Assessment of the effectiveness of hospital recycling program by improving the recycling behavior of nurses

Background: Today, one of the most important causes of environmental pollution is the increase in the amount of waste. The introduction of recyclable wastes into household wastes and medical wastes brings economic and environmental burdens and it is important that the waste is properly separated at the source. The purpose of this study was to determine the effect of the "Hospital Recycling Program" on the recycling behaviors and waste quantities of wastes generated during the practices of the nurses. Materials and Methods: The pre-test post-test control group experimental study was conducted at Ege University Medical Faculty Hospital Department of General Surgery and Department of Cardiovascular Surgery between June 2017 and February 2018. The study was completed with the intervention group consisted of 32 nurses and the control group of 32. For the first time in the study, the clinics performed weekly waste measurements and Nurse Description Form, Environmental Behavior Scale, and Sustainable Hospital Recycling Scale was pre-tested by nurses. Then, within the scope of the Hospital Recycling Program based on Planned Behavior Theory, a training, video demonstration was made for the intervention group; Green University Booklet and brochures were given, recycling boxes were put in clinics. Two weeks after the end of the program, one week of waste measurements were made and The post-tests of the scales were carried out. SPSS 20.0 package program, LISREL 8.8 package program, and G-Power software were used in evaluating the data. The chi-square test and the Friedman test were used to evaluate the homogeneity of the intervention and control groups. Data were analyzed using the number, percentage, mean, median, minimum, maximum, standard deviation values, Shapiro-Wilk test, Student t-test, Mann Whitney U test, Paired Sample t-test and Wilcoxon Signed Ranks test. Results: The mean age of the nurses in the whole group was 34.42±7.62; %96,9 of the nurses were women, 53% are married and 85,9% are undergraduate. The average duration of vocational work is 11,80±8,08 years. 57.8% of the nurses are doing nature walk/sightseeing and 4.7% are members of an environmental group. 34.4% of the nurses are separate waste for recycling in the apartment sits. No statistically significant difference was found between the groups when the pre-test post-test score difference of the Environmental Behavior Scale of the nurses in the intervention and control groups was examined (p>0.05). When the pre-test post-test score difference of each of the total and sub-dimension scores of the Sustainable Hospital Recycling Scale is examined among the groups; statistically significant differences were found in attitude (p=0.001), perceived behavior control (p=0.016), perceived/conditional situations (p=0.001), behavior intention (0.040) and recycling behavior (p=0.029). In dimension of behavioral outcomes (p=0.846), importance of behavioral outcomes (p=0.366), subjective norm (p=0.195), perceived expectations (0.343), importance of expectations (p=0.850), facilitating conditions/situations (p=0.054), there was no significant difference. When the whole scale sum is considered, it was found that the Hospital Recycling Program made a statistically significant difference in the intervention group (p=0.001). In two different models created by Path Analysis; perceived behavioral control (Model I: β=2.47, p<0.05, Model II: β=2.57, p<0.05) was found to have an effect on intention, the total change in the intention variable was 19% in Model 1 and 16% in Model 2. In Model 2, it was determined that "Hospital Recycling Program" (β=2.14, p<0.05) had a significant effect on the attitude and 7% of the total change in the attitude variable. When waste measurements are considered, there was no statistically significant difference between the groups in the changes in the amounts of domestic and cutter piercing waste (p>0.05); there was a significant decrease in the amount of medical waste of the intervention group compared to the control group (p=0.003) and a significant increase in the amount of recyclable waste (p=0.001). Conclusion: The results of this study show that the Hospital Recycling Program based on the Planned Behavior Theory has a positive effect on nurses' recycling behaviors and amount of recycling waste. Keywords: Theory of Planned Behavior; Hospital Recycling Program; nurse; recycling behavior, sustainability.