CHAPTER IV COMPARISON OF INFECTION CONTROL PRACTICES IN NICU WITH WHO STANDARD PROTOCOL

SECTION -A 1. INFECTION CONTROL PRACTICES

S.NO 1.1

STANDARD PRACTICE PROCEDURES FOR ENTERING THE NURSERY: Woolens & shoes should be removed and nursery slipper should be worn before entering the NICU. The nails should be kept short and trimmed emove wat!hes and rings on entering the NICU. "o hand washing

EXISTING PRACTICE

Separate Nursery slippers are in use.

Cut short nail.

Wat!h and rings are not removed. Steps of proper handwashing are not followed.

4 5

The hands should be dried with single use auto!lave sterile towel or preferably disposable paper towel.

Separate non sterile hand towel is in use and o!!asionally hand drier and roller towel are being used. $ra!ti!e of rinsing the hand with %&"

inse the hands with sterilium# before tou!hing any baby.

solution 'Sterilium( whi!h !ontains ethanol )*+ and ,.*+.Chlorhe-idine.

.ask and !ap should be worn. Separate suit or dress must put on before entering the NICU.

Wearing !ap before entering NICU not mask. The staff nurses working in the unit are wearing separate uniform before entering into the unit.

1.2 HAND WASHING: S.NO 1.2.1 /. STANDARD PRACTICE FACILITIES AVAILA"LE FOR HAND WASHING %!!ess to !lean running water is essential EXISTING PRACTICE $resen!e of ,0 hours

running water supply. $resen!e of separate hand washing area with one

,.

large washbasins with hand free !ontrol tap

sinks with hand free !ontrol tap.

1.2.2

FACILITIES AVAILA"LE FOR DRYING HANDS /. ,. 1. 0. "isposable paper towel eusable single use towel oller towel hand drier "isposable paper towel is not available . eusable single use towel# oller towel# hand drier are available. $lain soap is not in use %ntimi!robial soap 2

1.2.3 /

MATERIALS $lain Soap

%ntimi!robial Soap Spe!ifi! antisepti!s

"ettol %ntisepti!s4 *+ povidone iodine %&" solution 'Sterilium( whi!h !ontains ethanol

*+ 3 ).*+ $ovidone iodine /+ Tri!losan

%l!oholi! rub )5+ ,.0+ Chlorhe-idine

)*+ and ,.*+.Chlorhe-idine glu!onate is in use.

1.2.4 /

HAND WASHING TECHNI#UE: emove 6ewellery 'rings# bra!elets( and wat!hes before washing hands

emove 6ewellery 'rings# bra!elets( and wat!hes before washing hands

, 1 0 *

7nsure that the nails are !lipped short. oll the sleeves up to the elbow. Wet the hands and wrists 8eeping hands and wrists lower than the elbows 'permits the water to blow to the banger tips avoiding aim !ontamination. %pply soap 'plain or %ntimi!robial( and lather thoroughly.

Nails are !ut short.

Roll the sleeves up to the elbow.

Wet the hands and wrists

Not in pra!ti!e. %pply soap 'dettol( and

lather thoroughly. Use firm# !ir!ular motions to wash the hands. ub hands palm to palm ight palm with over left

Use firm# !ir!ular motions to wash the hands and arms up to the elbows. ub hands palm to palm

ight palm over left dorsum with interla!ed fingers and vi!e versa.

dorsum

interla!ed

fingers and vi!e versa. $alm to palm with finger

/5 // /, /1 /0

$alm to palm with finger interla!ed. <a!ks of fingers to opposing palms with finger interlo!ked. otational rubbing# ba!kwards & forwards with !lasped fingers of right hard in left palm and vi!e versa. ub for minimum of /5 2 /* se!onds. inse hands thoroughly.

interla!ed. Not in pra!ti!e Not in pra!ti!e ubbing for /5 se!onds. inse hands thoroughly. Not keeping the hand

/*

8eeping the hand lower than the fore arms.

lower than the fore arm "rying the arms by

/9

"ry arms thoroughly with auto!laved napkins or disposable sterile paper to well or air dry. "is!ard the towel in an appropriate !ontainer without tou!hing the bin lids with hand.

reusable single use towel and roller towel. "is!ard paper towel in an appropriate manner.

/)

"uration "uration of entire pro!edure with /: soap and water305395 se! al!ohol based formulation3 ,5315 se!

of

entire with entire with

pro!edure is /* se! antimi!robial soap. "uration of pro!edure is ,5 se! *+ povidone iodine .

1.2.5 PICTORIAL STANDARD HAND WASHING TECHNI#UE:

SECTION - " 2. ENVIRONMENTAL MANAGEMENT PRACTICES S. NO STANDARD PRACTICE 2.1 PERSONAL PROTECTIVE E#UIPMENTS: / G$%&'(: Wear gloves when in !onta!t with blood# body fluids# se!retions# e-!retions and mu!ous membrane. T)*'( %+ ,-(*%(./$' 0$%&'( Clean=non sterile gloves for routine !are of the

>loving is pra!ti!ed while performing all the invasive pro!edures e-!ept I? !annulation and spe!imen !olle!tion. Not in pra!ti!e

infe!tious patients , Sterile gloves for invasive pro!edures M.(1(: Wear a mask to prote!t mu!ous membranes of the mouth and nose when undertaking pro!edures. T)*'( %+ 2.(1: N ;* 2 "uring open=a!tive infe!tious diseases N /55 2 "uring invasive pro!edures Standard surgi!al splash proof masks 2 .ainly when dealing with droplet infe!tions 1 A*3%45G%64: Wear !lean# non3sterile gown to prote!t the stain %pron is available only for from splashes of blood and body fluids. mothers and nurses are using separate suit. 0 C.*( Wear disposable !aps Using disposable !ap in ea!h shift * "%%7(5($-**'3(4 Wear boots 'or( slippers before entering into intensive !are unit. Using slippers before entering into NICU. Not pra!ti!ing always.

2.1.1

WHEN LEAVING PATIENT CARE UNIT Using gloved hands# untie the gown string of tied emove gloves and dis!ard in an appropriate Not in pra!ti!e "is!ard gloves in separate bin Not in pra!ti!e.

in front and remove shoe !overs manner

emove gown and apron# tou!h only inside of

gown and apron while removing and pla!e in an appropriate disposal bag. rub. 2.2 HANDLING OF PATIENT CARE E#UIPMENTS 8-9 N'',$'( .4, ()3-40'( :8Use disposable only( 3 "is!ard in pun!ture3proof !ontainer with a lid that !loses it. 8--9S%-$', *.7-'47 :.3' ';<-*2'47 S7'7=%(:%*' .4, 7='32%2'7'3(4 3Clean with detergent and water and dry 3Should be wiped with sodium hypo!hlorite /3,+ or)5+ al!ohol and dried after !leaning. 3%void immersing in anti septi! solution. emove mask and !ap in an appropriate !ontainer. "is!ard mask and !ap in separate bin. emove boots and keep in an appropriate pla!e. Wash hands up to wrist thoroughly with soap and epla!e slippers on a stand. &and washing te!hni@ue is in pra!ti!e before leaving the NICU.

water# dry and de!ontaminate with )5+ al!oholi! hand

&ub of the needles are immersed in ,+ hypo!hlorite solution for duration of , hours in a separate bottle before the disposal. Cleaned with spirit and kept dry for ea!h patient. 3-Using separate thermometer
and Stethoscope for each baby is in practice.

8---9I4(73<2'47(:8L.3)40%(:%*' .4, /$.,'(> 73.:='.$ 7</'( .4, (<:7-%4 :.7='7'3(9. emove all protein# organi!# inorgani! matter at point of generation 'e.g. blood and body se!retions( by !leaning with soap and water and return to the steriliAing servi!e department for appropriate repro!essing. 8-&9AM"U /.0 .4, 2.(1: Clean with detergent# dry and send to the steriliAing servi!e department steriliAe. If used for infe!ted patient # immerse in ,+ gluteraldehyde for one hour. 8&9V'47-$.7%3>.4, &'47-$.7%3 7</-40(: Clean ma!hine with detergent and water# dry# and disinfe!t with )5+ al!ohol. Cilters should be single use.

3Baryngos!ope blades are washed with soap and water spirit then before disinfe!t with

using.laryngos!ope handle and bulb disinfe!t with )5+al!ohol. 3Using disposable tra!heal tubes and su!tion !atheter. Cleaning with spirit and send it to CSS". Not in pra!ti!e.

?entilator and o-ygen tubing are !leaned with soap and water# dry in air# steriliAe with ethylene o-ide and kept in a sterile.

8&-9(<:7-%4 ';<-*2'47 .4, %?)0'4 .,2-4-(73.7-%4 ,'&-:'(:: 3 .ask is single patient use and should be !leaned at least daily and also as it be!omes soiled. 8&--9W.32'3> -4:</.7%3 .4, ,3'((-40 73%$$')4 Clean with sodium hypo !hloride /3, + or al!ohol )5+.

3Using single mask for one baby. 3 D-ygen hoods are !leaned with soap and water and dried in air.

Clean with detergent and water then wipe with )5+ ethanol.

8&---9 F'',-40 .37-:$'( 3Cleaning with soap and water 3 boiling for ) min. Cleaning with soap and water and boiled for /5 min after ea!h use.

8&---9 F<34-7<3' @ /',> +3.2'(> 7./$'> I5V (7.4,> 6=''$ :=.-3> *-$$%6( .4, 2.773'(( : Clean with detergent and water and dry Wipe with disinfe!tant su!h as )5+ al!ohol or /+ sodium hypo!hlorite and dry after !leaning.

Cleaning with Bysoformin 5.*+ that is *5ml is dissolve in /5 liters of water. '% solution !ontaining >luteral E>lyo-alE "ide!yl "imethyl %mmonium Chloride( is in use.

8-?9 T'$'*=%4' .4, T%)( Clean with detergent and water# and dry. "isinfe!t with )5+ al!ohol daily. Use for one single patient. Clean with detergent and water# and dry. If toys are !ontaminated with mi!ro organisms wipe with disinfe!tant or /3,+ hypo!hlorite solutions. 2.3 HANDLING OF A SOILED LINEN LINEN: If reusable4 launder as per the institutional guidelines for soiled linen.

Clean with detergent and water disinfe!t with sterilium.then keep all these arti!les during fumigation

Sponge towels are washed with soap and water and drying under sun in laundry and sent for auto!lave in CSS". 3"isinfe!ting mattress !over with ,+ !arboli! a!id 'phenol( .op washes separately in detergent solution and rinse in hot water#soak in 5.*+of Bysoformin for 15 minutes then rinse and dry.

MOPS: Wash mops separately from other !loth or linen

2.4

CLEANING OF ENVIRONMENTAL SURFACES IN THE PATIENTAS ROOM WALL AND FLOOR: Cleaning with %l!ohol ')5+( Isopropyl# ethyl al!ohol# methylated spirit. "amp mop with detergent and water Cleaning the floor and wall with Bysoformin5.*+ 3"ilution ratio4 *5ml in /5 liters

C%22%,'> 7%-$'7 ('.7( Clean seat and arms with detergent and water and dry whenever used. Wipe with disinfe!tant '/3, + sodium hypo!hlorite( 2.5 1 and dry after !leaning. PREVENTION OF NEEDLE STICB INCURIES: $la!e used disposable syringes and needles s!alpel blades and other sharp items in a pun!ture resistant 2 3 !ontainer with a lid. Take e-tra !all when !leaning sharp reusable instruments or e@uipments. Never re!ap or bend needles.

of water. Cleaning seat and arms with detergent # water and disinfe!t with phenol.

$la!ing the used syringes and needles in a separate tray Not in pra!ti!e e!aping of needles is not in pra!ti!e.

Sharp must be appropriately de!ontaminated and or destroyed or per the national standard or guidelines.

3&ub of the needles are immersed in ,+ hypo!hlorite solution for duration of , hours in a separate bottle before the disposal.

2.6 1

SPILLAGE MANAGEMENT S*-$$.0' @ %+ /$%%,> /%,) +$<-,(> (':3'7-%4( .4, '?:3'7-%4(4 3Wipe with paper towel or reusable !loth to soak up the ma6ority of the spill 3Clean with detergent and water 3"ry the area with ) + sodium hypo!hlorite Wiping with water and )+ sodium hypo!hlorite.

2. WASTE MANAGEMENT: 2. .1 STANDARD COLOR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF "IOMEDICAL WASTE C%$%3 Y'$$%6 W.(7' C.7'0%3) <andages# body fluids solid linen &uman anatomi!al waste materials !ontaminated with blood# mi!robiology waste Sharp needles# syringes# s!alpels & blades glass that may !ause pun!ture and !uts I? Sets Catheters R', Canulas >loves .i!robiology & bio te!hnology waste 7-pired medi!ine# !hemi!als used as "$.:1 disinfe!tions# inse!ti!ides !hemi!als used in biologi!al in!ineration# ash and !ytoto-i! drugs Se!ured land fills "isinfe!tion & shred=mutilate D-(*%(.$ "ire!t in!ineration =deep burial "isinfe!tion& shred= mutilate

"$<'

2. .2. EXISTING PRACTICE OF WASTE MANAGEMENT:

"isposal of bio medi!al waste is taken !are by &ouse keeping department. "isposal of waste is segregated a!!ording to the !olor !oding and type of waste material. C%$%3 W.(7' C.7'0%3) <andages# body fluids# solid linen &uman anatomi!al waste .aterials !ontaminated with blood and body fluids Sharp needles and syringes <lades >lass I? sets Catheters D-(*%(.$ "ire!t in!ineration =deep burial

Y'$$%6

<lue

"isinfe!tion& shred= mutilate

ed

"isinfe!tion & shred=mutilate

Canuals

"$.:1

>loves 7-pired medi!ine# "isinfe!tant ash Cytoto-i! drugs.

Se!ured land fills

COMPARISON OF INFECTION CONTROL PRACTICES IN PICU WITH WHO STANDARD PROTOCOL

SECTION -A 1. INFECTION CONTROL PRACTICES

S.NO

STANDARD PRACTICE PROCEDURES FOR ENTERING THE PICU Woolens & shoes should be removed and nursery slipper should be worn before entering the $ICU. The nails should be kept short and trimmed emove wat!hes and rings on entering $ICU. o "o hand washing.

EXISTING PRACTICE

1.1

Separate slippers are in use.

Cut short nail.

Wat!h and rings are not removed. o Steps of proper handwashing are not followed. o Separate nonsterile hand towel is in use and o!!asionally hand drier and roller towel are being used.

4 5

o The hands should be dried with single use auto!lave sterile towel or preferably disposable paper towel.

inse the hands with sterilium# before tou!hing any !hild.

$ra!ti!e of rinsing the hand with sterilium hand rubs. Wearing !ap before entering NICU not mask. The staff nurses working in the unit are wearing separate uniform before entering into the unit.

.ask and !ap should be worn. Separate suit or dress must put on before entering the $ICU.

1.2 HAND WASHING: S.NO 1.2.1 /. STANDARD PRACTICE FACILITIES AVAILA"LE FOR HAND WASHING %!!ess to !lean running water is essential Barge washbasins with hand free !ontrol tap FACILITIES AVAILA"LE FOR DRYING HANDS *. "isposable paper towel 9. ). 1.2.3 / eusable single use towel oller paper towel $resen!e of ,0 hours running water supply. $resen!e of separate hand washing area with one sinks with hand free !ontrol tap. EXISTING PRACTICE

,.

1.2.2

"isposable paper towel is not available. eusable single use towel and oller paper towel are available. $lain soap is not in use %ntimi!robial soap # "ettol is used for hand

:. &and drier MATERIALS $lain Soap

%ntimi!robial Soap Spe!ifi! antisepti!s

washingl %ntisepti!s4 *+ povidone iodine

*+ 3 ).*+ $ovidone iodine /+ Tri!losan

%l!oholi! rub )5+ ,.0+ Chlorhe-idine

%&" solution 'Sterilium( whi!h !ontains ethanol )*+ %N" ,.*+.Chlorhe-idine glu!onate is in use.

1.2.4 / , 1 0 *

HAND WASHING TECHNI#UE: emove 6ewellery 'rings# bra!elets( and wat!hes before washing hands 7nsure that the nails are !lipped short. oll the sleeves up to the elbow. Wet the hands and wrists 8eeping hands and wrists lower than the emove 6ewellery 'rings# bra!elets( and wat!hes before washing hands Nails are !ut short. oll the sleeves up to the elbow. Wet the hands and wrists Not in pra!ti!e.

elbows 'permits the water to blow to the banger tips avoiding aim !ontamination. %pply soap 'plain or %ntimi!robial( and lather thoroughly. Use firm# !ir!ular motions to wash the hands and arms up to the elbows. ub hands palm to palm. ight palm over left dorsum with interla!ed fingers and vi!e versa. $alm to palm with finger interla!ed. <a!ks of fingers to opposing palms with finger interlo!ked. otational rubbing# ba!kwards & forwards with !lasped fingers of right hard in left palm and vi!e versa. /1 /0 ub for minimum of /5 2 /* se!onds. inse hands thoroughly. ubbing for /5 se!onds. inse hands thoroughly. Not keeping the hand lower than the fore /* 8eeping the hand lower than the fore arms. "ry arms thoroughly with auto!laved /9 air dry. "is!ard the towel in an appropriate /) /: !ontainer without tou!hing the bin lids with hand. "uration of entire pro!edure with soap and water305395 se! al!ohol based formulation3 ,5315 se! arm "rying the arms by reusable single use Use firm# !ir!ular motions to wash the hands. ub hands palm to palm ight palm over left dorsum with interla!ed fingers and vi!e versa. $alm to palm with finger interla!ed. %pply soap 'dettol( and lather thoroughly.

/5 //

Not in pra!ti!e

/,

Not in pra!ti!e

napkins or disposable sterile paper to well or towel and roller towel.

"is!ard paper towel in an appropriate manner. "uration of entire pro!edure is /* se! with antimi!robial soap. "uration of entire pro!edure is ,5 se! with *+ povidone iodine . "uration of entire pro!edure is /*

se! with *+ povidone iodine

1.2.5 PICTORIAL STANDARD HAND WASHING TECHNI#UE:

1.2.5 PICTORIAL EXISTING HAND WASHING TECHNI#UE:

SECTION - " 2. ENVIRONMENTAL MANAGEMENT PRACTICES S. NO STANDARD PRACTICE 2.1 PERSONAL PROTECTIVE E#UIPMENTS: / G$%&'(: Wear gloves when in !onta!t with blood# body fluids# se!retions# e-!retions and mu!ous membrane. T)*'( %+ ,-(*%(./$' 0$%&'( Clean=non sterile gloves for routine !are of the Sterile gloves for invasive pro!edures Sterile gloving is not pra!ti!ing whilie inserting iv !atheter and spe!imen !olle!tion. , M.(1(: Wear a mask to prote!t mu!ous membranes of the mouth and nose when undertaking pro!edures. T)*'( %+ 2.(1: N ;* 2 "uring open=a!tive infe!tious diseases N /55 2 "uring invasive pro!edures Standard surgi!al splash proof masks 2 .ainly when dealing with droplet infe!tions 1 A*3%45G%64: Wear !lean# non3sterile gown to prote!t the stain %pron is available only for from splashes of blood and body fluids. patient attenders and nurses are using separate suit. 0 C.*( Wear disposable !aps Using disposable !ap in ea!h shift .asking is in pra!ti!e..

>loving invasive

is

pra!ti!ed pro!edures

while performing all the e-!ept I? !annulation and spe!imen !olle!tion. Not in pra!ti!e

infe!tious patients

"%%7(5($-**'3(4 Wear boots 'or( slippers before entering into intensive !are unit.

Using slippers before entering into $ICU.

2.1.1

WHEN LEAVING PATIENT CARE UNIT Using gloved hands# untie the gown string of tied emove gloves and dis!ard in an appropriate Not in pra!ti!e "is!ard gloves in separate bin. Not in pra!ti!e.

in front and remove shoe !overs manner

emove gown and apron# tou!h only inside of

"is!ard mask and !ap in separate bin. epla!e slippers on a stand. &and washing te!hni@ue is not in pra!ti!e before leaving $ICU.

gown and apron while removing and pla!e in an appropriate disposal bag. emove mask and !ap in an appropriate !ontainer. emove boots and keep in an appropriate pla!e. Wash hands up to wrist thoroughly with soap and

water# dry and de!ontaminate with )5+ al!oholi! hand 2.2 rub. HANDLING OF PATIENT CARE E#UIPMENTS 8-9 N'',$'( .4, ()3-40'( :8Use disposable only( 3 "is!ard in pun!ture3proof !ontainer with a lid that !loses it.

&ub of the needles are immersed in ,+ hypo!hlorite solution for duration of , hours in a separate bottle before the disposal.

8--9S%-$', *.7-'47 :.3' ';<-*2'47 S7'7=%(:%*'> (*-02%2.4%2'7'3 .4, 7='32%2'7'3(4 3Clean with detergent and water and dry 3.ay be wiped with sodium hypo!hlorite /3,+ or)5+ al!ohol and dried after !leaning. 3%void immersing in anti septi! solution.

Cleaned with spirit and kept dry 3Immersing in antisepti! solution is restri!ted. 3Using separate thermometer and Stethos!ope for ea!h baby

8---9I4(73<2'47(:8L.3)40%(:%*' .4, /$.,'(> 73.:='.$ 7</'( .4, (<:7-%4 :.7='7'3(9. emove all protein# organi!# inorgani! matter at point of generation 'e.g. blood and body se!retions( by !leaning with soap and water and return to the steriliAing servi!e department for appropriate repro!essing. 8-&9AM"U /.0 .4, 2.(1: Clean with detergent# dry and send to the steriliAing servi!e department steriliAe

Baryngos!ope and blades are !leaned with spirit before and after ea!h use. 3Using disposable tra!heal tubes and su!tion !atheter.

Cleaning with spirit and send it to CSS".

8&9V'47-$.7%3> (<:7-%4 ';<-*2'47 .4, %?)0'4 .,2-4-(73.7-%4 ,'&-:'(:: 3Clean ma!hine with detergent and water# dry# and disinfe!t with )5+ al!ohol. Cilters should be single use. 3.ask is single patient use and should be !leaned at least daily and also as it be!omes soiled.

?entilator and o-ygen tubing are !leaned with soap and water# dry in air# steriliAe with ethylene o-ide and kept in a sterile. 3Using single mask for one baby. 3 D-ygen hoods are !leaned with soap and water and dried in air. 3<ag and mask are washed with soap and water & "ry in air. Then it immersed in ,+ gluteraldehyde for ,5 minutes. insed with sterile water# dried and kept in sterile !ontainer.

8&-9W.32'3 .4, ,3'((-40 73%$$')4 Clean with sodium hypo !hloride /3, + or al!ohol )5+. 8&--9 FEEDING ARTICLES 3Cleaning with soap and water 3 boiling for ) min. 8&---9 F<34-7<3' @ /',> +3.2'(> 7./$'> I5V (7.4,> 6=''$ :=.-3> *-$$%6( .4, 2.773'(( : Clean with detergent and water and dry Wipe with

Clean with detergent and !arboli! a!id Cleaning with soap and water and boiled for /5 min after ea!h use. Cleaning with / +sodium hypo!hlorite 'phenol(.

disinfe!tant su!h as )5+ al!ohol or /+ sodium hypo!hlorite and dry after !leaning. 8-?9 T'$'*=%4' .4, T%)(: . Clean with detergent and water# and dry. If toys are !ontaminated with mi!ro organisms wipe with disinfe!tant or /3,+ hypo!hlorite solutions. 2.3 HANDLING OF A SOILED LINEN LINEN: If reusable4 launder as per the institutional guidelines for soiled linen. Sponge towels are washed with soap and water and drying under sun in laundry and sent for auto!lave in CSS". 3"isinfe!ting mattress !over with ,+ !arboli! a!id 'phenol( MOPS: 2.4 Wash mops separately from other !loth or linen CLEANING OF ENVIRONMENTAL SURFACES IN THE PATIENTAS ROOM WALL AND FLOOR: Cleaning with %l!ohol ')5+( Isopropyl# ethyl al!ohol# methylated spirit. "amp mop with detergent and water Cleaning the floor and wall with 5.*+ Sodium hypo !hloride or ,+ !arboli! a!id solution three times a day. 3"ilution ratio4 ,5ml of ,+ !arboli! a!id with ;:5 ml of water C%22%,'> 7%-$'7 ('.7( Clean seat and arms with detergent and water and dry whenever used. Wipe with disinfe!tant '/3, + sodium hypo!hlorite( 2.5 1 and dry after !leaning. PREVENTION OF NEEDLE STICB INCURIES: $la!e used disposable syringes and needles s!alpel blades and other sharp items in a pun!ture resistant !ontainer with a lid. Cleaning seat and arms with detergent # water and disinfe!t with phenol. .op washes separately Clean with detergent and water disinfe!t with /+sodium hypo!horite solution.

$la!ing the used syringes and needles in a separate tray

2 3

Take e-tra !all when !leaning sharp reusable instruments or e@uipments. Never re!ap or bend needles.

Not in pra!ti!e. e!apping of needles is not in pra!ti!e.

Sharp must be appropriately de!ontaminated and or destroyed or per the national standard or guidelines.

3&ub of the needles are immersed in ,+ hypo!hlorite solution for duration of , hours in a separate bottle before the disposal.

2.6 1

SPILLAGE MANAGEMENT S*-$$.0' @ %+ /$%%,> /%,) +$<-,(> (':3'7-%4( .4, '?:3'7-%4(4 3Wipe with paper towel or reusable !loth to soak up the ma6ority of the spill 3Clean with detergent and water 3"ry the area with ) + sodium hypo!hlorite 2. WASTE MANAGEMENT: 2. .1 STANDARD COLOR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF "IOMEDICAL WASTE C%$%3 Y'$$%6 W.(7' C.7'0%3) <andages# body fluids solid linen &uman anatomi!al waste materials !ontaminated with blood# mi!robiology waste Sharp needles# syringes# s!alpels & blades glass that may !ause pun!ture and !uts I? Sets Catheters R', Canulas >loves "$.:1 .i!robiology & bio te!hnology waste 7-pired medi!ine# !hemi!als used as disinfe!tions# inse!ti!ides !hemi!als used in biologi!al in!ineration# ash and Se!ured land fills "isinfe!tion & shred=mutilate D-(*%(.$ "ire!t in!ineration =deep burial "isinfe!tion& shred= mutilate Wiping with water and )+ sodium hypo!hlorite.

"$<'

!ytoto-i! drugs

2. .2. EXISTING PRACTICE OF WASTE MANAGEMENT:

"isposal of bio medi!al waste is taken !are by &ouse keeping department. "isposal of waste is segregated a!!ording to the !olor !oding and type of waste material. C%$%3 W.(7' C.7'0%3) <andages# body fluids# solid linen &uman anatomi!al waste .aterials !ontaminated with blood and body fluids Sharp needles and syringes <lades >lass I? sets Catheters Canuals >loves 7-pired medi!ine# "isinfe!tant ash Cytoto-i! drugs. D-(*%(.$ "ire!t in!ineration =deep burial

Y'$$%6

<lue

"isinfe!tion& shred= mutilate

ed

"isinfe!tion & shred=mutilate

"$.:1

Se!ured land fills