Infection Prevention and Control – Waste Management SECTION: 14.27
Strength of Evidence Level: 3 __RN__LPN/LVN__HHA
PURPOSE:
To prevent injury and the spread of infection when handling medical waste in the patient’s home.
CONSIDERATIONS:
1. Follow applicable regulations for disposal of all infectious medical waste.
2. Instructions must be given to patient/caregiver on appropriate handling/disposal of waste in the home.
3. Volumes of blood/body fluids/body secretions can be safely disposed of in the patient's toilet. Pouring should be done slowly and carefully to minimize splashing, spattering or aerosolizing. If there is a potential for splashing, spattering or aerosolizing, Personal Protective Equipment (PPE) must be worn including mask, eye protection, gown and gloves.
4. All needle/sharps containers must be leak proof, puncture-proof, closable and be red in color and/or display the Biohazard symbol. Sharps containers must be easily accessible, maintained upright and discarded when 3/4 full.
5. All clinical staff must use only sharp safety devices provided by the agency.
6. Drugs like Avonex, Copaxone, and Rebif are dispensed in single dose syringes and needles. They are intended for patient self-injection and there are no safety devices for these medications. There are separate safety devices available for healthcare staff to use when administering these medications.
[Note: Agency procedure must be followed.]
7. Sharps containers that become contaminated on the outside must be placed in secondary containers.
EQUIPMENT:
Gloves
Hand hygiene equipment
PPE for standard precautions
Appropriate-sized sharps container
Impervious trash bags
PROCEDURE:
1. Disposal of needles, syringes and sharps.
a. Adhere to Standard Precautions.
b. Disposal of needles, syringes, lancets and other sharps used by clinical staff.
(1) Never re-cap, bend, clip or otherwise manipulate needles.
(2) Activate safety function of sharps device
(3) Placed immediately into a sharps container.
(4) When container is approximately 3/4 full or according to agency policy, secure lid and tape down, if necessary.
(5) Store and transport sealed containers separate from patient-care supplies, such as in the trunk of the car (See below).
c. Disposal of IV therapy needles and/or needles and syringes being used by the nurse on a frequent basis in a patient's home:
(1) If the home infusion therapy company supplies a sharps container to dispose of sharps, then utilize their system.
(2) A large, sharps container should be left in the home for short-term, frequent, parenteral therapy.
(3) At the end of therapy and/or when the container is 3/4 full, the clinician should secure lid and tape down for removal by the IV Company.
(4) If the IV company does not remove and replace containers, then the container must be disposed of by the agency.
d. Clinician instructions to patient/caregiver for disposal of needles, syringes, lancets and other sharps used by patient/caregiver:
(1) Adhere to Standard Precautions.
(2) Use a leak-proof, puncture-resistant, heavy plastic container with large mouth opening.
(3) Place sharp into container immediately after use.
(4) Maintain container in an upright position. When the container is 3/4 full, the lid should be secured to the container and taped down.
(5) Dispose of the sharps container per local authorities.
e. Office must have a designated area for storage of sharps containers. The containers are boxed as directed by the infectious waste hauler who transports them for final disposal. This area should be isolated from traffic and supplies, dry, and rodent free. Local and state storage requirements must be followed.
2. Disposal of contaminated patient-care supplies, e.g., dressings, catheters, etc.:
a. Adhere to Standard Precautions.
b. Place contaminated supplies in impervious bag and close tightly.
c. Double bag in a second impervious bag. A plastic trash bag lining a wastebasket is acceptable. Close tightly.
d. Dispose of double-bagged waste in household trash.
e. Clinician instructions to patient/caregiver for disposal of contaminated patient care supplies:
(1) Adhere to Standard Precautions.
(2) Dispose of contaminated supplies using a double-bag system.
(3) Dispose in household trash.
(4) Perform hand hygiene.
AFTER CARE:
1. Instructions given to patient/caregiver are documented in the patient’s record.
REFERENCE:
OSHA Regulations: Bloodborne Pathogens Standard (29 CFR 1910.1030).