UBND TNH KON TUM

______

(D THO)

K HOCH QUN L CHT THI Y T

TNH KON TUM N NM 2020
(Ban hnh km theo Quyt nh s /Q-UBND ngy thng
ca y ban nhn dn tnh Kon Tum)

nm 2015

Thng 8/2015

MC LC
PHN 1. HIN TRNG QUN L CHT THI Y T TNH KON TUM.......2
1. HIN TRNG QUN L CHT THI RN Y T..........................................2
1.1. Cc ngun cht thi rn y t................................................................................2
1.1.1. M t cc c s y t ti tnh Kon Tum..................................................................2
1.1.2. Khi lng cht thi pht sinh t cc c s y t...................................................2
1.1.3. K hoch m rng cc c s y t..........................................................................2
Bng 1.1. Ch tiu hng ti ca ngnh Y t tnh Kon Tum nm 2020..................2
Bng 1.2 K hoch m rng cc bnh vin cng lp tnh Kon Tum......................2
1.1.4. D tnh cht thi y t pht sinh trong tng lai 2
Bng 1.3. c tnh khi lng cht thi rn y t nguy hi pht sinh ti cc BV
tuyn tnh v tuyn huyn...........................................................................................2
1.2. X l cht thi rn y t.........................................................................................2
1.2.1. M hnh x l ti ch...........................................................................................2
Bng 1.4. Mt s cng ngh c s dng ti cc Bnh vin.................................2
1.2.2. M hnh x l tp trung theo cm.............................................................................2
1.3. Vn chuyn cht thi y t ra ngoi Bnh vin x l....................................2
1.4. Tiu hy sau cng cht thi y t..........................................................................2
2. HIN TRNG QUN L NC THI Y T...................................................2
2.1. Khi lng nc thi ca cc c s y t............................................................2
2.2. M t cc cng trnh x l nc thi trong tnh................................................2
2.3. Quan trc cht lng nc thi...........................................................................2
2.4. Tiu hy bn.........................................................................................................2
3. HIN TRNG T CHC TRIN KHAI V YU CU THC THI.............2
3.1. Khun kh php l cho qun l cht thi y t ti tnh Kon Tum.....................2
3.2. C cu t chc cho qun l v gim st qun l cht thi y t........................2
4. CC D N H TR QUN L CHT THI Y T TRONG TNH...........2
PHN 2. K HOCH CI THIN...........................................................................2
1. NH HNG CHUNG........................................................................................2
Bng 2.1. D tnh khi lng CTYTNH c x l ti cm 01............................2
Bng 2.2: D tnh khi lng CTYTNH c x l ti cm 02............................2
1.1. nh hng cho cc ch ngun thi...................................................................2
nh hng i vi cht thi rn...................................................................................2
2

nh hng i vi cht thi lng.................................................................................2

nh hng i vi kh thi...........................................................................................2
1.2. nh hng cho cc ch x l............................................................................2
Ch x l cht thi thng thng l Cng ty TNHH Mt thnh vin mi trng
th Kon Tum....................................................................................................................2
1.3. nh hng cho cc ch vn chuyn..................................................................2
2. XY LP V THIT B.......................................................................................2
2.1. Qun l cht thi rn............................................................................................2
2.1.1. Phng tin phn loi, thu gom, vn chuyn v lu gi...............................2
2.1.2. Phng tin vn chuyn cht thi nguy hi bn ngoi bnh vin......................2
2.1.3. C s x l cht thi y t.............................................................................................2
2.2.1. Cc cng trnh x l nc thi bnh vin...........................................................2
2.2.2. Cc cng trnh x l nc thi cho cc c s khc............................................2
3. NNG CAO NNG LC TH CH CHO QUN L CHT THI Y T...2
3.1. C cu t chc......................................................................................................2
3.1.1. Phn cng trch nhim v c ch phi hp gia cc c quan QL Nh nc...2
3.1.2. C cu t chc qun l cht thi trong cc c s y t............................................2
3.2. Nng cao nng lc qun l, o to v truyn thng nng cao nhn thc
trong cc c s y t......................................................................................................2
3.2.1. i vi Bnh vin.........................................................................................................2
3.2.2. i vi cc c s y t khc.........................................................................................2
3.3. Theo di v gim st thc thi..............................................................................2
3.3.1. Gim st tun th quy trnh.........................................................................................2
3.3.2. Gim st cht thi.........................................................................................................2
3.3.3. Gim st mi trng xung quanh..............................................................................2
4. GII PHP TI CHNH........................................................................................2

PH LC
Ph lc 1: Bn cc huyn ca Tnh Kon Tum.....................................................2
Ph lc 2: C cu t chc y t tnh Kon Tum.............................................................
Ph lc 3-1: c im chung ca cc Bnh vin trong tnh......................................
Ph lc 3-2: c im mi trng ca cc Bnh vin trong tnh.............................
Ph lc 3-3: D tnh cht thi y t pht sinh trong 2015 v 2020 (1).......................
Ph lc 3-4: D tnh cht thi y t pht sinh trong 2015 v 2020 (2).......................
Ph lc 3-5: D tnh nc thi y t pht sinh trong 2015 v 2020 (3)
Ph lc 3-6: Phng n x l v tiu hy cht thi y t ca cc Bnh vin............
Ph lc 3-7: Cc cng trnh x l nc thi Bnh vin.............................................
Ph lc 3-8: Kt qu ca t thanh tra, kim tra Bnh vin gn nht......................
Ph lc 3-9: Cc d n v h tr qun l cht thi y t trong tnh............................
Ph lc 3-10: Nhu cu u t cho h thng phn loi, thu gom, vn chuyn, lu
gi, x l v tiu hy cht thi y t..............................................................................
Ph lc 3-11: Nhu cu u t nng cao nng lc qun l..........................................
DANH MC BNG
Bng 1.1. Ch tiu hng ti ca ngnh Y t tnh Kon Tum nm 2020................2
Bng 1.2. K hoch m rng cc bnh vin cng lp tnh Kon Tum....................2
Bng 1.3. c tnh khi lng cht thi rn y t nguy hi pht sinh ti cc BV
tuyn tnh v tuyn huyn......................................................................................2
Bng 1.4. Mt s cng ngh c s dng ti cc bnh vin...............................2
Bng 2.1. D tnh khi lng CTYTNH c x l ti cm 01...........................2
Bng 2.2: D tnh khi lng CTYTNH c x l ti cm 02...........................2

DANH MC T VIT TT
BHL

Bo h lao ng

BOD5

Nhu cu oxy sinh hc trong 5 ngy

BTNMT

B Ti nguyn v Mi trng

BV

Bnh vin

BVK

Bnh vin a khoa

BVKKV

Bnh vin a khoa khu vc

BYT

B Y t

CTNH

Cht thi nguy hi

COD

Nhu cu oxy ha hc

CTRSH

Cht thi rn sinh hot

CTYTNH

Cht thi y t nguy hi

GB

Ging bnh

KSNK

Kim sot nhim khun

PKKKV

Phng khm a khoa khu vc

QCVN

Quy chun k thut quc gia

RBC

Rotating Biological Contactors

TTYT

Trung tm Y t

TYT

Trm Y t

UBND

y ban nhn dn

PHN 1
HIN TRNG QUN L CHT THI Y T CA TNH KON TUM
____________

1. HIN TRNG QUN L CHT THI RN Y T

1.1. Cc ngun cht thi rn y t
1.1.1. M t cc c s y t ti tnh Kon Tum
a) Tuyn tnh:
* Qun l nh nc:
- S Y t: Gm c 08 phng, ban (Vn phng S, Thanh tra S, phng T
chc cn b, phng Nghip v Y, phng Nghip v Dc, phng K hoch - Ti
chnh, phng Php ch v Ban qun l cc d n xy dng).
- Chi cc ATVSTP tnh l n v trc thuc S Y t, thnh lp v i vo
hot ng t qu IV nm 2008.
- Chi cc DS-KHHG tnh l n v trc thuc S Y t, thnh lp t nm
2008 trn c s gii th y ban Dn s, Gia nh v Tr em tnh.
* H d phng: C 8 n v gm:
- Trung tm Y t d phng tnh.
- Trung tm Phng chng bnh x hi.
- Trung tm Chm sc sc kho sinh sn.
- Trung tm Phng chng St rt - K sinh trng - Cn trng.
- Trung tm Kim nghim.
- Trung tm Truyn thng - Gio dc sc kho.
- Trung tm Kim dch y t.
- Trung tm Phng chng HIV/AIDS.
* H iu tr: Gm c 5 c s khm, cha bnh vi 750 ging bnh v
01 c s gim nh y khoa:
- Bnh vin a khoa tnh, hng II, 450 ging.
- Bnh vin a khoa khu vc Ngc Hi, hng III, 170 ging.
- Bnh vin Phc hi chc nng, hng III, 50 ging.
- Bnh x khu iu tr phong k Kia, 30 ging (trc thuc Trung tm
Phng chng bnh x hi).
- Bnh vin Y hc c truyn, 75 ging bnh (hng III).
- Trung tm Gim nh y khoa.
* H o to: 01 n v Trng Trung hc y t tnh.
b) Tuyn huyn: T chc b my y t tuyn huyn c t chc theo
Ngh nh s 13/2008/N-CP v Ngh nh s 14/2008/N-CP ngy 04/02/2008
ca Chnh ph; Thng t lin tch s 03/2008/TTLT-BYT-BNV ngy 25/4/2008
ca lin B Y t - B Ni v hng dn chc nng, nhim v, quyn hn, c cu
t chc ca S Y t, Phng Y t thuc UBND cp tnh, huyn, c th nh sau:
6

- C 9 Phng Y t huyn, thnh ph do UBND huyn, thnh ph qun l

v t chc v bin ch, ng thi chu s ch o ca S Y t v chuyn mn.
- Trung tm Y t (TTYT) ti tuyn huyn thc hin vi 2 chc nng y t
d phng v khm cha bnh.
Hin c 7 bnh vin a khoa (BVK) trc thuc 7 TTYT huyn vi 430
ging bnh gm: BVK huyn k H (hng III, 70 ging), BVK huyn
k T (hng III, 85 ging), BVK huyn Tu M Rng (50 ging, cha
phn hng), BVK huyn k Glei (hng III, 60 ging), BVK huyn Sa
Thy (hng III, 60 ging), BVK huyn Kon Ry (hng III, 55 ging),
BVK huyn Kon Plong (hng III, 50 ging). TTYT thnh ph Kon Tum v
TTYT huyn Ngc Hi khng c bnh vin.
Ngoi ra cn c 9 i YTDP trc thuc 9 TTYT huyn, thnh ph v 13
phng khm a khoa khu vc (PKKKV) trc thuc 8 TTYT huyn, thnh ph
vi 170 ging (PKKKV Ng My, PKKKV trung tm thnh ph Kon Tum,
PKKKV k Hring, PKKKV Ngc Wang, PKKKV Ya Xier, PKKKV
R Ki, PKKKV k Ring, PKKKV Nam M Rai, PKKKV k Rve,
PKKKV k R ng, PKKKV Tu M Rng, PKKKV k Mn,
PKKKV Mng Hoong). Ring huyn k T khng c PKKKV.
- C 9 Trung tm ATVSTP huyn, thnh ph trc thuc Chi cc ATVSTP
tnh v 9 Trung tm DS-KHHG trc thuc Chi cc DS-KHHG tnh.
c) Tuyn x: Ton tnh c 102 trm y t (TYT) x, phng, th trn vi
tng s 510 ging bnh (mi TYT x c 5 ging).
- 11 Trm y t x trc thuc Trung tm Y t huyn k H.
- 14 Trm y t x trc thuc Trung tm Y t huyn Sa Thy.
- 07 Trm y t x trc thuc Trung tm Y t huyn Kon Ry.
- 09 Trm y t x trc thuc Trung tm Y t huyn Kon Plng.
- 21 Trm y t x trc thuc thnh ph Kon Tum.
- 09 Trm y t x trc thuc Trung tm Y t huyn k T.
- 11 Trm y t x trc thuc Trung tm Y t huyn Tu M Rng.
- 12 Trm y t x trc thuc Trung tm Y t huyn k Glei.
- 08 Trm y t x trc thuc Trung tm Y t huyn Ngc Hi.
Tt c cc c s y t trn a bn tnh Kon Tum u c v tr giao thng
thun tin, gn trung tm cc huyn, thnh ph, th x, thun li cho vic vn
chuyn v x l cht thi y t (CTYT) tp trung theo cm bnh vin. Cc bnh
vin huyn c quy m t 50 - 250 ging (Ph lc 3-1).
Ti tnh cn mt s bnh vin, c s khm cha bnh cha c h thng x
l nc thi v cht thi rn y t hoc c u t nhng xung cp, h hng
khng s dng c. Hu ht cc c s ny u gp kh khn trong vic u t
mi, sa cha h thng x l cht thi.
7

Mc d c nhiu quy nh hng dn v qun l cht thi y t c

ban hnh song nhn chung nhn thc cng tc bo v mi trng cc n v
khm cha bnh cn hn ch v cha c quan tm ng mc.
1.1.2. Khi lng cht thi y t pht sinh t cc c s y t
a) M t ngun pht sinh cht thi y t nguy hi:
Cht thi y t l vt cht th rn, lng v kh c thi ra t cc c s y
t trn a bn (gm: cc c s khm, cha bnh cng lp v ngoi cng lp,
trm y t, cc n v y t d phng, o to cn b y t, sn xut, kinh doanh
dc phm). Cht thi y t gm cht thi y t nguy hi v cht thi thng
thng.
Cht thi rn y t gm:
- Cht thi rn sinh hot: L cht thi thng thng, pht sinh t cc
bung bnh (tr cc bung bnh cch ly), t cc cng vic hnh chnh (giy,
bo, ti nilon,), l cy v rc t cc khu vc ngoi cnh. L cht thi khng
cha cc yu t ly nhim cho con ngi.
- Cht thi rn y t nguy hi: L cht thi pht sinh t cc c s y t, c
mang cc yu t gy bnh, cc cht c hi, nu khng c x l trit s
gy nh hng n sc kho con ngi v mi trng. Cht thi rn y t nguy
hi gm:
+ Cht thi sc nhn (loi A): L cht thi c th gy ra cc vt ct hoc
chc thng, c th nhim khun, bao gm: bm kim tim, u sc nhn ca dy
truyn, li dao m, inh m, ca, cc ng tim, mnh thu tinh v v cc vt
sc nhn khc s dng trong cc loi hot ng y t.
+ Cht thi ly nhim khng sc nhn (loi B): L cht thi b thm mu,
thm dch sinh hc ca c th v cc cht thi pht sinh t bung bnh cch ly.
+ Cht thi c nguy c ly nhim cao (loi C): L cht thi pht sinh trong
cc phng xt nghim nh: bnh phm v dng c ng, dnh bnh phm.
+ Cht thi gii phu (loi D): Bao gm cc m, c quan, b phn c th
ngi; rau thai, bo thai v xc ng vt th nghim.
+ Cht thi pht sinh t cc hot ng chuyn mn y t nh cc chai l
thu tinh, cc vt liu nha,... c cha cc yu t ho hc nguy hi, phng x, d
chy, n.
b) S lng cht thi rn pht sinh ton tnh, s cht thi nguy hi mi
ngy mi ging bnh ca cc bnh vin.
Theo s liu thng k s b v tnh hnh qun l cht thi y t ca tnh
Kon Tum, khi lng cht thi rn y t pht sinh t cc c s y t trong ton tnh
Kon Tum l:
- C s khm, cha bnh l cc bnh vin tuyn tnh, tuyn huyn: Lng
cht thi rn pht sinh trong ngy l 1.863 Kg/ngy (trong : cht thi nguy hi
l 310.5 Kg/ngy; cht thi thng thng l 1.552,5 Kg/ngy).

- C s l cc phng khm a khoa: Lng cht thi rn pht sinh trong

ngy l 216 Kg/ngy (trong : Cht thi nguy hi l 36 Kg/ngy; cht thi
thng thng l 180 Kg/ngy).
- C s l cc trm y t x, phng, th trn: Lng cht thi rn pht sinh
trong ngy l 612 Kg/ngy (trong : cht thi nguy hi l 102 Kg/ngy; cht
thi thng thng l 510Kg/ngy).
Nh vy, ton tnh Kon Tum c tng khi lng cht thi rn khong
2.691Kg/ngy; trong , c 448,5 Kg cht thi y t nguy hi/ngy. D kin n
2020, tng lng cht thi rn vo khong 3.543 Kg/ngy; trong c khong
590,5 Kg cht thi rn nguy hi/ngy.
Cng tc thu gom, vn chuyn v x l hin ti cn nhiu hn ch, iu
ny s gy nh hng n sc khe ca cng ng nu khng kp thi x l.
1.1.3. K hoch m rng cc c s y t
Trong thi gian ti, ngnh Y t tnh Kon Tum s tp trung vo nhim v
hon thin h thng chnh sch, pht trin h thng y t. Xy dng h thng y t
ngy cng hin i, hon chnh v ng b t tuyn tnh, thnh ph n huyn,
x, phng, th trn vi cc ch tiu hot ng nh sau:
Bng 1.1. Mt s ch tiu ca ngnh Y t tnh Kon Tum n nm 2020
TT

Ch tiu

n v tnh

Ch tiu
n nm
2020

11,8

T l tng dn s t nhin

Tui th trung bnh

T sut cht tr di 1 tui

30

T sut cht tr di 5 tui

42

T sut cht m

60

T sut tr cn nng di 2.500g

T l suy dinh dng tr em di 5 tui (cn

nng/tui)

17

S ging bnh bnh qun/vn dn

Vn dn

46,5

S bc s bc s/vn dn

Vn dn

11-12

10

T l tr di 1 tui i tim chng y

98

11

T sut mc cc bnh nh st rt, bu c, lao

phong

12

T l x t b tiu ch quc gia y t x

100

71

thc hin cc nh hng ngnh ra, ngnh y t tnh Kon Tum thc
hin k hoch m rng cc c s y t (bnh vin cng lp tuyn tnh, huyn)
nh sau:
9

Bng 1.2. K hoch m rng cc bnh vin cng lp tnh Kon Tum

TT

C s y t

S ging
nm 2015

Phn
tuyn

Hnh thc

K
hoch

Thc
k

S
ging
k hoch
n nm
2020

Khi bnh vin tnh

BVK tnh

Tnh

a khoa

480

480

500

BVK khu vc Ngc Hi

Tnh

a khoa

170

200

300

Bnh x khu iu tr phong

k Kia

Tnh

Chuyn khoa

30

30

30

Bnh vin Y hc c truyn

Tnh

Chuyn khoa

50

75

150

Bnh vin PHCN

Tnh

Chuyn khoa

50

50

150

Bnh vin Lao v Bnh

phi

Tnh

Chuyn khoa

100

Bnh vin Sn - Nhi

Tnh

Chuyn khoa

100

II

Khi bnh vin huyn

BVK huyn k Glei

Huyn

a khoa

60

60

120

BVK huyn k T

Huyn

a khoa

85

85

150

10

BVK huyn Tu M Rng

Huyn

a khoa

50

50

100

11

BVK huyn k H

Huyn

a khoa

70

70

150

12

BVK huyn Kon Ry

Huyn

a khoa

55

55

120

13

BVK huyn Kon Plng

Huyn

a khoa

50

50

100

14

BVK huyn Sa Thy

Huyn

a khoa

60

60

120

15

BVK Ia HDrai (huyn

mi thnh lp nm 2015)

Huyn

a khoa

50

16

BVK TP. Kon Tum

Huyn

a khoa

50

III PKKKV
17

PKKKV k Mn huyn
k Glei

Huyn

Phng khm

10

10

15

18

PKKKV Mng Hoong

huyn k Glei

Huyn

Phng khm

10

10

15

19

PKKKV k Dc huyn
Ngc Hi

Huyn

Phng khm

20

20

20

20

PKKKV Tu M Rng
huyn Tu M Rng

Huyn

Phng khm

10

10

20

21

PKKKV k R ng

Huyn

Phng khm

10

10

15
10

TT

C s y t

Phn
tuyn

Hnh thc

S ging
nm 2015
K
hoch

Thc
k

huyn Tu M Rng

S
ging
k hoch
n nm
2020

22

PKKKV Ngc Wang

huyn k H

Huyn

Phng khm

10

10

15

23

PKKKV k Hring
huyn k H

Huyn

Phng khm

10

10

15

24

PKKKV k Rung
huyn Kon Ry

Huyn

Phng khm

10

10

10

25

PKKKV k Ring huyn

Kon Plong

Huyn

Phng khm

10

10

15

26

PKKKV R Ki huyn
Sa Thy

Huyn

Phng khm

10

10

15

27

PKKKV Ya Xir huyn

Sa Thy

Huyn

Phng khm

10

10

15

28

PKKKV Nam M Rai

huyn Sa Thy

Huyn

Phng khm

10

10

10

29

PKKKV Ng My thnh
ph Kon Tum

Huyn

Phng khm

20

20

20

30

PKKKV thnh ph Kon

Tum

Huyn

Phng khm

20

20

20

Trm y t

510

510

535

IV Trm y t x
31

Cc Trm Y t x trc
thuc Trung tm Y t cc
huyn, thnh ph

Trng hc

32

Trng Trung cp Y

1.1.4. D tnh cht thi y t pht sinh trong tng lai:

Da vo s lng cht thi y t nguy hi cc BV hin nay v quy m
ging bnh k hoch cc bnh vin n nm 2020, s lng cht thi rn y t
nguy hi c tnh nh bng sau:
Bng 1.3. c tnh khi lng cht thi rn y t nguy hi
pht sinh ti cc c s y t trn a bn tnh

11

Nm 2015
TT

C s y t

S
ging

Mc
x thi

D kin n nm 2020
Khi
lng
CTNH

(Kg/ging
/ngy)

(Kg/ngy)

S
ging

Mc
x thi

Khi
lng
CTNH

(Kg/ging
/ngy)

(Kg/ngy)

Khi bnh vin tnh

BVK tnh

480

1,5

110

500

1,5

116

BVK khu vc Ngc

Hi

200

2,2

55

300

1,9

74,5

Bnh x khu iu tr
phong k Kia

30

2,6

6,2

30

2,6

6,2

Bnh vin Y hc c
truyn

75

0,7

4,95

150

1,1

22

Bnh vin PHCN

50

2,2

10,2

150

2,2

30,6

Bnh vin Lao v Bnh

phi

100

1,8

23,5

Bnh vin Sn - Nhi

100

1,8

23,5

II

Khi bnh vin huyn

BVK huyn k Glei

60

2,4

13,8

120

2,2

23

BVK huyn k T

85

2,1

22,4

150

2,0

29,5

10

BVK huyn Tu M
Rng

50

1,5

11

100

2,2

20,5

11

BVK huyn k H

70

2,5

19

150

2,4

29,5

12

BVK huyn Kon Ry

55

1,5

12,1

120

1,5

24,2

13

BVK huyn Kon

Plng

50

2,3

13,2

100

2,2

19,5

14

BVK huyn Sa Thy

60

1,4

12,6

120

1,4

25,2

15

BVK Ia HDrai
(huyn mi thnh lp
nm 2015)

50

2,1

10,5

16

BVK TP. Kon Tum

50

2,1

10,5

15

1,4

3,3

III PKKKV
17

PKKKV k Mn

10

1,5

3,3

12

Nm 2015
TT

C s y t

S
ging

Mc
x thi

D kin n nm 2020
Khi
lng
CTNH

(Kg/ging
/ngy)

(Kg/ngy)

S
ging

Mc
x thi

Khi
lng
CTNH

(Kg/ging
/ngy)

(Kg/ngy)

huyn k Glei
18

PKKKV Mng
Hoong huyn k Glei

10

1,5

3,3

15

1,4

3,3

19

PKKKV k Dc
huyn Ngc Hi

20

1,5

4,4

20

1,4

4,4

20

PKKKV Tu M
Rng huyn Tu M
Rng

10

1,5

3,3

20

1,4

4,4

21

PKKKV k R ng
huyn Tu M Rng

10

1,5

3,3

15

1,4

3,3

22

PKKKV Ngc Wang

huyn k H

10

1,5

2,2

15

1,4

3,3

23

PKKKV k Hring
huyn k H

10

1,5

2,2

15

1,4

3,3

24

PKKKV k Rung
huyn Kon Ry

10

1,5

2,2

10

1,4

2,2

25

PKKKV k Ring
huyn Kon Plong

10

1,5

2,2

15

1,4

3,3

26

PKKKV R Ki
huyn Sa Thy

10

1,5

2,2

15

1,4

3,3

27

PKKKV Ya Xir
huyn Sa Thy

10

1,5

2,2

15

1,4

3,3

28

PKKKV Nam M
Rai huyn Sa Thy

10

1,5

2,2

10

0,9

2,2

29

PKKKV Ng My
thnh ph Kon Tum

20

1,5

4,4

20

1,4

4,4

30

PKKKV thnh ph
Kon Tum

20

1,5

4,4

20

1,4

4,4

510

1,5

91,2

535

1,5

95,7

IV Trm y t x
31

Cc Trm Y t x trc
thuc Trung tm Y t
cc huyn, thnh ph

Trng hc
13

Nm 2015
TT

32

C s y t

S
ging

Mc
x thi
(Kg/ging
/ngy)

D kin n nm 2020
Khi
lng
CTNH
(Kg/ngy)

S
ging

Mc
x thi
(Kg/ging
/ngy)

Khi
lng
CTNH
(Kg/ngy)

Trng Trung cp Y

Hin nay, khi lng cht thi nguy hi ca cc bnh vin pht sinh trn
a bn tnh Kon Tum nm 2015 c tnh khong 431,8 Kg/ngy v nm 2020
c tnh khong 712,1 Kg/ngy. Tng s lng cht thi y t (c nguy hi v
thng thng) hin nay pht sinh ti cc bnh vin trn a bn tnh Kon Tum l
3.220,5 Kg/ngy; c tnh n nm 2020 tng s cht thi y t (c nguy hi v
thng thng) pht sinh khong 5.353,1 Kg/ngy.
1.2. X l cht thi rn y t
Hin nay, ti tnh Kon Tum ang p dng m hnh x l ti ch. Cc cng
trnh x l cht thi y t ti ch u t trong khun vin ca cc BV. Cc c s
y t mt s ni cha c trang b phng tin vn chuyn cht thi y t ng
theo quy nh.
i vi cc n v cha c l t cht thi th cc cht thi y t c x
l theo phng php chn lp hoc thu BV khc x l hoc thu Cng ty Mi
trng v cng trnh th vn chuyn em i x l.
1.2.1. M hnh x l ti ch
Hin nay, trn a bn tnh tt c cc c s y t u x l cht thi rn y t
bng cng ngh l t 2 bung (bung t s dng nhin liu t l du DO).
Cc l t u c cng sut nh (15 Kg/ngy m). Mt s n v l t
xung cp, h hng khng th hot ng c. Bn cnh , i vi cc l t
cn hot ng th lng khi bi pht sinh ti l t gy mi hi, nhim mi
trng khng kh, do t gn khu dn c nn gp phi s phn i ca ngi
dn xung quanh.

14

L t ti BVK tnh Kon Tum

L t ti BVKKV Ngc Hi

Mt s hnh nh l t ti cc c s y t tnh Kon Tum

- i vi cc PKKKV, TYT x vng xa v kh khn th vn s dng

phng php t th cng v chn lp ti ch.
Bng 1.4. Cng ngh c s dng ti cc BV tnh, huyn
Kim
nh cht
lng
cng
ngh

Cng
ngh x
l

Nm lp
t/
Hot
ng

Cng sut
thit k
(Kg/h)

BVK tnh Kon Tum

L t

01 l
c lp
t nm
2001, 02
l nm
2012

02 l mi u t
nm 2012 khng
25Kg/ngy hot ng c; l
u t nm 2001
cn hot ng

BVKKV Ngc Hi

L t

2011

15Kg/ngy Hot ng c

Bnh x khu iu tr
phong k Kia

L t

2012

15Kg/ngy

BV Y hc c truyn

L t

2012

15Kg/ngy Hot ng c

BV Phc hi chc
nng

L t

2012

15Kg/ngy

BVK huyn k
Glei

L t

2011

15Kg/ngy Hot ng c

BVK huyn k T

L t

2008

15Kg/ngy Hot ng c

BVK huyn Tu M
Rng

L t

2013

15Kg/ngy Hot ng c

BVK huyn k H

L t

2012

15Kg/ngy

L t

2013

15Kg/ngy Hot ng c

L t

2011

15Kg/ngy Hot ng c

L t

2012

15Kg/ngy Hot ng c

Tn Bnh vin

BVK huyn Kon

Ry
BVK huyn Kon
Plng
BVK huyn Sa Thy

Tnh trng hot

ng

Khng hot ng
c

Khng hot ng
c

Khng hot ng
c

Khng
C
Khng

Khng

1.2.2. M hnh x l tp trung theo cm

Hin ti m hnh x l cht thi rn y t nguy hi tp trung v cm cha
c trin khai trn a bn tnh Kon Tum. Mt s BV c trang b l t
x l ti ch nhng b h hng ch ng lin h v k hp ng x l cht thi
15

vi cc n v c kh nng v chc nng x l cht thi y t nguy hi ch cha

thc s theo quy hoch chung v x l cht thi tp trung hay theo cm bnh
vin.
1.3. Vn chuyn cht thi y t ra ngoi Bnh vin x l
Hin nay, Cng ty Mi trng th thnh ph, huyn, th trn tnh Kon
Tum vn chuyn cht thi sinh hot, thu gom v vn chuyn cht thi y t nguy
hi trn a bn thnh ph a v khu chn lp x l. Cc n v ny c
cp php v m s hnh ngh vn chuyn.
1.4. Tiu hy sau cng cht thi y t
Hin ti, vi cc BV x l cht thi rn bng l t th cng th sau khi
x l tro l t s c chn lp ti ch. i vi cc BV c l t, tro l t
c em chn lp hoc c chuyn ti cc bi rc chung ca huyn x l.
Cn vi cc Bnh vin khi thu Cng ty Mi trng th x l th rc thi
c t ti l t rc ca n v ri em i chn lp ti bi rc tp trung. Mt
s bi rc trn a bn tnh ch l nhng bi cha rc, rc khng c chn lp.
Cch x l ny khng m bo cht thi v sinh mi trng trong khu vc
bi, gy nhim mi trng khng kh khu vc xung quanh v pht sinh nhiu
vi trng gy bnh. Nh vy, vic tiu hy sau cng CTYTNH hu nh khng
c kim sot.
CTYTNH nguy hi cc phng khm t nhn vn cn c thu gom, vn
chuyn, tiu hy chung vi cht thi thng thng. Tro ca l t cc Bnh
vin c l t c vn chuyn chung vi cht thi thng thng ti bi rc ca
a phng chn lp m khng c bin php tiu hy m bo. Cc cht thi
c php ti ch nh nha, giy ba c bn cho c nhn/c s thu mua ti
ch.
2. HIN TRNG QUN L NC THI Y T
2.1. Khi lng nc thi ca cc c s y t
Theo Quyt nh s 910/Q-UBND ngy 16/9/2011 ca y ban nhn dn
tnh Kon Tum v vic ph duyt danh mc v vic x l cc c s gy nhim
mi trng nghim trng (t 1) nm 2011 trn a bn tnh Kon Tum i vi 2
bnh vin l BVK tnh v BVKKV Ngc Hi.
Theo thng k s b cc c s y t, hin nay mi ngy mt lng nc
thi t cc Bnh vin tuyn tnh v tuyn huyn, cc trm y t x, phng, th
trn trn a bn tnh Kon Tum x ra mi trng khong 875 - 1.848 m3/ngy
m. Ti cc Bnh vin, lu lng nc thi khng n nh trong ngy, lu
lng thi ln v tp trung vo bui sng.
Theo c tnh lng nc thi pht sinh t cc ging bnh dao ng
trong khong 0,45 - 0,95 m3/ngy m (mc x thp nht 0,45 m 3/ngy, mc x
trung bnh 0,65 m3/ngy v mc x cao nht 0,95 m3/ngy). Vi c tnh nh
trn, d on lng pht sinh nc thi ti cc BV, PKKKV, TYT x, phng,
th trn n nm 2020 tng ng t 1.370 - 2.893 m3/ngy.

16

Ngoi ra, lng nc thi pht sinh t cc n v y t d phng khong 5

- 8 m /n v/ngy; t cc v phng khm t nhn di 1 m3/n v/ngy.
3

2.2. M t cc cng trnh x l nc thi trong tnh

Hin nay, trn a bn tnh Kon Tum mt s bnh vin khng c h thng
thu gom nc ma tch ring vi h thng thu gom nc thi (nh BVK tnh).
Cn li, nc thi sinh hot v nc thi nghip v hoc c dn v x l ti
h thng nc thi hoc x trc tip ra ngoi cng thot nc chung hoc t
ngm xung t. Ti mt s bnh vin khng c h thng x l nc thi (nu
c th hin ti h thng xung cp trm trng khng hot ng) nh BVK
huyn Kon Ry, BVK huyn k T, BVK huyn k H ang gy nh
hng n cuc sng ca dn c xung quanh do cc n v trn u nm trong
khu dn c. Cc PKKKV, TYT x u cha c h thng x l nc thi. Nc
thi nhng ni ny hu ht c dn vo hm rt ca cng trnh v sinh.
Hin ti, cc cng trnh x l nc thi ti cc c s y t (nu c) u p
dng cng ngh x l sinh hc v c kh trng trc khi thi ra mi trng.
Qu trnh nng cp quy m ging bnh nhng nm qua v tnh trng qu ti ti
cc bnh vin dn n qu ti cc h thng x l nc thi.
Hiu qu x l v cht lng nc sau x l cha c thc hin gim
st nh k nn cha nh gi c hiu qu v cht lng nc sau x l.
Trong thi gian ti cn nghim chnh hot ng vn hnh ca h thng x
l thng xuyn gim st hot ng v c cc kt qu kim tra phn tch cht
lng nc.
2.3. Quan trc cht lng nc thi
Hin nay, cng tc quan trc mi trng cht lng nc thi y t ti Kon
Tum thc hin nhng cha y , cc c s ch tin hnh phn tch khi c
yu cu ca c quan chc nng.
Trong nc thi Bnh vin ngoi nhim hu c v vi sinh nh trn cn
cha cc cht thi ty ra, d lng dc phm, mt s cht c hi c trng
t qu trnh chn on, xt nghim bnh nhn... c trng ca nc thi Bnh
vin l s xut hin ca cc loi vi khun gy bnh nh Somonella, Leptonspira,
Vibrio Choleral, Mycobacterium Tuberculosis... mt s lng ln trng giun,
sn gy nh hng nghim trng n sc khe cng ng nu khng c x
l trit .
Thi gian ti cc Bnh vin phi tin hnh bo co gim st mi trng
nh k ti c s mnh ng thi c bin php khc phc trong trng hp
khng m bo cc tiu chun mi trng v nc thi.
2.4. Tiu hy bn
Bn thi t cc h thng x l nc thi ca cc Bnh vin, c s y t
c trang b h thng x l nc thi c ht nh k bi Cng ty Mi trng
th thnh ph, huyn. Ty mc cng sut ca h thng m thi gian ht bn
t 6 thng n 2 nm ty cng trnh. Bn thi ny s c vn chuyn em i
x l.
17

3. HIN TRNG T CHC TRIN KHAI V YU CU THC

THI
3.1. Khun kh php l cho qun l cht thi y t ti tnh Kon Tum
- Lut bo v mi trng s 52/2005/QH11 do Quc hi nc CHXHCN
Vit Nam ban hnh ngy 29/11/2005 v c hiu lc t ngy 01/07/2006.
- Ngh nh s 80/2006/N-CP ngy 09/8/2006 ca Chnh ph quy nh
chi tit v hng dn thi hnh mt s iu ca Lut Bo v mi trng v Ngh
nh s 21/2008/N-CP ngy 28/02/2008 ca Chnh ph chnh sa. b sung mt
s iu ca Ngh nh 80/2006/N-CP
- Ngh nh s 81/2007/N-CP ngy 23/5/2007 quy nh t chc. b phn
chuyn mn v bo v mi trng ti cc c quan Nh nc v doanh nghip
Nh nc.
- Ngh nh s 12/2009/N-CP ngy 10/02/2009 v qun l d n u t
xy dng cng trnh v Ngh nh s 83/N-CP ngy 15/10/2009 sa i b
sung mt s iu ca Ngh nh s 12/2009.
- Ngh nh s 59/2007/N-CP ngy 09/4/2007 ca Chnh ph v qun l
cht thi rn.
- Ngh nh s 88/2007/N-CP ngy 28/5/2007 ca Chnh ph v thot
nc th v khu cng nghip.
- Ngh nh 72/2010/N-CP ngy 08/7/2010 ca Chnh ph quy nh v
phng nga, u tranh chng ti phm v vi phm php lut v mi trng.
- Thng t s 18/2009/TT-BYT ngy 14/10/2009 ca B Y t hng dn
t chc thc hin cng tc kim sot nhim khun trong cc c s khm cha
bnh.
- Thng t s 12/2011/TT-BTNMT ngy 14/4/2011 ca B Ti nguyn v
Mi trng quy nh v qun l cht thi nguy hi.
- Thng t 01/2012/TT-BTNMT ngy 16/03/2012 ca B Ti nguyn v
mi trng quy nh v lp, thm nh, ph duyt v kim tra, xc nhn vic
thc hin n bo v mi trng chi tit; lp v ng k n bo v mi
trng n gin. C hiu lc thi hnh t ngy 02/05/2012.
- Thng t s 26/2011/TT-BTNMT ngy 18/7/2011 ca B Ti nguyn v
Mi trng hng dn v nh gi mi trng chin lc, nh gi tc ng
mi trng v cam kt bo v mi trng.
- Thng t s 07/2007/TT-BTNMT ngy 3/7/2007 ca B Ti nguyn v
Mi trng hng dn phn loi quyt nh danh mc c s gy nhim mi
trng cn x l.
- Quyt nh s 43/2007/Q BYT ngy 3/12/2007 ca B trng B Y
t v vic ban hnh Quy ch qun l cht thi y t.
- Quyt nh s 170/Q- TTg ngy 08/02/2012 ca Th tng Chnh ph
ph duyt quy hoch tng th h thng x l cht thi rn y t nguy hi n nm
2025.
18

- Quyt nh s 1873/Q-BYT ngy 28/5/2009 ca B trng B Y t

ban hnh K hoch bo v mi trng trong ngnh y t giai on 2009 n
2015.
- Quyt nh s 3079/Q-BYT ngy 21/8/2008 ca B trng B Y t v
vic ban hnh quy ch t chc v hot ng ca h thng lm cng tc bo h
lao ng trong cc s y t.
- Quyt nh s 1040/2003/Q-BYT ngy 1/4/2003 ca B trng B Y
t v vic ban hnh Ti liu hng dn quy trnh chng nhim khun bnh
vin.
- Quyt nh s 1895/1997/Q-BYT ngy 19/9/1997 ca B trng B Y
t v vic ban hnh Quy ch bnh vin.
- Quyt nh s 23/2006/Q-BTNMT ngy 26/12/2006 ca B trng B
TNMT cng b Danh mc cht thi nguy hi.
- Quyt nh s 2149/Q-TTg ngy 17/12/2009 ca Th tng Chnh ph
ph duyt chin lc quc gia v qun l tng hp cht thi rn n nm 2025
v tm nhn n 2050.
- Quyt nh s 1930/Q-TTg ngy 20/11/2009 ca Th tng Chnh ph
ph duyt nh hng pht trin thot nc th v khu cng nghip Vit Nam
n nm 2025 v tm nhn n 2050.
- Quyt nh s 184/2006/Q-TTg ngy 10/8/2006 ca Th tng Chnh
ph ph duyt k hoch quc gia trin khai cng c Stockholm v cc cht
nhim hu c kh phn hy.
- Cng vn s 7164/BYT-KCB ngy 20/10/2008 ca B trng B Y t
v vic tng cng trin khai thc hin qun l v x l cht thi y t.
- Quyt nh s 02/2012/Q-UBND ngy 09/01/2012 ca y ban nhn
dn tnh Kon Tum v vic ph duyt Quy hoch pht trin s nghip chm sc,
bo v sc khe nhn dn tnh Kon Tum giai on 2011-2020, nh hng n
2025.
Quy chun k thut quc gia v tiu chun Vit Nam
- QCVN 02:2012/BTNMT-Quy chun k thut quc gia v l t cht
thi rn y t.
- QCVN 05:2009/BTNMT-Quy chun k thut quc gia v cht lng
khng kh xung quanh
- QCVN 06:2009/BTNMT-Quy chun k thut quc gia v cc cht thi
nguy hi trong khng kh xung quanh
- QCVN 08:2008/BTNMT-Quy chun k thut quc gia v cht lng
nc mt
- QCVN 09:2008/BTNMT-Quy chun k thut quc gia v cht lng
nc ngm

19

- QCVN 14:2008/BTNMT - Quy chun k thut quc gia v cht lng

nc thi sinh hot
- QCVN 28:2010/BTNMT-Quy chun k thut quc gia v cht lng
nc thi y t.
- TCVN 7957:2008: Thot nc - Mng li v cng trnh bn ngoi.
Tiu chun thit k.
- TCVN 7380:2004: L t cht thi y t - Yu cu k thut
- TCVN 7381:2004: L t cht thi rn y t - phng php nh gi
thm nh
- TCVN 6706:2000: Cht thi nguy hi - Phn loi
- TCVN 6707:2009: Cht thi nguy hi - Du hiu cnh bo
- TCVN 6696:2009: Cht thi rn - Bi chn lp hp v sinh - Yu cu
chung v bo v mi trng
- TCXDVN 320:2004: Bi chn lp cht thi nguy hi - Tiu chun thit
k
- TCXDVN 365:2007: Bnh vin a khoa - Hng dn thit k.
3.2. C cu t chc cho qun l v gim st qun l cht thi y t
S Ti nguyn v Mi trng tnh phi hp vi cc s ban ngnh chc
nng trn a bn nhm kim tra vic thc hin bo v mi trng ca cc bnh
vin, trung tm y t.
Ti cc Bnh vin, trung tm y t cha c i ng chuyn mn v qun l
v x l cht thi y t. Vic gim st x l tiu hy cht thi y t cn cha ng
b, hon thin.
4. CC D N H TR QUN L CHT THI Y T TRONG
TNH
- D n nng cp Bnh vin a khoa tnh t 400 ln 500 ging bnh
(Bnh vin lm ch u t) t Ngun vn trung ng h u t cc bnh vin
tuyn tnh, huyn v ngun thu X s kin thit tnh (c h tr u t h thng
x l cht thi rn bng cng ngh l t).
- D n Bnh vin huyn Kon Ry (bnh vin lm ch u t) t ngun
vn tri phiu Chnh ph (c h tr u t h thng x l cht thi lng ti bnh
vin).

20

PHN 2. K HOCH CI THIN

1. NH HNG CHUNG
Theo quyt nh 170/Q-TTg ngy 08/02/2012 ca Th tng Chnh ph
v: Ph duyt quy hoch tng th h thng x l cht thi rn y t nguy hi n
nm 2025 tnh Kon Tum s x l cht thi rn y t nguy hi theo 02 m hnh: x
l cht thi nguy hi theo cm bnh vin n nm 2015 v tp trung cho ton
thnh ph n nm 2020.
Cn c theo s pht trin chung ca tnh, nh hng m hnh x l cht
thi rn y t nguy hi theo cm bnh vin trn a bn tnh n nm 2020 c
p dng ti 02 bnh vin ln l: BV Y hc c truyn v BVKKV Ngc Hi.
* Cm x l s 01 (Cm Bnh vin Y hc c truyn tnh Kon Tum)
Cm x l cht thi y t nguy hi Bnh vin YHCT tnh Kon Tum s x
l cht thi y t nguy hi cho cc n v sau: Bnh vin a khoa tnh; Bnh vin
Phc hi chc nng; Bnh vin YHCT; Bnh x khu iu tr phong k Kia;
Trung tm Gim nh y khoa; BVK huyn k H; BVK huyn Kon Ry;
BVK huyn Kon Plng; BVK huyn Sa Thy; Cc PKKKV: Ng My,
k Hring; Ngc Wang, Ya Xier, R Ki, k Ring, Nam M Rai, k Rve v
PKKKV trung tm thnh ph Kon Tum. Ngoi ra, cm Bnh vin Y hc c
truyn cn chu trch nhim x l cho cc c s thuc h d phng, trng
trung hc y t, cc trm y t x phng. n nm 2020, x l thm cho 4 bnh
vin mi thnh lp ti trung tm thnh ph Kon Tum (Bnh vin Lao v Bnh
phi, Bnh vin Sn - Nhi, BVK thnh ph Kon Tum, BVK huyn Ia
HDrai).
Bng 2.1. D tnh khi lng CTYTNH c x l ti cm 01
S ging k
hoch
TT

1
2
3
4
5
6
7
8
9
10

Khi lng
CTRNH
(Kg/ngy)

Tn BV/C s y t

BVK tnh
BV Phc hi chc nng
BV YHCT
Khu iu tr phong k Kia
Trung tm Gim nh y khoa
Bnh vin Lao v Bnh phi
Bnh vin Sn - Nhi
BVK huyn k H
BVK huyn Kon Ry
BVK huyn Kon Plong

Nm
2015

Nm
2020

Nm
2015

480
50
75
30

500
150
150
30

110
10,2
4,95
6,2
0,5

70
55
50

100
100
150
120
100

19
12,1
13,2

Khong
cch n
bnh
vin
c tnh
trung
nm
tm
2020
(km)

116
30,6
22
6,2
0,5
23,5
23,5
29,5
24,2
19,5

4
4
0
3
4
4
4
24
24
39
21

11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

BVK huyn Sa Thy

BVK thnh ph Kon Tum
BVK huyn Ia HDrai
PKKKV Ng My
PKKKV trung tm thnh ph
Kon Tum
PKKKV k H'ring
PKKKV Ngc Wang
PKKKV Ya Xier
PKKKV R Ki
PKKKV k Ring
PKKKV Nam M Rai
PKKKV k Rve
Trung tm Y t d phng tnh
Trung tm phng chng St rt,
K sinh trng v Cn trng
Trung tm Phng chng bnh x
hi
Trung tm Chm sc sc kho
sinh sn
Trung tm Kim nghim
Trung tm Kim dch y t
Chi cc An ton v sinh thc
phm
Trung tm Y t thnh ph Kon
Tum
Trung tm Phng chng
HIV/AIDS
Trung tm Truyn thng gio dc
sc kho
Chi cc Dn s - K hoch ho
gia nh
Trng Trung hc y t
Cc Trm Y t x trc thuc
Trung tm Y t cc huyn k H
(11 TYT), Sa Thy (14 TYT),
Kon Ry (7 TYT), Kon Plong (9)
v thnh ph Kon Tum (21).
Tng cng

60

12,6

20

120
50
50
20

4,4

25,2
10,5
10,5
4,4

20
10
10
10
10
10
10
10

34

11

20

4,4

4,4

15
15
15
15
15
10
10

2,2
2,2
2,2
2,2
2,2
2,2
2,2
1,5

3,3
3,3
3,3
3,3
3,3
2,2
2,2
1,5

11
12
7
16
32
59
13
4

0,5

0,5

2,5

2,5

0,5
0,3

0,5
0,3

4
4

0,1

0,1

0,5

0,5

0,5

0,5

4
4
4

310

335

0,3

0,3

55

60

277,7

441,1

Tng lng cht thi rn y t nguy hi pht sinh ca c cm nm 2015 l

277,7 Kg/ ngy v c tnh nm 2020 l 441,1 Kg/ ngy. x l l c hiu
22

qu lng cht thi ny cho c cm BV, cn u t h thng x l cht thi rn y

t nguy hi theo cng ngh khng t vi cng sut 400 Kg/ ngy.
* Cm x l s 02 (Cm bnh vin a khoa Khu vc Ngc Hi)
Do c th v tr a l ca tnh Kon Tum, nn d kin bnh vin x l
trung tm phi p ng x l cho cc bnh vin a khoa tuyn huyn xa. Cc
d n m bo thit b vn chuyn, thu gom p ng c cc tiu chun ca
cc b ban ngnh.
Cm x l cht thi y t nguy hi BVKKV Ngc Hi s x l cht thi
y t nguy hi cho cc n v sau: BVK huyn k Glei, k T, Tu M Rng,
TTYT huyn Ngc Hi; cc phng khm k R ng, Tu R Mng, k Dc,
k Mn, Mng Hoong v cc trm y t.
Bng 2.2: D tnh khi lng CTYTNH c x l ti cm 02

Nm
2015

Nm
2020

Nm
2015

c tnh
nm
2020

Khong
cch n
bnh
vin
trung
tm
(km)

S ging k
hoch
STT

Khi lng
CTRNH
(Kg/ngy)

Tn BV/C s y t

BVKKV Ngc Hi

200

300

55

74,5

BVK huyn k Glei

60

120

13,8

23

45

BVK huyn k T

85

150

22,4

29,5

20

BVK huyn Tu M Rng

50

100

11

20,5

49

Trung tm Y t huyn Ngc Hi

PKKKV k R ng

10

15

3,3

3,3

22

PKKKV Tu M Rng

10

20

3,3

4,4

49

PKKKV k Dc

20

20

4,4

4,4

15

PKKKV k Mn

10

15

3,3

3,3

26

10

PKKKV Mng Hoong

10

15

3,3

3,3

70

11

Cc Trm Y t x trc thuc Trung

tm Y t cc huyn K T (9
TYT), Tu M Rng (11 TYT),
k Glei (12 TYT), Ngc Hi (8
TYT).

200

200

35,8

35,8

158

204

Tng cng

Tng lng cht thi rn y t nguy hi pht sinh ca c cm nm 2015 l

158 Kg/ngy v c tnh nm 2020 l 204 Kg/ngy. x l c hiu qu lng
cht thi ny cho c cm BV, cn u t h thng x l cht thi rn y t nguy
hi theo cng ngh khng t vi cng sut 200 Kg/ngy.
1.1. nh hng cho cc ch ngun thi
23

- 100% cc ch ngun thi l cc bnh vin, trung tm y t phi c c cu

t chc, cn b chuyn trch c o to, c s tay qun l cht thi ng thi
c k hoch theo di gim st.
- Phi hon thin cc th tc cp php v mi trng: Cam kt bo v mi
trng; ng k ch ngun thi; n bo v mi trng; Bo co hin trng
mi trng hng nm...
- p dng cc bin php phng nga, gim thiu pht sinh cht thi y t;
chu trch nhim i vi cht thi y t cho n khi chng c x l, tiu hy an
ton.
a) nh hng i vi cht thi rn:

Cht thi
thng thng

Hnh 2.1. S qun l cht thi rn y t

b) nh hng i vi cht thi lng:

- C s y t xy dng h thng thu gom ring nc ma v nc thi t
cc khoa, phng, khu sinh hot. Nc t h thng thu gom nc ma c th x
trc tip ra h thng thu gom nc thnh ph. Nc thu t cc phng, khoa v
khu sinh hot s tp trung vo x l trc khi x ra cng thu gom nc thnh
ph.
- i vi c s y t cha c h thng x l nc thi: Xy dng h thng
x l nc thi m bo nc thi x ra kin ngh t loi B QCVN
28:2010/BTNMT v nc thi y t.
- i vi c s c h thng x l nc thi nhng b hng, nc thi ra
mi trng khng t loi B QCVN 28:2010/BTNMT th phi tu b, nng cp
hoc xy dng mi nu cn:

24

Nc thi t Toilet

B t hoi

Nc thi sinh
hot, nc thi y t

H thng XLNT

Nc ma chy trn

Cng thot
nc chung
H ga t SCR

Hnh 2.2. S x l nc thi v nc ma cho Bnh vin

- Cng ngh x l nc thi bnh vin phi p ng cc tiu chun mi

trng cn ph hp vi a hnh, kinh ph u t, chi ph vn hnh, bo tr v
trnh k thut chuyn mn ca tng Bnh vin.
- Sau h thng x l nc thi, lng bn sinh ra c qun l nh cht
thi rn y t.
- Xy dng ca x nc thi thun tin cho vic kim tra, gim st.
- nh k kim tra cht lng x l nc thi, c s tay qun l vn hnh
v kt qu kim tra lin quan.
c) nh hng i vi kh thi:
- Cc phng xt nghim, kho ha cht, dc phm phi c h thng thng
kh v cc t ht hi kh c m bo tiu chun quy nh.
- Cc thit b s dng kh ha cht c hi phi c h thng x l kh t
tiu chun trc khi thi ra mi trng.
- Kh thi ra t cc l t cht thi rn y t (nu c) phi c x l t
tiu chun mi trng Vit Nam.
1.2. nh hng cho cc ch x l
Ch x l tiu hy cht thi y t phi p ng c cc iu kin quy
nh ti iu 74 ca Lut Bo v mi trng nm 2005.
- Ch x l cht thi thng thng l Cng ty TNHH Mt thnh vin mi trng
th Kon Tum.
- Ch x l CTR nguy hi l: Bnh vin Y hc c truyn tnh Kon Tum;
BVKKV Ngc Hi.
- Ch x l nc thi l tt c cc c s y t.
- Cc ch x l CTR nguy hi v nc thi phi c h thng x l vi
cng sut ph hp v cng ngh x l thn thin vi mi trng; c nhn vin
vn hnh v bo dng h thng c o to.
1.3. nh hng cho cc ch vn chuyn
- Ch vn chuyn cht thi sinh hot v cht thi y t nguy hi l Cng ty
TNHH Mt thnh vin mi trng th Kon Tum.
25

- Ch vn chuyn CTR y t nguy hi l: Cng ty TNHH Mt thnh vin

mi trng th Kon Tum; Bnh vin Y hc c truyn, BVK tnh Kon Tum;
BVKKV Ngc Hi (sau khi ng k v c cp php).
- Cc ch vn chuyn khc phi c c quan c thm quyn cp php
trong hot ng vn chuyn cht thi phi c phng tin, thit b chuyn dng
cho vic thu gom, vn chuyn, ng gi, bo qun v lu gi tm thi cht thi
y t nguy hi.
- C h thng, thit b, bin php k thut kim sot nhim v bo v
mi trng ti c s, c bit l khu vc v sinh phng tin, bi tp kt phng
tin, khu vc trung chuyn, lu gi tm thi hoc phn loi cht thi y t (nu
c).
- Vn chuyn cht thi y t theo l trnh ti u v tuyn ng, qung
ng, thi gian, bo m an ton giao thng v phng nga, ng ph s c,
ph hp vi quy nh ca c quan c thm quyn v phn lung giao thng.
2. XY LP V THIT B
2.1. Qun l cht thi rn
2.1.1. Phng tin phn loi, thu gom, vn chuyn v lu gi.
- Mua sm cc loi ti ng CTRYT, Hp ng sc nhn, cc loi thng
ng, B phng tin BHLD ng cho 1 nm.
- Xy dng 2 nh x l cht thi rn y t, nh lu tr cho 2 bnh vin l
Bnh vin Y hc c truyn tnh Kon Tum; BVKKV Ngc Hi.
- Xy dng mi bnh vin ng u 3 loi b b tng c dung tch 2m 3
bao gm: b b tng c lp cht thi sc nhn, b b tng c lp cht thi gii
phu v b b tng c lp cht thi tro l t.
2.1.2. Phng tin vn chuyn cht thi nguy hi bn ngoi bnh vin: Tnh Kon
Tum s p dng m hnh x l cht thi rn theo cm BV nn cn trang b
phng tin chuyn dng chuyn ch cht thi nguy hi trong cm BV.
- Mua sm 02 xe chuyn dng vn chuyn cht thi nguy hi cho cc cm
x l cht thi rn nguy hi l Bnh vin Y hc c truyn; BVKKV Ngc Hi.
2.1.3. C s x l cht thi y t
a) Phng php x l ban u cht thi c nguy c ly nhim cao
- Cht thi c nguy c ly nhim cao phi c x l an ton gn ni
cht thi pht sinh.
- Phng php x l ban u cht thi c nguy c ly nhim cao c th p
dng mt trong cc phng php sau: x l ban u bng phng php tit
khun bng hi nng m, vi sng hoc cc cng ngh hin i khc t tiu
chun.
- Cht thi ly nhim sau khi c thu gom s c x l ti c s (nu
c) hoc c vn chuyn ti khu x l tp trung x l trit .
26

b) Phng php x l v tiu hy cht thi ly nhim

- Theo quyt nh 170/Q-TTg ngy 08/02/2012 ca Th tng Chnh
ph v: Ph duyt quy hoch tng th h thng x l cht thi rn y t nguy hi
n nm 2015, tnh Kon Tum s p dng m hnh x l cht thi nguy hi theo
m hnh cm c s y t v n nm 2025 p dng m hnh x l CTNH tp
trung. Cc c s x l cht thi y t cm BV hoc tp trung trn a bn tnh
Kon Tum c th p dng cc phng php x l sau:
+ Kh khun bng hi nng m kt hp nghin ct.
+ Kh khun bng vi sng.
- Cht thi sc nhn; Cht thi gii phu; cht thi ha hc; cht thi dc
phm; cht thi gy c t bo; cht thi cha kim loi nng; cht thi phng x;
cc bnh p sut; cht thi rn thng thng; ha cht nguy hi nh tro l t
hoc ha cht cha nhiu kim loi nng s p dng cc bin php x l nh: tr
ha, ng rn, chn lp trong cc h chn xi mng, tr nh cung cp hoc vn
chuyn ti bi chn lp c bit dnh cho cht thi nguy hi...
- Bn ca h thng x l nc thi vn c xem l cht thi nguy hi s
c no vt nh k v tiu hy bi Cng ty cng trnh th c giy php v
phng tin chuyn dng.
- Cc cht thi c th ti ch nh nha, ba cc tng, hp kim loi s c
bn cho c s ti ch c giy php hnh ngh.
- Cht thi thng thng c Cng ty Cng trnh th thnh ph v
qun, huyn ti vn chuyn bi rc tiu hy.
m bo tiu hy v ti ch an ton cht thi, BV phi k hp ng
vi cc cng ty c giy php hnh ngh qun l cht thi v phi thit lp h
thng h s cht thi theo di cht thi t lc pht sinh ti khi tiu hy cui
cng. Tt c nhn vin v cng nhn c lin quan s c nng cao nhn thc v
c tp hun thc hin nhim v.
c tnh khi lng:
u t mua sm thit b kh trng bng hi nng m kt hp nghin ct
cht thi nguy hi cho BV Y hc c truyn v BVKKV Ngc Hi, vi cng
sut d kin nh sau:
- Cm 01 (Cm BVYHCT): h thng thit b cng sut 400 Kg/ngy.
- Cm 02 (Cm BVKKV Ngc Hi): h thng thit b cng sut 200
Kg/ngy.
2.1.4. Cng trnh tiu hy sau cng:
- Cht thi rn y t nguy hi sau khi c x l bng cng ngh khng t
s tr thnh cht thi rn thng thng v thu Cng ty TNHH Mt thnh vin
mi trng th Kon Tum vn chuyn em i x l ti ni x l tp trung ca
tnh, huyn, thnh ph.

27

- i vi cht thi rn y t nguy hi sc nhn: Xy dng 12 b b tng

c lp cht thi sc nhn cho cc BV. Trong , xy dng 03 b b tng c lp
cht thi sc nhn, 03 b b tng c lp cht thi gii phu, 03 b b tng c lp
tro l t cho 2 bnh vin trung tm x l.
2.2. Thu gom v x l nc thi
- La chn cng ngh x l nc thi bnh vin phi p ng cc tiu
chun mi trng, cn ph hp vi a hnh, kinh ph u t, chi ph vn hnh,
bo tr v trnh k thut chuyn mn ca tng bnh vin.
- Sau h thng x l nc thi, lng bn sinh ra c qun l nh cht
thi rn y t.
- Xy dng ca x nc thi thun tin cho vic kim tra, gim st.
2.2.1. Cc cng trnh x l nc thi bnh vin: Cn c vo hin trng hot
ng ca bnh vin v mc p ng yu cu x l nc thi ca cc
c s, nh hng v qun l thu gom, x l nc thi ti tng n v.
Mt s n v c u t nhng n nay xung cp h hng cn
u tu xy dng mi v nng cp sa cha. Ngoi ra mt s n v
khm cha bnh cha c u t h thng nc thi y t cn c u
t xy dng mi.
c tnh khi lng:
- u t mi h thng x l nc thi y t cho cc bnh vin, phng
khm a khoa khu vc (PKKKV): BVKKV Ngc Hi; BVK huyn k
Glei; BVK huyn k T; BVK huyn k H; Khu iu tr phong k
Kia; PKKKV k Mn, Mng Hoong huyn k Glei; PKKKV k Dc
huyn Ngc Hi; PKKKV Tu M Rng, k R ng huyn Tu M Rng;
PKKKV Ngc Wang, k Hring huyn k H; PKKKV k Rve huyn
Kon Ry; PKKKV k Ring huyn Kon Plong; PKKKV R Ki, Ya Xir,
Nam M Rai huyn Sa Thy; PKKKV Ng My thnh v PKKKV thnh
ph Kon Tum.
- u t b sung, nng cp h thng x l nc thi y t cho cc bnh
vin: Bnh vin Y hc c truyn tnh Kon Tum; BVK huyn Kon Plong;
BVK huyn Sa Thy.
2.2.2. Cc cng trnh x l nc thi cho cc c s khc
Ti cc c s y t khc ch yu l cc Trung tm y t, cc Trm y t x
phng, mc pht thi thp.
Duy tr vn hnh, bo dng cng trnh x l nc thi cho Trung tm Y
t d phng tnh, Trung tm y t thnh ph.
c lng khi lng:
- Xy mi h thng x l nc thi cho Trung tm y t thnh ph Kon
Tum.
- Xy mi 01 cng trnh x l nc thi cng sut nh/c s cho mi
trung tm y t v cc trm y t x, phng, th trn.
28

3. NNG CAO NNG LC TH CH CHO QUN L CHT THI

Y T
3.1. C cu t chc
3.1.1. Phn cng trch nhim v c ch phi hp gia cc c quan qun l Nh
nc:
Qun l cht thi y t i hi s phi kt hp ca nhiu ban ngnh nn
cn thit phi thnh lp mt Hi ng qun l cht thi y t ca tnh. Thnh
phn ca hi ng bao gm: Ch tch hi ng (lnh o UBND tnh), ph ch
tch hi ng (Gim c s y t), th k hi ng (Cn b ph trch qun l
cht thi y t ca s y t) v i din ca cc ban ngnh lin quan nh: S Ti
nguyn v Mi trng, S Xy dng, S Khoa hc v Cng ngh, S K hoch
v u t, S Ti chnh.
Hi ng qun l cht thi y t tnh c chc nng, nhim:
- Xem xt, xut, t vn cho lnh o tnh xy dng, sa i, b sung
cc quy nh v qun l cht thi y t sao cho ph hp vi quy nh ca php
lut v iu kin thc t ca tnh.
- T vn cho lnh o tnh v xy dng, chnh sa v b sung k hoch
qun l cht thi y t trong tnh.
- T vn, sa cha, thit k, xy dng, lp t cc cng trnh x l CTYT.
- T vn cho lnh o tnh ra cc gii php tho g cc vng mc
trong qu trnh trin khai hot ng qun l cht thi y t trn a bn tnh.
Trch nhim ca cc c quan qun l nh nc tham gia vo vic qun l
cht thi y t nh sau:
a) S Y t:
- Chu trch nhim qun l v xy dng k hoch x l cht thi y t trn
a bn trnh UBND tnh ph duyt v t chc trin khai thc hin n sau khi
c ph duyt.
- Chu trch nhim trc y ban nhn dn tnh v cc hot ng qun l
lin quan n cng tc bo v mi trng, x l cht thi, nc thi, kh thi y t
trn a bn tnh.
- Trc tip iu hnh, kt hp vi cc ban ngnh lin quan trong tnh, bo
m tin thc hin n theo ng k hoch.
- Ch o cc c s y t trong tnh xy dng k hoch hnh ng c th
nhm m bo t mc tiu, k hoch ra.
- Ch o trung tm y t d phng tng cng cng tc kim tra, gim st
vic thc hin quy ch qun l v x l cht thi y t trn a bn tnh.
- Giao cho ngi ng u cc c s y t:
+ Chu trch nhim v qun l cht thi y t t khi pht sinh ti khu tiu
hy cui cng.
29

+ Mua v cung cp cc phng tin chuyn dng, t tiu chun cho vic
phn loi, thu gom, vn chuyn v x l cht thi y t, phi hp vi cc c quan
mi trng, cc c s x l cht thi ca a phng x l, tiu hy cht thi
y t theo quy nh.
- Qun l tt vic x l cht thi ti cc c s hnh ngh y t t nhn.
- Ngnh y t t chc, nh gi k qu thc hin n qun l v x l
cht thi mi 6 thng v c nm.
b) S Ti nguyn v Mi trng:
- Thm nh bo co nh gi tc ng mi trng v n bo v mi
trng (Nu c) trong cc d n pht trin bnh vin.
- H tr chuyn mn trong vic xy dng v trang b h thng x cht
thi y t rn v lng.
- Theo di, gim st, thanh tra kim tra vic ng k ch ngun cht thi
nguy hi, xin cp php hnh ngh qun l CTNH, xy dng k hoch v trin
khai k hoch qun l cht thi nguy hi trong cc c s y t cng nh tc ng
ca cht thi y t i vi mi trng nc, khng kh, t.
- H tr ngun kinh ph cho qun l cht thi y t t ngn sch s nghip
bo v mi trng.
c) S Xy dng: Chu trch nhim quy hoch, thit k, xy dng bi chn
lp cht thi hp v sinh, quy hoch, thit k, xy dng, vn hnh cc h thng
cp, thot nc, x l nc thi th, thm nh thit k v cp php xy dng
cc cng trnh y t phi p ng yu cu x l cht thi y t.
d) S K hoch v u t: Chu trch nhim tham mu trnh U ban nhn
dn tnh cn i vn xy dng c bn cho cc cng trnh, d n lin quan n
lnh vc mi trng y t c ph duyt; phi hp cc c quan lin quan
nghin cu xut cc chnh sch u t cho bo v mi trng.
e) S Ti chnh: Chu trch nhim tham mu trnh U ban nhn dn thnh
ph cn i b tr d ton kinh ph v cng tc bo v mi trng y t hng nm
theo ch trng ph duyt ca cc cp c thm quyn.
f) S Khoa hc v Cng ngh: Khuyn khch xy dng cc ti nghin
cu trong lnh vc bo v mi trng nh u t pht trin cng ngh sch,
cng ngh thn thin vi mi trng, cc gii php x l mi trng
g) U ban nhn dn cc cp:
- a ch tiu qun l v x l cht thi y t vo k hoch pht trin kinh
t x hi hng nm ca a phng thng qua cp y ng, Hi ng nhn dn
cc cp xem xt quyt nh v ch o thc hin c hiu qu tng ni dung c
th nu trong n.
- y mnh v tng cng qun l nh nc v cng tc qun l v x l
cht thi y t trn a bn tnh.
h) Cng ty TNHH Mt thnh vin Mi trng th Kon Tum:
30

C trch nhim thu gom cht thi y t thng thng trn ton b tnh Kon
Tum v x l, chn lp theo ng quy nh ca php lut.
i) Phng Cnh st mi trng - Cng an tnh: Chu trch nhim thanh tra,
kim tra v x l cc c s gy nhim mi trng, cc c s khng thc hin
ng cc quy nh ca php lut v mi trng.
k) S Thng tin v Truyn thng, Bo Kon Tum, i Pht thanh - Truyn
hnh tnh v cc c quan thng tn, bo ch trung ng ng trn a bn tnh:
Kp thi ng a tin, tuyn truyn, ph bin kin thc, php lut v mi trng
v cng tc bo v mi trng; biu dng cc c nhn, n v c thnh tch
trong bo v mi trng; phn nh kp thi cc s vic vi phm php lut bo v
mi trng.
3.1.2. C cu t chc qun l cht thi trong cc c s y t
Cc bnh vin v c s y t nghim chnh thc hin cc quy nh ca cp
c thm quyn v cng tc qun l cht thi trong c s mnh.
a) Trch nhim ca Gim c bnh vin: Gim c c s y t thnh lp ra
ban ch o x l cht thi xy dng k hoch x l cht thi.
- Ban ch o bao gm: Lnh o Bnh vin, Trng cc khoa, phng
bnh vin (cc khoa lm sng, cn lm sng, khoa chng nhim khun, phng Y
t - iu dng, phng k hoch tng hp, phng hnh chnh - qun tr,).
- Gim c bnh vin b nhim mt ngi ph trch cng tc qun l cht
thi Bnh vin. Ngi ph trch cng tc qun l cht thi chu trch nhim ton
b trong vic xy dng mt k hoch v hng ngy kim tra gim st h thng
x l cht thi.
- m bo cho k hoch x l cht thi lun c cp nht v ph hp.
- Phn b kinh ph v nhn lc m bo cho k hoch x l cht
thi c thc hin mt cch c hiu qu.
- Thng nht cc quy trnh nh gi tnh hiu qu v hiu xut ca h
thng x l cht thi v m bo s ci tin lin tc ca h thng.
- m bo o to v hun luyn y cho cc nhn vin tham gia x l
cht thi.
- Bo co nh k hng nm tnh hnh x l cht thi trong c s y t ca
mnh v nh gi hiu qu ca h thng x l cht thi v S Y t.
b) Trch nhim ca ngi ph trch cng tc qun l cht thi:
- Ngi ph trch cng tc qun l cht thi chu trch nhim gim st v
iu hnh cc hot ng ca h thng qun l cht thi hng ngy, trc tip chu
trch nhim trc Gim c bnh vin.
- V phng din thu gom cht thi, ngi ph trch cng tc qun l
cht thi c cc nhim v sau:
Kim tra cc phng tin cha ng cht thi trong bnh vin v vic vn
chuyn ti ni tp trung cht thi hng ngy ca bnh vin.
31

Lin h vi b phn cung ng m bo c y cc phng tin

thch hp nh ti nilon, thng ng v cc phng tin bo h, xe y cht thi.
Phi hp vi cc trng khoa nhc nh h l thay th ngay cc ti nilon
v thng ng mi khi cn thit.
Trc tip gim st cng vic ca h l v cc nhn vin c phn cng
thu gom v vn chuyn cht thi.
iu tra hoc xem xt li cc bo co v nhng ri ro gy thng tch cho
nhn vin trong qu trnh thu gom v vn chuyn cht thi.
V phng lu tr cht thi, ngi ph trch cng tc qun l cht thi c
cc nhim v sau:
m bo cho khu vc tp trung cht thi ca Bnh vin c s dng
theo ng quy nh.
- V phng din vn chuyn, tiu hy cht thi, ngi ph trch cng tc
qun l cht thi c cc nhim v sau:
iu phi v ch o mi hot ng tiu hy cht thi.
Ch o phng php vn chuyn cht thi trong Bnh vin cng nh ra
khi Bnh vin m bo cht thi sau khi thu gom trong Bnh vin c vn
chuyn n ni tiu hy bng phng tin ng theo quy nh.
m bo cht thi khng lu gi qu thi gian ti thiu trong Bnh vin
theo ng quy nh v duy tr vic vn chuyn cht thi u n, do vy ngi
ph trch cht thi phi lin h thng xuyn vi cc t chc m nhim vic
vn chuyn.
- V phng din o to nhn vin, ngi ph trch cng tc qun l
cht thi Bnh vin c cc nhim v sau:
Phi hp cng vi cc phng chc nng lp k hoch trnh gim c bnh
vin ph duyt v trin khai thc hin vic o to cho mi nhn vin bnh vin
c lin quan n quy trnh qun l v x l cht thi y t.
m bo nhn vin bnh vin hiu c trch nhim ca h trong vic
thu gom, phn loi, lu gi cht thi.
Lin h cc trng khoa m bo rng tt c cn b y t c o to
v phn loi, thu gom, vn chuyn, v lu gi cht thi.
Hng dn cho mi nhn vin bit x l cc tnh hung khi xy ra tai nn
hoc s c v cch phng trnh.
c) Trch nhim ca trng khoa:
Trng khoa chu trch nhim v vic phn loi, bo qun v x l cht
thi pht sinh ra trong khoa:
- m bo mi bc s, iu dng, h l, y cng v cc nhn vin khc
hiu c cc th tc, quy nh v thu gom, bo qun cht thi.

32

- m bo cho nhn vin trong khoa c o to v cc quy trnh thu

gom, phn loi v lu gi cht thi.
- Gim st cng vi ngi ph trch cng tc x l cht thi cc bc s, y
t, iu dng, k thut vin, h l, y cng trong khoa thc hin ng quy trnh
phn loi thu gom cht thi v x l ban u ng theo quy ch qun l cht
thi.
d) Trch nhim ca trng iu dng:
- Trng iu dng chu trch nhim v chng trnh o to cho nhn
vin iu dng, h l, nhng nhn vin mi vo Bnh vin v k thut, quy
nh phn loi, lu gi vn chuyn v tiu hy cht thi.
- Trng iu dng phi hp vi cc trng khoa chng nhim khun
xy dng v thc hin chng trnh o to.
e) Trch nhim ca h l cc khoa, bung bnh:
- t cc thng cha t cc bung bnh, bung phu thut vo thng cha
cht thi chung ca khoa.
- Buc ti nilon khi cht thi n mc 3/4 ti.
- Thu b cht thi ri vi vo thng theo ng quy nh nu c ri vi ra
ngoi.
- C ra thng ng cht thi hng ngy.
f) Nhn vin i v sinh mi trng c trch nhim
- Vn chuyn cht thi bng xe y t cc khoa n ni lu gi cht thi
tp trung ca bnh vin. khng lm ri vi cht thi trn ng vn chuyn.
- Vn chuyn cht thi 2 ngy mt ln: vo bui sng, bui chiu v khi
cn thit
3.2. Nng cao nng lc qun l, o to v truyn thng nng cao nhn
thc trong cc c s y t:
Cc gii php nng cao nng lc qun l cho cc c s y t bao gm: (i)
o to v qun l cht thi y t cho cn b y t c lin quan; (ii) Xy dng s
tay qun l cht thi Bnh vin; (iii) Thit lp chng trnh theo di v gim st
qun l cht thi trong Bnh vin; (iv) Thc hin chng trnh tuyn truyn
nng cao nhn thc ca bnh nhn v cng ng. Cc gii php s c p dng
cho Bnh vin (ngun thi chnh) v cc c s y t khc (ngun thi th yu).
3.2.1. i vi Bnh vin
a) o to nng cao v qun l cht thi y t
- i tng: Cn b ch cht ca hi ng Kim sot nhim khun Bnh
vin, c th l ch tch Hi ng, Trng khoa KSNK, trng phng hnh chnh
qun tr hoc trng phng iu dng.
- S lng: 78 ngi (3 ngi/bnh vin x 26 BV)
- Hnh thc o to: Tp trung.
33

- Thi gian: 3 ngy.

b) o to v vn hnh v bo dng cng ngh x l cht thi:
- i tng: 1 cn b ph trch qun l vn hnh v bo dng h thng
thu gom, vn chuyn, lu gi, x l, tiu hy cht thi rn v 1 cn b ph trch
qun l vn hnh v bo dng h thng thu gom v x l nc thi Bnh vin
- S lng: 24 ngi (2 ngi/ bnh vin x 12 BV)
- Hnh thc o to: Tp trung.
- Thi gian o to: 3 ngy.
c) o to c bn cho nhn vin Bnh vin:
- i tng: C 4 nhm i tng: (i) bc s; (ii) iu dng, n h sinh,
k thut vin; (iii) h l v nhn vin v sinh; (iv) cn b thuc Hi ng Kim
sot nhim khun.
- S lng: 150 ngi (26 bnh vin).
- Hnh thc o to: Ti ni lm vic cho tng nhm i tng.
- Thi gian: 01 ngy/ lp.
d) Truyn thng nng cao nhn thc: Phng tin truyn thng c th
hin di cc hnh thc p phch, t ri, hnh nh ph hp vi tng nhm i
tng khc nhau.
- S dng t ri, tranh nh, pano p phch... tuyn truyn.
- i tng: bnh nhn v cng ng.
- S lng: 12 chng trnh (1 chng trnh/bnh vin x 1 bnh vin)
e) S tay qun l cht thi:
- H tr k thut xy dng s tay qun l cht thi bnh vin.
- S lng: 12 s tay (1 s tay/bnh vin x 12 bnh vin)
3.2.2. i vi cc c s y t khc: T chc tp hun cc quy nh v qun l
cht thi y t
- Ti tuyn tnh:
+ Hnh thc: Tp trung.
+ Thi gian: 01 ngy
+ i tng: Cn b tham gia qun l CTYT trung tm Y t d phng.
+ S lp o to: 01 lp
- Ti tuyn huyn (mi huyn 01 lp):
+ Hnh thc: Tp trung
+ Thi gian: 01 ngy
+ i tng: Cn b tham gia qun l CTYT.
34

- o to trong c s y t: Cc c s y t t chc cc lp tp hun cho tt

c nhn vin trong n v.
3.3. Theo di v gim st thc thi:
Chng trnh theo di gim st tun th quy trnh lin quan n cht thi
y t v quan trc cht lng mi trng bnh vin.
+ Thi gian thc hin: 01 nm
+ S lng: 12 chng trnh (01 chng trnh/bnh vin x 12 bnh vin)
+ Tn sut thc hin nh sau:
3.3.1. Gim st tun th quy trnh:
- Bnh vin s dng cng c gim st xem cc quy trnh chun lp
ra c c tun th. B cng c gim st tun th quy trnh c m t trong s
tay qun l Bnh vin.
- Tn sut gim st: 1 qu/ln x 4 qu/nm.
3.3.2. Gim st cht thi:
Tn sut gim st:
- Cht lng nc thi bnh vin:

1 ln/qu x 4 qu/nm.

- Cht lng kh thi ca l t:

1 ln/qu x 4 qu/nm.

- Hiu lc bt hoi vi sinh vt:

1 ln/qu x 4 qu/nm.

3.3.3. Gim st mi trng xung quanh:

Tn sut gim st:
- Mi trng xung quanh:

6 thng/ ln x 2 ln/nm.

- Mi trng khng kh xung quanh: 6 thng/ ln x 2 ln/nm.

- Vi sinh vt trong bnh vin:

6 thng/ ln x 2 ln/nm.

4. GII PHP TI CHNH

S Y t Kon Tum s tin hnh huy ng ngun nhiu ngun vn thc
hin qun l cht thi y t trn ton tnh (Ngn sch tnh, cc T chc Quc t
v cc ngun khc).
i vi ngun vn t D n H tr x l cht thi bnh vin, vay vn
Ngn hng th gii. S Y t xut u t xy dng h thng x l cht thi y
t nguy hi, hu cn ni b, nng cao nng lc qun l cho cc bnh vin
kho st v p ng y tiu ch u t ca D n:
- u t xy dng h thng x l cht thi nguy hi, hu cn ni b v
nng cao nng lc qun l cho Bnh vin Y hc c truyn tnh Kon Tum.
- u t xy dng h thng x l cht thi nguy hi, hu cn ni b v
nng cao nng lc qun l cho Bnh vin KKV Ngc Hi.

35

Tng mc u t s c tnh ton chi tit da theo nhu cu u t ca

tng Bnh vin v tun theo cc yu cu v hng dn ca chnh ph, d n v
nh ti tr.
i vi ngn sch a phng, S Y ngh u t h thng x l nc
thi y t cho cc n v cha c h thng x l v khng p ng c tiu ch
u t d n h tr x l cht thi Bnh vin.

36

PH LC
Ph lc 1:

Bn cc c s y t tnh Kon Tum

Ph lc 2:

C cu t chc h thng y t tnh

Ph lc 3-1:

c im chung ca cc Bnh vin trong tnh

Ph lc 3-2:

c im mi trng ca cc Bnh vin

Ph lc 3-3:

D tnh cht thi y t pht sinh trong nm 2015 v nm 2020 (1)

Ph lc 3-3:

D tnh cht thi y t pht sinh trong nm 2015 v nm 2020 (2)

Ph lc 3-3:

D tnh nc thi y t pht sinh trong nm 2015 v nm 2020 (3)

Ph lc 3-4:

X l v tiu hy cht thi y t

Ph lc 3-5:

Cc cng trnh x l nc thi Bnh vin

Ph lc 3-6:

Nhu cu u t nng cao nng lc qun l

Ph lc 3-7:

Cc d n h tr qun l cht thi y t trong tnh

Ph lc 3-8:

Nhu cu u t cho h thng phn loi thu gom, vn chuyn, lu gi,

x l v tiu hy cht thi y t

Ph lc 3-9:

Nhu cu u t nng cao nng lc qun l

37

Ph lc 1: Bn cc huyn ca Tnh Kon Tum

38

39