Infection Management and Environment Protection

Ppt. presentation for training of medical staff

1. 1 BIO MEDICAL WASTE MANAGEMENT

2. Objectives M inimise environmental threat and public health risk M inimise hospital acquired diseases to the medical staff and health care personnel who handle these wastes at generation point Stop recycling of disposable syringes, saline, I.V. fluid bottles, picked up by rag pickers and are recycled back into the market without any disinfection Manoj Kumar Sharma, Lab Tech, MSF

3. 3 Doctors and nurses Patients Hospital support staff Waste collection and disposal staff General public Environment Who’s at Risk ?

4. Who is responsible for Waste management Doctors Nurses Technicians Other staffs like ward boys Logistics The Bio-medical waste should be segregated as per categories applicable. Manoj Kumar Sharma, Lab Tech, MSF

5. STEPS FOR BIO-MEDICAL WASTE MANAGEMENT Waste generator is responsible for The steps that should be followed are: Segregation Collection and Storage Transportation Treatment and Disposal 5

6. How segregation of wastes is to be done? 6 Black Bucket - General waste (non infectious) Red Bucket - Infectious plastic waste like saline bottles, syringes, catheters, etc Yellow Bucket - Anatomical and Soiled waste . White (Puncture Proof Container) - Metal and Glass sharp waste like broken vials, needles etc

7. Do’s 1. Always segregate waste at source of generation 2. Segregate infectious waste into: a. Sharps (Metal and Glass sharps) like needles, blades, lancets, broken ampoules, vials, slides in white puncture proof container b. Solid wastes (Infectious plastic waste) like syringes, tubing, catheters etc to be disposed in red plastic bins/bags c. Anatomical waste (placenta, body parts) and soiled waste (Items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, beddings, other material contaminated with blood) in yellow plastic bins/bags d. Non-infectious (General) waste like waste similar to household waste including packaging material, cartons, fruit and vegetable peels, syringe and needle wrappers, medicine covers in black plastic bins and bags 7

8. Don’ts Never mix infectious and non-infectious waste at source of generation, during waste collection, waste storage, waste transportation or during final disposal of waste. Points to remember :- Bins should be located at all points of waste generation No infectious waste should be stored beyond 48 hours 8

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10. COLLECTION AND STORAGE OF WASTE Do’s Always collect the waste in covered bins Fill the bins up to the 3/4 th level Clean the bins regularly with soap and water/disinfect the bins regularly 10

11. Don’ts Never overfill the bins Never mix infectious and non-infectious waste in the same bin Never store waste beyond 48 hrs 11

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13. TRANSPORTATION OF WASTE Do’s Always carry/transport the waste in closed containers Use dedicated waste collection bins/trolleys/wheel barrows for transporting waste Transport waste through a pre-defined route within the health care facility 13

14. Don’ts Never transport the waste in open containers or bags, it may spill and lead to spread of infections Never transport waste through crowded areas 14

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16. TREATMENT AND DISPOSAL OF BIO-MEDICAL WASTE All sharp waste (Metal and Glass sharp waste) - Disinfected in their puncture proof containers and should be disposed off in the sharps pit. Infected organic waste (Body/Body parts) and soiled waste (Items contaminated with blood, and body fluids including cotton, dressings, soiled plaster casts, lines, beddings, other material contaminated with blood)- Should be taken to the onsite deep burial pits and covered with a layer of lime and soil or Incinerated. Infected recyclables such as plastics waste - Should be first cut and then put in the Red Bucket. It is disinfected using bleach solution (in a disinfection tank) and then shred. It is then sent for recycling or stored for deferred recycling. 16

17. General Waste Non-infected organic waste such as kitchen waste and leaf fallings have to be put in a compost pit, which is to be located within the premises. Standard composting methods such as mixing the waste with leaf fallings and soil should be adopted. Manure will be available and this should be used for the garden. Recyclable material such as packaging material, recyclable plastic and paper should be sold to authorized recyclers. Plastic should be shredded and disinfected before disposal. Care must be taken to ensure that the recyclable waste is not infected and also that it be kept separate from infectious waste at all times. 17

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19. CHEMICAL DISINFECTION Ensure the following points while chemical disinfection:- That the used product is treated prior to disposal. Treatment should be with a solution of 1% Bleaching Powder (10 Gm bleaching powder in 1 liter of water) The waste should be submerged in this solution for an hour Infected waste shall not be kept for more than 48 hours and so disinfection process shall be done every day. 19

20. SITE OF CHEMICAL DISINFECTION Sharp waste – Disinfectant be placed in the PPC Plastic waste – Disinfection be carried out in tumbler (Sub centre ) and disinfection tank (CHC/DH)   20

21. HANDLING MERCURY SPILLS Never touch mercury with bare hands as mercury is absorbed quickly though the skin. Remove all jewellery while dealing with mercury as mercury combines with gold, silver and other metals. Clear the area around the spill. Wear all the protective gear Contain the spread of mercury and use two hard cardboard sheets to gather all the mercury. Use a syringe to suck up mercury Pour contents of the syringe into the plastic/ glass container with 5 to 10 ml of water. Put sealing tap, if used in the plastic/glass container. Put the used syringe in a separate plastic container for further use. 21

22. At least two pairs of latex gloves (Mercury passes through a single pair of latex gloves) Face mask Protection for the eyes Sealing tape 10 c.c. syringe Covered plastic/glass container with water Mercury containment kit 22

23. Mercury can be stored indefinitely in this condition, but the hospital should seek out a government approved and licensed hazardous waste disposal firm or mercury recycler, which can handle mercury. Mercury collected in this manner can be cleaned and reused in the new equipment Storage and disposal of mercury waste 23

24. HANDLING LIQUID WASTE SPILLS Liquid waste is any blood, body fluid, pus, any discharge from wounds or liquid chemicals Clean the liquid waste spill by adding equal or more quantity of bleaching powder solution and leave the area for 30 minutes Wipe the area with a swab/cloth Discard the swab/cloth after cleaning the area into the Yellow bucket. 24

25. DISPOSAL OF DISINFECTANT Do’s Always dilute the disinfectant before disposal into drains Wear personal protective gears while handling disinfectants 25

26. Never dispose the chemicals, disinfectants without diluting them Never use expired chemicals or disinfectants. Send them back to the stores   DISPOSAL OF DISINFECTANT Dont’s 26

27. 27 Questions and answers