Biomedical Waste Handling and Disposal
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1 Approved by: Biomedical Waste Handling and Disposal Corporate Director, Environmental Supports Environmental Services Operating Standards Manual Number: Date Approved Next Review May 3, 2018 Purpose Applicability Responsibility Principles Procedures This Operating Standard provides guidance for the expectations of appropriate steps for the handling and disposal of biomedical waste to ensure safety. This Operating Standard applies to all Covenant Health Environmental Services staff, students, volunteers, and any other persons acting on behalf of Covenant Health Environmental Services (including contracted services providers as necessary). All Environmental Services employees are required to follow the steps outlined for handling and disposal of biomedical waste in order to maintain a clean and safe environment. This waste category encompasses biological material generated from teaching, clinical and research laboratories, operations and may pose a disease-related risk or threat to people or the environment. Examples of biomedical waste includes but not limited to: human fluid blood and blood products; items saturated with blood; body fluids contaminated with blood; and body fluids removed for diagnosis during surgery, treatment, or autopsy. TOOLS NEEDED Appropriate PPE, waste cart, keys, biohazard boxes, biohazard bags. SAFETY PRACTICES 1. Legislative Compliance 1.1. The disposal of biomedical waste must comply with all governmental acts, provincial regulations and municipal by-laws, to ensure the safety of employees handling the material. 2. Safety Practices 2.1. Always follow safe work practices, including proper ergonomic practices (i.e. proper procedures for reaching, bending, etc.), as per staff training Infection Prevention & Control (IPC) Hand Hygiene and Personal Protective Equipment (PPE) resources are available through the Covenant Health website: C_RoutinePracticesAcuteCare August2013.pdf 2.3. Change gloves and other PPE if they are visibly soiled or damaged
2 Page 2 of 6 STEPS Handling of Biomedical Waste 1. Wash/sanitize hands. Put on gloves. Put on (don) appropriate PPE as per risk assessment. Review How To Put On And Take Off Personal Protective Equipment (PPE). 2. Check that biomedical waste container is closed and secured. Biomedical waste container must be sealed and secured prior to being moved. 3. Inspect biomedical waste container for leakage prior to removal. In the event of a leak, spill or release notify the Environmental Services supervisor and report the incident as per site specific protocols. 4. Inspect biomedical waste container for anything sticking out of the container prior to removal. All incidents involving needle stick injuries and exposure to blood and/or body fluids must be reported and documented. 5. Inspect biomedical waste container for proper labeling and bar-coding. Biomedical waste container must be properly labeled and/or bar-coded prior to removing the container. If container is not properly labeled or has no documentation, notify supervisor and do not remove. On-Site Movement or Transportation of Biomedical Waste 6. Collect biomedical waste from designated areas/locations Using designated routes, pick biomedical waste from designated area (e.g. soiled utility room). Never over stack waste containers on the waste hauling cart. 7. Where moving from dirty to clean remove gloves and put on (don) a clean pair of gloves Soiled and/or contaminated gloves must be changed when necessary to avoid cross contamination. Follow proper Hand Hygiene Standard Operating Procedures. 8. Transport the designated biomedical waste hauling cart to primary waste holding area. (e.g. refrigerated storage room). Use designated service elevators (where required) to the appropriate floor location where the primary waste holding area (e.g. refrigerated storage room) is located. Storage of Biomedical Waste 9. Unlock primary waste holding area. Primary waste holding area (e.g. refrigerated storage room) for biomedical waste must be locked when unoccupied.
3 Page 3 of Unload biomedical waste containers from the designated waste hauling cart into the primary waste holding area (e.g. refrigerated storage room). Biomedical waste containers must be stacked so that they are stable, safe and easy to lift. Primary waste holding area (e.g. refrigerated storage room) for biomedical waste should be cleaned a minimum of once per year or when visibly soiled. 11. Lock primary waste holding area. 12. Remove (Doff) PPE. Perform hand hygiene. Follow proper Hand Hygiene Standard Operating Procedures. See Taking Off (Doffing) Personal Protective Equipment (PPE) poster. Preparing Biomedical Waste For Shipment (site specific requirement) 13. Perform hand hygiene. Put on (don) appropriate PPE as per risk assessment. Follow proper Hand Hygiene protocols. See How To Put On And Take Off Personal Protective Equipment (PPE). 14. Unload biomedical waste containers from the designated waste hauling cart and place on weigh scale (if available). Ensure the scale has been re-set to 0 prior to weighing. This should be done for each container. 15. Weigh each biomedical waste container separately. Biomedical waste containers shall be weighed prior to sending for shipment on sites, where applicable. 16. Record the container weight on the Waste Tracking sheet. The Waste Tracking sheet will be used to verify that the weights are consistent between what is being sent for disposal and what the facility is being charged for disposal at applicable sites. 17. Remove (Doff) PPE. Perform Hand Hygiene. Follow proper Hand Hygiene protocols. See Taking Off (Doffing) Personal Protective Equipment (PPE) poster. 18. Submit the Waste Tracking sheet to the Environmental Services office on a weekly basis. For verification purposes. 19. Replace waste tracking verification sheet with a new one. Once unloading and weighing of the biomedical waste containers has been completed, ensure the final storage area (e.g. Biomedical waste refrigerated storage room) is locked at sites where applicable.
4 Page 4 of 6 DEFINITION Biohazards are infectious agents or hazardous biological materials that present a risk or potential risk to the health of humans, animals or the environment. Biomedical Waste consists of a portion of medical wastes that require special precautions and handling due to the waste being infectious, a sharp, cytotoxic, or especially sensitive due to the nature of the waste. Examples of biomedical waste includes, but is not limited to: human fluid blood and blood products; items saturated with blood; body fluids contaminated with blood; and body fluids removed for diagnosis during surgery, treatment, or autopsy. EXAMPLES OF BIOHAZARDOUS CONTAINERS Footnotes Order of Cleaning: All items/areas MUST be cleaned from the cleanest item/area to the dirtiest item/area and from high to low. Mop head and water MUST BE CHANGED every three rooms, or before if visibly soiled. Microfibre Mop heads MUST BE CHANGED every room, or before if visibly soiled. Double dipping Soiled cloth must not be re-dipped into /disinfecting solution(s). Soiled cloths must be discarded into soiled linen bags on carts immediately after use. Cloths and rags MUST be changed frequently within each patient environment in order to prevent cross contamination. Washrooms Cleaned each time a patient/resident is discharged from occupied room. Follow Standard Operating Procedure for washroom cleaning.
5 Page 5 of 6 Maintenance report plugged or damaged toilets, urinals, sinks/fixtures, lights, walls, etc. to unit staff and to your Supervisor or submit maintenance requisition where appropriate. Cleaning/Disinfecting Products Never mix chemicals. Review MSDS sheets for product handling and precautions. Product(s) must be measured properly and changed after every case. Chemical must remain on surface for entire kill cycle / contact time. Refer to specific chemical directions. Ensure proper solution concentration testing Standard Operating Procedures are followed and documented. Use only hospital approved cleaning and disinfecting products. If at any time you are unsure of which tool(s) and/or product(s) to use for a task, consult your Supervisor Personal Protective Equipment (PPE) Clothing or equipment worn by staff for protection against hazards. To Don is to put on, and to Doff is to remove. Additional Precautions (AP) Precautions (i.e. Contact Precautions, Droplet Precautions, Airborne Precautions) that are necessary in addition to Routine Practices for certain pathogens or clinical presentations. These precautions are based on the method of transmission (e.g. contact, droplet, airborne). Damp Cloth Cloth must be wet to ensure that the surface stays wet for the required contact time of a disinfectant to be effective. Cleaning The physical removal of foreign material (e.g. dust, soil) and organic material (e.g. blood, secretions, excretions, microorganisms). Cleaning physically removes rather than kills microorganisms. It is accomplished with water, detergents and mechanical action. Disinfection The inactivation of disease-producing microorganisms. Disinfection does not destroy bacterial spores. Medical equipment/devices must be cleaned thoroughly before effective disinfection can take place. Hazard Assessment Health and Safety Hazard Assessments mitigate the risk of incident/injury or illness from exposure to biological, chemical, or physical contaminants. To reduce the risk of incident/injury or illness appropriate controls must be put into place. Health and Safety Hazard Assessments must be completed and reviewed before an ES employee is exposed to contaminants which may pose incident/injury or illness. This is done to protect the health and safety of ES employee, other staff and patients/residents. Employee Incident/Injury Reporting Report incidents or unsafe work to your Supervisor and/or to OHS through the incident management process as required. Risk Assessment Assessment conducted before each interaction with a patient/resident or their environment to determine the risk of exposure to infectious agents, and the appropriate interventions (additional precautions, PPE etc.) to reduce the risk of transmission. Two-Step Clean A two-step process is used to clean and then disinfect surfaces. First wipe surfaces thoroughly to clean the surfaces of visible organic material (dirt you can see) and then wipe again with a clean cloth saturated with disinfectant to remove invisible microorganisms (things you cannot see). Organic materials that are not properly removed during the first step may inactivate the disinfectant used in the second step, therefore both steps are essential. Cleaning Frequency Based on the Cleaning Frequency Standard.
6 Page 6 of 6 References Waste Management ( ) Emergency Response Codes ( I-25) Enterprise Risk Management ( III-90) Hand Hygiene (VI-10) Occupational Exposure to Blood and Body Fluids (#1111) Records Management (#1133) Workplace Health & Safety (#1121) Blood and Bodily Fluid Exposure Occupational Health and Safety Act Regulation and Code (2009). Records Management (II-130) Reporting of Work-related Incidents, Injuries, Illness (II-135) Canadian Environmental Protection Act (1999) (S.C. 1999, c.33). [and related Acts, Regulations, Standards and Agreements] Canadian Standards Association (CSA) (2009) (Z ). Handling of waste materials in health care facilities and veterinary health care facilities. Reaffirmed 2014 Environmental Protection and Enhancement Act RSA (2000) (Chapter E-12). [and related Acts, Regulations, Standards and Agreements] Health of Animals Act (1990) (S.C. 1990, c.21). [and related Acts, Regulations, Standards and Agreements] Transportation of Dangerous Goods Act (1992) (1992, c.34) [and related Acts, Regulations, Standards and Agreements] Occupational Health and Safety Act ( 2000) (Chapter O-2). [and related Acts, Regulations, Standards, Codes and Agreements] Public Health Act, RSA (2011) (Chapter P-37). [and related Acts, Regulations, Standards and Agreements] Waste Control Regulation (Alberta Regulation 192/96). [and related Acts, Regulations, Standards and Agreements]
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