Kit Management in Tertiary Institution
PROFESOR MADYA DR. TING HUA NONG
NURUL FARHANA BINTI HAMDAN FADEL
Healthcare waste management
of Research Proposal
First Aid Kit Management System in Tertiary
Provision of first aid kit become a mandatory as part of
employer responsibility as stated in Section 15 of Occupational Safety and
Health Act 1994 (OSHA 1994) and Section 25 of the Factories and Machinery Act
1967 (Occupational Safety and Health Act 1994); (Factories and Machinery Act,
1974). As the provision of First Aid must be consistent
and efficient as part of employee’s welfare, Department of Safety and Health
(DOSH) with collaboration with few other contributors had come out with the Guidelines
on First-Aid In The Workplace up to Second Edition revised version in 2004. The
main objective of the Guidelines is to assists on the first-aid facilities planning and implementation in the
workplaces by employers, occupiers and health and safety personnel. (Guidelines on First-Aid In The Workplace
(2nd Edition), 2004). However, the contents of the
Guideline is not covering a holistic idea of first aid management as it is too
focusing on the requirements without expanding the guidance on handling and disposal
As part of health
care products, the need of proper disposal of unused or expired first aid items
become important to reduce the burden on domestic waste treatment. Typical
component of first aid items vary with different type of products such as
paper, wood, consumable products, solvent based items and drug contained
materials. Some of the contents of first aid items are categorized as
hazardous waste. Even though the
quantity of first aid wastes produced is in small quantity, there is still some
risks and potential dangers for environment related to mishandling of wastes.
To start evaluating and understanding of the current state on first aid waste
handing, tertiary institutions are selected as the starting case study
considering nowadays university
communities can be considered as ”mini cities” with different degrees of
effect on the environment (Adeniran,
Nubi, & Adelopo, 2017). Due to this, it is justifiable for the need of proper first aid
kit management based on ‘cradle to grave’ concept to be introduced and
implemented in any workplace including tertiary institutions environment.
4.0 Literature Review
4.1 Definition of Health Care and First Aid
In Guidelines on
The Handling and Management of Clinical Wastes in Malaysia, health care can be
defined as any medical activities such as monitoring, diagnosis or treatment
prevention of disease of handicap in humans or animals performed under the
supervision of any person authorized by their professional qualifications (Guidelines on The Handling and
Management of Clinical Wastes in Malaysia (3rd Edition), 2009 ). The definition of first aid
as stated in Guidelines on First Aid in the Workplace by DOSH is the assessment
and interventions carried out by a first aider for the injury with minimal
equipment until qualified medical or health personnel arrive to provide
treatment. First aid provision is including all appropriate facilities,
services and personnel required for the immediate treatment of injury or
illness at a workplace (Guidelines on First-Aid In The
Workplace (2nd Edition)). First aid emphasized on
early treatment once casualty occurred while health care is covering all phases
of casualty treatment. By comparing both definition, first aid also can be
categorized as a subset of health care elements.
4.2 Requirement of first aid provision
There are few
first aid component in the workplace or premise such as first aid kit,
first-aiders, first-aid room and first-aid equipment. The size or quantity of
first aid kit and number of first aiders in particular workplace are based on few factors such
industry type, workers headcount, number of work shifts and distance of workplace
location to the nearest medical clinic or hospital (Guidelines on First-Aid In The
Workplace (2nd Edition), 2004). Considering the large
headcount of employees in large premise, the provision of first aid items can
be as many as health care facilities.
4.3 First Aid waste Categorization
The World Health
Organization (WHO) define health care waste as any waste generated by health
care activities including waste produced from ‘minor’ or ‘scattered’ source (World Health Organization,
Definition and Characterization of health-care waste). As first aid is part of
health and medical services, hence the waste can be categorized based on their components.
First aid products potentially end up to produce several categories of waste
such as infectious waste, sharps, pharmaceutical waste and chemical waste. In
Guidelines on The Handling and Management of Clinical Wastes in Malaysia, the
categorization of first aid is almost as similar as WHO categorization on
health care waste. Table 1 is the list of first aid waste categories;
1: First Aid Waste Categories
First Aid Products
Equipment or materials that have been in contact
with blood or any body parts of injured person suspected to contain pathogens.
Tissues (swabs, gauze pads and dressings)
Bandages (triangular, elastic and roller)
Alcohol prep pads
Barrier device for CPR such as pocket mask and face shield
Any equipment with sharps or pointed parts that able
to cause an injury to human.
Items contaminated by pharmaceuticals product
Bottles and boxes of pharmaceuticals products.
Pharmaceutical waste (clinical waste)
Waste containing chemical substances that are
expired or no longer needed
Burn aid cream
Products or items in the solid state that are
expired or no longer needed
Cold pack compress gel
Unused absorbent paper
Any products or tools that contained high densities
of poisonous metal.
As first aid facilities and items are mainly used for early treatment of
casualty, most of the study do not really focusing much on the hazardous waste
elements in first aid items. There are no previous published studies assessing
and categorized first aid elements particularly in hazardous elements. The
assessment and categorization was always conducted in bigger scale of health
care waste focusing in large health care services such as hospitals, clinics,
pharmacies and university clinics (Hossain, Santhanam, Nik Norulaini, & Omar, 2011); (Ananth, Prashanthini, & Visvanathan, 2010).
4.5 Overview of
health, safety and environmental impact
of study had been conducted to identify the impact of health care waste towards
the human and environment if the waste is not manage properly. As developing
country, the management of health care wastes still disorganized as most of
wastes are still handled and disposed together with domestic wastes. Thus it
creating a great health risk to the public and the environment (Bdour, Altrabsheh, Hadadin, & Al-Shareif, 2007); (Coker et al., 2009); (Sawalem, Selic, & Herbell, 2009). The waste generated from health
care facilities and services eventually pose the danger and risk to health and
to the environment even though the percentage of health care waste is
relatively small compare to the total waste (Bos & Izadpanah, 2002). Due to infectious nature of health care
waste, it can also being harmful to human health and environment during
handling and disposal of health care solid waste (Hossain et al., 2011); (Bokhoree, Beeharry, Makoondlall-Chadee, Doobah, & Soomary, 2014).
Health care is
considered as hazard in the workplace as it can expose infection risk, toxic
effects and injuries among health care community in the health care facilities.
Anyone from the circle of health care community such as workers, waste handlers
and patients are equally threatening by the exposed health risk (WHO, 2017).
Besides it can lead to the risks of environmental pollution and degradation,
poor management of health care waste management can lead to workplace injuries
and diseases regardless of infectious and non-infectious.(Al-Habash & Al-Zu’bi, 2012); (Nwachukwu, Orji, & Ugbogu, 2013); (Hossain et al., 2011). Some studies emphasizing
that anyone who work in the health care facilities that potentially in contact
with generated health care waste are in danger as the waste are likely to have
hazardous components. It is including
any waste that consists of human tissue, blood or other body fluids,
excretions, drugs or other pharmaceutical products, swabs or dressings or
syringes, needles or other sharp instruments.
water effluents that contained pharmaceuticals elements from health care waste
proven to have a great effect towards wild aquatic animals. 2012). Study was conducted
and proved that fish exposed to 50% or 100% wastewater effluent had higher
tissue concentrated with pharmaceuticals in their brain and plasma. This
phenomena indirectly may potentially change the behavior of the affected fish (McCallum et al., 2017). As the effect of the health
care to wastewater-exposed fish is known, it was obvious that inappropriate
health care waste management is leading to serious health hazards and
environmental pollution in this modern world.
of health care solid waste management practice also can exposed health care
staffs, patients and hospitals environment with diseases such as cholera,
dysentery, skin infection, and infectious hepatitis (Patwary et al., 2009; Tamplin, Davidson, Powis, & O’Leary, 2005).
These type of diseases able to spread easily through epidemic way if the waste
is not manage appropriately (Coker et al., 2009) .Thus, appropriate methods for the safe
management of health care waste must be practicing urgently.
5.0 Objective of Study
The aim of this research
is to ensure proper disposal of first aid waste through holistic management
approach. The first objective of this research is to identify a current first aid kit management in tertiary
institutions. Besides, another objective to be achieved in this study is to propose effective first aid kit management
6.0 Methodology of Study
6.1 Data Collection
will be involved 2 stages of data collection. First stage is baseline survey through
at least 20 institutions to get a baseline data for current first aid kit
management practice in Malaysia. The survey will answered by 1 responder to
represent the organization at which population associated with it. Sampling method to be used in this research is
nonrandom approach of purposive sample as the sample selected (individual to
answer the questionnaire) must be the person who are very well known of
handling the management of first aid provision and maintenance in the selected
institutions. Subject completed instruments for the stage 1 of this research
will be questionnaires. Second stage will be case study approach at which two
institutions are chosen to demonstrate the current practice in depth.
To introduce new
concept of first aid kit management, benchmarking from guidelines, policies and
procedures will be conducted to acquire the best approach.
6.3 Gap Analysis
The first aid
kit management practice will be clustered in few categories to complete the
cycle of ‘cradle to grave’ concept. The holistic management practice as to be
introduced from the benchmarking will be compared to current practice to
understand the gap of current first aid kit management practice in tertiary
Flow chart of first aid kit management methodology
7.0 Work Schedule of Study
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Altrabsheh, B., Hadadin, N., & Al-Shareif, M. (2007). Assessment of medical
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Beeharry, Y., Makoondlall-Chadee, T., Doobah, T., & Soomary, N. (2014).
Assessment of Environmental and Health Risks Associated with the Management of
Medical Waste in Mauritius. APCBEE
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