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Florida State Hospital State of Florida Operating Procedure Department of No FLORIDA STATE HOSPITAL STATE OF FLORIDA OPERATING PROCEDURE DEPARTMENT OF NO. 153-14 CHILDREN AND FAMILIES CHATTAHOOCHEE, May 8, 2017 Infection/Disease Control BIOMEDICAL WASTE CONTROL PROGRAM 1. Purpose: To provide current and consistent guidelines for an active, effective program for the management of Biomedical Waste. 2. Policy: Florida State Hospital shall have an effective Biomedical Waste Control Program which includes the effective segregation, handling, labeling, storage, treatment, and disposal of biomedical waste. 3. References: a.29 Code of Federal Regulations (CFR) 1910.1030 Occupational Safety & Health Administration Regulation, Occupational Exposure to Blood borne Pathogens b. Florida Statutes (F.S.), Chapter 395.1011, which requires identification, segregation and separation of biomedical waste from solid waste and requires that any transporter of biomedical waste be notified of the existence and location of such waste c. Florida Statutes (F.S.), Chapter 403.702, which requires that biomedical waste be treated and disposed of in a manner adequate to protect human health, safety and welfare and the environment d. Florida Statutes (F.S.), Chapter 403.703, which defines “solid waste,” and “biomedical waste” e. Florida Administrative Code (FAC), Chapter 64E-16, Biomedical Waste f. Children and Families Operating Procedure 155-24, Guidelines for Infection Prevention and Control Program In State Mental Health Treatment Facilities 4. Definitions: a. Biomedical Waste: Any solid or liquid waste which may present a threat of infection to humans, including non-liquid tissue, body parts, blood, blood products, and body fluids from humans and other primates; laboratory and veterinary wastes which contain human disease-causing agents; and discarded sharps. The following are also included: (1) Used, absorbent materials saturated with blood, blood products, body fluids, or excretions or secretions contaminated with visible blood; and absorbent materials saturated with blood or blood products that have dried. (2) Non-absorbent, disposable devices that have been contaminated with blood, body fluids, secretions or excretions visibly contaminated with blood, but have not been treated by an approved method. This Operating Procedure supersedes: Operating Procedure 153-14 dated May 31, 2016 OFFICE OF PRIMARY RESPONSIBILITY: Quality Improvement DISTRIBUTION: See Training Requirements Matrix May8,2017 FSHOP153-14 b. Body Fluids: Those fluids which have the potential to harbor pathogens, such as human immunodeficiency virus and hepatitis B virus and include blood, blood products, lymph, semen, vaginal secretions, cerebrospinal, synovial, pleural, peritoneal, pericardial and amniotic fluids. In instances where identification of the fluid cannot be made, it shall be considered to be a regulated body fluid. Body excretions such as feces and secretions such as nasal discharges, saliva, sputum, sweat, tears, urine, and vomitus shall not be considered biomedical waste unless visibly contaminated with blood. c. Standard Precautions: Blends the major features of universal (blood and body fluid precautions) and body substance isolation into a single set of precautions to be used for the care of all persons in hospitals. These precautions are designed to reduce the risk of transmission of both recognized and unrecognized sources of infection. d. Personal Protective Equipment (PPE) or Barrier Equipment: Protective equipment to be worn by employees as barriers to prevent possible exposure to blood/body fluids, secretions, excretions, non-intact skin and mucous membranes. e. Contaminated: Soiled by any biomedical waste. f. Decontamination: The use of physical or chemical means to remove, inactivate, or destroy blood borne pathogens on a surface or items to the point where they are no longer capable of transmitting infectious particles and the surface or items is rendered safe for handling, use, or disposal. g. Hazardous Waste: Those materials defined in Chapter 62-730, Florida Administrative Code (FAC). h. International Biomedical Symbol: A symbol used in conjunction with one of the following phrases, “BIOMEDICAL WASTE,” “BIOMEDICAL,” “BIOHAZARDOUS,” OR INFECTIOUS.” The symbol shall be red, orange, or black and the background shall be such that the colors contrast. i. Laboratory Waste: Any laboratory waste contaminated with a human disease-causing agent. Examples are contaminated specimen and culture containers, sharps, implements used to manipulate specimens that are capable of causing disease in humans and cultures containing human disease- causing agents, components of diagnostic kits contaminated by use with specimens or cultures, live or attenuated vaccines, medium inoculated with a human disease-causing organism, specimens that are capable of causing disease in humans and cultures containing human disease-causing agents, stocks of infectious agents, associated biological, waste from the production of biological and recombinant materials, that have the potential to transmit disease to humans. j. Leak Resistant: For sharps containers, the prevention of liquid from escaping to the environment in the upright position. k. On-site: An area which is part of, or included on the license of and at the same physical address as the facility where the biomedical waste is generated. l. Outer Container: Any rigid type container used to enclose packages of biomedical waste. m. Point of Origin: The room or area where the biomedical waste is generated. n. Packages: Any material that completely envelops biomedical waste. This includes red bags, sharps containers and outer containers. o. Puncture Resistant: The ability of a container, including the lid, to withstand punctures from contained sharps during normal usage and handling. 2 May8,2017 FSHOP153-14 p. Restricted: The use of any measure, such as a lock, sign, or location, which is necessary to prevent unauthorized entry. q. Sealed: Free from openings that allow the passage of liquids. r. Saturated: Soaked to capacity. s. Sharps: Devices with physical characteristics capable of puncturing, lacerating, or otherwise penetrating the skin. Examples include needles and scalpels. Intact or broken glass and hard plastic are considered sharps if they are contaminated with blood or blood products, body fluids, or blood contaminated excretions or secretions. t. Sharps Container: A rigid, leak and puncture resistant container, designed primarily for the containment of sharps, clearly labeled with the phrase and international biological hazard symbol. u. Disinfection: A process that kills or destroys most disease-producing micro-organisms; rarely kills all spores. v. Sterilization: A process which destroys all micro-organisms and their spores. 5. General: a. Under this definition of biomedical waste certain factors must be present simultaneously for infection to occur. They are as follows: (1) presence of a pathogen (2) sufficient virulence (3) dose (4) portal of entry (5) susceptible host b. Common Categories of Biomedical Waste: (1) Sharps--Devices with physical characteristics capable of puncturing, lacerating, or otherwise penetrating the skin. These devices include but are not limited to razor blades, needles, intact or broken glass, or hard broken plastic. The risk of infection from these devices is related to contamination with potential pathogenic materials and the provision of entry into a host via a puncture or cut. (2) Cultures and Stocks of Infectious Agents--These materials typically have a high concentration of pathogenic organisms present. (3) Blood, blood products and body excretions--Due to the number of persons who have infectious diseases that are undiagnosed, it is prudent to handle the blood, blood products, excretions and secretions of all persons with standard precautions. c. The handling and disposal of biomedical waste is governed by Chapter 381, Florida Statutes (F.S.), Section 381.0098 provides that the Department of Health shall regulate the packaging, labeling, storage, and treatment of biomedical waste. The Department of Environmental Protection has jurisdiction for off-site and on-site incineration and all disposal sites. 3 May8,2017 FSHOP153-14 6. Procedure: a. Handling and Disposal of Biomedical Waste: (1) Biomedical Waste shall be identified and segregated from other solid waste at the point of origin within the generating facility. (2) Biomedical Waste shall be handled and disposed of in such a way that it does not cause a risk to persons or the environment. (3) Discarded sharps shall be segregated from all other solid waste. (4) Containment of all biomedical waste before or during transportation must be effected in such a manner that no discharge or release of any waste occurs. (5) Biomedical waste shall not be stored longer than 30 days. The 30 day period shall commence when the first non-sharps item of biomedical waste is placed into a red bag or sharps container, or when a sharps container containing only sharps is sealed. (6) Due to the potential risk of disease transmission, Standard Precautions shall be carried out when doing any procedure with likelihood of exposure to blood and certain body fluids. b. Waste Management Records: (1) All Biomedical waste management records shall be maintained for three (3) years and made available for inspection by the department upon request. (2) All transporter pick-up receipts/ manifests shall be sent to the Environmental Specialist in the Quality Improvement Program for filing. c. Handling of Contaminated Equipment: (1) Any equipment which
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