waste & sharps management - liz forde 2016 · liz forde, infection prevention and control, cork...
TRANSCRIPT
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Waste and sharps management
Liz Forde, Infection Prevention and Control,Cork Community Hospitals & Cork Community Nursing
2016
Use Standard Precautions for ALL Residents at ALL times #safepatientcare
Outline
• Guidance available
• Lifecycle of Healthcare Risk Waste (HCRW)-• Segregation, packaging, storage & disposal
• Consequences of incorrect disposal
• Safe Use of Sharps
• Safe Disposal of Sharps
• Resources available
Waste Management Guidance
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Producer responsibility
Ensure that waste contractors hold a valid waste collection permit
1. Obtain a copy of the waste collection permit
2. Check that the waste permit lists your local Authority
3. Check the vehicle used to carry the waste is listed on the waste collection permit
4. Waste categories - Individual waste codes permitted
5. Waste Transfer form documentation is completed for all hazardous or risk waste
6. Ensure your waste is being brought to an EPA licensed facility for processing
September 2016Use Standard Precautions for ALL Residents at ALL times
#safepatientcare
Waste Segregation
September 2016
€822 per tonne
€1,871 per
tonne
€ 177 per
tonne
Healthcare Risk Waste Packaging
•Provides protection to personnel
•Identifies the type of waste generated &
•Disposal stream employedADR Regulations- Health & Safety driven
• Secondary Packaging• Wheeled bins
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DoH&C Poster - 2014
• All primary packaging for
HCRW must have
• diamond shaped risk label
with Class no.6
• Information label to
include e.g UN No. 3291-
Clinical Waste
• Permanent mark showing
UN type-testing e.g.
4H2/Y3/S/99/NL/VL823
Safe handling
• Staff training on segregation and handling procedures
• Yellow bags must not be used for sharps or breakable
items or for fluid
• Do not overfill bags or bins – close securely with cable tie
when 2/3 full.
• Carrying bags/bins through the clinical area should be kept to a minimum
• Carry bags/bins away from your body & by the neck only
• Bags should not be decanted from one to another, thrown or dropped to avoid damaging the bag
Swan Neck Closure for HCRW Bags
3. Put the bag individual tagged tie on the loop to
make a handle and pull
tightly.
Change when bags are 2/3 full
1. Twist the end to make a neck 2.Fold the neck into a loop
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Closing Instructions for Rigid Bins
1. Push down opposite corners
2. Push down the other corners
3. Check all sides are closed and apply tagged tie
Risk Waste Traceability
Must be
Tagged
Complete
label
Records of tags issued - kept for at least 3 years
External Storage
• Suitable sited
• Lockable & enclosed
• Well ventilated & Hygienic
• Secure from interference from unauthorised persons
• ADR Road Transport doc -signed by the contractor collecting the waste and a member of staff on site.
• Kept for 5 years
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Prior to disposal, infectious and sharps waste
goes for treatment in
SRCL, Dublin
And finally…
Replacing fossil fuel in cement kilns
Suitable for landfill
Outline
• Guidance available
• Lifecycle of HCRW-• Segregation, packaging, storage & disposal
• Consequences of incorrect disposal
• Safe Use of Sharps
• Safe Disposal of Sharps
• Resources available
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Unnecessary cost
Non risk disposed as risk - approx 6 times greater cost
Make waste segregation easier
September 2016Use Standard Precautions for ALL Residents at ALL times
#safepatientcare
• Only provide the correct type & size of bin needed
• Put the waste bin in the correct location
Remove risk bin if not needed
Place the non risk bin beside the sink
If needed, use a smaller risk bin
•Sharps Management
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Nurse
43%
Technician
15%
Student
4%
Dental
1%
Housekeeping/
Maintenance
3%
Clerical /
Admin
1%
Other
5%
Physician
28%
Occupational Groups of Healthcare Personnel Exposed to Blood/Body
Fluids,
NaSH June 1995—December 2003
(n=23,197)
Sharps injuries - Who gets injured?
http://www.cdc.gov/sharpssafety/PPT/2PreventingNeedlesticksPartI.ppt#291,12,Who Gets Injured?
When are sharps injuries most likely to occur?
•During use of a sharps device on a patient - 41%
•After use and before disposal of a sharp device - 40%
•During or after appropriate or inappropriate disposal of sharps device - 15%
• CDC 2008
Safe Use of Sharps – Be prepared
• Be prepared to use the device the moment the sharps are first exposed
• Receive training on how to use sharps safety devices
• Before undertaking any procedure, assess any risk of exposure
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Safe Use of Sharps – Be prepared
• Organise your equipment at the point of use
• Locate a sharps container/bring tray with integral bin within reach
• Work in well lit areas
• Assess patient’ ability to cooperate• Get help if needed
• Ask the patient to avoid sudden movement
Safe Use of Sharps – Be aware
During a procedure
• Keep the exposed sharps in view
• Be aware of people around you
• Stop if you feel rushed or distracted
• Focus on your task
• Needles should not be recapped
• Needles must not be bent, broken or removed from the syringe after use
• Sharps must not be passed from hand to hand & handling should be kept to a minimum (NICE, 2012)
Safe Use of Sharps – Be aware
During a procedure
• Activate safety feature of device as soon as the procedure is completed
• Observe audible or visual cures that confirm the feature is locked in place
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Safe Disposal of Sharps
• Be responsible for the device you use
• Dispose of sharps with care• Discard immediately at the point of use into an approved sharps bin by the user
• Use temporary closure on sharps bin when carrying a bin
•While disposing• Inspect container
• Keep hands behind sharps
• Never put fingers/hands into container
• If you are disposing sharps with attached tubing
• Be aware that tubing attached to sharps can recoil and lead to injury
• Maintain control of both tubing and the device during disposal
Clean Up and Dispose With Care
While disposing of Sharps (cont’d)
Safe Disposal of Sharps
Sharps containers
•Keep sharps bin in a safe place • Out of reach of children• At a height that allows safe disposal• Secure position to avoid spillage
•Fill sharps container to 3/4 fill line
•Close & Remove from use once fill line is reached
•Complete sharps bin label with• Date of assembly & signature• Date of Closure & signature• Location
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Safe storage of sharps bins
Photo 1: Difficult to access Sharps bin on lower shelf of trolley
Photo 2:Bin stored on shelf in clean utility, opening not visible
If bin overfull or a sharps not properly
disposed may pose needle stick injury to next user
Suggest trolley mount for easy access
Remember clean bins and trays
Risk of exposure to bloodborne viruses (HBV, hepatitis C virus, and HIV) through contaminated equipment and supplies
Hepatitis B virus
•remains viable for up to 7 days or more
Hepatitis C Virus
•is viable in the environment for at least 6 – 23 hours
WHO (2010) Best practices for injections and related procedures toolkit
Safe use of sharps bins poster
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Trolley Mount
“Kickabout”
Wall Mount
Consider
•Where do you use your sharps bin?
•What do you need to make it safer?
• Appropriate sizes
• Safer Storage of Sharps Bins
• Wall mounting sharps bins
•Following are resources available
September 2016Use Standard Precautions for ALL Residents at ALL times
#safepatientcare
www.greenhealthcare.ie
Sample signage
Green Healthcare Network:
Platform for healthcare staff to ask questions, seek advice and share information
Contact : [email protected]
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Guidance documents and case studies developed by the programme –individual and combined booklets.
www.greenhealthcare.ie
September 2016Use Standard Precautions for ALL Residents at ALL times
#safepatientcare
PCCC: 16% of landfill bag comprised of mixed recyclables
To conclude
Always handle sharps with care•Be prepared
•Be aware
•Dispose with care
Have a Safe Day!
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References
Department of Health and Children (2010) Segregation, Packaging and Storage- Guidelines
for HealthcareRisk Waste - Working Draft. 4th Edition: Department of Health and Children, Dublin:
Stationary Office
Environmental Health Agency - Reducing Waste in Irish Healthcare Facilities
EU Council Directive 2010/32/EU of 10th May 2010 implementing the Framework agreement
in prevention from sharps injuries in hospital and healthcare sector
Health and Safety Authority (2014) Guide to the European Union (Prevention of Sharps Injuries in the Healthcare Sector) Regulations 2014
Health Service Executive (2014) Waste Management Awareness Handbook
National Institute of Clinical Excellence (2012) Infection: prevention and control of healthcare-associated infections in primary and community care
S.I. 135 (2014) Prevention of Sharps Injuries in the Healthcare Sector Regulations 2014
World Health Organisation (2010) Best practices for injections and related procedures toolkit