Lesson plan of

Demonstration on
Biomedical waste
Management

Submitted to- Mr. EKE Lama Tamang

Submitted by- Ms Sneha Sehrawat
Msc nursing Ist year
Rufaida College of Nursing

IDENTIFICATION DATA
NAME:

Ms. Sneha Sehrawat

CLASS:

MSc Nursing Ist Year

SUBJECT:

Advanced Nursing Practice

TOPIC:

Biomedical waste management (BMW)

GROUP:

MSc Nursing Isr year students

SIZE OF THE GROUP:

24

DURATION:

20 mins

PLACE:

MSc Nursing Ist Year classroom

METHOD OF TEACHING:

Demonstration

AV AIDS USED:

Cutouts and power point presentation.

DATE:

11..11.2016

TIME:

11-11:30 AM

LANGUAGE:

English

SUPERVISOR:

Mr. EKE Lama Tamang

PREVIOUS KNOWLEDGE:

Students have previous knowledge

regarding the topics in BSc Nursing programme.

GENERAL OBJECTIVE

After the class, students will be able to:

Acquire knowledge of topic- Bio medical waste management.
Vocalize their learning about the topic .
Explain various types of wastes.
Able to critically analyze the existing waste management in nursing education
practice.
Discuss advantages and disadvantages of Bio medical waste management.
Understand the use and assimilate this knowledge in future teaching practices.

Student teacher will be able to :1. Develop confidence in facing the group.
2. Develop confidence in teaching.
3. Develop skills in classroom management.
4. Develop in-depth knowledge about the Topic.

5. Develop skills in conduction of evaluation .

6. Develop skills in appropriate utilization of A.V. aids.
7. Develop skills in demonstration method of teaching.

Time

2
min

Specific
Objectives

Contents

Teaching Learning
Activities with A.V.aids

INTRODUCTION
All over the country,
unsegregated and
untreated biomedical
waste is being
indiscriminately discarded
into municipal bins, dump
sites, on roadsides, in
water bodies or is being
incompletely and
improperly burnt in the
open. All this is leading to
rapid proliferation and
spreading of infectious,
dangerous and fatal
communicable diseases
like hepatitis, AIDS and
several types of cancers. In
urban and rural areas alike,
incidence and prevalence
of several such human
diseases has increased and
the per capita medical
expenditure has also gone
high several folds.
Although, yet to be
proven, morbidity or
illness amongst both urban

Evaluation

and rural dwellers has

increased albeit for
different reasons.
.

1
min.

ANNOUNCEMENT OF
THE TOPIC: Today we
will be studying about bio
medical waste
management.
After the class
the group will
be able to:

2
min

To define bio
medical waste
management.

Bio-medical waste: Bio-Medical Waste

is any waste, which is generated during the
diagnosis, treatment or immunization of
human beings or animals. These wastes are
also generated during research activities or
in the production or testing of biological
material.
Redefining it scientifically, Biomedical
waste is defined as any solid, fluid or
liquid waste, including its container and any
intermediate product, which is generated
during its diagnosis, treatment or
immunization of human beings or animals,
in research pertaining thereto, or in the
production or testing of biological and the
animal wastes from slaughter houses or any
other like establishments.
Infectious wastes are those biomedical
wastes which contain sufficient population
of infectious agents that are capable of
causing and spreading infections among
people, livestock and vectors. Infectious
wastes include human tissues, anatomical
waste, organs, body parts, placenta, animal
waste (tissue / cell cultures), any
pathological / surgical waste, microbiology
and biotechnology waste (cultures, stocks,
specimens of micro-organism, live or
attenuated vaccines, etc.), cytological,
pathological wastes, solid waste (swabs,
bandages, mops, any item contaminated

Student teacher define bio

medical waste
management

with blood or body fluids), infected

syringes, needles, other sharps, glass,
rubber, metal, plastic disposables and other
such wastes.

2
min

To define
cytotoxic
substance.

CYTO TOXIC WASTE

Cytotoxic substances, as the word suggests
are toxic to cells and are often antineoplastic which inhibit cell growth and
multiplication. These drugs when come in
contact with normal cells can damage them
and cause severe disability or even death of
those affected. These drugs could be present
in the waste generated from the treatment of
cancer patients or from other work related to
testing and control of cancerous cells.

2
min

To define
infected plastic
waste.

INFECTED PLASTIC WASTE

1
min

To define
hospital
domestic
waste.

HOSPITAL DOMESTIC WASTE

Infected plastics are those biomedical

plastics which have been used for
administering patient care or for performing
related activities and may contain blood or
body fluids or are suspected to contain
infectious agents in sufficient number which
may lead to infections among other humans
or animals. These generally include IV
tubes / bottles, tubings, gloves, aprons,
blood bags / urine bags, disposable drains,
disposable plastic containers, endo-tracheal
tubes, microbiology and biotechnology
waste and other laboratory waste.

Most hospital waste is similar to household

waste and can be disposed of in the same
way. In addition to this, however, hospitals
generate certain special types of waste
which should not be handled by domestic
refuse collection services, because of the
risk of infection, because they are hazardous
in other ways, or for ethical reasons.

Define bio
medical
waste
managemen
t?
Student teacher defines
cyto toxic substance.

Define cyto
toxic
waste ?

Student teacher defines

infected plastic wastes.

Student teacher defines

hospital domestic waste.

Define
hospital

RADIOACTIVE WASTE
1
min

2
min

2
min

To define
radioactive
waste.

To define
handling and
disposal of
wastes.

To enlist
various sources
of bio medical
waste .

Radiations are used for wide variety

applications in research, industry,
medicine, manufacturing, agriculture,
consumer goods and services. The
common concern is that in all these
uses, care must be taken to ensure that
everyone is protected from the potential
hazards of radiation.

Student teacher defines

radioactive waste.

SHARPS HANDLING AND

DISPOSAL:

Student teacher defines

handling and disposal of
wastes.

Sharps consist of needles, syringes,

scalpels, blades, glass etc., which have
the capability to injure by piercing the
skin. As these sharps are used in patient
care, there is every chance that infection
can spread through this type of injury.
Nurses can get a sharp injury before and
after using a sharp on a patient. Further,
sharps discarded without any special
containment or segregation can injure
and transmit disease to those who
collect waste (including safai
karamcharis, municipal sweepers and
ragpickers). There have been reports that
waste collected from the hospitals are
resold, this creates an additional
occupational and community health
hazard.
Sources of Bio medical Waste
Hospitals produce waste, which is
increasing over the years in its amount and
type. The hospital waste, in addition to the
risk for patients and personnel who handle
them also poses a threat to public health and
environment.
Major Sources

Govt. hospitals/private
hospitals/nursing homes/
dispensaries.

domestic
waste?

Define
handling
and disposal
of wastes?

Student teacher enlists

various sources of bio
medical waste .

Enlist
various
sources of
bio medical
waste ?

Primary health centers.

Medical colleges and research

centers/ paramedic services.

Veterinary colleges and animal

research centers.

Blood banks/mortuaries/autopsy
centers.

Biotechnology institutions.

Production units.

Minor Sources

5
min

To define
Collection and
Treatment of
Bio-Medical
Waste

Physicians/ dentists clinics

Animal houses/slaughter houses.

Blood donation camps.

Vaccination centers.

Acupuncturists/psychiatric
clinics/cosmetic piercing.

Funeral services.

Institutions for disabled persons

Collection and Treatment of BioMedical Waste

Hospital waste should always be collected
in disposable containers which satisfy the
following requirements: they must be
moisture-resistant and non-transparent;
sellable in such a way as to prevent egress
of micro-organisms; safe to transport; and
colour-coded to distinguish them from
household refuse bags. The waste must be
collected in such containers at the point
where it is generated, and removed from the
wards daily without being sorted or
transferred to other containers. The
containers must be carefully sealed.
Generally, plastic bags are used for Type B
and C waste, and plastic buckets for Type D

Student teacher defines

Collection and Treatment
of Bio-Medical Waste

waste. The material these disposable

containers are made of must be appropriate
for the next treatment stage. If the waste is
subsequently incinerated, for example,
combustible materials with a low level of
toxicity must be used; if it is heatdisinfected the materials must be steampermeable. This requirement also applies,
incidentalIy, to all disposable items
purchased by hospitals.
The waste must be transported to a central
incineration plant outside the hospital in
specially designed vehicles which do not
compress it. The interior of the vehicle body
must be easy to clean and it must be
adequately ventilated.

1
min

1
min

To define
medical waste
incineration.

To explain
disposal of
plastic wastes.

MEDICAL WASTE INCINERATION Student teacher defines

medical waste
Acid gases include nitrogen oxide,
incineration.
which has been shown to cause acid rain
formation and affect the respiratory and
cardiovascular system. As large amounts
of plastic are incinerated hydrochloric
acid is produced. This acid attacks the
respiratory system, skin, eyes and lungs
with side effects such as coughing,
nausea and vomiting.

PLASCTICS IN HEALTHCARE
Disposal of PVC via incineration leads
to the formation of dioxin and furans.
Dioxin and furans are nwanted byproducts of incineration with
carcinogenic and endocrine-disrupting
properties. They are toxic at levels as
low as 0.006 picograms per Kg of body

Student teacher explains

disposal of plastic wastes.

Define
medical
waste
incineration
?

weight.

5
min

To explain
regarding
sharps handling
and disposal.

SHARPS HANDLING AND

DISPOSAL
-Make needle reuse impossible: Auto
disable syringes, like Solo Shot device,
cannot be used more than once and
therefore cannot carry infection from
one patient to another.
-Take the sharp out of sharps waste:
Needle removers de-fang syringes,
immediately removing the needles after
injection and isolating them in secure
containers. The syringe cannot be
reused, and theres no risk of accidental
needle sticks.
-Keep needles away from vulnerable
hands: Special stickproof containers
capture used needles and other medical
waste until they can be destroyed. PATH
is working to increase access to these
safety boxes, identifying low-cost
options and making them available for
all types of injections.
Using a needle cutter/destroyer:
1. Place used needle in the
cutter/destroyer.
2. Cut/destroy the needle and the nozzle
of syringe in the destroyer/cutter.
3. Separate syringes barrel and plunger
and put in liquid disinfectant.

Student teacher explains

regarding sharps handling
and disposal.

4. After every shift empty the contents

of needle container/destroyer into liquid
disinfectant, remove
through pouring out contents through a
sieve.

2
min

To explain
elaborate
radioactive
waste disposal.

RADIOACTIVE WASTE DISPOSAL

Facilities and procedures described in
the rules:

Student nurse explains

radioactive waste disposal.

(a) Collection: It is mandatory to

mention the facilities available e.g.
polythene lined waste bins for collection
of solid wastes, and corrosion resistant
cardboards or delay tanks for collection
of liquid wastes.
(b) Transfer: it is important to state the
type of container employed during
transfer of waste/sourcese.g. cardboards,
sturdy polythene bags, radio-graphy
camera
(d) Disposal: Identify the disposal
methods for solid, liquid and gaseous
wastes briefly such as for:
i). Solids: Burial pits, municipal
dumping site or waste management
agency e.g. BRIT etc.
ii). Liquids: Sanitary sewerage system,
soak-pit, waste management agency etc.
iii). Gaseous wastes: Incineration
facility, fume hood etc.

Explains
radioactive
waste
disposal?

1
min

To explain
mercury
disposal.

MERCURY HEALTH HAZARD:

When products containing mercury are
incinerated, the mercury becomes
airborne and eventually settles in water
bodies from, where via biomagnification in the food chain and
bioaccumulation, it reaches humans. If it
is flushed, it enters water bodies directly,
and if it is thrown in bins it could enter
the body of animals via skin or
inhalation, or permeate into the ground
causing soil and groundwater
poisoning. This metal accumulates in the
muscle tissues.

Student teacher explains

mercury disposal.

Summary
Today, we studied about
bio medical waste
management, its various
types, segregation,
transportation, disposal
and safe handling practices
related to bio medical
waste handling and
management.
Conclusion
Safe and effective
management of waste
is not only a legal
necessity but also a
social responsibility.
Proper collection and
segregation of
biomedical waste.
Try to reduce the
waste generation.
Individual awareness
and participation.

 Use recycle products.

REFERENCES
1. Mandal S. K. and Dutta J. ,
Integrated Bio-Medical Waste
Management Plan for Patna City,
Institute of Town Planners, India
Journal 6-2: 01-25 (2009).
2. Singh V. P., Biswas G., and Sharma,
J. J., Biomedical Waste
Management An Emerging
Concern in Indian Hospitals Indian,
Journal of Forensic Medicine &
Toxicology, Vol. 1, No. 1. (200712).

3. Hem Chandra, Hospital Waste an

Environmental Hazard and Its
Management, (1999).

4. Govt. of India, Ministry of

Environment and Forests Gazette
notification No 460 dated July 27,
New Delhi: 1998: 10-20

5. Glenn, Mc.R & Garwal, R. Clinical

waste in Developing Countries. An
analysis with a Case Study of
India, and a Critique of the
BasleTWG Guidelines (1999)

6. CEET: Biomedical Waste

Management-Burgeoning issue
(2008)

7. Gravers PD. Management of

Hospital Wastes- An overview.
Proceedings of National workshop
on Management of Hospital Waste,
(1998)

8. Thornton J., Tally MC, Orris P.,

Label with agent,

concentration and
hazard warnings.

Communicate about
workplace hazards.

Wentreg J. Hospitals and plastics

Dioxin prevention and Medical
Waste Incineration; Public Health
Reports. 1996; 1:299- 313.

9. Surjit S. Katoch Biomedical Waste

Classification and Prevailing
Management Strategies,
Proceedings of the International
Conference on Sustainable Solid
Waste Management, p. p.169-175
(2007).

10. The Bio Medical Waste

(Management and Handling) Rules,
(1998).

11. Dr. Saurabh Sikka, Biomedical

Waste inIndian Context.

12. Shalini Sharma* and

S.V.S.Chauhan, Assessment of biomedical waste management in three
apex Government hospitals of Agra,
Journal of Environmental Biology,
29(2), p. p 159-162 (2008)

13. Bekir Onursal, Health Care Waste

Management in India. The world
Bank (2003).