الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Recentlythere is a growing concern about the safe managementof healthcare waste including laboratory waste generated from hospitals. A laboratory facility is an important component in healthcare centers and is widely acknowledged as the basis of medical diagnosis. All laboratory procedures and duties generate different types of hazardous waste.
Safe management of LW could be achieved by ensuring management of waste in the processes of safe handling, segregation, collection, storage, transport, treatment and final disposal in order to mitigate and minimize health risks and prevent environmental contamination as requiredin various internationalwaste management and environmental protection laws.
The present study aimed to assess LWM and to develop an integrated LWM system at MRI, Alexandria university. To reach this aim, a cross-sectional study was conducted in Alexandria MRI medical and research laboratories, Alexandria University, followed by One group pre- test post -test design.
The target population was consisting ofthe heads of the laboratories, the administrators who are responsible for waste management and all laboratory personnel including the technical staff and waste workers.
The Sample size was for cross-sectional study,all administrators (15) were interviewed including the heads of laboratories, heads of infection control, occupational safety and health officer and the director of Environmental Affairs and Community Service;all laboratory personnel (200) from 40 laboratories were interviewed including the technical staff and waste workers.For application of educational intervention program, 120 laboratory personnel were chosen from the whole sample according to the proportional allocation technique and were subjected to the educational program.
Data collected through: Firstly,an observational checklist regarding laboratory waste management practices.Secondly, a predesigned interviewing questionnaire for the head of each department of laboratories and the administrators who are responsible for laboratory waste management regarding theadministrative management aspects.And finally, apredesigned interviewing questionnaire for all laboratory personnel to assess their knowledge and practice regarding the laboratory waste management.
An intervention program was designed according to the results of pre-test and was tailored according to the needs of laboratory personnel.The same pre-test questionnaire was introduced to the selected group, immediately at the end of the program and three months later to re assess the intervention program impacts on their knowledge and practice regarding laboratory waste management.
Appropriate statistical procedures were applied to handle the data, so the following results were found:
Results of the observational checklist regarding Laboratory waste management practices in MRI:
• Regarding segregation of laboratory waste, results revealed adequate segregation of sharps, infectious and general waste, segregation bags andcontainers were strong enough, of good quality and were labeled with a label of the date and the name of department, a biohazard symbol was attached to the bags used in most of laboratories.
• There was no temporary storage room for laboratory waste inside the departments of all laboratories in MRI.
• Concerningthe treatment of laboratory waste inside the laboratories, only one quarter (25%) were using autoclave and chemical disinfection in treatment of waste while the other three quarter (75%) never use any waste treatment methods.
• Study results reported that 75% of laboratories disposed chemicals in the sewer without prior treatment, 70% of laboratories disposed blood and body fluids without treatment.
• Regarding the laboratory waste collection, only 47.5% of laboratories had a table for waste collection timingand special clean containers for hazardous waste collection and transport.
• Spill kit for cleaning waste spillage was availablein the majority of laboratories 72.5%.
• As for the PPE use inside the laboratories, laboratory personnel in 47.5% of laboratories and waste workers inside 87.5% oflaboratories were frequently wearing the PPE.
Results of the interviewing questionnaires of the opinions of the heads of laboratories and the administrators regarding regulation, legislative and policy aspects concerning laboratory waste management in MRI:
• All administrators (100%)reported the availability of governmental legislation for hazardous waste management including laboratory waste.
• Regarding the presence of a written policy and a guidance manual for hazardous waste management including laboratory waste in their departments the majority of participants (80%) confirmed their presence.
• All administrators reported that there was an infection control team in MRI which was responsible for hazardous waste management including laboratory waste and there was a coordination with solid waste management company in Alexandria for treatment and final disposal of these waste.
• As for funding, all administrators confirmed that there was no specific sustainable funding for resources which were required for waste management as waste bags and containers and the PPE.
• Only 13.3% indicated that there was enforcement of PPE use among the laboratory personnel while the majority (86.7%) revealed the absence of this enforcement.
• As regards to the organization of training program, the majority of administrators (73.3%) reported that a training program for hazardous waste management was conducted frequentlyin MRI for laboratory personnel and other hospital staff especially waste workers.
• Regarding availability of posters to increase the awareness about laboratory waste management, only one third of administrators (33.3%) reported it was available while the other two third (67.7%)reported the absence of such posters.
Results of the impact of the Educational Intervention Program:
• Study results revealed that there was a significant improvement in the total knowledge level after applying the educational intervention program from fair in the pretest assessment with a score mean (61.41±8.31)to good in immediate posttest (78.97±8.34), while this level decreased to (74.49±6.80) in follow up assessment but it was still higher than that of the pretest.
• The percentage of participants showing good knowledge increased from 6.7% before the intervention program to 68.3% in immediate posttest and 51.7% in follow up.
• There was a significant improvement in the total practice level after the educational program from poor level in the pretest assessment with a score mean of (42.74±12.95) to fair level in immediate assessment and in follow up with a score mean (65.35±15.65) and (72.78±17.41) respectively, and there was statistically significant difference between pretest, immediate posttest and follow up (p1,2,3<0.001).
• The study results revealed that the percentage of laboratory staff with good practice improved from 0.8% in pretest to 31.7% in immediate posttest and to 55.0% in follow up assessment after the educational program implementation.
In conclusion, the overall improvement in the knowledge and practice among the study participants after applying the educational intervention program confirmed that the conduction of the training was an effective tool for this improvement.
The results from the present study made the followingrecommendations to be implemented:
• To Implement the proposed system for integrated LWM suggested by the researcher including waste minimization possibilities, segregation and cost-effective treatment/disposal choices.
• To ensure a safe system of LW handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment through the coordination between the different personnel in MRI according to their responsibilities.
• To apply training programs to MRI laboratory staff and waste workers according to the needs and regularly updating their knowledge.