J.L.Himali.R. Wijegunasekara
Introduction: Health Care Waste (HCW) Management is an important aspect in hospital management. Clinical wastes are regarded as œhazardous and include; Sharps, Infectious waste, Pathological waste, Pharmaceutical waste & cytotoxic waste, Chemical waste and Radioactive waste which constitute about 10“25% of health-care wastes. Description: Clinical waste management system of National Hospital of Sri Lanka are described under basic stages in clinical waste management; Generation; Collection; Segregation; Transportation; Storing; Disposal and mechanisms of Monitoring and Evaluation. Feeling: I was enthusiastic to learn the clinical waste management system in NHSL; I felt euphoric to see the successful operation of the programme; However, I was perturbed to see the sudden disruption of disposal mechanism and at last, I felt calm to see the hospital coping up with the problem. Evaluation: Good aspects were identified as correct color coding system, segregation, collection, transportation, storage, outsourced disposal, awareness of the staff, availability of guidelines and procedures, financial ability and monitoring mechanisms. Bad aspects were identified as deficiencies in segregation, availability of containers & personal protective equipment, transportation, non - utilization of hydroclave machines, interruption to the disposing mechanism and insufficiencies in monitoring mechanisms. Analysis: Color coding; adherence to national guidelines for segregation, transportation, storage and disposal; staff training; supervision, review and monitoring of the process; continuous provision of supplies; financial capacity; and intra sectoral and inter sectoral assistance have facilitated smooth systematic functioning of the process; while deficiencies in all the stages of waste management process; deficiencies in supply chain; deficiencies in inter sectoral collaboration and coordination; and deficiencies in monitoring mechanisms; have resulted in non - optimal operation of this process with complete disruption of some stages occasionally. Conclusion/Recommendations: Good aspects have contributed vastly for a satisfactory clinical waste management system. There are some deficiencies in different magnitude which need to be attended according to the need of priority. Recommendations are given accordingly.
