No. 7 Dealing with Spills of Blood and Body Fluids Page 1 of 6
INDEX SUBJECT PAGE 1.1 Training and competency 3 1.2 Introduction 3 1.3 Spills in Clinical Areas 3 1.4 Spills in the Home Environment 4 1.5 References 5 Page 2 of 6
1.1 Training/Competency: Formal education is provided on Trust induction and annual updates. All staff should also receive training on correct decontamination procedures in the clinical and domiciliary settings. 1.2 Introduction Staff cleaning spills of blood and blood stained body fluids must check that there has been an appropriate COSHH assessment on any chemicals to be used. They must also protect themselves with appropriate protective clothing i.e. gloves and plastic apron. If there is a risk of splashing, eye protection must also be worn. 1.3 Spills in the clinical area Minor Spillages Drips or splashes of blood on inanimate surfaces should be wiped up using a paper towel soaked with sodium hypochlorite 1% (10,000ppm). Gloves and aprons must be worn to reduce exposure, and the area requires ventilating. Waste should be disposed of into a yellow clinical waste bag. Since hypochlorite solutions can be corrosive, the treated surface should be rinsed with clean water and dried. Do not use on carpets or soft furnishings. Major Spillages of Blood Wear protective clothing, i.e. apron and gloves and eye protection. Major spillages can be treated with absorbent chlorine-releasing granules (e.g. Haz-tabs or Precept) which will ensure that the active agent comes into contact with any micro-organisms throughout the spillage and will limit the spread of liquid blood. When treating a spillage, staff must wear gloves, aprons and eye protection. Because chlorine gas is released during the inactivation process, windows should be opened to ensure adequate ventilation. Sprinkle granules over the spill until all the moisture is absorbed leave for two minutes. Collect spilt material and granules using either the supplied spillage kit scoop or disposable paper towels, and discard into a yellow clinical waste bag. Wipe surface with a paper towel Page 3 of 6
soaked in sodium hypochlorite 1% (10,000ppm) solution, and finally the surface should be rinsed with clean water and dried. If blood is spilt on carpets/soft furnishings then excess needs to be wiped up using paper towels and area needs to be professionally steam cleaned. Detergent will not destroy micro-organisms. Chlorine can be used but it may discolour the carpet/soft furnishings. Blood Spillage on Staff (a) On intact skin. The spilled blood should be washed off with copious amounts of soap and warm water, paying particular attention to finger nails. (b) On micro membranes. Splashes of blood or body fluids entering the eye should be removed by immediate irrigation. Ideally sterile saline eye wash packs should be used if available. Alternatively running water (drinking water) can be used instead. Irrigation should continue until all traces of the contaminating material have been removed. The incident must be reported. Follow the Management of Sharps/Exposure Policy 5. 1.4 Spills in the home environment Action In the clients home environments staff must still use standard infection control precautions especially protective clothing and hand washing; however the equipment and products available may be different. Where possible use materials that can absorb the spill and dispose safely. Generally, the spill should be cleaned with detergent and warm water and dried as well as possible The resulting waste if not a large quantity should be double wrapped in plastic bags and placed in the householder s domestic waste bin by the householder. If the spill is very large, or there is a particular hazard, such as a known blood borne virus a special collection and decontamination service may be required. Rationale To minimise the risk of cross infection. To remove the bulk of the spill. To remove organic matter To prevent further exposure. To protect from further exposure. Page 4 of 6
1.5 References Ayliffe G.A.J. Coates D. Hoffman P.N. (1993) Chemical Disinfection in Hospital. PHLS Ayliffe G, Babb J, Taylor L. (1999). Hospital Acquired Infections: Principles and Prevention. 3rd Edition Butterworth-Heinemann. Oxford. Damani N. (2003) Manual of Infection Control Procedures. 2 nd edition. Greenwich Medical Media Ltd. London Department of Health (2000) HIV Post Exposure Prophylaxis, Guidance from the Chief Medical Officers; Expert Advisory group on AIDS. Department of Health (1998) Guidance for Clinical Healthcare workers: Protection Against Blood Borne Viruses, Recommendations of the Expert Advisory Group on Hepatitis. Duggal H. et al (2002) Infection Control. A Handbook for Community Nurses. Whurr publishers. London. Hart S. (1991) Blood and Body Fluid Precautions. Nursing Standard March 15. Vol. 5. No 25. Wilson J (2001) Infection Control in Clinical Practice Second Edition. Balliere Tindall. Infection Control Nurses Association (ICNA) (2003) Guidelines for General Practice Health Service Advisory Committee (1999). Safe Disposal of Clinical Waste. London Health and Safety Executive (1995) Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) HMSO (1974) Health and Safety at work Act London Page 5 of 6
HMSO (1991) Environmental Protection Act (Duty of Care) Regulations London HMSO (1999) Control of Substances Hazardous to Health London. Horton R. Parker L. (2003) Informed Infection Control Practice. Churchill Livingstone. London The Journal of Hospital Infection (2001) The epic Project: Developing National Evidencebased Guidelines for Preventing Healthcare Associated Infections. The Guidelines for Standard Principles Vol. 47.Supplement Page 35 Lawrence J. (2003) Infection Control in the Community. Churchill Livingstone. London Sebazco S. (1996) Universal Precautions. Asepsis. First quarter. Vol. 18. No1. Wilson J. (1999) Infection Control In Clinical Practice. London. Bailliere Tindall. Wilson J. (2000) Clinical microbiology. An introduction for Healthcare professionals. London. Bailliere Tindall. Page 6 of 6