Hand Hygiene and Biomedical Waste Management
WHO five moments for hand hygiene
- Before touching a patient.
- Before a clean or aseptic procedure.
- After body fluid exposure risk.
- After touching a patient.
- After touching patient surroundings.
Technique and timing
Alcohol-based hand rub: a coin-sized amount, 20-30 seconds, covering palms, backs, finger webs, knuckles, thumbs, fingertips and wrists, rubbed until dry. Soap and water: 40-60 seconds, ten strokes at each step, dried with a paper towel that is then used to turn off the tap. Soap and water is mandatory when hands are visibly soiled, after using the toilet, before eating, and for spore-formers such as C. difficile and norovirus, because alcohol does not kill spores. Nails short, no rings, no wristwatch, no artificial nails.
Biomedical waste: Biomedical Waste Management Rules, 2016
- Yellow bag: human anatomical waste, soiled dressings, expired medicines, chemical and cytotoxic waste, discarded linen.
- Red bag: contaminated recyclable plastic such as IV tubing, bottles, gloves and catheters.
- White translucent puncture-proof container: sharps - needles, blades, broken glass ampoules.
- Blue container: glassware and metallic implants. The 2016 rules removed the green category; general waste goes to the municipal stream. Bins are filled to three-quarters, labelled with the biohazard symbol, category and date, and untreated waste is stored no longer than 48 hours. Never recap, bend or break needles by hand.
Worked example
After a dressing change the GDA finds a used needle, a blood-soaked gauze and an unsoiled glucose bottle. The needle goes to the white sharps container, the gauze to the yellow bag, and the bottle to general waste - not the red bag, which is only for contaminated recyclable plastic.
Traps that cost marks
- Putting sharps in yellow or red.
- Using a green bin under the 2016 rules.
- Wearing gloves as a substitute for hand hygiene.