SANS 10248-2-2009 Management of healthcare waste - Part 2 Management of healthcare risk waste for healthcare facilities and healthcare providers in rural and remote settings《医疗废物管理.pdf

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1、 Collection of SANS standards in electronic format (PDF) 1. Copyright This standard is available to staff members of companies that have subscribed to the complete collection of SANS standards in accordance with a formal copyright agreement. This document may reside on a CENTRAL FILE SERVER or INTRA

2、NET SYSTEM only. Unless specific permission has been granted, this document MAY NOT be sent or given to staff members from other companies or organizations. Doing so would constitute a VIOLATION of SABS copyright rules. 2. Indemnity The South African Bureau of Standards accepts no liability for any

3、damage whatsoever than may result from the use of this material or the information contain therein, irrespective of the cause and quantum thereof. ISBN 978-0-626-23414-0 SANS 10248-2:2009Edition 1 SOUTH AFRICAN NATIONAL STANDARD Management of healthcare waste Part 2: Management of healthcare risk wa

4、ste for healthcare facilities and healthcare providers in rural and remote settings Published by SABS Standards Division 1 Dr Lategan Road Groenkloof Private Bag X191 Pretoria 0001Tel: +27 12 428 7911 Fax: +27 12 344 1568 www.sabs.co.za SABS SANS 10248-2:2009 Edition 1 Table of changes Change No. Da

5、te Scope Foreword This South African standard was approved by National Committee SABS TC 1087, Disposal of healthcare waste, in accordance with procedures of the SABS Standards Division, in compliance with annex 3 of the WTO/TBT agreement. This document was published in November 2009. This document

6、supersedes SANS 10248:2004 (edition 2) in part. Annex B forms an integral part of this document. Annexes A and C are for information only. Introduction This document was developed as a result of the difficulties that rural and remote settings encounter in the management of healthcare waste (see anne

7、x A). Certain sections in SANS 10248-1 are repeated in this part to indicate the differences. This document gives guidance and help for alternative ways in which healthcare risk waste can be managed effectively as an interim measure. Guidance is also given for emergency situations, taking into accou

8、nt the constraints under which some of the healthcare facilities operate. The document can be used as a step in the process of continuous improvement in the management of healthcare waste in rural and remote settings. Exposure to healthcare risk waste can result in health risks to the public, patien

9、ts, healthcare workers, waste workers and the environment. Waste management measures can reduce such risks substantially. Effective containment of waste and safe handling measures can provide significant protection, for example, a) segregation can reduce the amount of healthcare waste instead of acc

10、umulating large quantities of waste; b) good stock management of chemicals and pharmaceuticals not only reduces waste quantities but also saves purchase costs; c) proper identification of healthcare risk waste packages warns healthcare personnel and waste handlers about its contents; and d) segregat

11、ion of healthcare risk waste makes it easier to decide on the method of disposal and treatment. Where there is a lack of infrastructure, this standard should not be used to contravene any legislative requirements or allow for any circumstances that can expose the healthcare workers, patients or the

12、general public to the hazards of healthcare risk waste. SANS 10248-2:2009 Edition 1 1 Contents Page Foreword Introduction 1 Scope . 3 2 Normative references. 3 3 Definitions. 4 4 Requirements . 5 4.1 General. 5 4.2 Documentation requirements. 64.3 Contractual commitments 6 4.4 Work procedures and wo

13、rk instructions. 6 4.5 Training 84.6 Workplace hygiene. 8 4.7 Health and safety . 9 5 Identification, classification, segregation and collection of healthcare waste 9 5.1 Identification . 9 5.2 Classification 10 5.3 Waste segregation . 11 5.4 Collection 11 6 Packaging requirements for healthcare was

14、te. 12 6.1 Packaging for healthcare general waste 12 6.2 Packaging for infectious healthcare risk waste 13 6.3 Packaging for sharps . 14 6.4 Packaging for chemical waste 15 7 Healthcare risk waste store 17 7.1 General. 17 7.2 Storage of infectious waste 18 7.3 Provisions for pharmaceutical waste . 1

15、9 7.4 Provisions for chemical waste 19 8 Transport of healthcare risk waste . 19 8.1 General. 19 8.2 Transport of healthcare risk waste off-site. 19 9 Treatment and disposal methods. 20 9.1 On-site treatment and disposal 20 9.2 Off-site treatment and disposal 21 9.3 Transfer stations 21 SANS 10248-2

16、:2009 Edition 1 2 Contents (concluded) Page Annex A (informative) Healthcare facilities and providers, and types of problems typically experienced in rural and remote settings 22 Annex B (normative) National legislation and other publications. 24 Annex C (informative) Examples of forms. 26 Bibliogra

17、phy. 30 SANS 10248-2:2009 Edition 1 3 Management of healthcare waste Part 2: Management of healthcare risk waste for healthcare facilities and healthcare providers in rural and remote settings 1 Scope This standard specifies provisions and requirements for the safe management of healthcare risk wast

18、e for healthcare facilities and healthcare providers operating in rural and remote settings. 2 Normative references The following referenced documents are indispensable for the application of this document. For dated references, only the edition cited applies. For undated references, the latest edit

19、ion of the referenced document (including any amendments) applies. Information on currently valid national and international standards can be obtained from the SABS Standards Division. SANS 1518, Transport of dangerous goods Design, construction, testing, approval and maintenance of road vehicles an

20、d portable tanks. SANS 10228, The identification and classification of dangerous goods for transport. SANS 10229-1, Transport of dangerous goods Packaging and large packaging for road and rail transport Part 1: Packaging. SANS 10231, Transportation of dangerous goods Operational requirements for roa

21、d vehicles. SANS 10232-1, Transportation of dangerous goods Emergency information systems Part 1: Emergency information system for road transport. SANS 10232-3, Transportation of dangerous goods Emergency information systems Part 3: Emergency response guides. SANS 10248-1, Management of healthcare w

22、aste Part 1: Management of healthcare risk waste from a healthcare facility. VC 8054, Disinfectants and detergent-disinfectants. SANS 10248-2:2009 Edition 1 4 3 Definitions For the purposes of this document, the definitions in SANS 10248-1 and the following apply. 3.1 alternative usable or available

23、 as another possibility 3.2 alternative technology approved method, technique or process for microbial inactivation or for otherwise altering the biological, chemical or physical characteristics of healthcare risk waste to sterilize such healthcare risk waste by means of technology which do not cons

24、titute controlled combustion treatment 3.3 anatomical waste pathological waste waste that contains tissues, organs, body parts, blood and body fluids from patients, foetuses and animal carcasses, but excludes teeth and hair NOTE 1 Anatomical waste is considered as a subcategory of infectious waste e

25、ven though it can also include healthy body parts. NOTE 2 Blood and body fluids from healthy individuals do not fall under this category. NOTE 3 Animal carcasses generated by the public are not covered by this definition. 3.4 emergency situation situation where, for example, a supply of new sharps c

26、ontainers is delayed or not available, plastics bags for general healthcare waste are not available, or general healthcare waste or healthcare risk waste cannot be collected due to stormy weather, a strike or any other situation 3.5 formal homecare provision of healthcare to, for example, terminally

27、 ill patients, or assistance with childbirth, within a private dwelling by a qualified person that represents an organization 3.6 healthcare facility place or site where professional health services are dispensed to human or animal patients or where biological research is carried out, for example, l

28、aboratories, and includes, inter alia, hospitals, clinics, laboratories, rehabilitation centres, sick bays, old age homes, free-standing operating theatres, day units, mobile and stationary clinics, and field stations where biomedical samples are taken 3.7 healthcare general waste portion of waste t

29、hat poses a minimum degree of risk to human health and the environment, i.e. from administrative and housekeeping activities, for example, paper, pens, flowers, food packaging, plastics cooldrink bottles, old mops, builders rubble and garden waste, within the healthcare facility 3.8 healthcare provi

30、der individual, or an organization, that provides a level of primary healthcare to the community, and includes general practitioners, formal homecare and informal homecare, midwives and birth helpers SANS 10248-2:2009 Edition 1 5 3.9 healthcare risk waste human and animal anatomical waste, infectiou

31、s human and animal waste, sharps, chemical waste, pharmaceutical waste and radioactive waste generated by healthcare professionals, healthcare facilities and other non-healthcare professionals, for example, tattooists and taxidermists NOTE Healthcare risk waste is a subcategory of hazardous waste. 3

32、.10 healthcare waste all the waste generated by a healthcare facility and waste originating from healthcare undertaken at home 3.11 informal homecare provision of healthcare to, for example, ill patients, or assistance with childbirth or any other assistance required by ill patients, within a privat

33、e dwelling by family or community members 3.12 rural and remote setting formal or informal healthcare facilities in areas that are permanently or periodically difficult to access by road or rail, and where there are limited private or public services, for example, waste removal, electricity, water a

34、nd telecommunication 3.13 sharps items such as needles, syringes, blades or clinical glass, that are capable of causing cuts, abrasions or puncture wounds 3.14 transfer station authorized storage facility situated close to the main routes of waste management contractors for the temporary storage of

35、healthcare risk waste and to facilitate its transfer and removal for treatment and disposal at an authorized treatment facility 4 Requirements 4.1 General NOTE The types of healthcare facilities and providers, as well as the typical problems experienced in rural and remote settings are given in anne

36、x A. The manager, or the person in charge of the day-to-day running of a healthcare facility, or a healthcare provider, shall: a) retain overall responsibility for the management of healthcare risk waste in accordance with the relevant requirements and regulations of the current relevant national le

37、gislation (see annex B); b) ensure that there is a budget for the management of healthcare risk waste; and c) be trained in the identification, classification, segregation, containerization and storage of healthcare risk waste (see clause 5). SANS 10248-2:2009 Edition 1 6 4.2 Documentation requireme

38、nts The minimum documentation to be used in a healthcare facility operating in a rural and remote setting shall be: a) work instructions and work procedures that are documented, implemented and maintained; b) work instructions and work procedures for training that are developed in a comprehensible f

39、ormat (see 4.4); c) safety instructions and precautions for the handling and storage of all healthcare risk waste; d) an emergency response policy and strategy to deal with spills of infectious waste and chemical waste; e) emergency procedures in the event of a breakdown of basic facilities, for exa

40、mple, electricity, water, communications, or road access; f) procedures for recording all injuries in accordance with the relevant requirements and regulations of the current relevant national legislation (see annex B); and g) a policy that describes record keeping for waste management. 4.3 Contract

41、ual commitments 4.3.1 Where a healthcare facility in a rural and remote setting agrees to a contract with a waste management contractor, the healthcare facility shall ensure that the waste management contractor has a license or permit authorized by the relevant authority for the treatment or disposa

42、l (or both) of each category of healthcare risk waste in accordance with the relevant requirements and regulations of the current relevant national legislation (see annex B). 4.3.2 A healthcare facility in a rural and remote setting can have an agreement with a regional hospital for the removal and

43、transportation of the healthcare risk waste. Such an agreement shall be a written agreement. 4.3.3 The healthcare facility shall be responsible for the healthcare risk waste from generation to its final disposal in accordance with the relevant requirements and regulations of the current relevant nat

44、ional legislation (see annex B), even when a contract has been agreed to with a waste management contractor for the treatment and disposal of this waste. 4.3.4 The agreement between the healthcare facility and the waste management contractor can include requirements such as the different categories

45、of waste for disposal, approximate volume of waste, schedule for collection (where applicable), and documented evidence of the treatment and disposal of the waste. 4.4 Work procedures and work instructions 4.4.1 The work procedures and work instructions for the management of healthcare risk waste sh

46、all be in a format that is easy to read and that is comprehensible to operators. They shall also be in a language that is common in the area of the healthcare facility. Work instructions can be in the form of a picture or a drawing. An example is given in figure 1. SANS 10248-2:2009 Edition 1 7 Figu

47、re 1 Work instruction in the form of a drawing 4.4.2 The work procedures and work instructions shall cover at least the following: a) the identification of the healthcare risk waste category in accordance with 5.1 and table 1; b) the segregation of the healthcare risk waste into the correct colour-c

48、oded container (see 5.3 and table 1); c) cleaning and disinfection; d) the correct use of equipment and personal protective equipment; e) the storage of the healthcare risk waste at the point of generation until its collection; f) the storage of healthcare risk waste in the waste store; g) the on-si

49、te treatment of the healthcare risk waste, were relevant; h) visual warnings (see figures 2(a) and (b); and i) details on hazardous healthcare material, dangerous areas and technical facilities that can create hazards. Figure 2(a) Fire and open flames prohibited SANS 10248-2:2009 Edition 1 8 Figure 2(b) Contaminated sharps Figure 2 Examples of visual warnings 4.5 Training 4.5.1 The senior nursing manager or nursing supervisor of a healthcare facility in a rural and remote setting shall ensure that all nursing staff and assistants are trained in the