AB157. Perception and practices on waste management of nurses in a selected hospital in Angeles City: a narrative photovoice study

Background: Healthcare waste (HCW), a by-product of healthcare facility operations, poses serious infection and environmental risks—especially in resource-limited settings. Nurses, as both generators and frontline handlers of HCW, play a vital role in its management. Despite Department of Health guidelines mandating color-coded segregation and proper disposal, challenges persist due to gaps in training, resources, and policy enforcement. However, limited research explores how nurses perceive and practice HCW management within Philippine hospitals.

Methods: This study investigated nurses’ perceptions and practices on HCW management in a selected hospital in Angeles City using a qualitative, narrative-photovoice design. Seven nurses with at least three months of clinical experience were purposely and referentially recruited. Photovoice, a participatory method where participants use photography to reflect on issues, guided data collection. Participants captured images of HCW processes and responded to SHOWeD questions to interpret their photos. Semi-structured interviews were transcribed and analyzed using Braun and Clarke’s six-phase thematic analysis, with reflexivity to preserve authentic participant voices.

Results: Five themes emerged: (I) “Slipping Through the Cracks of Safe Waste Practices”; (II) “Making Do Amid the Mess of Broken Systems”; (III) “Building Competence through Knowledge and Experience”; (IV) “Walking the Clean Line with Integrity and Responsibility”; and (V) “Sorting Out the Clutter for Cleaner Communication and Systemic Waste Management”. While nurses showed dedication and creativity, they were often hindered by limited training, lack of supplies, and heavy workloads.

Conclusions: The study highlights nurses’ critical role in HCW safety, but also the structural barriers they face. To address this, the researchers recommend regular HCW training, consistent provision of standardized bins, strengthened policy enforcement through audits, and the creation of interprofessional leadership committees. These actions can improve compliance, protect health workers and patients, and promote sustainable HCW practices.

Keywords: Healthcare waste management (HCW management); photovoice; nurses; waste segregation; occupational safety