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Infection control and contaminated waste disposal practices in Southern Sydney Area Health Service Dental Clinics.

The sterilization and contaminated waste disposal practices in all 14 dental clinics operated by the Southern Sydney Area Health Service were surveyed. All of the clinics used autoclaves for sterilization. All hand instruments, handpieces and triplex syringes were autoclaved between patients. Chemical disinfection solutions were used in 12 of the 14 dental clinics, mainly for surface decontamination. Five dental clinics had separate storage areas for contaminated waste which compiled with contaminated waste separation and disposal guidelines. The practice of recapping needles with fingers and some inadequate washing facilities are areas that require particular attention.

Catchment Area, Health↗

Audit of waste collected over one week from ten dental practices. A pilot study.

An audit of the waste practices of ten general dental surgeries identified problems that have occurred due to the lack of specific dental guidelines or codes of practice in this area. Occupational health and safety requirements for types and locations of sharps containers, and lack of consensus on what constitutes a sharp, were identified as areas needing attention. Cross-infection control items, such as gloves, masks, single-use cups, and protective coverings, were found to constitute up to 91 per cent of total waste. When infectious waste was reclassified by the audit team as 'that waste which was visibly blood stained,' a reduction in waste in this category was made, during the audit, at each practice. The practice of disposing of radiographic fixer and developer into the sewerage system occurred in three out of the ten practices, even though the Australian Dental Association Inc. has discouraged this practice.

Blood↗

Ensuring injection safety during measles immunization campaigns: more than auto-disable syringes and safety boxes.

Measles immunization campaigns are effective elements of a comprehensive strategy for preventing measles cases and deaths. However, if immunizations are not properly administered or if immunization waste products are not safely managed, there is the potential to transmit bloodborne pathogens (e.g., human immunodeficiency virus and hepatitis B and hepatitis C). A safe injection can be defined as one that results in no harm to the recipient, the vaccinator, and the surrounding community. Proper equipment, such as the exclusive use of auto-disable syringes and safety boxes, is necessary, but these alone are not sufficient to ensure injection safety in immunization campaigns. Equally important are careful planning and managerial activities that include policy and strategy development, financing, budgeting, logistics, training, supervision, and monitoring. The key elements that must be in place to ensure injection safety in measles immunization campaigns are outlined.

Disposable Equipment↗

Basic infection control procedures in dental practice in Khartoum-Sudan.

OBJECTIVES: To survey the infection control procedures used by dental practitioners in Khartoum, Sudan. METHODS: Questionnaires were distributed to150 randomly sampled dentists practising in Khartoum state. Each questionnaire comprised 17 questions about basic infection control procedures. RESULTS: A 100% response rate to the questionnaire showed that 92% of dentists routinely wore gloves when treating patients, 50% face masks, 61% a gown and 14.7% protective eye wear. Furthermore 52% of the practitioners had been immunised against Hepatitis B. The majority of practitioners (72%) used dry heat as their method of instrument sterilisation, 22% used an autoclave, 2% used boiling water and the remainder used chemical sterilisation. Safe disposal of clinical waste was undertaken by only 23% of dentists although 47% of practitioners stored sharp items in closed containers. All respondents used disposable dental needles, but only a few used other disposable items. There was a significant difference in the implementation of cross infection control procedures between salaried and private dental practitioners, especially with regard to handpiece sterilisation, use of disposables, the wearing of face masks and the availability of additional sets of instruments. CONCLUSION: There is a clear need to improve the existing situation particularly with regard to immunisation of dentists against Hepatitis B, the safe disposal of clinical waste and instrument sterilisation in Khartoum.

Cross Infection↗

Reducing the risks related to the handling and disposal of health-care waste.

Guidelines on the management of hospital waste aim not only to minimise the risks posed to staff at all levels but also to contain potential environmental hazards, such as infection and sharps injuries. It is therefore important for all personnel to be vigilant and to ensure that they dispose of clinical waste safety and appropriately.

Guidelines as Topic↗

Model injection centre (MIC).

PATH, an international NGO in collaboration with Niloufer Hospital, Hyderabad has set up a centre called Model Injection Centre (MIC) at Niloufer Hospital. The concept of safe injections are practised on the clients visiting the institution and demonstrated to all those health providers who visit the MIC. The centre is supposed to address all the three components of injection safety issues: Safe to the recipient, safe to the health staff and safe to the community. The MIC offers an opportunity to observe and demonstrate safe injections being practised.

Ambulatory Care↗

Home medication injection among Latina women in Los Angeles: implications for health education and prevention.

Reuse of needles and syringes after home injection of medications and vitamins may be a risk for transmission of HIV. An exploratory study was done to determine (1) how commonly injectable medications were used in the home; (2) whether needles and syringes were reused; and (3) common practices for cleaning needles and syringes. A survey was conducted of low income Latina women (n = 216) who were attending a Public Health Foundation nutrition programme for women, infants and children (WIC) in Los Angeles. To clarify and expand on the survey findings, focus group interviews were done with an additional 55 women attending WIC. Quantitative data were analysed using descriptive and comparative statistics. Qualitative data were subjected to content analysis. The use of injectable medications purchased in Mexico was fairly common (43.5%); reuse of disposable needles and syringes (48%) and sharing (36%) among injectors were also common. Methods of cleaning needles and syringes were inadequate to CDC recommended guidelines. Injectors and non-injectors differed significantly in ethnicity, religion, and marital status. The only significant predictor of medication injection was educational level. Analysis of qualitative data revealed the reasons that Latina subjects were injecting medication; how they were transporting medicines from Mexico; and how they were cleaning their equipment. The practical implications for health education and prevention programmes should include an awareness that home use and reuse of needles for injection of medications may be common in some social groups and that knowledge of the potential dangers in reuse and sharing of needles may not extend to home medication injection.

Adult↗

The treatment of infectious waste arising from home health and medical care services: present situation in Japan.

The management of waste materials arising from home health and medical care services (HHMC wastes) in Japan is now receiving greater attention from governmental workers dealing with general household waste materials. In general, HHMC waste materials are collected in a mixed form, transported and disposed of along with municipal solid wastes. As a result, municipal workers are suffering needle stick accidents so that infections associated with HHMC waste materials may occur. The collection and transportation by patients and their families of HHMC waste materials with sharp-edges, such as injection needles, to medical-related facilities can prevent municipal workers from experiencing needle-prick accidents. One of the most important strategies for medical-related facilities is hence the education of patients and their families. Improved rules for handling HHMC waste materials are essential for the safe and effective management.

Data Collection↗

The nursing process: a tool for healing the environment.

Assessment, planning, implementation and evaluation can be useful in addressing environmental issues. "Eco-teams" can develop comprehensive waste management programs through implementing a "reduce, reuse, recycle, buy recycled" approach. Serious commitment to such behavior can result in significant savings while reducing dramatically the resources, energy and pollution associated with manufacture and disposal of many items commonly used in healthcare settings.

Environmental Health↗