Desafios e oportunidades de melhorias no gerenciamento de resíduos sólidos em uma unidade hospitalar

Abstract

Healthcare Waste (HW), due to its characteristics and potential biological risk, requires differentiated management compared to urban solid waste, encompassing stages from generation to environmentally appropriate final disposal. Inadequate management of this type of waste can lead to negative impacts on public health and the environment. In this context, the objective of this study was to diagnose and evaluate the management of HW in a large hospital located in the northern region of Paraná State, Brazil, in the year 2024. The analysis was divided into three distinct periods: 1st period – pre-intervention (before improvements); 2nd period – study environment assessment; and 3rd period – post-intervention (after the implemented improvements). In the first period, data on waste generation from the hospital's solid waste management sector were analyzed for the months of January to May 2024. During the second period (June and July 2024), a detailed survey was conducted to assess compliance and non-compliance with current legislation, particularly RDC No. 222/2018. The evaluation considered aspects such as segregation of waste at the point of generation, packaging methods, collection, transportation, conditions of temporary storage facilities, and final disposal, as well as the institution’s internal and external physical infrastructure. Following the assessment phase, improvements were implemented in the hospital. In the third period, waste generation data from the pre and post-intervention stages were analyzed using key performance indicators (KPIs) and a SWOT analysis. The main non-conformities identified included inadequate intermediate storage areas (ISAs), damaged or unidentified containers, lack of defined routes and schedules for internal collection, improper disposal of waste in both internal and external areas, sources of unsanitary conditions, and deficiencies in the temporary storage area. Between August and December 2024, improvements were carried out, including adjustments to the ISAs, replacement and standardization of containers, proper visual signage, establishment of defined routes and schedules for internal collection, reorganization of the temporary storage facility, inclusion of recyclable segregation, and acquisition of new transport carts. To assess the results, KPIs and SWOT analysis were applied, allowing a comparative evaluation of the analyzed periods. The data revealed a total of 1,050 tons of HW generated in 2024. Most of this comprised general, recyclable, and organic waste, accounting for 91% in the pre intervention period and 86% in the post-intervention period, while infectious waste (biological, sharps, and chemical) accounted for 13% and 9%, respectively, in the same periods. After the improvements, significant progress in waste management was observed, particularly in segregation practices, reduction of general waste generation, and increased recyclable separation. It is concluded that the implemented actions contributed positively to the improvement of HW management in the studied institution. However, the continuation of this process is essential, through ongoing monitoring and continuous training of the involved professionals, aiming to consolidate the achieved results and ensure the sustainability of the adopted practices.