CLINICAL WASTE MANAGEMENT By: NADIRATUL NOZIANA ABD MAJID EXECUTIVE ENGINEER

CLINICAL WASTE CLINICAL WASTE MANAGEMENTMANAGEMENT

By: NADIRATUL NOZIANA ABD MAJIDEXECUTIVE ENGINEER

AIMS & OBJECTIVE

Provide information on the correct method of clinical waste management & handling.

To develop awareness so as to appreciate health , safety and environmental

protection issues relating to clinical waste.

PMSB VISSION

PMSB WILL PROVIDE QUALITY SERVICE IN THE

HEALTHCARE AND RELATED SERVICE

INDUSTRIES WITH UNSURPASSED DEDICATION

TO CUSTOMER SATISFACTION THROUGH

INNOVATION AND A MOTIVATED, COMMITTED

AND EFFICIENT WORKFORCE WHO TAKE

PRIDE IN THEIR WORK.

PMSB CUSTOMERS

GH

Private Hosp/Clinics

BIOHAZARD SIGN

LEVEL OF BIOHAZARD

Level 1 - Varicella, Canine hepatitis

Level 2 - Hepatitis A, B and C,

Influenza A

Level 3 - SARS, Yellow fever

Level 4 - Ebola, Dengue fever

HOSPITAL WASTE CATEGORY

Clinical waste- scheduled waste

Radioactive waste- scheduled waste

Chemical waste- scheduled waste

Pressurized containers

General waste

COMPOSITION OF CLINICAL WASTE

5% Pathological 3% PVC 30% Plastic other than PVC 32% Paper including wax Paper 10% Hospital dressing 10% Miscellany-flowers, rags etc. 10% Non combustible-glass, sharps,

metal

DEFINITION OF CLINICAL WASTE

Clinical waste - 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, being waste which unless rendered safe may prove hazardous to any person coming into contact with it.

DEFINITION OF CLINICAL WASTE

Clinical Waste -Any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research, or the collection of blood for transfusion, being which may cause infection to any person coming into contact with it.

CATEGORY OF CLINICAL WASTE

Category A

Blood Body fluids excretions Soiled surgical dressings Swabs Material from

infectious diseases

Category B

Discarded syringes, needles, broken glass, and other contaminated disposable sharp instruments

Category C

Lab or post mortem room waste

Category D

Pharmaceutical and cytotoxic waste

Category E

Used disposal bed pan liners, urine containers, incontinence and stoma pads

User Training

Pottering Service

Store Management & Consumable Supply

Transport Service

Incineration

PMSB: CRADLE TO GRAVE SERVICE

Yellow Plastic Bags

Blue Plastic BagsCable TiesCW Label

Bag HolderPaddle Bin

Sharp ContainerTrocar Container

CONSUMABLES

PMSB CONSUMABLES

Consumables are supplied to all hospital site. They must be used correctly and not

misused.

Nursing and clinical staff responsibilities:

• Segregation at SOURCE: Clinical Waste correctly segregated from General Waste.• ONLY CW is deposited in yellow bags.• ONLY SHARPS in sharps container.• Seal bags when 3/4 FULL using cable ties. Never seal bags by stapling.

WASTE SEGREGATION: DOS & DON’TS

Waste Cat. A, C, D, & E throw into yellow bags.

Infectious waste, do prior treatment by autoclave & throw into blue bags.

Waste Cat. B throw into Sharp containers. Sharp containers are firmly pressed prior to

disposal. Don’t force needle/syringes into the sharp

container.

WASTE SEGREGATION: DOS & DON’TS

Oops!! I terr..throw clinical waste into the black bag….

What should I do?

WASTE SEGREGATION

If clinical waste and domestic

waste are mixed, it should be treated as schedule waste…

Clinical Waste + Domestic Waste Clinical Waste

CLINICAL WASTE GUIDELINE…

WASTE SEGREGATION

• Place contaminated waste bag into another bag of the correct color

(yellow bag).• Under no circumstances should

incorrectly segregated waste be taken out of a waste bag or container once

deposited.

CLINICAL WASTE GUIDELINE…

MANUAL HANDLING OF CLINICAL WASTE BAG

Check if it is properly sealed. Check label and ensure it shows the source of

waste. Pick the bag up by the neck only. Bags should not be clasped against the body. Do not attempt to carry too many bags at one

time. Do not throw or drop the bags. Do not support the bag from the bottom. Do not leave the waste unattended. Conduct spillage clean-up when the need arise.

MANUAL HANDLING OF SHARP CONTAINERS

No darting needles into the bin. Sealed when 3/4 full. Syringes with attached needles shall be discarded together. Do not shed needle. Do not press down the bin lids when closing. Shake the container gently before closing. Check if bin is labeled with date and site of origin. Keep out of reach of children. Intravascular guidewires, cannulae, blood taking sets, glass slides, glass dry vials & ampoules shall be discarded into the correct size containers.

Syringes/needles in yellow bag - Big Mistake…

Result in deadly consequences!!!

LABELLING

All bag and sharp containers shall be labeled for identification purpose.

WHY??

Should any problem arise, the waste can be easily traced.

LABELLINGLabels should have:

• Date waste first generated

• Name, Add & Contact no. of waste generator

• Marked with biohazard symbol and code SW404

Designated area for storage. Locked & attended at all time. Separated from general waste store. Minimum 2 days storage capacity. Accessible only by authorized person. Facilities for washing hands made available. Connected to sewerage system. PPE made available. Refrigerated storage required if stored for >24

hours. Free from vermin, droppings, etc. Odour control. Good housekeeping.

STORAGE OF CLINICAL WASTE

“Old mortuary house turn domestic waste store…. Temporarily utilised as

CW storage in 1996”

STORAGE OF CW- THEN

STORAGE OF CW-NOW

Landfill Autoclave (Steam

treatment) Irradiation Microwave Treatment Chemical Disinfection

• Incineration

CLINICAL WASTE DISPOSAL

Combustion of waste at high temperature with O2 to produce

inert ash, CO2, H2O and trace levels of pollutants.

WHAT IS INCINERATION

Because generation of waste increases daily. Scarcity of landfill sites. Sustain clean environment. Reduces pollution due to open burning. Ensures total destruction of pathogen & organic

material. Complies with DOE emission control standard.

NEED FOR INCINERATION

CW DISPOSAL-THEN

CW DISPOSAL - NOW

Malaysia’s 1st Clinical Waste Incinerator

Located at Bukit Rambai, Melaka Operation since October 1996 Stepped hearth technology,

capacity 2 x 250 kg/hr ISO 9001:2000 (Nov 1997) ISO 14001:1996 (Dec 2001) OHSAS 18001:1999 (May 2003)

PMSB INCINERATOR PLANT

Waste Receive Cold Room Burning Process Control

Bin WashingPreparing

Clean Bins Ash Handling Ash Removalfor Disposal

PLANT PROCESS

PMSB INCINERATOR PLANT

CLINICAL WASTE MANAGEMENT IS A JOINT EFFORT - TO

SUSTAIN GOOD HEALTH, SAFETY & ENVIRONMENT….

WRONG PRACTICE

REVISE BACK….

YELLOW BAG

CLINICAL WASTE CATEGORY….

A?.. B?.. C?.. D?.. E?..

REVISE BACK….

SHARP CONTAINER

CLINICAL WASTE CATEGORY…

A? ..B?.. C?.. D?.. E?..

SEGREGATION (PENGASINGAN) Clinical Waste Groups

Group A Wool Cotton Gloves, Swabs Plasters and bandaging Soiled surgical dressing Materials used to clean spillage.

Human biopsy materials

Human tissues Blood, Urine,

Stools Organ, Limbs Body parts Placenta

Yellow Bag (Beg Kuning)

Group B Sharps instruments and objects

Syringes

Needles Cartridges Scalpel blades

Sharp

Container (Bekas Tajam)

Group C Clinical Waste arising from laboratories /

infectious wastes Pathology Haematology

Blood transfusion

Microbiology Post-mortem

room wastes

Light Blue Bag (Beg Biru

Muda)

SEGREGATION (PENGASINGAN)

Clinical Waste Groups

Group D Pharmaceutical wastes Expired drugs Sera

Low level radioactive waste X-ray dept.

Cytotoxic waste Treatment of cancer

patient Vaccines

Sharp Container (Bekas Tajam)

Group E Disposable pads Disposable bed -pan liners Disposable diapers

Incontinence pads Urine containers Stoma bags

Yellow Bag

(Beg Kuning)