An Educational Intervention to Reduce Regulated Medical Waste: The Inpatient Medicine and Outpatient Dermatology Settings

IF 3.2 4区医学 Q1 DERMATOLOGY International Journal of Dermatology Pub Date : 2025-02-09 DOI:10.1111/ijd.17682

Genevieve S. Silva, Jeromy W. Gotschall, Fengling Hu, Elizabeth Whidden, Phoebe Cunningham, Jacob Niculcea, Cody Chapman, Prateek V. Sharma, Greg Evans, Farah Hussain, Zelma C. Chiesa Fuxench, Kirstin Knox, Misha Rosenbach

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Abstract

Background

Improving regulated medical waste (RMW) management is crucial for enhancing planetary health and cost savings. We sought to assess an educational intervention on clinical staff understanding and behavior regarding RMW management.

Methods

This two-month (2023–2024) controlled, prospective educational intervention at the University of Pennsylvania Health System surveyed healthcare workers, including physicians, nurses, and medical assistants, from four inpatient medicine floors and two dermatology clinics. Half of the medicine and dermatology settings were controls. The intervention included in-person staff training sessions and printed materials (posters, bin stickers) describing waste segregation and RMW's environmental, health, and cost impacts. A deidentified online survey pre- and post-intervention measured RMW knowledge and behaviors. The primary outcome was a change in performance on survey questions on proper RMW disposal and RMW's negative externalities. Secondary outcomes were self-reported changes in environmental beliefs and waste stewardship motivators and behaviors, qualitative responses around stewardship barriers, and the impact of clinical role on intervention efficacy.

Results

Average baseline inpatient knowledge scores were 6.17 of 9 versus 7.51 for outpatient. The inpatient intervention increased the odds of answering each question correctly by 3-fold (odds ratio: 3.71, 95% CI: 2.218–6.401, p < 0.001). The outpatient clinical role was associated with receptivity to the intervention: the intervention effect was 12.7 times stronger for nursing staff than for physicians (95% CI: 1.86, 263.29, p = 0.024). The intervention improved the overall understanding of RMW's negative environmental impact.

Conclusions

An educational intervention can improve understanding of RMW's proper disposal and environmental impact, particularly among nursing staff, and inform future interventions.

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教育干预，以减少管制医疗废物：住院医学和门诊皮肤科设置。

背景：改善受管制的医疗废物管理对于促进地球健康和节约成本至关重要。我们试图评估临床工作人员对RMW管理的理解和行为的教育干预。方法：在宾夕法尼亚大学卫生系统进行为期两个月（2023-2024）的对照前瞻性教育干预，调查了来自四个住院医疗楼层和两个皮肤科诊所的医护人员，包括医生、护士和医疗助理。一半的医学和皮肤病学设置为对照。干预措施包括人员亲自培训课程和印刷材料（海报、垃圾箱贴纸），描述废物分类和RMW的环境、健康和成本影响。在干预前和干预后进行了一项匿名在线调查，测量了RMW的知识和行为。主要结果是对RMW妥善处置和RMW的负外部性的调查问题的表现发生了变化。次要结果是自我报告的环境信念和废物管理动机和行为的变化，围绕管理障碍的定性反应，以及临床角色对干预效果的影响。结果：住院患者的平均基线知识得分为6.17分（9分），而门诊患者的平均基线知识得分为7.51分。住院患者干预使正确回答每个问题的几率提高了3倍（优势比：3.71,95% CI: 2.218-6.401, p）。结论：教育干预可以提高护理人员，特别是护理人员对RMW的正确处置和环境影响的理解，并为未来的干预提供信息。

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来源期刊

International Journal of Dermatology 医学-皮肤病学

CiteScore

4.70

自引率

2.80%

发文量

476

审稿时长

3 months

期刊介绍： Published monthly, the International Journal of Dermatology is specifically designed to provide dermatologists around the world with a regular, up-to-date source of information on all aspects of the diagnosis and management of skin diseases. Accepted articles regularly cover clinical trials; education; morphology; pharmacology and therapeutics; case reports, and reviews. Additional features include tropical medical reports, news, correspondence, proceedings and transactions, and education. The International Journal of Dermatology is guided by a distinguished, international editorial board and emphasizes a global approach to continuing medical education for physicians and other providers of health care with a specific interest in problems relating to the skin.