武汉市基层医疗机构医疗废物管理现状及对策

Current situation and countermeasures of medical waste management in primary medical institutions of Wuhan

目的了解武汉市基层医疗机构医疗废物的管理现状,发现问题并提出改进对策。方法2018年7月采取分层抽样法现场调查武汉市13个区45所医疗机构医疗废物管理情况。结果45所医疗机构2017年医疗废物产生量中位数为0.32 kg/床·日,医疗废物处置费中位数为0.67元/床·日,使用后未被污染的一次性输液瓶合理处置率为64.44%。93.33%的医疗机构有医疗废物领导小组,仅有57.78%明确了医疗废物管理主管部门,医疗废物分类正确率为60.00%。97.78%的医疗机构有医疗废物暂时储存设施、设备,防护用品配备齐全率为73.33%,洗手设施及手卫生用品配备齐全率为64.44%。所有医疗废物全部交由医疗废物集中处置中心处理,仅35.56%的医疗机构能保证医疗废物暂存时间不超过2 d。二级医疗机构在医疗废物暂存时间和明确医疗废物管理主管部门两项指标的合格率高于一级医疗机构(均P<0.05),其余指标比较差异均无统计学意义。结论武汉市基层医疗机构医疗废物管理已逐步规范,但仍存在不同程度的问题,尤其是一级医疗机构医疗废物暂存时间超过2 d的问题,需要加大多部门沟通合作力度,加强培训与监管,探索适宜的管理模式。

Objective To understand the current situation of medical waste management in primary medical institutions in Wuhan,find out the problems and put forward improvement countermeasures.Methods In July 2018,a stratified sampling method was used to investigate the medical waste management of 45 medical institutions in 13 districts of Wuhan.Results In 2017,the median of production of medical waste generated by 45 medical institutions was 0.32 kg/bed-day,the median of medical waste disposal fee was 0.67 yuan/bed-day,the rational disposal rate of uncontaminated disposable infusion bottles after use was 64.44%.93.33%of medical institutions had leading groups for medical waste management,only 57.78%of medical institutions identified administrative department of medical waste management,the correct rate of medical waste classification was 60.00%.97.78%of medical institutions established the temporary storage facilities and equipment for medical waste,and equipping rate of complete protective equipment was 73.33%,equipping rate of complete hand washing facilities and hand hygiene products was 64.44%.All medical institutions put medical waste to centralized medical waste disposal center,only 35.56%of medical institutions could transfer medical waste within 2 days.The qualified rates of medical waste temporary storage time and administrative department defining for medical waste management in secondary medical institutions is higher than primary medical institutions(both P<0.05),there were no significant difference in the other indexes.Conclusion Medical waste management in primary medical institutions of Wuhan has been gradually standardized,but there are still problems,especially the temporary storage time of medical waste in primary medical institutions>2 days.It is necessary to increase communication and cooperation in multiple departments,strengthen training and supervision,and explore an appropriate management mode.