Medical Waste-Sorting and Management Practices in Five Hospitals in Ghana.

Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.

Improving efficiency, securing savings.

The NHS in England could save £1 bn annually if all NHS acute Trustsachieved the median level of estates and facilities running costs, the second (and 'final') report by Lord Carter and his team into the 'productivity and efficiency' of acute NHS Trusts across England, published on 5 February,suggests. As HEJ, editor, Jonathan Baillie reports, Lord Carter's team'songoing recent discussions with senior personnel working in a range of disciplines at 32 NHS Trusts--which followed dialogue with an initial 22 Trusts--identified 'unwarranted variation' in the use of resources ranging from staff to land and buildings on such a scale that effectively addressing this 'variation' could, the DH-commissioned team says, potentially reduce by £5 bn annually the NHS in England's costs.

HTM advocates 'holistic approach'.

Dr Nick Hill, a fellow of IHEEM, and chair of the Institute's Water Technical Platform, whose career encompasses over 25 years' experience working on all aspects of water, considers some of the key guidance contained in the new Health Technical Memorandum, HTM 04-01, Safe Water in Healthcare Premises (2016), which was published last month.

The RCT equivalence route to registration.

Iain Threlkeld BEng(Hons), CEng, FIHEEM, MIPEM, head of Clinical Engineering at Bradford Teaching Hospitals NHS Foundation Trust, looks at the background to the establishment of the Register of Clinical Technologists, and describes a new 'equivalence route' to registration designed for experienced clinical technologists with a suitable degree-level qualification.

Prevailing approaches are broken.

Planning and managing electrical compliance in line with BS7671 is challenging due to the lack of correct information, the volume of data, and the need to manually handle this electrical information. In this article, Michael Joubert, BSc Mech. Eng. (Industrial), MBA, operations director at EDIS, explains why electrical compliance management 'no longer needs to be a laborious and time-consuming task', and how estates managers in large hospitals are successfully addressing it.

Challenges set by the ErP Directive addressed.

In January this year, new Eco-design requirements for ventilation products came into force in the form of the Ecodesign Directive 2009/125/EC for energy-related products (ErP). The tighter requirements signal the growing need for products that are even more energy-efficient, which will help EU countries reach their carbon reduction commitments. Here David White, UK service sales manager at supplier of air technology solutions, Fläkt Woods, considers what the new standards will mean for HVAC systems in hospitals and healthcare facilities.

Ensuring that fire doors are fit for purpose.

Neil Ashdown, general manager of the Fire Door lnspecion Scheme (FDIS), considers the key steps for ensuring that fire doors are correctly specified, installed, maintained, inspected, and, when necessary, repaired, to enable them to effectively fulfil their role.