Infection Control, Biomedical Waste Management and Occupational Safety
Domain overview
This domain tests standard precautions, sterilisation and disinfection, biomedical waste segregation and post-exposure safety. The examiner expects colour-code accuracy and correct immediate action.
Core rules and concepts
Standard precautions apply to every patient: hand hygiene at the five moments, gloves for body fluids, eye protection when splashing is likely, and safe sharps handling. Do not recap needles; drop them straight into a puncture-proof sharps container and replace the container when three-quarters full. Clean before disinfection. Autoclave at 121°C and 15 psi for 15–20 minutes and monitor with a biological indicator; dry heat uses 160°C for two hours.
Biomedical waste is segregated at the point of generation. Yellow: human anatomical waste, soiled dressings, expired medicines and cytotoxic waste. Red: contaminated recyclable plastics such as IV tubing and gloves. White: sharps in a translucent puncture-proof container. Blue: glassware and metallic implants. Store waste below 48 hours, label it with the biohazard symbol and date, and never mix categories.
For a blood spill, wear gloves, cover with absorbent material, apply freshly prepared 1% sodium hypochlorite for about 30 minutes, then clean.
Worked example
A nurse sustains a needle-stick injury from a blood-contaminated needle. She should wash the wound with soap and running water, not squeeze it, apply an antiseptic and report immediately. The source patient is assessed with consent for HIV, hepatitis B and hepatitis C. HIV post-exposure prophylaxis should start as soon as possible and within 72 hours; hepatitis B protection depends on vaccination status and may need immunoglobulin. Baseline and follow-up testing are arranged.
Traps that cost marks
Recapping needles; putting sharps in a red bag; mixing yellow and red waste; using too weak a chlorine solution for a blood spill; delaying PEP; and recording waste without the date or category.