiplied. Hospital waste management has a wide range of effects on patients' health as well as those
of healthcare professionals (doctors, nurses, sanitary staff, etc.) and the general public. 2011 (Mathur).

In a daily basis, biomedical waste, which contains both dangerous and attractive compounds, is
generated. It is essential that health care providers are aware of the threats posed by biological waste in
the workplace. According to estimates, between 10 percent and 25 percent of the total amount of
healthcare waste generated is at risk of being contaminated by waste processing, segregation,
treatment, and annihilation processes. Biomedical waste formed during human services exercises must
be disposed of in accordance with a policy that is both safe and dependable, as they pose a larger
danger of contamination or damage than other forms of rubbish. Poor handling practices pose a
substantial threat to the general public's health and safety, as well as having negative repercussions for
the environment.

Nurses who are accountable for providing crucial healthcare services to the sick and afflicted lack this
knowledge by and large. Health concerns from biomedical waste can be prevented if enough
information is given concerning the proper management and disposal of biomedical waste, as well as
necessary safety procedures. Knowledge, attitude, and practice (KAP) among healthcare workers
(HCWs) are used to evaluate an institution's board framework.

Biomedical waste management is a critical component of health care. To prevent the transmission of
infectious illnesses including HIV, hepatitis B, and more, all health care establishments should rigorously
follow to the Biomedical waste management regulations. Because they are the backbone of the
healthcare system, nurses must be well-versed in its intricacies. Biomedical waste management and
treatment will be required knowledge for students to execute clinical activities during their study time.
As a result, the researcher intends to investigate the matter (Lybarger,2019).
Biomedical waste management is a very important preventive measure against human health and
environmental problems. Biomedical waste disposal and treatment go hand in hand with medical
care, as protecting plants and animals from waste is an important social duty. National health
insurance and the World Health Organization (WHO) evaluate the disposal of clinical waste in
hospitals and laboratories to assess hospital quality. (V.G.,2018).

According to estimates, between 10 percent and 25 percent of the total amount of healthcare waste
generated is at risk of being contaminated by waste processing, segregation, treatment, and
annihilation processes. BMWs formed during human services exercises must be disposed of in
accordance with a policy that is both safe and dependable, as they pose a larger danger of
contamination or damage than other forms of rubbish. Poor handling practices pose a substantial
threat to the general public's health and safety, as well as having negative repercussions for the
environment. It is expected that hospital waste creation in U k will increase by 8-10 percent
annually, or 0.33 million metric tons per year, depending on the number of beds in the facility,
according to the World Health Organization (WHO) ( Rodenbeck, 2019). Educating the nation's
health-care workforce is critical, and hospitals play a critical role in this effort (Sharma, 2020).
Because of a lack of information, hospitals have become more like breeding grounds for disease
rather than locations where disease can be confined. Medical facilities should be compelled to train
and prepare their staff from qualified training centres to increase general knowledge and practice, as
identified by BMW executives. In order to strengthen training centres, continuous and consistent
training should be provided at the centres rather than as one-time events ( Rodenbeck, 2019). One
step forward can be achieved by employing advanced approaches such as the stringent adherence of
bio-clinical waste administration criteria, which are becoming increasingly popular. The sanitation
personnel who handle medical waste must be given special attention, and any medical staff errors
should be notified to the individual or committee in responsibility of biological waste management.
There are a lot of concerns that can be overcome if the BMW administration is executed
successfully. Biological waste management involves a wide range of tasks, ranging from collection
and storage through transport and disposal of biological waste. If these wastes are not properly
disposed of, diseases such as AIDS, hepatitis B and C, tuberculosis (TB), and other hazardous and
destructive illnesses could spread, endangering hospital staff, waste handlers, patients, and their
families, as well as any adjacent communities where the wastes are disposed of in a negligent
manner, according to the CDC (Tiwari, 2018).

The amount of medical waste generated globally must be properly treated and handled to be
disposed of in a way that is not harmful to the environment or human health. As the healthcare
industry has grown more complex, it has become increasingly vital for facility managers to seek out
new approaches that are both scientifically safe and cost-effective, as well as to keep their personnel
up to date on the latest discoveries. Those who generate medical waste and those who dispose of it
must all undergo extensive training before they are authorized to work in this field, and this training
is required for everyone involved. When it comes to guaranteeing high-quality patient care in
healthcare facilities, a comprehensive waste management system and personnel education and
awareness of trash disposal cannot be understated (MATHUR, 2012).

The safe disposal of biomedical waste (BMW) can only be achieved with adequate information on
health problems, a correct attitude towards the management of BMW and the correct application of
safety procedures. (WHO, 2006). It is difficult for hospitals to manage bio medical waste due to lack
of awareness (Lichtveld, 2019). Nosocomial infections are responsible for one of the most serious
diseases in ten, which have been linked to poor management of medical waste.
To prevent the transmission of infection from the inappropriate disposal of biomedical waste proper
training to the nurses or the people dealing with the waste must be given training with the help of
video assisted teaching programme that can be easily understood by the nurses or the people who
are responsible for handling biomedical wastes.

1.3. AIMS, OBJECTIVES, AND RESEARCH QUESTIONS

Aims

The main aim of the research is to find out the effectiveness of video assisted teaching programme
among nurses in clinical waste management.

Objectives

An evaluation of the effectiveness of a video training program on the management of biomedical

waste with nurses.

RESEARCH QUESTION

By using the PICO framework, the focused research requestion was formulated.

1. What is the effectiveness of video assisted teaching programme on biomedical waste

management among Nurses?

1.4 Rationale

Biomedical waste management is crucial for infection control and educating the public about
hazardous waste that poses a serious risk to human life. It's significant to me because I believe—or
have come to realize—that biomedical waste is the kind of trash that is more dangerous and more
likely to spread quickly. Different dangers that are released from hospitals, clinics, and laboratories
contain various infections and can occasionally lead to diseases that are incurable. During my
undergraduate studies at college, I was assigned to the general ward where a variety of patients
with various conditions were hospitalised. It was unacceptable in any medical field, especially when
you are dealing with various disease conditions within the ward, when I observed the way in which
waste was being disposed of in the ward, which was not actually done in a proper manner. I also
realised that different nurses have their own way of disposing waste even though there are different
colour code bins in the station. Even after asking them questions about it, I realised that there is a
definite need for nurses as well as all other staff members working in hospitals, clinics, and labs to
have proper training on biomedical waste management. After a few quick queries, I too concluded
that the medical profession needs more than simply a theoretical education to comprehend a
scenario or know what is going on. For all nurses to fully comprehend the disposal, a video-assisted
instruction programme is important or required, and appropriate demonstration is needed.

Bio medical waste management is necessary because biomedical waste can negatively affect health
and have major repercussions for those who encounter it, managing this trash has a tremendous
impact. Effective management of biological waste in a workplace depends greatly on the
segregation, storage, and safe disposal of the waste. Improved biomedical waste management
mostly depends on waste segregation. The amount of infectious trash must be reduced immediately;
else, management won't be able to regulate the amount of garbage.

Poor waste management at healthcare facilities directly endangers the health of the public,
healthcare professionals, and the environment. The management of biological waste must reduce
the chance that waste handlers, scavengers, and people who live close to hospitals will become
contaminated outside of the hospital. Additionally, management is necessary because of the
potential for soil, water, and air contamination as well as because of improper incineration
emissions and ash. It is essential for getting rid of leftover medications so they can be repackaged
and sold.

A video-assisted programme would aid the nurses in updating their understanding of the causes,
prevention, and management of biomedical waste as well as in changing their attitudes toward that
management. The effectiveness of the video assisted education programme may be explained by a
significant improvement in post-test knowledge and attitude scores compared to protest knowledge
and attitude scores. To ensure correct care, assistance, and prompt management of biomedical
waste in order to prevent complications, nurses should be encouraged to increase their knowledge
in this area.

Today's nursing students can be more easily engaged through the use of video in nursing education
classes thanks to its simplicity, innovation, and user-friendliness. Whether it's a foundations course
for undergraduate students or a theoretical foundations course for graduate students, video
presentations can be simply incorporated into nursing courses at any level. More nursing students
than ever before enrol in nursing programmes with a working grasp of the latest media outlets and
communication technology. Nurse educators are required to embrace innovative communication
tools to improve the learning environment today. Nursing education must include clinical practise
because it connects theory and practise. One area of clinical practise that involves precision and
competence that becomes better with time is biomedical waste management. Future health
indicators and the standard of care will improve as a result of teaching these students about
obstetrical palpation, raising their awareness, and helping them become the professionals who can
contribute more to the field of treatment. The adage holds that the safest investment in hazard-free
care is proper practise, and right practise results from correct education.

For the sake of the environment and the general welfare of the population, waste production should
be reduced. People need to be made aware of the problems related to biomedical waste and
encouraged to participate in programmes designed to reduce waste. The medical staff needs to be
trained to increase awareness and encourage accountability for preventing exposure and improper
waste disposal. Medical professionals must adhere strictly to all guidelines established by relevant
governing authorities.

BMWM should be a collaborative effort with committed government support, honourable BMW
practises monitored by healthcare professionals and HCFs, ongoing monitoring of BMW practises,
and tough legislative support. Our fundamental right to live in a sanitary and secure environment.
Separation of waste at source and WR is the foundation of BMWM. In terms of improved
segregation, transportation, and disposal techniques, the current BMWM 2016 guidelines are an
improvement over previous regulations in order to lessen environmental pollution and ensure the
safety of the staff, patients, and general public. Additionally, it is encouraging to see the
development of newer, more inventive, eco-friendly techniques for disposing of BMW and the
increased usage of non-PVC medical equipment. All BMWM donors should make a commitment to
ensuring a cleaner and greener environment.

A major task that is vital to the preservation of resources, the sustainability of the ecosystem, and
global cleanliness is scheduling the waste management and reconditioning for all of the trash
produced in healthcare institutions. Recycling medical waste reduces the amount of raw materials
used and cuts down on the amount of garbage that needs to be dumped in a landfill. It lessens the
risks and threats to the communities that hospitals may pose. Accurate waste management results
in a decrease in the prevalence of HIV/AIDS, sepsis, hepatitis, and other diseases spread by infected
medical equipment. The illegal trade in used syringes, injection needles, and medical equipment can
also be halted with the application of effective management strategies. Attentiveness about perils of
biomedical waste and its appropriate disposal is compulsory for a nontoxic and vigorous future.

Summary:

Treatment of biomedical waste is the process used to get rid of the waste's negative consequences.
Numerous treatment techniques are available to ensure the highest level of safety during waste
management and disposal. The chapter contains the detail information about the bio medical waste
and what could be the effects of improper disposal of bio medical waste. It gives the idea about the
proper disposing of waste and prevention. It also provides the knowledge about the proper disposal
of bio medical waste management which can be given by using video assisted teaching programme.
This chapter also focuses on the use of video assisted teaching about bio medical waste that can give
more knowledge and clear vision on the proper disposal of bio medical waste management with the
hospital, clinics, labs or any other field related to medical where there is segregation of different
medical waste containing different diseases.

CHAPTER :2 SYSTEMATIC REVIEW

2.1 Introduction

It is the summary of the best obtainable primary research on a clearly formulated question by
finding, appraising, and synthesizing various original articles in a systematic and explicit method
(Brooks and McNeely, 2013). It is the systematic collection, appraisal, reporting and where
necessary link credible evidence-based independent research together. When making informed
decisions, systematic review is the best choice for study design (Burls, 2016).
This Systematic Review will include studies that have used qualitative, quantitative, and mixed
methods.