Implementing HTM 0701 Segregation of Waste in Mersey Care NHS Trust

1
Implementing HTM 07-01Segregation of Wastein
Mersey Care NHS Trust
2
Relevant Regulations and Guidance

• European Hazardous Waste Directive (91/689/EEC)
• Special Waste Regulations 1996
• The Special Waste (Amendment) Regulations 2001
• Hazardous Waste Regulations 2005
• HTM 07-01 - 2006 (Department of Health)

3
Objectives

• Why we must segregate waste.
• Waste streams.
• Awareness of new colour code for wastes.
• Assessing waste - What waste goes in what stream.
• Clinical Waste Posters
• Community Variations
• Waste Bin Notices

4
(No Transcript)
5
Why Segregate Waste

• Waste is segregated into appropriate waste
  streams to ensure that it is disposed of safely
  and with the minimum possible environmental
  impact.

6
Segregation of WastesWaste Streams

• Colour Coding
• Separate Collection
• Appropriate Containers
• Cost of Disposal
• Sector Specific Variations (Community)

7
Hazardous Waste

• Some wastes are harmful to human health or to the
  environment, either immediately or over an
  extended period of time. These are called
  hazardous wastes. If your business produces
  hazardous waste you have a 'duty of care' to make
  sure it's disposed of properly.

8
Mersey Care Hazardous Wastes

• Mersey Care NHS Trust produce two types of
  Hazardous Wastes.
• Sharps.
• Waste Electrical Items.

9
Hazardous Properties

• Chemical Hazard
• Medicines even small amounts
• Infection Hazard (H9)
• Only highly pathogenic infections
• (Group A pathogens)
• such as Smallpox, Ebola, Viral Hemorrhagic fever
  (full list follows)

10

• Crimean-Congo haemorrhagic fever virus
• Ebola virus
• Flexal virus
• Guanarito virus
• Hantaan virus
• Hantavirus causing haemorrhagic fever with renal
  syndrome
• Hendra virus
• Junin virus
• Kyasanur Forest disease virus
• Lassa virus
• Machupo virus

• Marburg virus
• Monkeypox virus
• Junin virus
• Kyasanur Forest disease virus
• Lassa virus
• Machupo virus
• Marburg virus
• Monkeypox virus
• Nipah virus
• Omsk haemorrhagic fever virus
• Sabia virus
• Variola virus

11
Hazardous Waste Stream

• The only hazardous waste streams within Mersey
  Care NHS Trust will be for sharps.
• No YELLOW BAG waste stream will remain.
• Plain YELLOW BAGS should NOT be used.

12
Used Virkon Granules

• Used Virkon is licensed to be disposed of down
  the drain.
• They should be disposed of down a toilet, sluice
  or drain, and never placed into clinical waste
  bags.

13
Other Hazardous Wastes

• Old Fridges
• Fluorescent Tubes
• Old Televisions, Computers etc
• Used Engine Oil
• These items should be collected by special
  arrangement with the porters/transport dept at
  Ashworth.

14
Non Hazardous Wastes
Everything Else All other waste
15
Colour Codes for Hazardous Waste

• Sharps

16
What happens to Hazardous Waste

• All hazardous clinical waste (sharps) must be
  incinerated.

17
Infectious Waste

• Waste which has been assessed as containing
  pathogenic organisms.
• Infectious properties should not generally be
  assumed.
• Standard (Universal) precautions should still be
  applied when handling body fluids, and using
  Personal Protective Equipment

18
How do I know if waste is Infectious?

• Soiled dressings from wounds where there is
  evidence of infection.
• During confirmed outbreaks of DV treat all
  vomit and faeces as infectious.
• Blood from known Blood Borne Virus infected
  patients (HBV,HIV,HCV)
• Personal Protective equipment contaminated with
  body fluids from infected patients.

19
What happens to Infectious Waste

• Infectious waste does NOT need to be incinerated.
• Infectious waste can go to Alternative
  Treatments this means it can go to special
  facility which heats the waste with steam to kill
  the pathogens (autoclaving) the remaining waste
  can then go to deep landfill.

20
Offensive - Tiger Waste

• Clinical waste which does not pose a known
  infection risk is classed as Offensive Waste
• This waste should form the majority of clinical
  waste in Mersey Care NHS Trust

21
Examples of Offensive Waste

• Incontinence Pads.
• Urine Collection Pots.
• Disposable Colostomy Bags
• Sanitary Towels
• Catheters and urine collection bags
• Bed pans and Urine Bottles
• Body fluid soiled, gloves, aprons, dressings and
  paper towels (from uninfected patients)

22
What happens to Offensive Waste?

• Offensive waste can go direct to DEEP landfill.
• Deep landfill simply means it is buried beneath
  other waste and not just tipped only the surface
  of the landfill site.

23
Household Waste

• The Majority of waste produced by Mersey Care NHS
  Trust is household waste.
• This is a non-clinical waste.
• Household waste normally goes into black bags
  (Paper Azo-sacks in High Secure)
• Household waste is much cheaper to dispose of
  than other types of waste.

24
Household Waste Examples

• Paper Towels
• Plastic cups
• Newspapers.
• Rinsed Medicine Tots.
• Packaging from medication
• Uncontaminated, gloves and aprons
• Flowers
• Small uncontaminated Dressings and Bandages
• (less than 220mm x 130mm 8½ x 5)
• THIS IS NOT AN EXHAUSTIVE LIST

25
What happens to Household Waste?

• Household waste can be disposed of directly to
  landfill.
• It can be collected by the council.
• There is no requirement to bury household waste.
• Household waste is much cheaper to dispose of
  than other types of waste.

26
Community Settings

• Special rules apply to Community settings
• In the Community, up to 50 Offensive Waste can
  be placed into the household waste stream with
  the clients consent.
• Community Patients in their own homes,
  residents of care homes (without nursing care)
  This does not apply to any healthcare centres or
  community clinics.

27
Bins, Boxes and Bags
28
Clinical Waste Bin Labels
29
Household Waste Bin Labels
30
Hospital Waste Stream Colour Coding Posters 1
31
Hospital Waste Stream Colour Coding Posters 2
32
Community Waste Stream Colour Coding Posters 1
33
Community Waste Stream Colour Coding Posters 2
34
Waste Collection Bins
Offensive/Tiger Waste Infectious Waste
Sharps
35
Time to test your knowledge

• In your packs you will find a set of 4 cards each
  represents a different waste stream
• Yellow Sharps
• Orange Infectious
• Yellow and Black Offensive/Tiger
• Black - Household

36

• For each of the following scenarios hold up the
  colour card that you think represents the correct
  stream for the waste described.

37
Scenario 1

• Six clients on your ward have had diarrhoea and
  vomiting in the past 24hrs.
• No samples have been obtained to date
• Infection Control have closed the ward to
  admissions.
• A previously asymptomatic client has diarrhoea.
• You clean up the client, wearing apron and
  gloves.
• Where do you put your used PPE?
• Hold up the card which represents the correct
  colour waste stream.

38
Scenario 2

• You have just discharged a patient
• You have removed the old linen from the bed into
  a white linen bag and cleaned the bed with Virkon
  spray.
• Where do you put your used apron and gloves ?
• Hold up the card which represents the correct
  colour waste stream.

39
Scenario 3

• You have just given a client a depot injection
  using a safety needle and syringe.
• Where do you put the used needle and syringe?
• Hold up the card which represents the correct
  colour waste stream.

40
Scenario 4

• A doubly incontinent client uses incontinence
  pads.
• You have given the client a shower since they
  have become cover in faeces.
• Your PPE is contaminated with body fluids
• Where do you put the used incontinence pad and
  contaminated PPE
• Hold up the card which represents the correct
  colour waste stream.

41
Cascading

• Please display the new colour code posters in
  your clinic rooms.
• Please cascade the information on the new waste
  streams to all staff back in your clinical area.