A sequential explanatory study on knowledge, attitudes, and practices of biomedical waste management among healthcare workers using a Kirkpatrick framework.

Background: Biomedical waste management (BMW) is critical for public health and environmental protection. Training programs often assess knowledge but rarely evaluate translation to workplace practice. The study assessed knowledge, attitudes, and practices of BMW and explore perceived barriers to co...

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Publicado en:Discover Public Health Vol. 23; no. 1; pp. 1 - 14
Autores principales: Kushwaha, Poonam, Dam, Nilanjan, Shekhar, Saket, Singh, Satya Prakash
Formato: research tables/charts Journal Article
Publicado: Springer Nature 7/9/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 7/9/2026
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      pub: Springer Nature
      place: New York, New York
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        atl: A sequential explanatory study on knowledge, attitudes, and practices of biomedical waste management among healthcare workers using a Kirkpatrick framework.
      aug:
        au:
          Kushwaha, Poonam
          Dam, Nilanjan
          Shekhar, Saket
          Singh, Satya Prakash
        affil: https://ror.org/02vhyd254 Department of Community Medicine, Rama Medical College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
      sug:
        subj:
          Professional Knowledge Evaluation
          Attitude of Health Personnel Evaluation
          Professional Practice Evaluation
          Medical Waste Disposal
          India
          Human
          Male
          Female
          Adult
          Tertiary Health Care
          Structured Questionnaires
          Semi-Structured Interview
          Descriptive Statistics
          Purposive Sample
          Thematic Analysis
          Self Report
          Quantitative Studies
          Qualitative Studies
          Content Analysis
          Practice Guidelines
          Nursing Staff, Hospital
          Interns and Residents
          Blue Collar Workers
          Learning
          Immunization Programs
          Occupational Health
          Staff Development
          Personnel Turnover
          Personnel Staffing and Scheduling
          Supervisors and Supervision
          Organizational Culture
          Implementation Science
          Employee Orientation
          Data Analysis Software
          Adult: 19-44 years
          Male
          Female
      ab: Background: Biomedical waste management (BMW) is critical for public health and environmental protection. Training programs often assess knowledge but rarely evaluate translation to workplace practice. The study assessed knowledge, attitudes, and practices of BMW and explore perceived barriers to compliance using Kirkpatrick framework. Methods: A sequential explanatory study was conducted at a tertiary hospital in North India. Phase-I surveyed 250 healthcare workers via structured questionnaire to assess KAP corresponding to Kirkpatrick Levels 1–2, response rate 87.7%. Level 1 was inferred from questions on perceived usefulness and relevance of training. Phase-II conducted 12 face-to-face semi-structured interviews with purposively sampled staff from high BMW-generating departments until thematic saturation. Interviews explored self-reported behaviour and perceived organizational outcomes corresponding to Levels 3–4. Quantitative data were analyzed descriptively. Qualitative data were analyzed by content analysis in QDA Miner Lite v3.0.7 with independent coding by two researchers. Integration was achieved at interpretation stage via joint display, and meta-inference per GRAMMS guidelines. Results: Participants were predominantly female (75.2%). 58% were nursing staff/trainees/BMW handlers. High awareness was observed for BMW rules 97.2% and color-coding 98.0%, but practice gaps persisted: only 68.4% used full PPE, 71.1% used hub-cutters, and 66.8% knew 1% sodium-hypochlorite preparation. Qualitative analysis identified four domains: Level 1-Reaction: training perceived useful but short; Level 2-Learning: high knowledge but skill gaps; Level 3-Behavior: self-reported compliance undermined by understaffing, turnover, lack of supervision; Level 4-Results (perceived): vaccination achieved but audits and injury reduction absent per participant perception. Integration showed positive reaction and learning were associated with, but did not consistently translate to, self-reported behaviour due to systemic barriers. Conclusion: Despite high awareness, self-reported compliance was suboptimal. Perceived gaps in training, enforcement, staffing, and accountability were associated with limited knowledge-to-practice translation. Participants perceived organizational outcomes remained limited. Refresher training, workforce stabilization, and supervisory audits may be needed for safety outcomes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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