30/08/2016. Outline. Waste and sharps management. Waste Management Guidance

Transcription

1 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 1

2 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 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Waste Segregation 822 per tonne 1,871 per tonne 177 per tonne September 2016 Healthcare Risk Waste Packaging Provides protection to personnel Identifies the type of waste generated & Disposal stream employed Secondary Packaging Wheeled bins ADR Regulations- Health & Safety driven 2

3 DoH&C Poster All primary packaging for HCRW must have diamond shaped risk label with Class no.6 Information label to include e.g UN No 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 Change when bags are 2/3 full 1. Twist the end to make a neck 2.Fold the neck into a loop 3. Put the bag individual tagged tie on the loop to make a handle and pull tightly. 3

4 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 Complete label Must be Tagged 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 4

5 And finally Prior to disposal, infectious and sharps waste goes for treatment in SRCL, Dublin Suitable for landfill Replacing fossil fuel in cement kilns Outline Guidance available Lifecycle of HCRW- Segregation, packaging, storage & disposal Consequences of incorrect disposal Safe Use of Sharps Safe Disposal of Sharps Resources available 5

6 Unnecessary cost Non risk disposed as risk - approx 6 times greater cost Make waste segregation easier 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 September 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Sharps Management 6

7 Sharps injuries - Who gets injured? Occupational Groups of Healthcare Personnel Exposed to Blood/Body Fluids, Housekeeping/ Maintenance 3% Student 4% Technician 15% Clerical / Admin 1% Dental 1% Other 5% Nurse 43% NaSH June 1995 December 2003 (n=23,197) Physician 28% 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 7

8 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 8

9 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 Safe Disposal of Sharps Clean Up and Dispose With Care While disposing of Sharps (cont d) 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 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 9

10 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 10

11 Trolley Mount Wall Mount Kickabout 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 Sample signage Green Healthcare Network: Platform for healthcare staff to ask questions, seek advice and share information Contact : eileen.oleary@ctc.ie September 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare 11

12 Guidance documents and case studies developed by the programme individual and combined booklets. PCCC: 16% of landfill bag comprised of mixed recyclables September 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare To conclude Always handle sharps with care Be prepared Be aware Dispose with care Have a Safe Day! 12

13 References Department of Health and Children (2010) Segregation, Packaging and Storage- Guidelines for Healthcare Risk 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 10 th 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 13