Universal Precautions: METHODS OF IMPLEMENTATION AND CONTROL All employees will utilize universal precautions (MIOSHA Rule 325.70005) Rule 5. Universal precautions shall be observed to prevent contact with blood and other potentially infectious materials. If differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials. Preventing an Occupational Exposure: The primary means of minimizing the risk of infection from bloodborne pathogens is minimizing the risk of exposure. This is done through the use of engineering controls, work practice controls, personal protective equipment, good housekeeping practices, and periodic review of these preventive measures. Components of this section include: Engineering Controls All Areas Medical Dental Work Practice Controls All Areas Medical Dental Personal Protective Equipment All Areas Medical Dental Housekeeping Cleaning and Disinfection Laundry Regulated Waste Sharps Containers Other Regulated Waste Handling and Disposal Sharps Containers Other Regulated Waste ENGINEERING CONTROLS Engineering controls act on the source of the hazard and eliminate or reduce employee exposure without reliance on the employee to take self-protective action. This is achieved through the use of equipment designed for this purpose. This office utilizes the following engineering controls: I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 1 of 18 Rev:
Dental Area Disposable sharps container Surgical Gloves (latex or nitrile) Utility gloves Dental instruments Amalgam scrap container Shield Lathe High volume evacuation Tongs/forceps Eye Wash Station Biohazard Waste bags Shield for Visible Cure Light Rubber Dams Cassettes Medical Safety Retractable Needles Labeled regulated waste Nitrile Surgical Gloves Utility gloves Eye Wash Station a. For each engineering control checked above, detail its use on the Engineering Controls chart on the next page. This chart describes when and how these items are used (under what circumstances or in which particular tasks or procedures). b. Van Buren/Cass County District Health Department s Nursing Director & Community Dental Clinics will inspect and maintain the engineering controls checked above. This inspection will be conducted at least annually. They may use, at their discretion, the Engineering Control Inspection Sheets which are included in the Forms section of the exposure control plan. This inspection will include evaluation of the effectiveness of existing engineering controls and review the feasibility of instituting more advanced engineering controls. c. The Director of Nursing and the Community Dental Clinics shall solicit input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps in the identification, evaluation, and selection of effective engineering and work practice controls and shall document the solicitation in the exposure control plan. They may do this, at their discretion, at staff meetings, in conjunction with the annual bloodborne pathogen training, by individual contact with employees, or at specially called meetings. d. In the dental office needle recapping is routinely done because such actions are required by a specific dental procedure. The justification for this procedure are that multiple injections and/or re-injections are necessary throughout many dental procedures. Needles are recapped to prevent an accidental needlestick exposure between injections. Needles are recapped using a needle recapping device or the one-handed scoop technique. e. In the Dental office needles are removed from the syringe because we use metal, non-disposable syringes that are sterilized after patient use. f. Outside the dental office, disposable syringes, and needles are used and discarded in a sharps container after each use. Lancets are used for finger sticks and are discarded immediately after use. g. In the Dental office regulated and liquid waste is disposed in an appropriate container that has a red Biohazard bag. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 2 of 18 Rev:
ENGINEERING CONTROLS MEDICAL CONTROL WHEN USED HOW USED Labeled Regulated Waste Whenever waste not appropriate Non-sharp contaminated items Containers for sharps container is produced, and not soaked with blood such as gauze, Kleenex, gloves, towels etc., are placed in this unit. Disposable sharps container Whenever needles or other sharps Needles, scalpels and other are used. sharps are placed in container immediately after use. Surgical Gloves Whenever the hands may come in Gloves placed on hands prior (Nitrile) contact with blood or other body to potential exposure and fluids. removed immediately after exposure. Utility Gloves For cleaning the work environment Gloves placed on hands prior and washing instruments. to cleaning activity and removed when finished. Safety Retractable Needle Whenever skin is pierced- After skin is pierced needle devices Injections/blood draws/tb tests retracts or is covered with a sheath Eye Wash Station Whenever blood, other body fluids, Subject places head in proper chemicals, or other foreign object alignment to have eyes rinsed that may have splashed into the with warm water to remove eye. any foreign object. Labeled Regulated Waste Containers ENGINEERING CONTROLS DENTAL CONTROL WHEN USED HOW USED Whenever waste not appropriate For sharps containers in produced and not soaked with blood. Non-sharp contaminated items such as gauze, Kleenex, gloves, towels etc., are placed in this unit. Disposable sharps container Whenever needles or other Needles, scalpels and other sharps are used. sharps are placed in container immediately after use. Surgical Gloves Whenever the hands may Gloves placed on hands prior (Nitrile) come in contact with blood or to potential exposure and other body fluids removed immediately after exposure. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 3 of 18 Rev:
Utility Gloves For cleaning to work Gloves placed on hands prior environment and washing to cleaning activity and instruments. removed when finished. Lathe Shield Whenever the lathe is used Shield is a part of the lathe for polishing or trimming and must always be present when using lathe. Autoclave All metal reusable instruments After cleaning instruments after each use. placed in autoclave and heated to 270 for 20 minutes. Eye Wash Station Whenever blood, other body Subject places head in proper fluids, chemicals, pieces of alignment to have eyes tooth or other foreign object rinsed with warm water to has splashed into an eye. remove any foreign object. Biohazard Waste Bags Amalgam Scrap Container When contaminated items such as gauze, Kleenex, towels, etc. are soaked with blood and/or teeth are removed. After amalgam restorative procedures Bags are placed on cart and used whenever there are items soaked with blood or teeth that have been pulled. Bags are removed immediately after use and placed in appropriate container for disposal. Deposit excess amalgam into container. High-Volume Evacuation During Dental procedures Placement adjacent to area being treated minimizes splashing and splattering of blood/saliva. Shield for Curing Light During dental procedures Hold shield between curing light and eyes. Tongs/forceps Rubber Dams Cassettes To pick up broken glass and contaminated reusable sharps in container. During dental procedures (RCT, Removal of amalgams and placement of composites to maintain dry sterile fields) Whenever hand instruments need sterilization Pressure on the tongs or forceps holds the items between the jaws so it can be transported. Suitable clamp and Rubber Dam material to be placed over area to be treated. Instruments are placed in individual compartments in the cassette then placed in sterilizer. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 4 of 18 Rev:
WORK PRACTICE CONTROLS Work practice controls also focus on the source of the hazard. They reduce the likelihood of exposure to blood or other potentially infectious materials through changes in the way in which a task is performed. The protection they provide is based upon the behavior of the employee. The following work practice controls are employed by this office: WORK CONTROLS ALL AREAS a. Hands should be washed immediately after removing gloves or other protective clothing, as soon as possible after hand contact with blood or other potentially infectious material, and upon leaving the work area. Hand-washing shall be completed using the appropriate facilities, such as utility or restroom sinks. Waterless antiseptic hand cleansers shall be provided on responding units to use when hand-washing facilities are not available. When hand-washing facilities are available, hands shall be washed with warm water and soap or antiseptic cleanser. When hand-washing facilities are not available, a waterless antiseptic hand cleanser shall be used. The manufacturer s recommendations for the product shall be followed. When antiseptic cleansers or towelettes are used, employees shall wash their hands with soap and water as soon as feasible. b. An employer shall ensure that employees wash their hands and any other skin with soap and water following contact of such body areas with blood or other potentially infectious material, or flush mucous membranes with water, immediately or as soon as feasible after contamination. c. Broken glass will be picked up by using a brush and dust pan, and discarded into a sharps container. Broken glass will not be picked up by hand. d. Needles will not be bent, broken or sheared. e. Eating, drinking or smoking is prohibited in the work area. f. Application of cosmetics or lip balm is prohibited in the work area. g. The handling of contact lenses is prohibited in the work area. h. The storage of food or drink is prohibited in the work area. i. All reusable equipment will be sterilized or decontaminated. j. If it is not feasible to sterilize some reusable equipment, it will be decontaminated. k. When reusable equipment is heavily soiled, it will be precleaned to remove the heavy contamination prior to decontamination. l. All tasks and procedures, will be performed in such a manner as to minimize splashing, spraying, spattering or generation of droplets of blood, saliva or other body fluids. m. Personal protective equipment will be utilized during every situation or procedure where exposure to blood, saliva or other body fluids is reasonably anticipated. n. While treating or working with patients, employees will refrain from touching materials not needed for the procedure. o. Employees should keep gloved hands away from eyes, nose, mouth or hair. p. Hair should be kept away from the face. q. A contaminated gloved hand should never touch patient charts. DENTAL AREA a. Impressions, bite registrations and appliances will be rinsed and disinfected before sending to the laboratory. b. Contaminated equipment will be labeled prior to servicing or shipping. c. Prescription glasses will be decontaminated prior to leaving the dental work area or prior to leaving the dental office. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 5 of 18 Rev:
d. No two-handed needle recapping is allowed but the one-handed scoop technique or use of a needle recapping device is acceptable in the dental office only. e. Biopsy specimens will be placed in a container that is labeled with biohazard label. Care will be taken not to contaminate the outside of the container by handling it with a contaminated gloved hand. f. All Healthcare workers and patients will be properly positioned at all times. g. Contaminated x-ray film packets will be opened in the darkroom or automatic processor with disposable gloves. h. All regulated and liquid waste is disposed of in an appropriate BioHazard waste container. i. All computer keyboards and mice will be wiped down using a hospital grade disinfectant after each use. MEDICAL AREAS a. Needles and syringes outside of the dental office used to penetrate the skin will be discarded immediately after use in a sharps container. b. Lancets will be disposed of in a sharps container immediately after use. c. Gloves will be worn whenever a gynecological exam is performed or any other exam with potential exposure to blood or body fluids. Where occupational exposure remains after institution of engineering controls and work practice controls, personal protective equipment will be provided as supplemental equipment. PERSONAL PROTECTIVE EQUIPMENT The Van Buren/Cass County District Health Department supplies the following personal protective equipment and is intended for employee protection against occupational exposure. The personal protective equipment will be of the proper size, material and will be readily accessible to all employees. Dental Area Masks/face shields Glasses with side shields Lab coats Gloves Uniforms Masks for CPR Medical Area Masks/face shields Glasses with side shields Lab coats Gloves Emergency Ventilation Devices Masks for CPR Goggles N95 masks a. The type and amount of personal protective equipment chosen to protect against contact with blood or saliva is based upon the type of exposure and quantity of these substances which can be reasonably anticipated to be encountered during the performance of a procedure. b. Van Buren/Cass District Health Department is responsible for providing, laundering, repairing, replacing and disposing of personal protective equipment. c. Personal protective equipment that is penetrated by blood will be removed immediately or as soon as feasible. d. All personal protective equipment will be removed prior to leaving the work area. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 6 of 18 Rev:
e. A new pair of gloves is to be used with each patient. Gloves are not to be washed or decontaminated for re-use but discarded immediately after use. f. All personal protective equipment shared by employees must be decontaminated between employee use. g. Personal protective equipment will be considered appropriate only if it does not permit blood or saliva to pass through to or reach the employee s work clothes, street clothes, undergarments, skin, eyes, mouth or other mucous membranes under normal conditions of use and for the duration of time the protective equipment will be used. h. For all personal protective equipment listed above, refer to the chart on the next page which describes where personal protective equipment is located, when it is to be worn, when it is to be changed, how it is to be decontaminated or disposed of and where it is to be stored after removal. i. The Director of Nursing and Community Dental Clinics will document annually, consideration and implementation of appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure. They may use, at their discretion, the Safety Device Evaluation form in the Forms section of the exposure control manual. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 7 of 18 Rev:
PERSONAL PROTECTIVE EQUIPMENT MEDICAL ITEM LOCATION WHEN TO WEAR DECONTAMINATION/DISPOSAL Face Masks, face shields, goggles, Clinic area in sites Designated by the Whenever protection is needed against likely When soiled by blood or bodily fluids, wash with soap and water glasses with side Director or exposure to blood or bodily or other cleansing fluid as soon shields supervisor fluids as procedures are finished. Exam gloves Same as above Same as above Remove as soon as procedure is finished and dispose in regular waste. Lab Coats Same as above Same as above Remove when contaminated, placed in washer (in-house) to be cleaned. Utility gloves Same as above Same as above May be washed and reused when dry. (Usually used for cleaning of work area) Emergency ventilation device, mask for CPR With AED device Whenever protection is needed against likely exposure to blood or other bodily fluids. After use the device must be cleansed according to the manufacturer s instructions or disposed of. N95 masks In immediate area of nursing staff Whenever protection is needed against likely exposure to airborne containments Must be used in accordance to manufacturer s instructions. These masks are replaced as needed. NOTE: Any shared equipment will be cleansed and decontaminated before use by another employee. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 8 of 18 Rev:
PERSONAL PROTECTIVE EQUIPMENT DENTAL ITEM LOCATION WHEN TO WEAR DECONTAMINATION/DISPOSAL Masks/face shields Operatory Treating patients Place in labeled container Glasses with side Operatory Treating patients Clean after treating patients with shields soap and 70% alcohol. *See Note below Lab Coats/uniforms Staff Room Treating patients Remove when contaminated Place in washer (in-house) to be cleaned Gloves Operatory Treating patients After used, place in labeled container for disposal. Disposable Operatory Anticipating splashing or Dispose of in regular waste container Garments splattering in each Operatory or sterilization area Emergency ventilation device, mask for CPR With AED device Whenever protection is needed against likely exposure to blood or other bodily fluids. After use the device must be cleansed according to the manufacturer s instructions or disposed of. NOTE: Wearing prescription glasses alone is not enough protection when performing a surgical procedure. Must also wear side shields and/or face shield for maximum protection. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 9 of 18 Rev:
HOUSEKEEPING 1. Cleaning and Disinfection a. Van Buren/Cass County District Health Department will ensure that the facility is maintained in a clean and sanitary condition. b. Van Buren/Cass County District Health Department has determined the appropriate schedule for cleaning and disinfecting the various surfaces, equipment and rooms in this facility. Refer to the Cleaning and Disinfection schedules. c. Sterilants and disinfectants are used in this office according to manufacturer s directions. All disinfectants (aerosol and/or non aerosols) used in this office will be EPA registered tuberculocidal hospital disinfectants and/or ADA approved disinfectants. d. The following protective coverings are used to protect the following surfaces and equipment from contamination: Type of Protective Covering Towels Paper Cover Impervious paper covers Head rest covers Plastic seals Use Tray Cover Examination Table Blood drawing surface Head Rest on Dental Chair Keyboard & Mice cover These protective coverings are replaced according to the following schedule: Towels Table Covers Impervious paper covers Head rest covers Plastic Keyboard & mice covers After Each Use After Each Use After Each Use After Each Use When worn & barrier broken e. Reusable dental instruments that could penetrate the skin are considered reusable sharps in this facility. When such instruments are stored or processed in containers, employees will not reach into the container by hand to remove these instruments. They instead will turn the container over to allow the instruments to spill out onto a counter where they can be handled safely. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 10 of 18 Rev:
CLEANING /DISINFECTING PROCEDURES FOR CLINICAL AND DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT EQUIPMENT A. Scales (all) Clinic Staff Each clinic session Phenolic Agent Gloves (Cetalcide G, Lysol IC, Caviwipes, Hillyard #181,etc) Or equivalent B. Centrifuge (same as above) (same as above) (same as above) Gloves C. Standing Lamps (same as above) (same as above) (same as above) Gloves D. Waiting Room Chairs Cleaning Crew Daily (same as above) Gloves E. Dental X-ray Dental Staff (same as above) (same as above) Gloves F. Keyboards & Mice Protective Screens Clinic & Dental Staff Each Use (same as above) Gloves (not the computer screen) G. Autoclave Dental Staff Exterior/Daily Interior/according to maint. schedule With approved autoclave cleaner H. Playroom Toys Cleaning Crew Weekly Soap & Water then spray with Sponge, gloves Lysol or equivalent I. Refrigerator Cleaning Crew Monthly Phenolic Agent (be sure to defrost first) Gloves Gloves Procedure: 1. Wear gloves while cleaning 2. Apply solution as directed on product label 3. Allow to air dry NOTE: This procedure applies to impervious external surfaces I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 11 of 18 Rev:
CLEANING PROCEDURES FOR CLINICAL & DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT EXAM AND TREATMENT EQUIPMENT A. Stethoscopes Clinic Staff After each use Phenolic Agent (Cetalcide G, Lysol IC, Caviwipes, Hillyard #181) or equivalent Gloves B. Lancets Nurse or Clinical Asst. Immediately after use None Disposable Sharps Procedure: 1. Lancets are disposed of immediately after use in Sharps container DENTAL OPERATORY Handpieces Dental Staff After each use Soap & Lysol or its equivalent Gloves Counters/Sinks Dental Chairs SEE HORIZONTAL SURFACES SEE EXAM TABLES AND DENTAL CHAIRS Procedure (for handpieces): 1. Wear gloves while cleaning 2. Wipe surface with disinfectant towel 3. Lubricate after each use 4. Autoclave after each use I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 12 of 18 Rev:
CLEANING PROCEDURES FOR CLINICAL & DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT EXAM TABLES AND DENTAL CHAIRS A. Exam Tables Clinic staff Daily or as needed Procedure: 1. Always wear gloves while cleaning 2. Clear table of covering 3. Wash with soap and water if necessary 4. Apply disinfectant solution, as directed on label 5. Allow to dry Phenolic Agent (Cetalcide G, Lysol IC, Caviwipes, Hillyard #181) or equivalent Gloves, Towel NOTE: This should be done after each clinic and also whenever a table is soiled during an examination. B. Dental Chairs Dental Staff After each use Phenolic Agent (Cetalcide G, Lysol IC, Caviwipes, Hillyard #181) or equivalent Gloves, Towel Procedure: 1. Always wear gloves while cleaning 2. Wipe and ReWipe with disinfectant towel 3. Allow to air dry NOTE: This should be done after each use I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 13 of 18 Rev:
CLEANING PROCEDURES FOR CLINICAL & DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT FLOORS A. Carpet 1. Vacuum Cleaning Crew Daily or as needed N/A Vacuum (canister type) 2. Shampoo Cleaning Crew as needed N/A Shampooer B. Tile Cleaning Crew Daily Phenolic Agent or its equivalent Procedure: 1. Cleaning solution must be changed periodically for each area as needed(dental, Clinic, Public Restrooms) Bucket, mop, sponge WALLS A. Walls surrounding toilets and urinals Cleaning Crew Daily Phenolic Agent or equivalent Gloves, sponge B. Other areas (same as above) as needed (same as above) Gloves, sponge HORIZONTAL SURFACES A. Lab/Exam Rooms/Dental Operatories (ie: areas for centrifuges/autoclave and all cabinets/counters/stands/drawers, etc.) Clinic & Dental Staff/Cleaning Crew Daily or as needed Phenolic Agent (Hillyard #181, Lysol Cetalcide G, Caviwipes) or equivalent Gloves B. Sinks (same as above) (same as above) (same as above) Gloves C. Paper Towel Dispensers (same as above) (same as above) (same as above) Gloves D. Other counters and surfaces (same as above) (same as above) (same as above) Gloves I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 14 of 18 Rev:
CLEANING PROCEDURES FOR CLINICAL & DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT SPILLS AND SOILS A. Blood, Urine, Vomitus, Feces Clinic & Dental staff with help of Janitorial (if available) Immediately after incident Sanitary absorbing agents such as Chlora Sorb or similar agent, Phenolic Agent (Hillyard #181 Cetalcide G and Lysol) or Cat Litter Dust pan, broom, paper towel, sponge, protective gloves. Procedure: 1. Always wear gloves while cleaning 2. Apply ChloraSorb or similar absorbing material - as recommended for vomitus and other spills. 3. For small spills or urine, absorb with paper towels. 4. Use germicidal agent, such as such as those listed above and use according to directions to disinfect the material and the soiled area. 5. Dispose of disinfected material in the regular waste. 6. Wash cleaning equipment 7. Dispose of disposable gloves or wash protective gloves. 8. Wash hands. 9. Return cleaning agents to their secure area. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 15 of 18 Rev:
CLEANING PROCEDURES FOR CLINICAL & DENTAL AREAS SUBJECT RESPONSIBLE PERSON WHEN AGENTS EQUIPMENT TRASH CONTAINERS A. Clinic Areas Cleaning Crew Daily Phenolic Agent (Hillyard Plastic trash bags #181, Lysol Cetalcide G, Caviwipes) or equivalent B. Dental Regulated Waste Dental Staff Daily (same as above) Plastic trash bags Containers C. Restrooms regular trash Cleaning Crew Daily (same as above) Plastic trash bags D. Sanitary disposal container (same as above) (same as above) (same as above) Impervious liners Procedures: 1. Always wear gloves. 2. Discard disposable items contaminated with body fluids, e.g., gloves, urine cups, cotton balls, in plastic lined trash container with lid. 3. Close bags and discard daily 4. Do not re-use plastic bags 5. Disinfect clinic area trash containers with Phenolic agent weekly. EYE WASH STATIONS A. Medical/Dental Lab Cleaning Crew Weekly 10% Bleach Solution Gloves Procedures: 1. Rinse covers with 10% bleach solution and flush with water for 15 seconds, then replace. Revised: 9/2007; 3/2008; 3/2011; 9/2011; 2/2014; 6/2015; 3/2016 I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 16 of 18 Rev:
2. Laundry a. Protective gowns (lab jackets) are considered contaminated laundry when soiled with blood or other potentially infectious material. b. Contaminated laundry will be bagged at the location where it was used and shall not be sorted or rinsed in areas where patients are cared for. Contaminated laundry will be placed in a red bag, which is labeled with a BIOHAZARD label. c. When contaminated laundry is wet and may present a reasonable likelihood of soak through from the bag, the laundry will be double bagged. d. BIOHAZARD bags are located in the dental and medical lab areas. e. Van Buren/Cass County District Health Department has a laundry facility in the Hartford, Dowagiac and Mattawan building. Employees may not take contaminated laundry home to be laundered. Contaminated laundry is cleaned and laundered at these facilities on a weekly basis or as needed using bleach with the laundry cleaning process. f. Employees are responsible for cleaning their own contaminated laundry using universal precautions. 3. Regulated Waste a. Regulated waste will be properly contained and disposed of so it will not become a means of transmission of disease to employees. b. Contaminated disposable sharps will be discarded into a sharps container immediately or as soon as feasible after use. In this office, sharps containers will be: * Closable (closed prior to removal or replacement). * Puncture resistant. * Leak-proof on sides and bottom. * Labeled with a biohazard label or be red in color. * Maintained upright during use. * Replaced routinely, and disposed of according to the Michigan Medical Waste Regulatory Act of 1990. * Located at each site where sharps are used. c. Other non-sharps regulated and liquid waste will be discarded into appropriate containers. In this office containers will be: * Closable (closed prior to removal or replacement). * Constructed to contain all contents and prevent leakage of fluids during handling, storage, transport or shipping. * Labeled with biohazard label or be red in color. * Located in each work area. * Disposed of in accordance to the Michigan Medical Waste Regulatory Act. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 17 of 18 Rev:
d. Whenever the outside of a primary container holding regulated/liquid waste becomes contaminated, it should be placed into a secondary container that meets the requirements of the first container. 4. Handling and Disposal a. Sharps Container Handling and Disposal Sharps containers shall be filled to designated fill-line capped. Filled containers will be stored in a secured area until picked up or transported for disposal. Every three (3) months (unless needed sooner) Stericycle will pick up filled and closed sharps containers. They will provide large boxes with red plastic bags. A receipt certifying incineration of these containers will be sent to the agency and kept on file with the Administrative Assistant. Partially filled sharps containers will be stored closed in a locked room within each Clinic. Each filled sharps container must be dated when locked. Contaminated sharps should be kept no longer than 3 months before being incinerated. Full sharp containers in Mattawan will be transported to Hartford for disposal. b. Biohazard Regulated and/or Liquid Waste Handling & Disposal Regulated or liquid waste containers with a BioHazard bag will be emptied each evening by Dental staff and a new red biohazard bag will be placed. These bags are placed in the lab area for pickup of housekeeping that will dispose of bag in appropriate container. Every three (3) months (unless needed sooner) Stericycle will pick up regulated/liquid waste BioHazard bags/boxes. They will provide appropriate containers for housing bags until pickup. A receipt certifying incineration of these bags will be sent to the agency and kept on file in the Administrative Assistant s office. c. Transporting Sharps Containers Whenever a partially filled sharps container needs to be transported to an office the lid should not be locked. Partially close opening and duct tape to prevent spillage. Sharps containers should be placed in upright in vehicle and in such a position that it will not tip easily. Duct tape should be removed once at facility and container placed in locked room until it is used and filled. If container is not to be used, the lid must be locked and container is placed in storage area for pickup for incineration. Container should be dated upon closure. It is not necessary to duct tape a sharps container when transporting when the lid is in the locked position. I:\R JOHANSEN\OPPM\VBCHD\Manuals\ExposureControlPlan\Current\MethodsofImplementationControl.docPage 18 of 18 Rev: