Healthcare Waste Management and Infection Control

This assignment delves into the crucial aspects of healthcare waste management and infection control. It explores proper disposal techniques, legal regulations, and the impact of improper waste handling on public health. Students analyze a case study involving a student nurse's wasteful practices and propose solutions to address this issue. Ethical considerations related to patient confidentiality are also discussed through a scenario with an infected patient.

Course : Diploma of Nursing (Enrolled-Division 2 Nursing)
Course
Offer : 16VDONC2
Course
Unit : HLTIN403C Implement and monitor infection control policy
and procedures
Assessmen
t type : Question and answers
1. Identify 3 (three) industry codes of practice relevant to infection control in
a healthcare setting.
Ans:- 1. Ensuring the use of appropriate antimicrobial agent and reducing the risks
of antimicrobial resistance.
2. To maintain a clean environment and to practice hand and hygiene.
3. Provision of adequate isolation facilities.
2. Briefly describe the significance of infection control auditing in a
healthcare setting (In minimum 30 words).
Reference document: Australian Guidelines for the Prevention and Control
of Infection in Healthcare (2010), Page 220.
Ans:- The infection control audit is normally conducted to check whether the
infection control strategies taken up in a health care setting is in compliance with
the government infection control policies (Biswal 2013). It acts as an important
tool for improving the standards of the infection control practice and to raise
awareness among the clinical staffs regarding the importance of infection control.
3. Identify 3 (three) management level personnel responsible for
organization-wide infection control.
Ans:- 1. Human Resource Manager
2. Nurse administrator.
3. Infection control coordinator
4. VCHN Regional Health recently implemented an infection control policy and
protocol on spills management. Protocol is given below:
Infection Control - Spills Management - Biological, Chemical and Waste
Protocol

Procedure:
Risk Management: Because the status of all person regarding blood-borne
infections are unknown, spills of biological fluids (blood and body fluids) must be
considered to have the potential for infection transmission. To prevent the
possibility of infection transmission, spills need to be dealt with promptly and
effectively.
Equipment:
 Blood spill kit for biological spills (containing Bio-waste absorbent)
 Gloves, protective glasses and impermeable gown
 Dust pan and scoop
 Hazard signs
 Paper hand towels
 Neutral detergent
 Mop and bucket
 Infectious waste bag
Method:
Biological Spills
 Biological spills are cleaned immediately
 Collect spill cleaning kit
 Don protective apparel from kit, including gloves, plastic apron, protective
glasses
 Place hazard signs around the spill
 Pour Bio-waste infectious waste absorbent sparingly onto spill, wait until it
turns into a jelly consistency
 Remove as much of the spill as possible with the dustpan and scoop and
dispose it immediately into infectious waste bag
 Use more paper towel to wipe- up spill completely
 Clean the spill site with hot water and neutral detergent
 Place all materials used in infectious waste bag, including gloves
 Seal waste bag, and place in appropriate waste storage area
 Wash hands
 The person who found and attended to the clean-up of the spill is
responsible for restocking the spill kits and notifying the Infection Control
Practitioner if additional equipment is required.
 Complete Incident Report form
 Chlorinated disinfection is only to be used for a highly infectious case, e.g.
Avarian flu, CJD, gastro-enteritis.
It is likely that all products that can clean spills of blood on carpets will cause
damage to the carpet.
Spills on carpet should be managed as follows:
 Clean immediately

 Place Hazard signs around the spill
 Collect Spill Kit from pan room, decontamination room in theatre, east pan
room in Residential Care and in the store room at Oncology Centre.
 Remove as much of the spill as possible with the dustpan and scoop and
dispose it immediately into infectious waste bag
 Other body fluids spill shall be removed with an approved carpet cleaner or
detergent in the same manner as non-carpeted areas
 If staining of the carpet or upholstery is likely, notify the Nurse Unit
Manager / After Hours Clinical Co-ordinator who will organise a
professional cleaner as soon as practicable
 Complete Incident Report form
 Chlorinated disinfection is only to be used for a highly infectious case, e.g.
Avarian flu, CJD, gastro enteritis
 The person who found and attended to the clean-up of the spill is
responsible for restocking the spill kit and notifying the Infection Control
Practitioner if additional equipment is required.
Chemical Waste Spill:
 Isolate spill and using signs keep area clear
 Response will vary depending on the chemical
 Relevant Material Safety Data sheets are available from the MSDS folder
in the work area
 Immediately notify the Environmental Services Manager or for afterhours
contact the After Hours Clinical Co-ordinator
 Complete Incident Report form.
General Waste:
 Protective clothing shall be worn
 Pick up waste with a dustpan and scoop and place in green waste bag
 Mop area with hot water and neutral detergent.
Protocol reference number: 271
Date Issued: 18/9/2014
Date of Next Review: 9/9/2016
Approved By: Chief Executive Officer
Contact Person: Deputy Director of Clinical Services
Developing Team Lead: Janet James
How would you respond to the following scenarios? Read the scenarios and
provide responses adequately referring to the protocol attached.

Ms. Pam Albert is a recently joined housekeeping staff at VCHN Regional Health.
Mr. Ian Murdock is an EN and a member of Infection Control Committee (Better
Practice Advisors) at this facility. Ian is delegated to monitor Ms. Pam's work
practices as part of quality and compliance monitoring.
Ian supervised Ms. Pam while she was attending to a general waste spill (heavily
soiled incontinence pads on the floor) in a medical ward. The following are the
observations made by Ian on Pam's work practices.
 Pam used dustpan and scoop to pick up waste and placed in green waste
bag.
 Pam mopped area with hot water and neutral detergent.
 Pam did not wear any protective clothing other than gloves while
managing the general waste.
 Pam did not use hazard signs while mopping the floor.
4.1Discuss the infection control risk in this scenario (minimum 20 words).
Ans: - Infectious agents can be transmitted to other wards of the hospital as Pam
did not use any signs of keeping the area clear. Someone can walk past that area
and may transmit the germs via shoes or socks. Improper disposal of the infectious
wastes may cause drug resistant diseases (Nhmrc.gov.au. 2018). Infections
spreading to neonatal wards may be fatal.
4.2Did Pam comply with the Infection Control - Spills Management - Biological,
Chemical and Waste Protocol? Provide rationale to support your argument
(minimum 30 words). However, Pam is in need of more training.
Ans:-Although Pam almost followed the protocol for the management of general
wastes but, Pam would have used signs or texts to indicate that the bag contains
infectious wastes. Pam could have worn other protective clothing along with the
gloves. The Blood soiled pads or adult diapers may carry infectious pathogens
which can spread if not discarded properly.
It was necessary to use hazard signs while mopping the floor as the floor might
contain infectious germs that can be carried to the hospital wards via shoes
(Biswal 2013).
4.3After monitoring Pam's work practices, Ian discussed the observations with
Pam. It was evident from the discussion that Pam does not possess an insight into
Infection Control - Spills Management - Biological, Chemical and Waste Protocol
implemented in VCHN Regional. Pam did attend the orientation provided to her
on day one and two. However, Pam is in need for more training.
Whom could Ian liaise with to organise further training or coaching for Ms Pam
on Infection Control? Identify two significant personnel.
Ans:- Apart from Ian , a registered nurse and consultant microbiologist can be

present. A registered nurse would give a better insight of the places in the hospital
that required more attention in terms of infections and a more detailed description
of the VCHN Regional Health Policies. The microbiologist can provide
information regarding the different portals of entry of the microbes and the
diseases caused by them.
4.4Write in your own words how Ian could provide a constructive feedback to
Pam based on the discussions above. Include the information on the infection
control protocol in your answer (Minimum 100 words.)
Ans: - Female hygiene stuffs and used adult diapers can account for nosocomial
infections and can be lethal to certain patients. Hence it is necessary to maintain
the protective gears. Pam should have used a face mask and a leg protector as well
while clearing out the wastes. Pam should have used hazard signs around the
wastes unless the spill is clear. While dealing with blood soiled pads it is
necessary to dispose the wastes with the help of a pan (Chartier 2014). While
cleaning the blood spills it is necessary to cover the spill with an absorbent
clumping for allowing the spill to absorb. After washing the area with a detergent
solution, it is better to cleanse the area with sodium hypochlorite solution. Hand
and hygiene should be performed after the procedure.
4.5Ian considers the statement 'Protective clothing shall be worn' as vague. How
could Ian re-write the statement to be more specific and clear to the staff?
Ans: - Protective clothing like latex gloves, face masks, coveralls, leg protectors
and hospital aprons should be worn (Mayhall 2012).
4.6 Identify another possible area of improvement (any inadequacy) in the
protocol.
Ans: - There has to be differently coloured plastic bags for the disposal of the
general wastes and highly infectious wastes. After the cleaning of the spills, it is
important to restock or replace the spill kit with a new one, such that they are
readily available in times of need. It is better that the kit should be used in a 6
gallon leak proof bucket. A laminated copy of the spill cleanup procedures should
be provided to the new comers handling with spills (Chartier 2014).
4.7 What could Ian do to ensure these inadequacies are corrected and included in
the protocol? Include in your answer how Ian could involve the healthcare team
members in amending the protocol (minimum 30 words).
Ans: - Inadequacies should be brought under the notice of the registered nurse, the
quality improvement coordinator or finally under the occupational health and the
safety committee. It is important to point out the changes and the rationale behind
the changes, and then record them officially on paper before proposing them in
front of the committee.
4.8 Adopting the role as Ian, complete the report template “Attach Files" section
of the question.

5. Crystal, enrolled nurse, is taking care of Mr. Adam who is infected with
hepatitis B (HBV). Adam is concerned about the stigma and discrimination
associated with his hepatitis B virus (HBV) status. Provide responses to the
following questions based on this scenario.
5.1 Why is it important to maintain Mr. Adam privacy and confidentiality in
relation to his infectious status? (minimum 30 words)
Ans: - Hepatitis B virus is transmitted through blood, semen or other infected body
fluids. Hepatitis B can be transmitted through unprotected sex with infectious
partners. Thus the patient might experience a high level of stigma, shame and
anxiety which can destroy their dignity and integrity. Destruction of the dignity
may further deteriorate their physical and mental health status. Maintenance of the
privacy and confidentiality of a person is one of the ethics of nursing that should
not be breached.
5.2 Explain briefly how Crystal could address the client confidentiality in this
scenario?
Ans: - Confidentiality shall be maintained while dealing with the medical records.
Electronic health records shall be well preserved under legal laws to prevent any
unauthorised access. Separate rooms shall be managed and care should be taken
such that any medical discussions are not overheard. Medical reports should only
be disclosed to authentic person or for public welfare.
6. You observed that Emma, a student nurse, always takes one additional wound
dressing pack while performing wound care to clients. This pack usually remains
unpacked and is thrown away with the used materials. Is there any issue in this
scenario? What could you do in this scenario being a responsible enrolled nurse?
(minimum 30 words)
Ans: - Prevention of the wastage of excessive clinical toolkits can be helpful in
reducing the health care cost of a particular health care setting. Emma can take the
additional wound dressing pack, but it should be preserved at a secured and a
clean place such that it can be used further.
As a responsible nurse I would try to encourage Emma to do the dressing using
one pack only and if she needed one then an extra dressing pack can be brought
from the storage.

References
Biswal, S., 2013. Liquid biomedical waste management: An emerging concern for
physicians. Muller Journal of Medical Sciences and Research, 4(2), p.99.
Chartier, Y. ed., 2014. Safe management of wastes from health-care activities. World Health
Organization.
Magill, S.S., Hellinger, W., Cohen, J., Kay, R., Bailey, C., Boland, B., Carey, D., de Guzman,
J., Dominguez, K., Edwards, J. and Goraczewski, L., 2012. Prevalence of healthcare-
associated infections in acute care hospitals in Jacksonville, Florida. Infection Control &
Hospital Epidemiology, 33(3), pp.283-291.
Mayhall, C.G., 2012. Hospital epidemiology and infection control. Lippincott Williams &
Wilkins.
Nhmrc.gov.au. (2018). [Australian Guidelines for the Prevention and Control of Infection in
Healthcare (2010) | National Health and Medical Research Council. [online] Available at:
https://www.nhmrc.gov.au/guidelines-publications/cd33 Accessed 7 Feb. 2018].