Hospital Waste Management Compliance (disposal and environmental protection)
Does site have a written management plan (to show the observer) for nonhazardous general waste, liquid medical waste, and solid medical waste?
Does site have clearly assigned staff responsibilities that cover all steps in the waste management process?
Does site have appropriate and adequate supplies and equipment for infection prevention and waste management (see infection prevention guide), including decontaminants, containers, and protective clothing?
Does site have and use infection prevention job aids and medical waste management protocols or curricula from USAID, EngenderHealth, WHO, etc.?
Sorting: Are there internal rules for appropriate separation of waste by type at the place where it is generated (e.g., needles and sharps disposed of in special sharps containers, such as covered leak-proof, puncture-proof cardboard boxes, plastic bottles, or tin cans)?
Handling: Is there appropriate collection and transportation of medical waste within the facility (e.g., handling medical waste as little as possible before temporary storage and disposal; removing and emptying waste containers from operating, procedure, and sluice rooms before completely full, at least once a day; Observing good hygiene; and wearing protective clothing)?
Interim storage: Is medical waste appropriately and temporarily stored safely, packaged, and labeled within the facility (e.g., always for less than 24 hours, before disposal; stored in a designated, closed-off area that is minimally accessible to staff, visitors, and food; correct response for spills, injury, exposure is followed)
Final disposal, general: Are solid medical waste, liquid medical waste, sharps, and hazardous chemical waste from the health facility eliminated appropriately (e.g., all solid and liquid waste and contaminated waste disposed of away from the community; never stored in open container; never thrown onto an open pile)?
Final disposal of solid waste: Is solid waste disposed of appropriately (e.g., at the facility, if possible, under the supervision of staff who understand the risks, by burning or burying, or by transporting it to an off-site disposal site).
Burning: If final disposal of solid waste is by burning, functional burning in a drumor brick incinerator is best. Less optimal would be open burning, in a small designated area far from the premises. If wet, waste should be doused with kerosene first before starting the fire.
Burying: If final disposal of solid waste is by burying, is this done safely (e.g., at a designated, fenced, or walled-off space in view of the facility, with a pit large enough for all the solid medical waste generated at the site, to prevent scavenging and accidental injury)? Does the pit have an impermeable plastic or clay lining? Is the burial pit at least 50 m away from any water source, to prevent contamination? Does the site have proper drainage? Is it located downhill from any wells, free of standing water, in an area that does not flood? Is the bottom of the pit 2 meters above the water table? (Consult local water engineer/water authority about the location of the water table.) Is waste covered with 10–30 cm of soil?
If final disposal is off-site, are precautions taken to ensure that waste is transported and disposed of safely?
Completion
Additional observations and comment on infection prevention and waste storage/disposal:
Name & Signature of Assigned Personnel
