13 Support services Flashcards
With regards to waste disposal, what are important points with regards to safe removal of waste?
It is essential that all health care facilities have clearly defined guidelines to ensure the safe identification, packaging, labelling, storage, transport, treatment, and disposal of waste, from the point of generation to the point of final disposal.
What is “infectious waste”
In England and Wales infectious health care waste is defined as ‘substances containing viable microorganisms or their toxins which are known or reliably believed to cause disease in man or other living organisms’ and therefore subject to special requirements for handing, collection, and disposal to prevent infection. Infectious waste is categorized in to Category A waste which is highly infectious waste and must be transported in a form that, when exposure to it occurs, is capable of causing permanent disability, life-threatening or fatal disease to humans or animals. Example of this type of waste includes patient-derived health care waste contaminated with haemorrhagic fever viruses, monkeypox or variola as well as laboratory
cultures of hazard group 3 or 4 pathogens (HTM 07-01; Department of Health, 2011 ).
Category B is any infectious substance that does not fall into category A, i.e. all other routine infectious waste should be included in this category.
What is “special waste”
Special waste is defined as waste that is dangerous to life and difficult to dispose of by
its nature, for example, cytotoxic and cytostatic, radioactive, and other pharmaceutical
waste. Disposal of this type of waste is subject to strict regulations.
What is “offensive waste”
This is health care waste that may cause offence (e.g. incontinence waste) but presents
no hazard as listed in the categories above. It is handled and disposed of to minimize
any offence but this can be done at a substantially lower cost than hazardous wastes.
What is non-clinical waste?
Non-clinical or household waste is defined as other waste not in the categories of
either clinical, special, or offensive waste. It is non-toxic, non-infectious, or its basic
nature is unlikely to prove a health hazard or give offence in its existing form. Disposal
of this type of waste is suitable for landfill in a permitted or licensed site.
What is non-clinical waste?
Non-clinical or household waste is defined as other waste not in the categories of
either clinical, special, or offensive waste. It is non-toxic, non-infectious, or its basic
nature is unlikely to prove a health hazard or give offence in its existing form. Disposal
of this type of waste is suitable for landfill in a permitted or licensed site.
When disposing of waste, what are some key practical things?
Must label bags where they came from
Must seal bin bag when 3/4 full, to prevent breakage
Bin bangs must be in pedal-bin to prevent touching of bin
Waste bin bags should be stored in a “dirty” area
Waste should be transported in rigid containers
Spillage must be dealt with appropriately
What methods do these bin bags need disposed of?
Yellow Orange Purple Yellow/ black stripes Black
Yellow - Requires disposal by incineration
Orange - Requires disposal by incineration or may be treated by alternative
treatment methods e.g. heating or microwave-based treatments.
Alternative treatments methods are usually less expensive than incineration
Purple - For cytotoxic and cytostatic drugs. Requires disposal by incineration
Yellow and black stripes - Offensive waste require disposal by landfill in a permitted or
licensed site
Black - Domestic waste is suitable for landfill in a permitted or licensed site
White Waste requires recovery of ingredients
How do these sharps boxes need disposed of?
Yellow with a yellow lid
Yellow with a orange lid
Yellow with a purple lid
Yellow with a yellow lid -
Partially discharged sharps including those contaminated with medicines
other than those that are cytotoxic and cytostatic. Requires disposal by
incineration
Yellow with a orange lid -
Fully discharged sharps that are not contaminated with cytotoxic and
cytostatic medicines. Requires disposal by incineration or alternative
treatment
Yellow with a purple lid -
Sharps including those contaminated with cytotoxic and cytostatic
medicines. Requires disposal by incineration
What standard must a sharp box meet?
All sharps boxes must be correctly assembled and used according to the manufacturer’s instructions. They must be puncture resistant and should comply with appropriate standards (e.g. UN 3291, British Standard BS 3720).
Should be closed and disposed of when 3/4 full
Must be marked who has sealed it, and which ward is disposing of it
Sharps provide a much higher risk of infection to staff members than clinical waste
Hospital kitchens can be the source of outbreaks of infection
They should be assess twice a year for quality control
What things should be checked?
Preparation of food requires attention to raw materials, personal hygiene, kitchen
hygiene, and especially time/temperature control of all food-handling operations
including cooking, cooling, reheating, and distribution (see Box 18.1 ). Assuring safe
food requires management and control of microbiological, chemical, and physical
hazards.
Linen from a VHF patient
How should it be disposed of?
Cat 4 pathogen should be bagged in yellow clinical waste bags and incinerated
Linen from a VHF patient
How should it be disposed of?
Cat 4 pathogen should be bagged in yellow clinical waste bags and incinerated
When disposing of a body care must be taken not to transmit infection to staff or other family members who view the body
Which infections are considered “high risk”?
Anthrax
Plague
CJD Rabies Smallpox VHF YF
Body requires bagging on ward
Not available for staff to view
Should not be embalmed
embalming is injecting chemical preservatives into the body to slow the process of decay. Involves needles and blood contact, so considered high risk
What UK guidelines dictate how a body must be prepared and handled?
Control of Substances Hazardous to Health [COSHH]