Infectious Waste - Biohazard Waste

KP's Principles of Responsibility

y states that all Kaiser Permanente physicians and employees are expected to follow all applicable laws and policies, use good judgment, be accountable for their actions, and conduct business with integrity and with the interests of members and patients in mind.

When you mix infectious waste and regular solid waste together,

you are not permitted to separate them Once combined, the entire contents are considered infectious waste!

Red bags for all other treatment methods Biohazard bags must be labeled with the international biohazard symbol and appropriate wording;

"biohazard," "biomedical waste," "infectious medical waste," or "regulated medical waste"

Orange bags

for autoclaved waste

biohazard color

red

"Aerosol Waste" Labeled Black Container

All unused, partially used, or non-empty: Hand Sanitizer Cans Gebauers Spray Cans Inhalers Spray Paint, Lubricants Cans Compressed Air Smoke detector test spray Cans

"P-listed Hazardous Waste" Labeled Black Container

All expired or unused product and the empty container of: Arsenic Trioxide - includes iv bag and delivery tubing Epinephrine, powder form only Warfarin Aminopyridine Nicotine Physostigmine, Physostigmine Salicylate

POTENTIALLY INFECTIOUS MATERIAL

Any body fluid with visible blood Amniotic fluid Cerebrospinal fluid Pericardial fluid Peritoneal fluid Pleural fluid Saliva in dental procedures Semen/vaginal secretions Synovial fluid Anywhere body fluids are indistinguishable

Waste is considered Infectious when it is:

Contaminated by an organism that is pathogenic to healthy humans; The organism is not routinely available in the environment; and The organism is in significant quantity and virulence to transmit disease.

Medical Waste — Sharps Waste Disposal

Devices that are designed to puncture or capable of puncturing or cutting the skin and that are contaminated with blood or potentially infectious body fluids. Examples include: Needles Syringes with or without needles attached Trocars Pipettes Scalpel blades Guide wires Blood vials Broken or unbroken glassware that has been in contact with infectious agents Serum bottles Waste Container for medical waste sharps: All sharps waste must be placed in a red, blue or clear sharps container, labeled with the word "Sharps" AND the international biohazard symbol. DO NOT place in regular trash container.

ROUTINELY OVER CLASSIFIED ITEMS

Diapers (adult and baby) Paper towels Unsaturated dressings and chucks Wrappers and packaging IV bags and oxygen tubing Gloves with no visible contamination Urine catheters and bags Paper, newspapers, and food containers Urine cups and specimen containers with no visible blood Empty Medication vials and broken glass

Universal Waste — Disposal of Lamps

Do not place any lamps in regular trash containers. Examples include: Fluorescent tubes and lamps Ultraviolet (UV) lamps Microscope light bulbs High intensity discharge lamps Sodium vapor lamps LED lamps Lamp waste is primary generated and managed by the Facility Engineering/Plant Operations or the EVS department. If you generate lamp waste contact Engineering, Plant Operations or EVS for assistance in disposal. Waste lamp containers are required to be labeled "Universal Waste" "Lamps" with the accumulation start date. 22 WASTE MANAGEMENT Waste container for Lamps: Containers must be labeled "lamps, universal waste" with the accumulation start date. ©

PENALTIES FOR VIOLATIONS

Fines are assessed based on the severity of the instance and negligence. Fines can be up to $25,000 per day

DISEASES CAUSED BY BLOODBORNE PATHOGENS

HIV / AIDS Hepatitis B

OVER CLASSIFICATION

It is the improper disposal of solid waste that does not meet the definition of infectious medical waste and is discarded as if it were infectious. It is the most commonly cited violation, with a 90+% majority of permitted facilities being cited and penalized for this reason. It increases the financial burden on patients and taxpayers in the form of increased disposal costs for health care facilities

"Department Specific Bulk Hazardous Waste Stream" Properly Labeled Container

Laboratory: Lab solvents hazardous waste container Engineering: Used oil hazardous waste container Pathology: Formalin with tissue hazardous waste container EVS: Bulk volumes of expired hand sanitizers, cleaning chemicals on pallets or in drums

Hazardous Waste Containers: "Most in One" Black Container

Many, but not all of the types of hazardous waste generated by KP can be placed in the black container labeled "RCRA Healthcare Products Waste." It is more commonly known as the "Most In One" hazardous waste container. Examples of allowable items: Procedure Site Marking Pens/ Skin Dyes Insulin vials or pens Vaccines: Flu Multi-dose vials, MPSV4-Menomune Bulk Chemo Therapy Agents (except Arsenic Trioxide) Expired or unused Benzoin tincture and Chloro-prep products Expired or partially used surface disinfectant wipe canisters (e.g., Saniwipes) Shampoos with Selenium Barium Silver creams, unused silver wound dressings Expired pre-filled formalin containers Hand gel sanitizer containers Vitamins

Universal Waste — Disposal of Electronic Devices

Place electronic devices that are not managed by IT or Clinical Technology Department disposition processes; and that do not potentially contain stored confidential information in a electronic device, universal waste container. For large items use existing processes to contact EVS, Engineering, EH&S or your SOL for disposal. Examples includes equipment such as power strip extension cords, electric staplers, table top lamps, clocks, printers, televisions, microwaves, and ballasts. This also includes devices that contain unremovable batteries such as: pumps, cautery pens, calculators, glucose monitors, and flash/pen lights. Look for this label on the waste container: Waste container for Electronic Devices: Containers must be labeled "electronic devices, universal waste" with the accumulation start date.

the contents of suction canisters, may be disposed of in several ways:

Placed directly in the Biohazardous waste, Poured down a sanitary sewer, Solidified using an approved disinfectant solidifier and discarded in the solid waste

PHI

Protected Health Information - confidential individual health information. All paper (hand written or printed) After visit summary (AVS) sheets Care-related faxes Check-in/Payment receipts Claims and billing records Dietary tickets Encounter lists/ Appointment logs Medical records Medical referral forms Member coverage and benefits information Patient menus Patient print out sticker Patient safety engineering work orders Pharmaceutical prescription forms Patient care documents/Medication lists Patient questionnaires Post-It sticky notes Test orders or result printouts Vendor contracts Visit notes Wrist bands

"Silver Containing Products Waste" Labeled Black Container

Silver Nitrate Sticks, expired or used

The single most effective measure to control the transmission of Bloodborne Pathogens is:

Universal Precautions - Treat all human blood and other potentially infectious materials like they are infectious for Hepatitis B and HIV

universal waste - disposal of batteries

This includes all types of batteries: AA, AAA, C, D, 9-volt, Lithium, button cell/hearing aid, rechargeable, and lead acid. Leaking or damaged batteries must be managed as hazardous waste, contact your EH&S professional or SOL for assistance. Place batteries in a designated universal waste battery collection container: Put battery in a plastic bag (one per bag) or tape terminal ends before placing into the designated container If plastic bags or tape are not available, contact your supervisor Devices that contain batteries: Do not place device in battery collection containers Remove battery or place battery containing device in an electronic devices waste container. Waste Container for batteries: Containers must be labeled "batteries, universal waste" with the accumulation start date.

Medical Waste — Pharmaceutical Waste Disposal

What Is Pharmaceutical Waste? All prescription and over the counter (OTC) medications that do not require collection as trace chemotherapeutic or hazardous waste* Liquid medications, injectable and oral Pills and tablets All IV bags and tubing, including saline All empty vials, IV sets Patches, lozenges, and medicinal lollipops Hand lotions, soaps, and toothpaste (unused or partially used). Personal care products are potentially toxic to the fish and wildlife and cannot be placed in regular trash. * Departments that generate hazardous waste or trace chemotherapy waste will have a designated collection process approved by the EH&S Manager/Safety Operations Leader . Waste container for Pharmaceutical Waste: All Pharmaceutical Waste must be placed in a blue or blue lidded container that is labeled with the international biohazard symbol and the words "Incinerate Only". DO NOT place in regular trash container .

Medical-waste/pathology

What is Pathology Waste? Human specimens or tissues removed from a minor procedure, surgery, or autopsy disposed by KP. Bone fragments Tissue, skin tags Biopsies, surgical specimens, limbs Organs and placentas Rigid walled suction canisters, and flexible walled suction canisters with solidifier waste Departments that Generate Pathology Waste include: Operating rooms Procedure rooms Dermatology/Mohs lab Labor and Delivery Pathology

Universal Waste

batteries, electronic equipment, and lamps

Isolation wastes that do not meet the definition of infectious medical waste

disposable gowns face masks shoe covers

Medical Waste

includes biohazardous waste, pathology waste, pharmaceutical waste and trace chemotherapy waste. Materials and devices with any amount of visible fluid blood and/or otherwise potentially infectious body fluids. Contaminated single use or disposable speculums without batteries. Speculums with non-removable batteries are hazardous waste.* Blood transfusion bags and/or tubing. Flexible walled suction canisters with free flowing liquids, not solidified. Any waste items with free-flowing body secretion containing blood components (e.g. urine, stools, pleural, peritoneal, amniotic fluids).

Hazardous Waste

specific pharmaceuticals and chemicals What Is Hazardous Waste? Hazardous waste includes items that are toxic, flammable, corrosive, or reactive as defined by federal or state regulations. Hazardous waste must be placed in designated hazardous waste containers. Do not place hazardous waste in regular trash containers or medical waste containers. Hazardous waste must be segregated so that incompatible materials are not mixed together. For this reason, several hazardous waste containers may be in your department. Primary examples of the types of hazardous waste containers include: RCRA Healthcare Hazardous Waste Container (Most in One); Aerosol Waste Container; PListed Waste Container; and the Silver Nitrate Waste Container.

INFECTIOUS WASTE IS NOT

•Used personal hygiene products •tissues •feminine products •diapers •Gauze and dressings containing small amounts of blood, •Fixed pathological tissues, •Uncontaminated medical tubing and devices Tubing with any visible fluid blood must be disposed in the biohazard waste Also, Human remains and body parts being used for medical purposes, under the control of a licensed doctor or dentist Human remains lawfully interred in a cemetery or in preparation for interment Hair, nails, and extracted teeth