Evaluating the link between the management of clinical waste in the National Health Service (NHS) and the risk of the spread of infections: A case study of three hospitals in England

This study aimed to evaluate waste management practices in three case study NHS Trusts in England and the potential risks of the spread of pathogens causing healthcare associated infections (HCAls). Using a combination of microbiological techniques, interviews and questionnaire surveys, four target microbes were studied, namely: meticillin resistant Staphylococcus aureus (MRSA), meticillin sensitive Staphylococcus aureus (MSSA), Clostridium difficile (C. difficile) and vancomycin-resistant enterococci (VRE). Waste Flow Diagrams (WFDs) were used to map the flow of the waste. While there was a perceived link between the management of the waste and the spread of the microbes by staff, none of the target organisms were isolated. The findings suggest that when the waste is properly contained and managed that it should not pose a significant risk in terms of the spread of the four bacteria tested in this study. In addition, the results demonstrate that there is a need for staff perceptions and beliefs to be addressed in the development of policies and training related to infection control and its link to waste management. (C) 2010 Elsevier GmbH. All rights reserved.