LESSON PLAN

TOPIC : Bio-medical waste management.

GROUP : [Link]. Nursing IInd year students

VENUE : JIET College of nursing (classroom)

DURATION : 60 minutes

METHODS OF TEACHING : Lecture and discussion.

TEACHING AIDS : Handouts, chalkboard and projected Aids.

CENTRAL OBJECTIVE : On completion of this teaching session, the staff nurses will acquire adequate knowledge related to

Bio-medical Waste Management and apply the same in the clinical practice.

SPECIFIC OBJECTIVES: On completion of this teaching session the student nurses will be able to: -

 Explain the meaning of biomedical waste management

 List the types of waste
 Explain the generation of waste
 Enumerate different categories of wastes
 Discuss about biomedical waste handling and collection
 Describe various method of waste treatment and disposal
 Analyze the need and incorporate specific measures against protection from biomedical hazards
 Discuss the immediate measures to be taken for sharp injuries.
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On completion of Introduction: All human activities produce waste. These wastes
2minute this teaching may be dangerous and requires safe disposal. Many of our hospitals Introduces the
s session the staff topic.
nurses will be able do not have a satisfactory waste disposal system.
to: Health care professionals who are involved in handling of
biomedical waste need to be well equipped with the latest
information & knowledge in managing these wastes.
Due to lack of adequate waste disposal facility the hospital
waste are disposed openly which cause hazards to human life. Hence
to overcome this problem the biomedical waste management and
handling rules in India came into existence in the year 1997.

1) Explain the I. Meaning: Bio medical waste refers to any waste which is LCD
2 meaning of generated during the diagnosis treatment or immunization of human displaying
minutes biomedical waste. Explains. the meaning
beings or animal or in research activities pertaining there to or in the
Group of
production or testing of biological &includes category 1 to 10 (Govt Listens and view biomedical
of India Biomedical waste management and handling rules 1997). the slides. waste.
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Explains about
2) 10minut List the types of [Link] of waste: The hospital waste can be classified into two types of waste LCD on
es waste. Groups: types of
Clinical waste waste.
Non clinical waste &
(1) Clinical waste is generated during routine patient care, surgery& Handout.
high-risk units. Examples of clinical wastes are: Listens and view
1) Soiled dressing the slide.
2) Body fluids Clarify the
3) Amputed limbs doubts
4) I.V needles and syringes
5) Drainage bags
6) Pathology waste
7) Blood products
Laboratory wastes belongs to high-risk category.
Non-clinical waste: this includes wrapping paper, office paper;
plastic that has not been in contact with the patients.
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Hospital waste can also be classified as:

1) Solid waste
2) Liquid waste.
Solid waste: this includes the following:
 Dry garbage –(ordinary floor refuse, papers
 Wet garbage – from kitchen (eg. Fruit peels, left over food)
 Wet tissues & bones (from O.T, labor room, mortuary.)
 Packing materials -cardboard, cartons, papers etc
 Surgical waste (dressings, cotton pads)
 Metal waste (tins, cans, bottles)
 Glass (broken bottles, syringes)
 Disposable plastic items from all the areas of hospitals
Liquid waste: This group includes sullage, &sewage, which
emanates from bathrooms, lavatories, toilets, kitchen, pantries,
laundry &dressing room.
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Explains the
3) 2minute Explain the III. Generation of waste: the term generator refers to any person
generation of
s
generation of nominated on behalf of a hospital, nursing home, clinics, dispensary
waste
wastes. lab, animal house, slaughter house institutions established by or
under the control of govt which generates or cause to be generated,
handles, or cause to be handled any biomedical waste.
Listens and
Hence all the hospitals, nursing homes, veterinary hospitals,
refers the
clinics, dispensaries, diagnostic centers, pathological laboratories,
handout.
blood banks mortuary or any other health care establishments are
potential generators of waste. There are no national studies on
quantity of hospital waste generated per day; but it can safely be
presumed the average waste generated per day in most of the
hospitals roughly about 1 –3kg / bed per day.
Hospital is one of the major source of waste generation.
[Link] of biomedical waste: As per the biomedical waste
LCD
Enumerate
4) management & handling rules there are total 10 categories of waste. Enumerates displaying
different categories
10 categories of category of
of wastes.
minutes waste wastes.
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Clarifies doubts. Transparenc
Category 1: Human anatomical waste (human tissues, Organs, body
y on
parts)
categories of
Category 2: Animal waste (animal tissues, organs body parts, fluid
waste
blood and experimental animal used in research waste generated by
veterinary hospitals)
Category 3: Microbiology& biotechnology waste (from laboratory
cultures, stocks or specimen of microorganisms live or attenuated
vaccines, human cell, culture used in research and infectious agents
from research, waste production of biological toxins, dishes and
devices used for transfer of cultures).
Category 4: waste sharps (needles, syringes, scalpels, blades, glass
etc)
Category 5: Discarded medicines & cytotoxic waste comprising of
outdated contaminated & discarded medicines.
Category 6: solid waste (items contaminated with blood and body
fluids including cotton dressing, soiled plaster caste, linen, beddings
other materials contaminated with blood)
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Category 7: solid waste (waste generated from disposable items

other than the waste sharps such as tubing’s, catheters, I.V sets
Category 8: Liquids waste generated from laboratory and washing,
cleaning, housekeeping & disinfecting activities
Category 9: Incineration ash (ash from any biomedical waste).
Category 10: Chemical used in production of biological, chemical
used as insecticide etc.
Biomedical waste segregation: Segregation refers to separation of Discusses about
different types of waste by sorting or the systematic separation of waste
biomedical waste into designated categories. Waste segregation is segregation.
the most important step in the entire process of biomedical waste Group
management. Segregation should be done at the point of generation. participates in
The colored plastic bags / containers is the best system to discussion
segregate various waste. Special attention should be given while
segregating wastes such as:
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Syringes & needles require special attention while segregation and

storage
Syringes and needles should be damaged before putting it into a
container to prevent rag pickers from collecting it for recycling
Sharps must be kept in puncture proof containers to avoid injuries.
In all rooms except isolation ward there should be a container for
general waste, as waste from isolation is regarded as infectious
waste. Single use container is used to collect infectious waste.
Most appropriate way of identifying the categories of waste is by
sorting the waste into color-coded plastic bags or containers. The
type of containers& recommended color coding system are:
Transparenc
Color coding Type of container waste category y on color-
Yellow plastic bags category 1,2,3 coding
system for
waste.
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Red disinfected category3, 6&7

Container or plastic
Bags

Blue puncture proof container category4&7

Or plastic bags

Black plastic bags category 5,9&10

Waste storage: storage location must be designated inside the health

care establishment. Storage time for waste should not exceed:
Temperate climate: 72 hrs in winter.
48 hrs in summer.

Warm climate: 48hrs during cool season

24hrs during hot season
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The color-coded bags in the wards should be emptied when they are
two third full. Bags should be carried by neck to prevent them
swinging away from the body. Bags should be stored in vermin
&vandal proof cages
5) 8minute Explain the V. Waste handling and collection: The waste bags must be lifted Explains
s
techniques of only when they have been secured. They should always be carried by techniques of
waste handling and the neck. The porters should wear heavy-duty gloves when waste handling.
collection. transporting the waste. The bag must confirm to the different color-
coding system and should be labeled with basic information on their Listens and
content. The bags, which do not require incineration, are made up of clarifies doubts.
chlorinated plastics. Manual handling should be minimized to reduce
the incidence of needle stick injuries. Appropriate cleaning should be
done in case of accidental spillage. All the sharp container must
carry a sign of biological hazards. The vehicle used to transport the
waste must be washed every day. The transport container must be
properly
Enclosed
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Sharp container must be carried by handle. Sharps handling must

be done minimum.
6) 10minut Describe various VI. Waste treatment and disposal: There are five broad categories Describes Slide on five
es
methods of waste of medical waste treatment technologies. method of waste waste
treatment & Mechanical process treatment treatment
disposal. Thermal process & Disposal. technologies
Chemical process
Biological process.
Irradiation process Listens and
Mechanical process: - The primary mechanical process is views the slide.
compaction & shredding. Compaction involves compressing the
waste into container to reduce its volume. Shredding involves
granulation grinding and pulping to break waste into smaller pieces
Thermal process: - Thermal process use heat to decontaminate the
waste. Temperature used to destroy the microorganism ranges from
49º to 91º. There are 2 categories of thermal
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Process:
a) High heat system: - This includes combustion, pyrolysis and
b) High temperature plasma to decontaminate and destroy the waste
Temperature is usually less than 150º c
Basic thermal treatment process are as follows:

Autoclaving (steam sterilization): This is a low heat thermal process

and is designed to bring steam into direct contact with the waste for
disinfection. Category 4&7 are treated by autoclaving/micro waving
or chemical treatment.
Microwave treatment: This process involves preshredding the waste,
injecting it with steam and heating it for 25 minutes at 95º c under a
series of microwave units.
Incineration: Incineration system use high temperature combustion
under controlled conditioned to convert waste containing infection &
pathological material.
There are three types of incinerators: -
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Rotary kiln
Multiple hearth incinerator
3) Controlled air incinerator
Category 1,2,3& 6 are treated by incineration
Plasma system: this system utilizes a plasma torch or burner for
heating the waste to super high temperature
Chemical processes: Disinfectants used are mostly chlorine
compounds, phenolic compounds, iodine alcohols, formaldehydes
etc these are used as aqueous Solutions.
Irradiation process: Irradiation is synonymous with electromagnetic
or ionizing irradiation. Cobalt 60 & electro beam accelerator unit or
electron beam is used for irradiation & sterilization
Biological processes: - Biological enzymes for treatment of the
medical waste. Biological reaction decontaminate the waste
.
& cause the destruction of all the organic constituents.
Disposal of waste: This refers to burial, deposit, discharge dumping
or release of any biomedical waste into or on any air,
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land or water. Disposal of solid waste is done by landfills, use of
Pills, composting & biogas. Liquid waste is disposed by discharge
into sewers, soakage pits, & waste stabilizing ponds
Category 5 (discarded medicine & cytotoxic drugs); incineration ash
(category 9) & chemical waste (category 10) are disposed in secured
landfills. The cheapest & effective means of disposing of clinical
waste if incineration facility is not available is liming .In liming a
2minutes deep trench is dug which is half filled with waste then
covered with lime with 50 cms of surface before filling rest of the pit
with soil.
VII. Protection from biomedical hazards: Nurses face the risk of
exposure to blood borne infection, if they suffer from sharp devices
such as needles & scalpels. Hence all nurses have a much higher risk Transparenc
than other health care employees.
y on
Following methods of protection of biomedical waste hazards can
protective
7) 10minut Analyze the need be followed: Discusses
es for protection from 1) Hand protection waste treatment system & handling can subject & Analyses the devices used
biomedical the hands into chemical, mechanical and biological need for bio for
safety.
hazards. Group biosafety.
participates in
discussion
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Obtain hepatitis B immunization if required
Obtain anti retro viral chemotherapy (depending on the type of
injury and hospital policy)
Procure a counseling
CONCLUSION: Biomedical wastes are potentially hazardous. The most practical approach to the management of biomedical waste is to identify &
segregate waste by placing them in color-coded bags. This practice reduces the total treatment cost. Health care workers need to be guided & given
adequate knowledge about the hazardous effects of biomedical waste. The most vital component of the waste management is to develop a system
through education, training and persistent motivation of the health personnel.

EVALUATION:
What is a biomedical waste?
How will you classify biomedical waste?
How many categories of wastes have been defined by biomedical waste and handling rules (Govt of India)?
What is meant by segregation?
Name any three treatment technologies used for waste disposal.
What immediate measures will you take after sustaining a sharp injury?

TYPES OF WASTE
OTHER CLASSIFICATIONS OF WASTE

CLINICAL WASTE: COLOR WASTE TYPE OF

SOILED DRESSINGS CODING CATEGORY
SOLID WASTE CONTAINER
BODY FLUIDS YELLOW Category 1,2,3 Disinfected plastic
AMPUTED LIMBS LIQUID WASTE bags
I.V NEEDLES AND SYRINGES RED Category3, 6&7 Puncture proof
DRAINAGE BAGS container/ plastic bags
PATHOLOGY WASTE
BLOOD PRODUCTS BLUE Category4&7 Plastic bags
LABORATORY WASTE
BLACK Category Plastic bags.
5,9&10
CATEGORIES OF BIOMEDICAL WASTE COLOR CODING SYSTEM FOR BIOMEDICAL WASTES

Category 1: Human anatomical waste (human tissues,

Organs, body parts)
Category 2: Animal waste (animal tissues, organs body
parts, fluid blood and experimental animal used in
research waste generated by veterinary hospitals)
Category 3: Microbiology& biotechnology waste (from
laboratory cultures, stocks or specimen of microorganisms
live or attenuated vaccines, human cell, culture used in
research and infectious agents from research, waste
production of biological toxins, dishes and devices used for
transfer of cultures).

Category 4: waste sharps needles, syringes, scalpels, blades,

glass etc) PROTECTION FROM BIO-HAZARDS
Category 5: Discarded medicines & cytotoxic waste comprising
of outdated
contaminated & discarded medicines.
Category 6: solid waste (items contaminated with blood and Wear heavy duty rubber gloves while handling waste
body fluids including cotton dressing, soiled plaster caste, linen,
beddings other materials Wear gloves and apron to reduce injury and infection
contaminated with blood)
Category 7: solid waste (waste generated from disposable
items other than the waste sharps such as tubing’s, catheters, Follow universal precautions
I.V sets
Category 8: Liquids waste generated from laboratory and Wear appropriate footwear
washing,
cleaning, housekeeping & disinfecting activities
Category 9: Incineration ash (ash from any biomedical waste). Obtain Hepatitis B immunization
Category 10: Chemical used in production of
biological, chemical used as insecticide etc.
Thank
You…