Steps in biomedical was management

1. Nurses role on
INFECTION
CONTROL AND
BIO MEDICAL
WASTE
MANAGEMENT
E.Sundara Bharathi M.Sc (N)
Quality Council, Senior Nursing Officer,
JIPMER

2. INTRODUCTION
The waste that is generated
during
-the laboratory diagnosis,
-treatment or
-immunization of human
beings or animals
-or in research activities
-or in the production of
biological activities.

3. INTRODUCTION
conti
• on27th July,1998; Govt. of
India, The MoEF, introduced
the Bio-Medical Waste
(Management and Handling)
Rules under the provisions of
Environment Act 1986
• Revised in 2016
• Amended in 2018 also

4. OBJECTIVES
• To Provide a system of management.
• Identifying, defining & classifying.
• Disinfection/decontamination of infected items.
• Onsite appropriate ‘‘treatment technology’’.
• Creating a system.

5. Basic
principles
of
BMWM
• Authorization
• Not mix with general waste
• Segregation :BMWM rules 2016
• Labeling of bags.
• Transportation.
• Treated and disposed within 48 hours
• Vaccine
• Annual report.

6. COMPARITION
BMWM RULE 1998 BMWM RULE 2016
Categories Ten Four
Overlapping of
category
Yes No
Maximum limit for
release of furans
Not specified Specified
Incinerator
May have only One
chamber
Upgrade to have
secondary chamber
Chlorinated bags Using it
Phase out in two
years
Cytotoxic drugs Black cover bag Yellow bag
Use of bar code No concept
Introduced within one
year

7. Method of disposal Incineration/shredding
/sharp pits
The newer method –
plasma
pyrolysis/encapsulati
on/incineration
Occupier must have
disposal facility
Should have Not required within
75 kms
Giving treated BM
solid waste to the
municipal solid
waste( Incineration
Ash)
Allowed Not allowed
Majority of idea Discording the BMWs For recycling

8. GENERATION
SEGREGATION
COLLECTION
STEPS IN BMWM
TRANSPORTATION
TREATMENT
DISPOSAL

9. GENERATION
Bio medical waste generated in 2018.
CONTAINERS PER DAY IN Kgs PER MONTH IN Kgs
YELLOW 617 18523
RED 226 6806
SHARP 26 320
BLUE 132 3968
BLACK 2461 73859

10. SEGREGATION

12. SEGREGATION

23. BMWM PRACTICES FOR COVID-19
Color coded
bag/box
Broadly include
Items
Disposal method
Yellow
Infectious non-
plastic, non-sharp
Incineration
Red
Infectious plastic,
non-sharp
Autoclave or
microwave (recycle)
White Sharp box Sharp (metal) Sharp pit
Blue Box
Glass , metal
implants
Autoclave (recycle)

24. SPILL MANAGEMENT
• Need immediately action
• Kept Away from area.
• Extra Care for if is sharp present.
• Spills should be removed before
the area is cleaned.
• Allow ventilation.
• Avoid liquids on spill.

25. SPILL MANAGEMENT conti..
• Used 1% hypochlorite on a small spill.
• Chlorinating agents are not suitable for use on
soft furnishings.
• It is recommended that supplies of personal
protective equipment, paper towels and health
care risk/yellow waste bags are available for spills
management.
• If non- disposable cloths/mops are used to clean
spillage area they must be thermally or
chemically disinfected.

26. SPILLS KIT
• A spill kit should be readily available in each
clinical area and should include the following:
• Scoop and scraper
• Single use glove
• Protective apron
• Surgical mask and eye protector
• Absorbent agent
• Clinical waste bags and ties

27. SPILLS KIT conti..
• Disposable forceps
• Detergent
• Rough cloth
• Bleach
• Two card board pieces
• Instruction chart
• Buckets and mops of spills should be different from the
regular mops and buckets and should be cleaned
separately
• All parts should de disposed to ensure that cross-
contamination does not occur

28. MANGEMENT OF BLOOD AND OTHER
BODY FLUID SPILLAGES
SPILLS
SPOT
select appropriate PPE
wipe up spot immediately
with damp cloth, tissue or
paper towel
discard contaminated
materials in hypochlorate
perform hand hygiene
SMALL UPTO 10
CM
select appropriate PPE
wipe up spill immediately with
absorbent material
place contaminated absorbent
material into impervious container
or plastic bag for disposal
wipe the area with sodium
hypochlorite and allow to dry
perform hand hygeine
LARGE SPILLS >10CM
select appropriate PPE
wipe up spot immediately with damp cloth, tissue or
paper towel
Pour 1% over the spillage area
Cover this with a mop or towel for 10-15 minutes
Remove the mop with gloved hands and discard it in
yellow bag and Mop the area
Discard the gloves in Red bag
Wash hands with soap and water

29. BMW segregation Audit form at Covid unit
Date ward
Segregation
bags
available
Contents
Appropriate
to the bag
Total no.of
items
Yellow
Red
Sharp
puncture
proof box
1.Poster Yes/No
2.Spillage kit :
a) Mercury Yes? No
b) Blood Yes/No
Blue
cardboard
Black/gene
ral waste

30. BMW segregation Audit form at
collection point
Date ward
Segregation
bags
Available
Contents
Appropriate
to the bag
Total
no.of
items
Label
Tie
d
Yellow
Red
Sharp
puncture
proof box
Poster –Yes/No
Spillage kit –
Mercury Yes? No
Blood – Yes/No
Blue
cardboard
Black/gen
eral waste

31. REFERENCES….
• User manual of COVID19 BWM Version 1.0 on 28.05.2020 by
Central Pollution Control Board (Ministry of Environment, Forest
and Climate Change)
• HICC manual by MOHFW 2016
• JIPMER HICC manual, First Edition, 2016
• HICC workshop manual, JIPMER 2018
• Manual of Bio medical waste management, JIPMER 2016
• Bio medical waste management rules 2016, AIIMS, New Delhi.
• SOP for House keeping, AIIMS, Jodhpur.
• JIPMER IPC SOP CORONA 2nd version 09/04/2020
• https://ponocmms.nic.in
• http://pollutioncontrolboard.com/state/tamil-nadu-pollution-control-
board-tnpcb.html