Podiatry Waste Protocol 2013

Murray Medical Ltd 2013

CONTENTS

1. 2. 3. 4. 5.

Introduction Responsibilities Aim Definition of Clinical Waste Podiatry (Chiropody) Waste Protocol 5.1 Waste Classification 5.2 Segregation of Waste 5.3 Waste Containers 5.4 Storage 5.5 Transportation 5.6 Paperwork 5.6.1 Consignment Note 5.6.2 Waste Transfer Note 5.7 Domiciliary Dispensation 5.7.1 Segregation of Waste 5.7.2 Transportation 6. Collection of Waste 7. Health and Safety 7.1 Personal Protective Equipment 7.2 Immunisation 7.3 Accidents and Incidents 8. Pre- Acceptance Audit 9. Training 10. References

1. Introduction Healthcare professionals must recognise that the activities in which they undertake will have a significant impact on the environment. The production of clinical waste is one of these activities. This protocol describes the necessary arrangements and responsibilities for compliance with relevant legislation for the management of podiatry / chiropody waste.

2. Responsibilities This protocol is applicable to all independent practitioners and staff involved in the production, segregation, storage, handling and transportation of clinical waste.

3. Aim The aim of this protocol is to promote best practice and facilitate a consistent approach to podiatry / chiropody waste disposal that meets the requirements of current guidance and legislation.

4. Definition of Clinical Waste Clinical waste is defined in the Safe management of healthcare waste 2011 as any waste which consists wholly or partly of: Human or animal tissue Blood or other body fluids Excretions Drugs or other pharmaceutical products Swabs or dressings Syringes, needles or other sharp instruments

which unless rendered safe may prove hazardous to any person coming in contact with it and any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care,

teaching or research, or the other collection of blood for transfusion, which may cause infection to any person coming into contact with it. Broadly therefore, clinical waste can be divided into three main categories, namely: I. Infectious Waste is waste containing viable micro-organisms or their toxins which are known or reliably believed to cause disease in man or other living organisms. II. Hazardous Waste is waste with one or more properties that are hazardous to health or to the environment. III. Offensive/hygiene Waste is waste which is non-infectious and which does not require specialist treatment or disposal, but which may cause offence to those coming into contact with it.

5. Podiatry (Chiropody) Waste Protocol 5.1 Classification of waste The relationship between hazardous and non-hazardous waste within podiatry (chiropody) practice can be further simplified by assessing whether the waste is potentially infectious, and therefore hazardous. Or non-infectious and therefore non-hazardous (offensive). Only the waste producer can classify their waste as hazardous or non-hazardous as they are the only person with knowledge of the health status of the patient, the medicaments and materials used in their treatment and the waste generated from their care. 5.2 Segregation of Waste Podiatrists (Chiropodists) that produce both hazardous and non-hazardous clinical waste should adopt the practice of segregating their wastes. Failure to segregate infectious from non-infectious waste will mean that the entire waste stream will need to classified as infectious (hazardous) and consigned for appropriate treatment recovery and disposal. This will result in to an inappropriate method of disposal and an increased cost to the producer. For reference, the table below illustrates the waste segregation colour codes. 5.3 Waste Containers The person or persons responsible for the management of clinical waste disposal must ensure that there is an adequate supply of appropriate containers wherever clinical waste is produced. All clinical waste containers must be fit for purpose

and only contain the type of waste described for its disposal. For reference, the table below illustrates the appropriate vessels that must be used for the movement of waste by: container, waste type, EWC code and maximum storage between collections. 5.4 Storage Producers or appropriately trained staff have a responsibility to seal and label (at the point of origin) clinical waste, and then store it prior to transportation in such a way that it does not pose a risk to people, animals or the environment. Clinical waste should not be allowed to accumulate in treatment rooms, corridors, waiting rooms or other unsuitable places. It is advisable that clinical waste is removed from the site of production to the main collection area on a daily basis, or as determined by the producer. The storage area will be clearly reserved for clinical waste, must be secure and sited away from food preparation, general storage areas and from routes used by the public. Washing facilities will be provided for staff who transport and store the clinical waste in case of a spillage occurring. 5.5 Transportation Producers of clinical waste are not permitted to transport waste between external sites. Internal movement of waste is permitted by an appropriately trained member of staff who should adhere to the health and safely protocols below (point 8.0) 5.6 Paperwork 5.6.1 Consignment Note Part of the regulations state that the transportation of hazardous waste is to be covered by a consignment note. Each premise from which hazardous waste is collected will be identified by a unique code supplied by the Environment Agency. This code must be on every consignment note. All consignment notes must be kept on site for a period of 3 years. This consignment note procedure is designed to provide an audit trail of the waste from its production to its disposal. It also gives the waste producer an assurance that waste is being disposed of correctly. 5.6.2 Waste Transfer Note Part of the regulations state that the transportation of offensive/hygiene waste is to be covered by a waste transfer note. This is document is generally issued

annually and details the waste codes and volume of offensive / hygiene waste that is transferred during that period. All waste transfer notes must be kept on site for a period of 3 years. This waste transfer note procedure is designed to provide an audit trail of the waste from its production to its disposal. It also gives the waste producer an assurance that waste is being disposed of correctly. 5.7 Domiciliary Dispensation 5.7.1 Segregation of Waste With the home owners permission, small quantities of soft clinical waste generated by their treatment in the community can be disposed of in their domestic refuse. The waste should be wrapped in an opaque sac so that its contents is visible. If the patient is being treated in a medical, nursing or residential premises then the clinical waste can be segregated and disposed of onsite with written permission by the appropriate management. All sharps and hard clinical waste must be retained by the practitioner and stored in an appropriate container, transported and stored at a registered site for collection. 5.7.2 Transportation Small quantities of waste generated by healthcare professionals as a result of treating patients in the community, may be carried, appropriately contained, in the individuals vehicles, transported and stored at a registered site for collection.

6. Collection of Waste Clinical Waste will be collected from registered premises on behalf of the Murray Medical Ltd by a licensed waste carrier at specified frequencies. This depends on quantities, type of waste and storage times. A programme of collections will be agreed. It is imperative that the waste producer understands the importance of correct classification and marking of clinical waste bags. The Duty of Care is the responsibility of each member involved in the production, handling and disposal of clinical waste. 7. Health and Safety 7.1 Personal Protective Equipment

To prevent skin contact when handling clinical waste, the use of Personal Protective Equipment (PPE) is advised. Water repellent aprons and disposable gloves should be worn when handling clinical waste in a care setting. Heavy duty shoes/boots and gloves should be worn by staff who regularly handle and transport containers to storage (collection) areas. 7.2 Immunisation Hepatitis B and tetanus primary immunisation should be offered to all staff considered by who may be at risk from handling clinical waste. Immunisation records should be kept. 7.3 Accidents and Incidents When an accident/incident occurs which may put you, your staff or your patients / clients at risk, then a immediate first aid should be rendered or staff affected taken to the nearest Accident and Emergency Department. Where practical, the retention of the items and details of the accident will remain untouched so that they can be investigated to help prevent a re-occurrence. All accidents/incidents must be accurately recorded for future reference. 8. Pre- Acceptance Audit Since April 2010 the Environment Agency has imposed a restriction on companies authorised to incinerate, treat, dispose or facilitate the disposal of hazardous clinical waste without obtaining a pre-acceptance audit from healthcare waste producers. Since July 2012 all podiatrists (chiropodists) that produce hazardous / infectious clinical waste will have to produce a pre-acceptance audit prior to the removal of their waste. The audit must be carried out by the producer of the waste. On completion of the audit, a copy is held by the producer and a copy or copies are distributed to the company or companies who transfer and dispose of your waste. 9. Training All staff shall be made aware and instructed in the risks associated with clinical waste, segregation and storage. Appropriatly trained staff who are required to handle and move clinical waste shall be made aware of safe procedures in dealing with spillages or other incidents for their area of work. Staff should be trained to: Know how to use control measures and protective equipment. Check that storage containers are efficiently sealed before handling.

 Ensure that the origin of the waste is marked on the container. Handle sacks by the neck only. They should not be clasped against the body and never thrown or dropped. Be aware of the special problems relating to disposal of sharps. Check that the seal on any used waste storage container is unbroken when movement is complete. Know the procedure in case of accidental spillage and how to report an incident. Murray Medical Ltd can provide you and your staff with clinical waste training as a distance learning CPD module. Please contact us for details. 10. References Safe Management of Healthcare Waste 2011 The Health and Safety at Work Act 1974 The Environmental Protection Act 1990 The Environment Act 1995 The Control of Substances Hazardous to Health Regulations 2002 Health Service Advisory Committee, Safe Disposal of Clinical Waste The Waste Management Regulations 1994 and all associated legislation The Hazardous Waste Regulations 2005

a. b. c. d. e. f. g. h.

Murray Medical Limited 2013