感染性廢棄物於院內的安全問題探討-以某醫學中心為例

Study on safety and health issues associated with infectious wastes in a health care facility – a case study of a medical center in Taiwan

林德育(De-Yu Lin)

指導教授 ： 謝賢書

長榮大學/健康科學學院/職業安全與衛生研究所/碩士(2007年)

https://doi.org/10.6833/CJCU.2007.00099

摘要

感染性廢棄物於院內分類、收集、儲存、運送不當，可能造成職業危害。雖然國內對感染性廢棄物的貯存、清除、處理已有完備的法規及較多的研究，但在醫療院所內實際作業的風險較少被探討。
本研究選定某醫學中心為研究對象。該醫學中心除規模較大、聲譽卓著之外，其廢棄物管理制度亦頗為完備。研究方式以實地訪查為主，同時探討感染性廢棄物處理的制度面及執行面。在制度面，探討的內容包括分類、收集、貯存、運送、稽核管理等。在執行面之調查，則以兩個月的時間，定期調查該醫學中心各樓層不同科別和位置，實際瞭解醫院感染性廢棄物之清運作業流程，並訪談相關處理人員。觀察感染性廢棄物之分類及蒐集情形，記錄分類錯誤及有感染風險(如收集袋刺穿、過滿、未綁緊，針頭收集盒未密封等)之狀況。
本研究發現該醫學中心感染性廢棄物處理管理制度面雖完善，執行面上仍有部分缺失，如所有的感染性廢棄物垃圾桶中，分類錯誤佔9.3%；暫存區裡，所有的可燃性及非可燃性的感染性廢棄物垃圾袋中，刺穿、破損者佔3%。
該醫學中心在評鑑上已屬優良，但仍有改善感染性廢棄物處理管理的空間，由此可推知其他評鑑成績低於該醫學中心的醫院，其管理制度與安全衛生上的提升應更有改善的空間。

關鍵字

感染性廢棄物 ； 危害辨識 ； 內部稽核

並列摘要

Inappropriate classification, collection, storage, and transportation of infectious waste within hospital could be harmful to safety and health of hospital employees. Most of attentions on infectious wastes, in terms of regulatory control, were mostly focused on the final incineration plants. Little study has been conducted to investigate the potential risk of infectious waste posed to hospital employees in the collecting and handling processes within the health care facility.
The study selected a reputable medical center which has a well-established medical waste management program. We looked into the management system by reviewing the written procedures of classification, collection, storage, cartage, and internal auditing processes. Besides, we observed every detailed steps of the infectious waste handling process and interviewed the related workers for a month. The improper handlings, including piercing, overfilling, and loosely-tied of collective bags as well as unsealed needle-stick box were found.
The study revealed that the waste management program of the studied medical center is well implemented, but certain improper handlings existed. For example, 9.3% of incorrect classification of infectious waste was observed; piercing or damaged collection bags consisted of 3% of total infectious waste collection bags.
Although the studied medical center has been ranked excellent for its hospital waste management program among the health care facilities in Taiwan, the results indicated that there are still some potential risks present in the handling processes within the hospital. It is reasonable to expect that improper handlings of infectious waste inside hospitals are common phenomena in Taiwan. The concern of occupational health and safety of hospital employees should be taken seriously by the high-level management.

並列關鍵字

infectious waste ； hazard identififcation ； internal audit

參考文獻

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