Gestão e manejo de resíduos hospitalares: ciclo de melhoria em Hospital Universitário do Rio Grande do Norte

Abstract

Introduction: healthcare waste management is a set of procedures with the aim of minimizing waste generation and providing a safe, efficient destination. Therefore, it is essential to implement improvements aimed at waste management, aiming to protect workers and preserve public health, resources and the environment. Objective: Develop a cycle of improvement in the management and handling of infectious and chemical waste at the University Hospital of Rio Grande do Norte. Methodology: A quantitative study was carried out, with an experimental design, without a control group, before and after, from February 2022 to September 2023, based on an improvement cycle. The steps of an improvement cycle were carried out and eight quality criteria were measured before and after the interventions. The interventions carried out were: reformulation of the identification of waste classification stickers; relocation of trash bins; theoretical training and through realistic simulation with care teams and during the integration of new employees; construction of educational videos; updating the Hospital's Solid Waste Management Plan; preparation of an electronic form to record waste weighing and adjust the calibration of scales. The absolute and relative frequency of the level of compliance with the criteria and the absolute and relative improvement were analyzed comparing the pre- and postintervention period, considering a statistical significance of 5%. Results: the main causes of inadequate segregation are related to the inadequate identification and location of bins, the lack of continuous training, the lack of specific containers for chemical waste, and the lack of periodic monitoring. In the initial assessment, a good level of quality was found only in the criterion of “Identification of bins by type of waste”. In the reevaluation, after interventions, an increase in the quality level was noted in all criteria with a significant improvement in the adequate segregation of waste, the identification of the white bag and the completion of the waste weighing form. A significant reduction was observed in the rate of generation of infectious waste as well as in the average cost of waste generation per patient/day. Conclusion: The improvement cycle improved waste management and management, as well as reducing the costs arising from this process, proving to be an effective strategy in increasing the quality of health services.