KQX7001RESEARCH METHODOLOGYSEMESTER 12017/2018   RESEARCH PROPOSALFirst AidKit Management in Tertiary Institution LECTURER:PROFESOR MADYA DR. TING HUA NONG NURUL FARHANA BINTI HAMDAN FADELKQD160023 1.0  Fieldof ResearchHealthcare waste management2.0  Topicof Research ProposalFirst Aid Kit Management System in TertiaryInstitution3.0  IntroductionProvision of first aid kit in the workplace is consideredas mandatory as part of employer responsibility as stated in Section 15 of OccupationalSafety and Health Act 1994 (OSHA 1994) and Section 25 of the Factories andMachinery Act 1967 (Occupational Safety and Health Act 1994); (Factories and Machinery Act,1974).

  As the provision of First Aid must be consistentand efficient as part of employee’s welfare, Department of Safety and Health(DOSH) with collaboration with few other contributors had published Guidelineson First-Aid In The Workplace up to Second Edition revised version in 2004. Themain objective of the Guidelines is to assists on the first-aid facilities planning and implementation in theworkplaces by employers, occupiers and health and safety personnel. (Guidelines on First-Aid In The Workplace(2nd Edition), 2004). However, the contents of theGuideline is not covering a holistic idea of first aid management as it is toofocusing on the requirements without expanding the guidance on handling and disposalmethod. As part of healthcare products, the need of proper disposal of unused or expired first aid itemsbecome important to reduce the burden on domestic waste treatment.

Typicalcomponent of first aid items vary with different type of products such aspaper, wood, consumable products, solvent based items and drug containedmaterials. Some of the contents of first aid items are categorized ashazardous waste. Even though thequantity of first aid wastes produced is in small quantity, there is still somerisks and potential dangers for environment related to mishandling of wastes.

To start evaluating and understanding of the current state on first aid wastehanding, tertiary institutions are selected as a starting case study asnowadays university communitiescan be considered as ”mini cities” with different degrees of effect on theenvironment (Adeniran,Nubi, & Adelopo, 2017). Due to this, it is justifiable for the need of proper first aidkit management based on ‘cradle to grave’ concept to be introduced andimplemented in any workplace including tertiary institutions environment.4.

0   Literature Review 4.1   Definition of Health Care and First AidIn Guidelines onThe Handling and Management of Clinical Wastes in Malaysia, health care can bedefined as any medical activities such as monitoring, diagnosis or treatmentprevention of disease or handicap in humans or animals performed under thesupervision of any person authorized by their professional qualifications (Guidelines on The Handling andManagement of Clinical Wastes in Malaysia (3rd Edition), 2009 ). The definition of first aidas stated in Guidelines on First Aid in the Workplace by DOSH is the assessmentand interventions carried out by a first aider for the injury with minimalequipment until qualified medical or health personnel arrive to providetreatment. First aid provision is including all appropriate facilities,services and personnel required for the immediate treatment of injury orillness in the workplace (Guidelines on First-Aid In TheWorkplace (2nd Edition)).

First aid emphasized onearly treatment once casualty occurred while health care is covering all phasesof casualty treatment. By comparing both definition, first aid also can becategorized as a subset of health care elements. 4.2   Requirement of first aid provisionThere are fewfirst aid components in the workplace or premise such as first aid kit,first-aiders, first-aid room and first-aid equipment. The size or quantity offirst aid kit and number of first aiders in particular  workplace are based on few factors suchindustry type, workers headcount, number of work shifts and distance of workplacelocation to the nearest medical clinic or hospital (Guidelines on First-Aid In TheWorkplace (2nd Edition), 2004). Considering the largeheadcount of employees in large premise, the provision of first aid items canbe as many as health care facilities.

4.3   First Aid waste Categorization The World HealthOrganization (WHO) define health care waste as any waste generated by healthcare activities including waste produced from ‘minor’ or ‘scattered’ source (World Health Organization,Definition and Characterization of health-care waste). As first aid is part ofhealth and medical services, hence the waste can be categorized based on their components.First aid products potentially end up to produce several categories of wastesuch as infectious waste, sharps, pharmaceutical waste and chemical waste. InGuidelines on The Handling and Management of Clinical Wastes in Malaysia, thecategorization of first aid is almost as similar as WHO categorization onhealth care waste. Table 1 is the list of first aid waste categories;     Table1: First Aid Waste Categories Components First Aid Products Waste Category 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) Eye pads Gloves Adhesive tape Alcohol prep pads Cotton buds Barrier device for CPR such as  pocket mask and face shield infectious waste, (clinical waste) Clinical waste Any equipment with sharps or pointed parts that able to cause an injury to human. Scissors Safety pin Cervical collar plastic apron Splints Sharps (clinical waste) 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 Disinfectants Antiseptic Burn aid cream Yellow lotion Chemical waste Products or items in the solid state that are expired or no longer needed Cold pack compress gel Unused absorbent paper Unused swabs Solid waste Any products or tools that contained high densities of poisonous metal. Thermometer   Heavy metals As first aid facilities and items are mainly used for early treatment ofcasualty, most of the study do not really focusing much on the hazardous wasteelements in first aid items.

There are no previous published studies assessingand categorized first aid elements particularly in hazardous elements. Theassessment and categorization was always conducted in bigger scale of healthcare 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 ofhealth, safety and environmental impactA lotof study had been conducted to identify the impact of health care waste towardsthe human and environment if the waste is not manage properly. As developingcountry, the management of health care wastes still disorganized as most ofwastes are still handled and disposed together with domestic wastes. Thus itcreating 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 healthcare facilities and services eventually pose the danger and risk to health andto the environment even though the percentage of health care waste isrelatively small compare to the total waste (Bos & Izadpanah, 2002).  Health care waste can be harmful to humanhealth and environment during handling and disposal activities due toinfectious nature (Hossain et al., 2011); (Bokhoree, Beeharry, Makoondlall-Chadee, Doobah, & Soomary, 2014).  Health care isconsidered as hazard in the workplace as it can expose infection risk, toxiceffects and injuries among health care community in the health care facilities.Anyone from the circle of health care community such as workers, waste handlersand 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 injuriesand diseases regardless of infectious and non-infectious.

(Al-Habash & Al-Zu’bi, 2012);  (Nwachukwu, Orji, & Ugbogu, 2013); (Hossain et al., 2011). Some studies emphasizingthat anyone who work in the health care facilities that potentially in contactwith generated health care waste are in danger as the waste are likely to havehazardous components.  It is includingany waste that consists of human tissue, blood or other body fluids,excretions, drugs or other pharmaceutical products, swabs or dressings orsyringes, needles or other sharp instruments.Wateswater effluents that contained pharmaceuticals elements from health care wasteproven to have a great effect towards wild aquatic animals. 2012). Study was conductedand proved that fish exposed to 50% or 100% wastewater effluent had highertissue concentrated with pharmaceuticals in their brain and plasma. Thisphenomena indirectly may potentially change the behavior of the affected fish (McCallum et al.

, 2017). As the effect of the healthcare to wastewater-exposed fish is known, it was obvious that inappropriatehealth care waste management is leading to serious health hazards andenvironmental pollution in this modern world. Mismanagementof health care solid waste management practice also can exposed health carestaffs, 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 wasteis not manage appropriately (Coker et al.

, 2009) .Thus, appropriate methods for the safemanagement of health care waste must be practicing urgently.5.0   Objective of StudyThe aim of this researchis to ensure proper disposal of first aid waste through holistic managementapproach.

The first objective of this research is to identify a current first aid kit management in tertiaryinstitutions. Besides, another objective to be achieved in this study is to propose effective first aid kit managementsystem.6.0   Methodology of Study6.1   Data CollectionThis projectwill be involved 2 stages of data collection. First stage is baseline survey throughat least 20 institutions to get a baseline data for current first aid kitmanagement practice in Malaysia. The survey will answered by 1 responder torepresent the organization at which population associated with it.  Sampling method to be used in this research isnonrandom approach of purposive sample as the sample selected (individual toanswer the questionnaire) must be the person who are very well known ofhandling the management of first aid provision and maintenance in the selectedinstitutions.

Subject completed instruments for the stage 1 of this researchwill be questionnaires. Second stage will be case study approach at which twoinstitutions are chosen to demonstrate the current practice in depth.6.2   BenchmarkTo introduce newconcept of first aid kit management, benchmarking from guidelines, policies andprocedures will be conducted to acquire the best approach. 6.3   Gap AnalysisThe first aidkit management practice will be clustered in few categories to complete thecycle of ‘cradle to grave’ concept.

The holistic management practice as to beintroduced from the benchmarking will be compared to current practice tounderstand the gap of current first aid kit management practice in tertiaryinstitutions.                Figure 1: Flow chart of first aid kit management methodology   7.0   Work Schedule of Study Activity Timeline Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 Topic selection                 Literature review                 Survey preparation                 Survey distribution                 Case study                 Data analysis                 Conclusion                 Report writing                  8.0   ReferencesAdeniran, A. E.

, Nubi, A. T., &Adelopo, A. O. (2017). Solid waste generation and characterization in theUniversity of Lagos for a sustainable waste management. Waste Management, 67, 3-10.

doi:10.1016/j.wasman.2017.

05.002Al-Habash, M.,& Al-Zu’bi, A. (2012). Efficiency and Effectiveness of Medical WasteManagement Performance, Health Sector and its Impact on Environment in JordanApplied Study. World Applied ScienceJournal 19, 6, 880-893. doi:10.

5829/idosi.wasj.2012.19.06.2775Ananth, A. P.

,Prashanthini, V., & Visvanathan, C. (2010). Healthcare waste management inAsia. Waste Manag, 30(1), 154-161.

doi:10.1016/j.wasman.2009.07.

018Bdour, A.,Altrabsheh, B., Hadadin, N., & Al-Shareif, M.

(2007). Assessment of medicalwastes management practice: a case study of the northern part of Jordan. Waste Manag, 27(6), 746-759.doi:10.1016/j.

wasman.2006.03.004Bokhoree, C.,Beeharry, Y.

, Makoondlall-Chadee, T., Doobah, T., & Soomary, N. (2014).Assessment of Environmental and Health Risks Associated with the Management ofMedical Waste in Mauritius. APCBEEProcedia, 9, 36-41. doi:10.

1016/j.apcbee.2014.01.007Bos, A. V. D.,& Izadpanah, A.

(2002). Building Capacity for Comprehensive Medical WasteManagement in Asia. EM The UrbanEnvironment, 18-20.

Coker, A.,Sangodoyin, A., Sridhar, M.

, Booth, C., Olomolaiye, P., & Hammond, F.(2009). Medical waste management in Ibadan, Nigeria: obstacles and prospects. Waste Manag, 29(2), 804-811.doi:10.

1016/j.wasman.2008.06.040Factories and Machinery Act. (1974).Malaysia: Laws of Malaysia.

Guidelines on First-Aid In The Workplace(2nd Edition). (2004). Malaysia: Ministry of Human Resources.Guidelines on The Handling and Management ofClinical Wastes in Malaysia (3rd Edition). (2009 ).

Level 1-4, Podium Block2 & 3, Lot 4G3, Precinct 4, Federal Government Adminstrative Centre, 62574,Putrajaya, Malaysia: Ministry of Natural Resources and Environment.Hossain, M. S.,Santhanam, A.

, Nik Norulaini, N. A., & Omar, A. K. (2011). Clinical solidwaste management practices and its impact on human health and environment-Areview. Waste Management, 31(4),754-766. doi:10.

1016/j.wasman.2010.

11.008McCallum, E. S.,Krutzelmann, E., Brodin, T., Fick, J.

, Sundelin, A., & Balshine, S. (2017).Exposure to wastewater effluent affects fish behaviour and tissue-specificuptake of pharmaceuticals. Science of theTotal Environment, 605-606, 578-588.

doi:10.1016/j.scitotenv.

2017.06.073Nwachukwu, N. K.

,Orji, F. A., & Ugbogu, O. C. (2013). Health Care Waste Management – PublicHealth Benefits, and the Need for Effective Environmental RegulatorySurveillance in Federal Republic of Nigeria. doi:10.

5772/53196Occupational Safety and Health Act (1994).Malaysia: Laws of Malysia.Patwary, M. A.,O’Hare, W. T., Street, G.

, Maudood Elahi, K., Hossain, S. S., & Sarker, M.H. (2009). Quantitative assessment of medical waste generation in the capitalcity of Bangladesh. Waste Manag, 29(8),2392-2397.

doi:10.1016/j.wasman.2009.03.021Sawalem, M., Selic,E.

, & Herbell, J. D. (2009). Hospital waste management in Libya: a casestudy. Waste Manag, 29(4), 1370-1375.doi:10.1016/j.wasman.

2008.08.028Tamplin, S. A.,Davidson, D.

, Powis, B., & O’Leary, Z. (2005). Issues and options for thesafe destruction and disposal of used injection materials. Waste Manag, 25(6), 655-665. doi:10.

1016/j.wasman.2004.07.

007World Health Organization, Definition andCharacterization of health-care waste. Retrieved from http://www.who.int/water_sanitation_health/medicalwaste/002to019.pdf