MEDICAL WASTE MANAGEMENT

WELCOME
 EXPOSURE CONTROL PLAN

 Required when employees may be exposed to

bloodborne pathogens.
 This plan should include:
 Determination of employee exposure
 Implementation of methods of exposure control, including:
- Universal precautions
- Engineering and work practice controls
- Personal protective equipment
- Housekeeping
 Hepatitis B vaccination
 Post-exposure evaluation and follow-up
 Communication of hazards to employees and training
 Record keeping
 Procedures for evaluating the exposure incident.
 EXPOSURE STEPS

Despite the best precautions, exposure still can occur. If a person

is exposed to potentially infectious materials try to minimize the
exposure to that person and others.
If a person is exposed, they should:
 Wash the exposed area thoroughly with soap and running
water (use non-abrasive, antibacterial soap if possible).
 If blood is splashed in the eye or mucous membrane, flush the
affected area with running water for at least 15 minutes.

 See a physician immediately.

 EXPOSURE STEPS

Report the Incident — Employees should

immediately report exposure incidents to the
employer to permit timely medical follow-up.
 EXPOSURE STEPS

Referral to a Health Care Professional (HCP) —

Following a report of an exposure incident of a
bloodborne pathogen, the employer shall make
immediately available to the exposed employee a
confidential medical evaluation and follow-up at no cost
to the employee.
 EXPOSURE STEPS

Documentation — The employer must prepare a report

of the exposure incident of a bloodborne pathogen,
including the route(s) of exposure, the circumstances
under which the exposure incident occurred, and the
identity of the source patient — if known, and if
permitted by law.
 STAFF TRAINING

 Training should include an explanation of the

infectious waste management plan and assignment
of roles and responsibilities for implementation of
the plan.
 Training programs should be implemented:
 When the infectious waste management plan are first developed and
instituted.
 When new employees are hired, and
 When infectious waste management practices change.
 Continuous education is also an important part of
staff training.
 MERCURY

 EPAand AHA signed a Memorandum of

Understanding (MOU).
 Lessons learned about mercury:
· The risk of mercury spills is high. The cost to remedy spills has proven to
be very expensive.
· Ninety-nine percent of a typical hospital’s mercury is contained in
esophageal dilators, sphygmomanometer services kits, and barometers.
· Total cost to replace mercury devices is modest, especially in light of the
cost of spills.
· Non-mercury replacements are usually no more expensive than their
mercury counterparts.
 MERCURY
 Removal of a mercury device must mean “get it out of the hospital”,
not merely out of service.

 Purchasing Departments and associated staff must be vigilant in

purchasing and accepting shipments of supplies. Vendor substitution
could bring mercury back into the facility.

 Training for mercury auditing is best done on a one-on-one basis,

large groups make the process difficult.

 Mercury assessments must be performed in a safe and open

atmosphere, which encourages the discovery of all sources of mercury.
 CHECKLIST

A. SPILL PLAN EQUIPMENT & PROCEDURES

 Disinfectant
 Absorbent
 Shovel
 Gloves
 Public protection
 Bags and boxes
 Notification procedures
 Protective clothing
B. CONTINGENCY PLANS
 Alternate treatment site
 Other storage sites
 Exposure Control Plan
 CHECKLIST

C. HANDLING & STORAGE

 Handling procedures followed
 Packaging procedures followed
 Packages are transferred properly
 Storage areas marked and locked
 Storage areas disinfected
D. HEALTH & SAFETY TRAINING
 Risks associated with infectious waste
 Spill plan procedures
 Personal protective gear (gloves, aprons, goggles)
 Schedule of training
 Proof of training
 RECORDS

What Records Must You Keep?

 Medical records of exposure to bloodborne pathogens.

 Any training records on medical waste management.

 Any state or local requirements for shipping manifests of

medical wastes.

 Any state or local requirements for logs of equipment used to

treat medical wastes.
 TIPS FOR USING CONTRACTORS

 Remember, You Control Your Facility or Area!

 Review Procedures With Them Before Starting the Job!
 Ensure They Are Properly Trained!
 Determine Their Environmental Compliance Record!
 Determine Who Is in Charge of Their People!
 Determine How They Will Affect Your Facility’s
Environmental Compliance!
 ELEMENTS OF A SUCCESSFUL
MEDICAL WASTE PROGRAM

1. DETAILED WRITTEN MEDICAL WASTE INSPECTION

GUIDELINES.
2. DETAILED WRITTEN MEDICAL BEST MANAGEMENT PRACTICES.
3. EXTENSIVE EMPLOYEE TRAINING PROGRAMS
4. PERIODIC REINFORCEMENT OF TRAINING
5. SUFFICIENT DISCIPLINE REGARDING IMPLEMENTATION
6. PERIODIC FOLLOW-UP
 THE IMPORTANCE OF A
CLEAN ENVIRONMENT

“I would ask all of us to remember

that protecting our environment is
about protecting where we live and
how we live. Let us join together to
protect our health, our economy, and
our communities -- so all of us and
our children and our grandchildren Carol Browner
can enjoy a healthy and a prosperous
life.” Former EPA
Administrator