Transcript No Slide Title

SAFE MANAGEMENT OF
HEALTHCARE WASTE
Regulatory regimes
Healthcare waste management
Infection control
and
health and safety
legislation
Environment and
waste legislation
Transport
legislation
Duty of care
Statutory requirements
Section 34 of Environmental Protection Act
The Environment Protection (Duty of Care)
Regulations
Everyone who produces, imports, carries, treats
or disposes of controlled waste is required to
fully comply with duty of care
As producers of waste responsible for
management and disposal
In England and Wales, Hazardous Waste
Regulations require that most premises
producing hazardous waste must be
registered with the Environmental Agency
Premises are exempt from registration if
they produce less than 500 kg of hazardous
waste in any period of 12 months
Healthcare waste produced in a care
home, residents with no nursing care.
It is the responsibility of the
producer, eg, district nurse to
dispose of the waste.
Infection Control
Code of Practice – key points to take account of:
Risk from waste disposal properly controlled
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Assessing risk
Appropriate policies
Arrangements to manage risk
Monitoring the way arrangements work
Aware of legislative changes
Infection Control
Code of Practice – key points to take account of:
Precautions with handling waste:
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Training and information
Personal hygiene
Segregation of waste
Use of appropriate Personal Protective Equipment
Immunisation
Appropriate procedures for handling waste
Appropriate packaging and labelling
Clear procedures for dealing with accidents incidents and
spillages
Appropriate treatment and disposal of waste
Systems in place to ensure that the risks to
service users from exposure to infections
caused by waste present in the environment
are properly managed and that duties under
environmental law are discharged most
importantly are:
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Duty of care in the management of waste
Duty to control discharges to sewers
Health and Safety at work legislation
COSHH
Pre acceptance audits
Care homes providing nursing or medical
care must complete a pre acceptance for
the waste contractor by 1 July 2013
Subsequent audits completed and
submitted every five years
What is a waste pre acceptance audit?
Legally authorised waste disposal facilities are required to
know the composition of the waste before they accept it.
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Check each room of your care home to see what waste
containers are present
Look in each in use waste container to see what is actually in
them (this should be done visually, without putting your
hands inside the containers); type of waste eg offensive
Question your staff about how they would dispose of
different items (understanding and practice can vary)
It is also worthwhile checking your storerooms and
cupboards to see if there are any pieces of equipment or
reagents that you may not have considered.
Do we have to do it?
There is a legal duty to provide the
person (contractor) who takes your
waste with information to enable
them to decide if the plant can safely
dispose of waste
What happens if I don’t do it?
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In breach of “duty of care”
Environment Agency can take
enforcement action against you
Inform CQC
Waste contractor can no longer collect
your waste
Who can undertake the audit?
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Self audit (need to understand
requirements)
Employ a third party
Your waste contractor may offer this
as a service (may be a charge, not
obliged to provide)
Importance of Waste Segregation
What happens if I don’t do it?
Segregation of different waste streams is necessary due to:
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In England and Wales, mixing of waste is prohibited by
law
Health and Safety – reduce needle stick injuries
Environmental – potential for waste minimisation
Financial – reduction of hazardous waste
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carbon reduction – unnecessarily, treating non
hazardous waste energy
duty of care – producer legally required to
classify and describe their waste
Colour Coding System
• Is not mandatory, best practice to aid
identification and segregation
Container labelling
Containers to be labelled to clearly
identify the waste type.
Eg, anonymous yellow bins used for
medicines
Infectious waste – orange stream
Waste must not contain chemicals, medicines or
anatomical waste
Orange clinical waste should not contain waste
that is non infectious – domestic, offensive
Orange stream is waste known or suspected to
contain pathogens classified in Category B
Orange waste stream is hazardous waste
Infectious liquid waste
Placed in a rigid leak proof receptacle
Not all treatment facilities are licensed to accept such
waste
Medicinal products – blue lidded receptacle
Cytotoxic / cytostatic waste
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Yellow with purple stripe or purple stream
Requires incineration
Ensure suitable medicinal receptacles / bags and
colour coded sharps containers are available
Sharps waste
Sharps are segregated and disposed of on the basis of
medicinal contamination.
The colour of the lid is based on contamination and how waste
is treated and disposed of.
Purple lid
Sharps contaminated with cytotoxic and cytostatic medicines
Yellow lid
Contaminated with used in administration of non cytotoxic and
non cytostatic medicines
Orange lid
Sharps not contaminated with medicines. Cannot intentionally
discharge syringes with residual medicines to dispose in the
waste stream
Offensive / hygiene yellow /
black bags
Waste that may cause offensive,
eg, incontinence products
Large equipment and mattresses
Equipment should be decontaminated prior
to disposal. If no hazardous properties
remain – eg, contaminated mattresses with
pervious cover intact once item disinfected
under specialist arrangements, can be
disposed of as domestic waste
Waste transfer note
Key element of duty of care is keeping track of
the waste. When the waste is transferred from
the producer to the transferee a transfer note
must be completed. An annual transfer note can
be used to cover all regular transfer of non
hazardous waste. Copies of transfer notes must
be retained by all parties for a minimum of two
years.
Consignment notes
Completion is the legal responsibility of
the waste producer. Consignment notes
must be completed for hazardous / special
waste.
Consignment notes must be kept by the
waste producer for a minimum of 3 years
from the date of collection.