Introduction
Health services are progressing every year by adding more health institutes including health servicesin Hajj season. These activities are followed by the generation of increasing amounts of waste. Medical wastes represent about one fifth of the total amount of waste produced during healthcare activities. Medical wastes involve hazardous, infectious, toxic or radioactive waste, which are considered risky to health workers. Management of healthcare waste includes segregation at site of production, collection, transportation, storage, treatment and final disposal. This study investigates the knowledge of health workers at Al Zaher and Ajyad hospitals of the medical waste management and factors influencing their knowledge during hajj season 1426 H.
Methodology
A descriptive cross-sectional study was conducted. A self-administered questionnaire was designed and distributed among health workers in Ajyad and Al Zaher hospitals inquiring basic demographic data, the types of medical waste and their management. The main parts of the questionnaire included medical waste segregation, storage, transport inside and outside the hospital, and final disposal, and whether participant health care worker had received previous training on healthcare waste (HCW) management during regular duty and Hajj duty. To assess the knowledge, a composite score based on 41 knowledge questions was developed and used for further analysis. The median of the composite, the 25% and 75% quartiles, score was used as cut off points to divide the workers into three categories: high knowledge group, intermediate group, and low knowledge group.
Results
The sample size was 421 healthcare workers. The study population included 292 (69.4%) from Al Zaher hospital, and 129 (30.6%) from Ajyad hospital. Among the total sample, 107 (25.5%) were physicians 195 (46.3%) nurses, 89 (21.1%) technicians, and 30 (7.1%) other workers. The largest percentage of workers in a single department were working the surgery department 88 (20.9%), and emergency room department 86 (20.4%), medicine department 68 (16.2%), and other different departments 179 (42.5%). There were 218 (51.8%) Saudis.
Defects in knowledge were clear in almost all aspects of HCW type and the various sequences of its management. Of the total study population, only 76 (18.1%) health workers had received previous training on management of medical waste, and only 30 (7.1%) had received training in medical waste management in Hajj.
The knowledge of the health workers according to the defined score in this study was: low knowledge group (206 healthcare workers, 48.9%), intermediate knowledge group (120 healthcare workers, 28.5%) and high knowledge group (95 healthcare workers, 22.6%). Statistically significant factors influencing knowledge were age, gender, nationality, and previous training. Knowledge increased with age, such that about 101 (49%) of the workers under 30 years were in the low knowledge group, decreasing in those 30-40 years of age 70 (34.0%). The largest proportion of intermediate knowledge workers were in the over 40 year age group 43 (35.8%), and the largest proportion of high knowledge workers were in the 30-40 year age group 46 (48.4%), and this showed borderline significance (p-value = 0.05). The proportion of high knowledge was higher among male health workers 59 (62.1%), while intermediate knowledge was higher among females 63 (52.5%), and low knowledge was higher among males 132 (64.1%), and this was statistically significant (p-value = 0.010).
The largest proportion of high knowledge workers were among non-Saudis 48 (50.5%), the largest proportion of intermediate knowledge was also among non-Saudis 70 (58.3%). Unfortunately, the largest proportion of low knowledge was among Saudis 121(58.7%), this was statistically significant (p-value = 0.011).
The proportions of high knowledge and intermediate knowledge health workers were among those who had received no previous training were 69 (72.6%) and 98 (81.7%), respectively. A high proportion of low knowledge was seen among those who had no previous training 178 (86.4%), and this was statistically significant (p-value = 0.015).
Conclusion
Our study showed that knowledge of health care workers of HCW management is still not sufficient. Health leaders should realize that the generation of healthcare risk waste is one of the most important priorities in the health services plan which must include providing comprehensive guidelines for effective management of HCW and related healthcare workers education. Increasing the knowledge of healthcare workers through teaching sessions, continuous training programs and workshops will certainly improve attitude and practice habits.