ANY WASTE GENERATED DURING THE DIAGNOSIS, TREATMENT OR IMMUNIZATION OF HUMANS OR ANIMALS OR IN RESEARCH ACTIVITIES PERTAINING

BIOMEDICAL WASTE
IS DEFINED AS
“ANY WASTE GENERATED DURING
THE DIAGNOSIS, TREATMENT
OR IMMUNIZATION OF HUMANS
OR ANIMALS OR IN RESEARCH
ACTIVITIES PERTAINING THERTO
OR IN THE
PRODUCTION OR
TESTING OF BIOLOGI

1. LokendraSingh Ranawat
(ICN)

3. BIOMEDICAL WASTE
IS DEFINED AS
“ANY WASTE GENERATED DURING
THE DIAGNOSIS, TREATMENT
OR IMMUNIZATION OF HUMANS
OR ANIMALS OR IN RESEARCH
ACTIVITIES PERTAINING THERTO
OR IN THE
PRODUCTION OR
TESTING OF BIOLOGICALS”

4. It is estimated that the quantity of wastegenerated from
hospitals in our country ranges from 1-2kg/bed/day

5. Human Anatomical Waste
Animal waste
Microbiology and Biotechnology waste
Waste sharps
Discarded medicines
and cytotoxic drugs

6. Soiled waste
Solid waste
Liquid waste
Incineration ash
Chemical waste

7. The key to the success of any waste
management strategy is
“Segregation at the point of generation’’

9. Waste to be put :
Anatomical tissues and body parts
soiled cotton gauzes
discarded medicines
microbiology culture plates

10. For Infectious Plastic Waste :
Catheters
Tubings
i.v.sets
Blood and urine bags
Plastic syringes
Used gloves

11. For waste sharps:
Needles
Scalpels
Lancets
Broken glass
Suture needles
Intact glass or broken bottles

12. For noninfectious/general
waste
Paper
Kitchen waste
Office waste
Plastic packaging material

13. YELLOW BAGS Red Bags Bluebags Black bags
IncinerationAutoclavingchemical
treatment/shr
edding
Secure landfill

14. 1.Do not store any medical waste beyond 48 hours.
2.Always wear gloves while handling sharps
3.Never leave sharps
4. unattended in open
5. containers or slabs
6.Never recap syringes
7.Red bag is not incinerated as it contains
cadmium and causes release of toxic emissions.
When a sharps container is 2/3 to ¾ full, its lid shall be closed and sealed with
autoclave tape in a crossover pattern before being removed from the
procedure room for disposal.

15. The hospital is authorized by RPCB(Rajasthan
Pollution control Board)for the management
and handling of Bio-medical Waste.
Bio-medical Waste is stored and transported to
the site of treatment and disposal in proper
covered vehicles within stipulated time
limits in a secure manner. (maximum within
48 hours)
Bio-medical Waste treatment facility is
outsourcedto authorized contractor i.e

17. Hand hygiene
Performing Hand washing,
antiseptic hand wash, alcohol-
based hand rub, surgical hand
hygiene/antisepsis.

18. Avoid
transmission
Reduces
Infection
Removes or kills
microorganisms
Protect
yourself

19. Washing with soap and waterkills many transient
micro-organisms and allows them to be mechanically
removed by rinsing.
Washing with antimicrobial productskills or inhibits
the growth of micro-organisms in deep layers of the
skin

20. 5/1/2024 20

22. Hand
wash(Medical)
Social HandwashingSurgical Hand
Washing
Washing hands with
plain soap and water
OR with other
detergents
containing an
antiseptic
agent,donefor at
least 1 minutes
Washing Hands
With Soap & Water
OR Antiseptic
Solution, done for
at least 30 seconds
Handwashingusing
an alcohol-based
handrubbefore
operations by
surgical personnel
,done for at least
5 –10 minutes

25. No Milking of the area And No Squeezing.
Wash the area with soap and water
Splashes to the nose, mouth or skin should be
flushedwith water.
Eyes should be irrigatedwith clean water,
saline or sterile irritants.
Inform to nursing in charge.
Reporting the incident to the nursing In
charge

26. Anti HbsAg Antibody titer
HIV Antibody
HCV Antibody
If Titer is low (<10 IU/ML) than give Booster
dose of Hepatitis B vaccine within 24-48
hours.

27. Anti HbsAg Antibody titer
HIV Antibody
HCV Antibody
If patient is HbsAg positive then:-
Start the Hepatitis B vaccination within 24-
48 hrs.
Give anti immunoglobulin within 24 hrs.

28. Anti HbsAg Antibody titer
HIV Antibody
HCV Antibody
If Titre is low (<10 IU/ML) than give Booster
dose of Hepatitis B vaccine within 24-48
hours.

29. Give anti retroviral therapy within 4 hrs.

31. 1.In Side the ICU`s–Only scrub suit are
allowed ( no apron) with cap and mask
2. Out side the ICU`s–Wear apron on scrub
suit avoid cap and mask.

32. Very high riskHigh riskModerate risk Low risk Minimal risk
•OT’s
•MICU
•SICU-I
•SICU-II
•CCU
•NICU
•CATH LAB
•HDU
•CSSD
•TRIAGE
GROUP-I
•General ward
•IPD Room
•OPD Room
•Labor room
•Procedure room
GROUP-II
•Laboratories
•Mortuary
•Medical imaging
•General pharmacy
GROUP-III
•Kitchen
•Rehabilitation
area
•Cafeteria
•Waiting room
•Public through
fares
•Administrative area
•Store
•Basement offices
•Staircases
•Elevators
•Medical record
•Engineering dept.
•External
surrounding

33. FOGGING

35. OT
Cath Lab
CSSD
All ICU`s
Lysoformin
plus
Lysoformin
e plus

37. Infection Control Practices:
Measures (activities) designed to reduce the
risk
of infection.
Infection control:
refers to policies and procedures used
to minimize the risk of spreading infections,
especially in hospitals and health care
facilities.

38. To reduce the occurrence of
infectious diseases.
caused by bacteria or viruses and spread by
human-to-human contact, animal-to-human
contact, human contact with an infected surface,
airborne transmission

39. Standard precautions
Additional precautions or
Transmission-Based Precautions.
CATEGORIES

40. Standard precautions are applied to all
patients regardless of their diagnosis.

41. Standard precautions
includes
Hand hygiene
Barrier precautions
Appropriate handling of patient care equipment and soiled
linen .
Prevention of needle stick / sharp injuries .
Environmental cleaning and spills –management and
Appropriate handling of waste.

42. Barrier precautions
Personal protective equipment includes :
Gloves
Protective eye wear (goggles)
Mask
Gown
Boots, Shoe covers
Cap and hair cover

43. PPE ARTICLES

44. ADDITIONAL PRECAUTIONS
Airborne precautions
Droplet precautions and
Contact precautions

45. Do’s and Don’ts of Glove Use
• Work from “clean to dirty”
• Limit opportunities for “touch
contamination” -
protect yourself, others, and the environment
–Don’t touch your face or adjust PPE with
contaminated gloves
–Don’t touch environmental surfaces except
as
necessary during patient care

46. ◦Do’s and Don’ts of Glove Use
◦(cont’d)
• Change gloves
–During use if torn and when heavily soiled
(even
during use on the same patient)
–After use on each patient
• Discard in appropriate receptacle
–Never wash or reuse disposable gloves

48. Insertion bundle Daily Maintenance

49. Optimal site selection
Hand washing !!!
Full body drape (sterile field)
Sterile Gloves, Gown, Towels
Surgical mask & cap
Chlorhexidine 2 % & 70% alcohol skin prep
All ports capped by MD
Immediate dressing application (dated)

50. Hand washing before access
Standard dressing changes (date &
time)
Swab ports with Chlorhexidine 2% &
70% alcohol swabs
Change IV bags q24 hours
Change IV tubing q72 hours
Daily review of necessity/Early
removal
Screen patients for infection
(integrated into the Daily Goal

51. Ventilator asssociated
pneumonia
(VAP)
1

52. A nosocomial pneumonia associated with
mechanical ventilation that develops within 48
hours or more of hospital admission and which
was not developing at the time of admission.
-early onset VAP
-late onset VAP

53. ….isapackage ofevidence-based
interventionsthat,when implemented
togetherforallpatientsonmechanical
ventilation,resultsindramaticreductionin
theincidenceofventilator-associated
pneumonia.

54. Adult Ventilator Bundle
VAP prevention measures
1.Handwashing
2.Patient positioning
3.Oral care
4.Management of oropharyngeal and
tracheal secretions
5.Daily “Sedation Vacation” and daily
assessment of readiness to extubate
General measures to improve care
1.Peptic ulcer disease prophylaxis
2.Deep vein thrombosis (DVT) prophylaxis

55. VAP Prevention
Wash hands
-before and after
suctioning,
-ventilator equipment,
-coming into contact
with respiratory
secretions
2 Minutes to Save a Life...
PRICELESS

56. HOB at 30-45°

57. –In-line suctioning using closed technique
–Normal saline
•Should not be routinely used to suction pts.
•Causes desaturation
•Does not increase removal of secretions
•Can potentially dislodge bacteria
•Shouldbe used to rinse the suction catheter after
suctioning.
suctioning

58. Daily interruption of sedation decreases vent
LOS
◦Vent LOS reduced by 33%
◦ICU LOS reduced by 35 %
Hold sedation daily until patient can follow
commands

59. •H2 blockers and antacids ↓ incidence of
stress ulcers
•Colonization of the GI tract occurs as the pH
rises
•These organisms ascend the GI tract and gain
access to the trachea
•Sucralfate protects the lining of the stomach
without ↑ pH
•CDC does not make a recommendation for
the choice of H2 blockers vs. Sucralfate for
the prevention of stress ulcers

60. W early weaning
H hand hygiene
A aspiration precautions
P prevention of contamination

61. SSI BUNDLES
AND
CAUTI BUNDLES

62. •Main Strategies:
•Education of personnel in the correct technique Main Strategies:
•Education of personnel in the correct techniques for insertion and
care.
•Insertion of a urinary catheter only when needed.
•Aseptic insertion technique.
•Hand washing when handling urinary catheter systems
•use for insertion and care.
•Insertion of a urinary catheter only when needed.
•Aseptic insertion technique.
•Hand washing when handling urinary catheter systems

63. •Proper Promotion of an unobstructed urinary
flow.
•securing to prevent the catheter from pulling.
•Maintenance of a closed drainage system.
•Early removal when not needed

64. •Periodic education of health care
personnel on catheter care.
•Inserting the smallest diameter
catheter.
•Avoiding irrigation of the system.
•Notroutinely changing indwelling
catheters .
•Alternatives to indwelling catheters
should be considered.

65. Insertion of antimicrobial-coated indwelling
catheters
1
•Silver alloy or nitrofurazone coated catheters reduced
asymptomatic bacturia and the incidence of infection in
patients catheterized for < 1 week.
Handheld bladder scanners (to determine the effectiveness of
voiding)and the use of nurse directed protocol
•resulted in an 81% reduction of device use and a 73%
reduction in UTIs
2

66. Antibiotic prophylaxis
Right antibiotic
Timing of Antibiotic
Antibiotic re dosing
Part preparation
Hair removal (avoid razors, use hair clippers!)
Hair removal is preferred immediately before surgery
Antiseptic use
Pre op showering and bathing
Glucose Control

67. Wash and clean thoroughly around the incision prior
to prep.
Apply antiseptic prep in concentric circles moving
toward periphery; large enough area to extend
incision (Chlorhexidine) recommendation is “back and
forth with friction”
Nails short, no artificial nails
Pre-op scrub for at least 2 minutes up to elbows
Clean fingernails prior to 1st scrub of day
No hand or arm jewelry

68. 1. VAP –VENTILATOR ASSOCIATED
PNEUMONIA
2.CAUTI-CATHETER ASSOCIATED URINARY
TRACT INFECTION
3.CLABSI-CENTRAL LINE ASSOCIATED BLOOD
STREAM INFECTION
4.SSI-SURGICAL SITE INFECTION
5.HIR-HOSPITAL INFECTION RATE
6.NSI-NEEDLE STICK INJURY
7.HH-HAND HYGIENE COMPLIANCES

69. HAI-HEALTHCARE ASSOCIATED INFECTION
HHC-HAND HYGIENE COMPLINCE
NSI-NEEDLE STICK INJURY
MRSA-METHIASILIN RESISTANT STAYPHYLOC
OCCUS AUREOUS
VRE-VANCOMYCIN RESISTANT ENTROCOCCAI
ETO-ETHYLINE TRI OXIDE
HIC-HOSPITAL INFECTION CONTROL
BMW-BIO MEDICAL WASTE

70. Do’s and Don’ts of Glove Use
• Work from “clean to dirty”
• Limit opportunities for “touch
contamination” -
protect yourself, others, and the environment
–Don’t touch your face or adjust PPE with
contaminated gloves
–Don’t touch environmental surfaces except
as
necessary during patient care

71. ◦Do’s and Don’ts of Glove Use
◦(cont’d)
• Change gloves
–During use if torn and when heavily soiled
(even
during use on the same patient)
–After use on each patient
• Discard in appropriate receptacle
–Never wash or reuse disposable gloves

72. Thank You