上海市金山区医疗废物管理现状及管理对策分析

Current status and management strategies of medical waste in Jinshan District, Shanghai

  • 摘要:
    目的 了解上海市金山区医疗废物管理现状,研究医疗废物管理存在的问题并分析其原因,为制订针对性的医疗废物管理改进对策提供科学依据。
    方法 收集2017—2021年上海市金山区卫生健康委员会监督所医疗废物日常监督检查信息,涵盖医疗废物的收集、分类、转运、贮存等各环节及卫生行政处罚情况。
    结果 医疗机构在制度建设、人员配备、内部交接和登记等方面合格率均超过95.00%,然而在暂存时间未超过48 h方面,仅2.31%的医疗卫生机构合格。在分类收集符合规定、登记保存3年、暂存未超过48 h、无买卖行为、及时消毒和清洁、流失采取紧急措施方面,私立医疗卫生机构合格率相对较低(P<0.05);在设置暂时贮存设施和执行转移联单制度方面,不同类型机构间存在差异,社区医疗卫生机构合格率相对较低(P<0.05)。近5年的行政处罚案例中,私立医疗卫生机构占比63.33%。
    结论 上海市金山区医疗废物管理已逐步规范,但仍存在不同程度的问题,尤其针对医疗废物贮存超过48 h问题,应建设医疗废物中转站,优化转运机制,确保应收尽收;同时,针对私立和社区医疗卫生机构管理薄弱环节,应建立医疗废物管理质量控制小组,强化信息化监督手段,优化管理流程,全面提升医疗废物管理水平。

     

    Abstract:
    Objective To assess the current status of medical waste management in Jinshan District of Shanghai, China, to identify existing issues, and to provide a scientific basis for formulating targeted strategies.
    Methods Data were collected from the routine supervision and inspection records of the Jinshan District Health Commission Supervision Institute from 2017 to 2021, covering all aspects of medical waste management, including collection, classification, transportation, storage, and administrative penalties.
    Results The compliance rates for the establishment of institutional frameworks, staffing, internal handover, and registration in medical and healthcare institutions all exceeded 95.00%. However, only 2.31% of the medical and healthcare institutions met the 48-hour storage limit requirement for medical waste. Private institutions had significantly lower compliance rates (P<0.05) in aspects such as proper classification and collection, maintaining records for three years, adhering to the 48-hour storage limit, refraining from commercial transactions, timely disinfection and cleaning, and implementing emergency measures for waste loss. Compliance rates also varied among different types of institutions regarding the establishment of temporary storage facilities and the implementation of the transfer manifest system, with community healthcare institutions exhibiting relatively lower compliance rates (P<0.05). Over the past five years, private medical and healthcare institutions accounted for 63.33% of administrative penalty cases.
    Conclusion While medical waste management in Jinshan District, Shanghai, has gradually become more standardized, challenges remain. To address the issue of medical waste being stored for over 48 hours, medical waste transfer stations should be established to improve transfer efficiency and ensure complete waste collection. Additionally, for private and community healthcare institutions, weak links in management should be addressed by establishing medical waste quality control teams, enhancing supervision through digital tools, and optimizing management processes to comprehensively elevate medical waste management.

     

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