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Medical Waste Management PDF
Medical Waste Management PDF
@ NOTES:
@
WELCOME NOTES:
Medical Waste Management 1/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
OBJECTIVES
Infectious Waste.
@
Define Medical Waste, Regulated Medical Waste and
NOTES
Discuss the Regulations Applicable to Medical Waste.
:
Discuss the Components of an Infectious Waste Management
Plan.
Outline an Exposure Control Plan.
Discuss Steps to take if Exposed to Infectious Waste.
Discuss the Problem of Mercury.
Discuss Records to Maintain.
Recommend Inspection Items.
Medical Waste Management 2/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
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MEDICAL WASTE MANAGEMENT - TRAINING STUDENT HANDOUT
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GOALS
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Be Familiar With Your Facilities Exposure Control Plan.
Understand the Steps to Take if Exposed to Infectious Waste.
NOTES:
Understand the Problem of Mercury.
Be Familiar With Records to Maintain.
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4. Sharps (e.g. hypodermic needles and syringes)
5. Certain animal wastes
NOTES
6. Certain isolation wastes (e.g. : from patients
wastes
with highly communicable diseases)
7. Unused sharps.
Medical Waste Management 5/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
WHAT IS AN INFECTIOUS
WASTE?
seven categories: @
Infectious wastes were categorized into the following
NOTES:
1. Isolation wastes – wastes generated by hospitalized
patients who are isolated to protect others from
communicable diseases.
2. Cultures and stocks of infectious agents and
associated biologicals – this category includes:
- Specimens from medical and biological laboratories
- Cultures and stocks of infectious agents from
clinical, research, and industrial laboratories
3. Human blood and blood products – this includes
waste blood, serum, plasma, and blood products.
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WHAT IS AN INFECTIOUS
WASTE?
4. Pathological waste – tissues, organs, body parts,
blood, and body fluids.
5. Contaminated sharps – contaminated hypodermic
needles, syringes, scalpel blades, Pasteur pipettes, and
broken glass.
6. Contaminated animal carcasses, body parts, and
animal bedding
@
7. Miscellaneous Contaminated Wastes – these include:
- Wastes from surgery and autopsy
NOTES:
- Miscellaneous laboratory wastes
- Dialysis unit wastes
- Contaminated equipment
Medical Waste Management 7/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
INFECTIOUS WASTE
MANAGEMENT PLANS
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Components of an Infectious WasteNOTES
Management Plan:
1. Designation of the waste that should be managed as infectious
:
2. Segregation of infectious waste from the noninfectious waste
3. Packaging
4. Storage
5. Treatment
6. Disposal
7. Contingency measures for emergency situations
8. Staff training
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@ NOTES:
DESIGNATION OF AN INFECTIOUS
WASTE
Medical Waste Management 9/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
SEGREGATING MEDICAL
WASTES
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SEGREGATING MEDICAL
WASTES
Whenever possible, do not combine
medical waste with hazardous chemicals
or radioactive waste.
Separate sharps waste from other
medical wastes. Sharps should be
stored in puncture-proof containers.
@
Separate pathology wastes from other
medical wastes.
Separate chemotherapy wastes
NOTES :
from
other medical wastes.
Medical Waste Management 11/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
SEGREGATING MEDICAL
WASTES
follows: @
If different types of waste are mixed, treat mixtures as
NOTES:
Mixtures of medical and radioactive waste --
decontaminate the biohazardous component and manage
as radioactive waste.
Mixtures of medical and hazardous chemical waste -- if
safe to do so, decontaminate the biohazardous
component and manage as chemical waste.
Mixtures of medical, radioactive, and hazardous
chemical waste -- if safe to do so, decontaminate the
biohazardous component and manage as radioactive
waste.
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Closing the top of each bag by folding or tying as
appropriate for the treatment or transport
NOTES:
Place liquid wastes in capped/ tightly stopped bottles.
Do not compact infectious wastes before treatment.
Medical Waste Management 13/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
HANDLING SHARPS
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Each year there are some 600,000 incidents where
people are accidentally stuck NOTES : and sharps.
by needles
The most common times of risk for spreading
bloodborne pathogens occurs:
– Recapping needles
– Failing to dispose of used needles properly in puncture-
resistant sharps containers
– Accidental breakage of the tubes used for collection of blood
in a variety of health care settings. There are an estimated
2,800 injuries from these glass capillary tube breakage every
year.
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@ NOTES:
HANDLING SHARPS
Medical Waste Management 15/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
HANDLING SHARPS
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Promptly dispose of used needles in
NOTES:
appropriate sharps disposal containers.
Report all needlestick and sharps-related
injuries promptly to ensure that you receive
appropriate followup care.
Tell your employer about any needlestick
hazards you observe.
Participate in training related to infection
prevention.
Get a hepatitis B vaccination.
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PACKAGING OF SHARPS
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routinely. Should not be overfilled to present a hazard.
Containers of contaminated sharps will be closed
immediately. NOTES:
Secondary containers must be closable and prevent
leakage during handling, storage, transport, or shipping.
Medical Waste Management 17/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
STORAGE
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Storage temperature and duration are important
NOTES: cause higher
considerations. Warmer temperatures
rates of microbial growth and putrefaction, resulting in
odor problems. EPA recommends:
Locating the storage area near the treatment site.
Minimizing storage time.
Proper packing that ensures containment of
infectious waste and the exclusion of rodents and
vermin.
Limited access to storage areas.
Prominently displaying the universal biological hazard
symbol on storage area door, waste containers, etc.
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TRANSPORT
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Transport of infectious waste in closed leakproof
trucks or dumpsters.
NOTES:in accordance
Use of appropriate hazard symbols
with local, state and federal regulations.
Medical Waste Management 19/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
ON-SITE TREATMENT
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There are several methods that have been successful in
NOTES
the treatment of infectious waste. The:following slides
will discuss treatment that may be available at your
facility. The methods discussed are:
1. Autoclaving (steam sterilization)
2. Incineration
3. Thermal inactivation
4. Gas/Vapor Sterilization
5. Chemical Disinfection
6. Sterilization by irradiation (radiofrequency and
microwave)
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AUTOCLAVING
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penetration.
Steam sterilization is most effective with low-density
material such as plastics, metal pans (panci), bottles,
NOTES:and
and flasks. High-density polyethylene
polypropylene plastic should not be used in this process
because they do not facilitate steam penetration to the
waste load.
Medical Waste Management 21/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
AUTOCLAVING
@
Plastic bags should be placed in a rigid container
NOTES
before steam treatment to prevent
clogging.
:
spillage and drain
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AUTOCLAVING
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•Prevention of burns from handling hot containers
•Management of spills
Check autoclave temperatureNOTES : that the proper
to ensure
temperature is being maintained for a long enough period
during the cycle.
Steam sterilizers should be routinely inspected.
Medical Waste Management 23/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
INCINERATION
@
Newly Regulated Emissions from
Medical Waste Incineration: NOTES:
1. Particulate Matter
2. Carbon Monoxide
3. Dioxin
4. Sulfur Dioxide
5. Hydrogen Chloride
6. Nitrogen Oxides
7. Cadmium
8. Lead
9. Mercury
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THERMAL INACTIVATION
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After treatment, the contents can be discharged into
the sanitary sewer.
NOTES:
This method requires higher temperatures and longer
treatment cycles than steam treatment.
Medical Waste Management 25/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
GAS/VAPOR STERILIZATION
@
Gas/vapor sterilization uses gaseous or vaporized
NOTES:
chemicals as the sterilizing agents.
Ethylene oxide is the most commonly used agent, but
should be used with caution since it is a suspected
human carcinogen.
Because ethylene oxide may be adsorbed on the
surface of treated materials, the potential exists for
worker exposure when sterilized materials are handled.
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CHEMICAL DISINFECTION
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– Contact time
– Other relevant factors such as temperature, pH, mixing
requirements, and the biology of the microorganism
NOTES :
Medical Waste Management 27/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
STERILIZATION BY IRRADIATION
Advantages of irradiation:
@
Electricity requirements areNOTES
Steam is not required.
:
nominal.
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RADIOFREQUENCY IRRADIATION
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This process heats the waste to >90 C.
The factors which affect radiofrequency irradiation
treatment of medical waste include the frequency and
wavelength of the irradiation, NOTES : of the
the duration
exposure, destruction and moisture content of the waste
material, temperature achieved throughout the waste
load during treatment, and waste storage duration.
Medical Waste Management 29/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
MICROWAVE IRRADIATION
@
Large microwave irradiation medical waste treatment units
include an initial destruction phase. NOTES
The waste is automatically fed into a waste grinding device
where it is shredded and sprayed with steam to increase the
:
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DRAIN DISPOSAL
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infectious agents
•Cultures and stocks of infectious agents
•Wastes from the production of NOTES : bacteria,
infectious
viruses, spores, discarded live and attenuated vaccines
Non-infectious medical waste disposal should only be
made to sanitary sewers only.
Medical Waste Management 31/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
@
Infectious waste that has been effectively treated is
and :may be mixed with
NOTES
no longer biologically hazardous
the disposed of as ordinary solid waste, provided the
waste does not pose other hazards that are subject to
federal or state regulations.
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CONTINGENCY PLANNING
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– cleanup procedures, protection of personnel, and
repackaging of waste
NOTES
Equipment failure – alternative :
arrangements for
waste storage and treatment (e.g. offsite treatment).
Medical Waste Management 33/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
DECONTAMINATION
@
All surfaces, tools, and other objects in contact
with potentially infectious NOTES : must be
materials
decontaminated and as soon as possible.
Equipment and tools must be cleaned and
decontaminated before servicing or being put
back to use.
Decontamination should be accomplished by
using
– A solution of 5.25% sodium hypochlorite (household
bleach / Clorox) diluted between 1:10 and 1:100 with
water.
– Lysol or some other EPA-registered tuberculocidal
disinfectant.
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DECONTAMINATION
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saw blades, tweezers, mechanical equipment
upon which someone has been cut, first aid
boxes, or whatever) you should
NOTESleave
: your
disinfectant in place for at least 10 minutes
before continuing the cleaning process.
Cleanup materials must be decontaminated.
Medical Waste Management 35/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
DECONTAMINATION
@
Steps to Clean Up a Spill of Human Blood
NOTES:
Wear gloves and lab coat to clean up spill.
If broken glass is present, use forceps to pick
up and place in sharps container.
Absorb blood with paper towels and discard in
biohazard waste container.
Using a detergent solution, clean the spill site
of all visible blood.
Wipe the spill site with paper towels soaked in
a disinfectant such as bleach diluted 1:10
Discard all contaminated materials into
biohazard waste container.
Wash hands with soap and water.
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- Housekeeping
Hepatitis B vaccination
Post-exposure evaluation and follow-up
NOTES :
Communication of hazards to employees and training
Record keeping
Procedures for evaluating the exposure incident.
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EXPOSURE STEPS
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@ NOTES:
EXPOSURE STEPS
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medical follow-up.
NOTES:
Medical Waste Management 39/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
EXPOSURE STEPS
Referral to a a Health
Care Professional (HCP)
— Following a report of an
@
NOTES:
exposure incident of a
bloodborne pathogen, the
employer shall make
immediately available to
the exposed employee a
confidential medical
evaluation and follow-up at
no cost to the employee.
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EXPOSURE STEPS
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occurred, and the identity of the
source patient — if known, and if
permitted by law. NOTES:
Medical Waste Management 41/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
STAFF TRAINING
@
Training should include an explanation of the
infectious waste managementNOTES : assignment of
plan and
roles and responsibilities for implementation of the plan.
Training programs should be implemented:
When the infectious waste management plan are first
developed and instituted.
When new employees are hired, and
When infectious waste management practices change.
Continuous education is also an important part of
staff training.
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@ NOTES:
MERCURY
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services kits, and barometers.
Total cost to replace mercury devices is modest, especially
in light of the cost of spills. NOTES :
Non-mercury replacements are usually no more expensive
than their mercury counterparts.
Medical Waste Management 43/ 60 © Copyright Training 4 Today 2000 Published by EnvironWin Software LLC.
MERCURY
@
Removal of a mercury device must mean “get it out
of the hospital”, not merely outNOTES :
of service.
Purchasing Departments and associated staff must
be vigilant in purchasing and accepting shipments of
supplies. Vendor substitution could bring mercury back
into the facility.
Training for mercury auditing is best done on a one-
on-one basis, large groups make the process difficult.
Mercury assessments must be performed in a safe
and open atmosphere, which encourages the discovery
of all sources of mercury.
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@ NOTES:
CHECKLIST
@
Protective clothing
B. CONTINGENCY PLANS
Alternate treatment site
Other storage sites NOTES:
Exposure Control Plan
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CHECKLIST
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@ NOTES:
RECORDS
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Any state or local requirements for logs of equipment
used to treat medical wastes.
NOTES:
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@ NOTES:
ELEMENTS OF A SUCCESSFUL
MEDICAL WASTE PROGRAM
@
3. EXTENSIVE EMPLOYEE TRAINING PROGRAMS
4. PERIODIC REINFORCEMENT OF TRAINING
NOTES:
5. SUFFICIENT DISCIPLINE REGARDING IMPLEMENTATION
6. PERIODIC FOLLOW-UP
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THE IMPORTANCE OF A
CLEAN ENVIRONMENT
@
“I would ask all of us to remember
NOTES:
that protecting our environment is
about protecting where we live and
how we live. Let us join together to
protect our health, our economy,
and our communities -- so all of us
and our children and our Carol Browner
grandchildren can enjoy a healthy Former EPA
and a prosperous life.” Administrator
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