protect yourself and protect others biosafety in specimen collection and transport
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Protect yourself and protect others Biosafety in specimen collection and transport. Laboratory specimen: collection, safe transport and biosafety. Learning Objectives. At the end of the presentation, participants should be able to: Identify principles in biosafety Practice hand hygiene - PowerPoint PPT PresentationTRANSCRIPT
SEARO – CSR Training on Outbreak Investigation
Laboratory specimen: collection, safe transport and biosafety
Protect yourself and protect othersBiosafety in specimen collection and
transport
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Learning Objectives
• At the end of the presentation, participants should be able to:– Identify principles in biosafety– Practice hand hygiene– Identify protective equipment to use for
different routes of infection– Describe safe disposal of some hazardous
wastes
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Biosafety: protect the patient
• First Rule: single use equipment• Disinfect• Work in a clean, dedicated area
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Biosafety: protect yourselfUse personal protective equipment
–disposable gloves – laboratory coats / gown –mask –protective eyewear / face shields if procedure is likely to generate aerosols
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Personal Protection: Gloves
• Whenever possible, suitable gloves should be worn when handling biohazardous materials– not a substitute for
regular and proper hand hygiene
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Personal Protection: Hand hygiene
Alcohol based hand rubs are gold standard in health care settings (if hands not visibly soiled)
Photos: WHO
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Personal Protection: Hand hygiene
Alcohol based hand rubs must complement with hand washing with normal soap
Photos: WHO
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Infection control precautionsPrecaution Use Requirements Disease
ExampleContact Patients known or suspected to have
serious illnesses easily transmitted by direct patient contact or by contact with items in the patient's environment
•Gloves•Gown
Nipah, Ebola, chickenpox
Droplet Barrier to stop infections spread by large (>5 microns), moist droplets produced by people when they cough, sneeze or speak
•Contact precautions•Well-fitting mask •Eye protection
Influenza, SARS, parainfluenza
Airborne Patients known or suspected to have serious illnesses transmitted by airborne droplet nuclei
•Contact precautions•Droplet precautions• N95 mask•Isolation room (In hospital)
TB, Legionella, measles, chickenpox
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Biosafety: protect others, protect the environment
– Package samples appropriately for transport– Decontaminate spills - 10% bleach– Disinfect working areas – 1% household
bleach– Soak contaminated non-disposable
equipment/ material – 1% household bleach for 5 minutes
– Place waste in leak-proof bags– Ensure safe final management of waste– Protect cleaning personnel – coat, gloves
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Spill clean-up procedure• Wear gloves and other PPEs as indicated • Cover the spill with a cloth or paper towels • Pour an appropriate disinfectant over the cloth • Apply the disinfectant concentrically • After about 30 min, clear away the materials. • If with broken glass collect and deposit into a puncture-
resistant container• Clean and disinfect the area of the spillage • Dispose of contaminated materials • Report the incident
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Some chlorine products available in the market
Chlorine product % available chlorine
Bleaching powder 35%
Stabilized/tropical 25%
High-test hypochlorite 70%Liquid laundry bleach 5%
Liquid laundry bleach 7%
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Chlorine Dilution according to useChlorine Product
Household Bleach (5% active chlorine)Household Bleach (30% active chlorine)Calcium Hypochlorite powder or chlorine granules (70%)
Disinfection of excreta, cadavers, body fluids
0.5% available chlorine solution
Add 1 litre of bleach to 9 litres of water (1:10 solution)Add 16 grams (1 tablespoon) to 1 litre of waterDissolve 7 grams (1/2 tablespoon) in 1 litre of water
Disinfection of gloved hands, bare hands/ skin, floors, clothing and equipment, bedding0.05% available chlorine solutionAdd 100 ml of bleach to 9.9 litres of water
Add 16 grams (1 tablespoon) to 10 litre of waterDissolve 7 grams (1/2 tablespoon) in 10 litre of water
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Disinfecting water using a 1% stock solution
• What you need:– (4 pcs) plastic water containers (>= 10-litre)– 1% chlorine stock solution– (1 pc)) 5-ml syringe– Comparator or test strip– (40 litres) of water (10 litres in each
container)
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Disinfecting water using a 1% stock solution
• Process of disinfection:– Prepare 1% chlorine stock solution– Fill the containers with 10 litres of water each– Using a syringe, add progressively greater doses of
1% chlorine solution e.g., • 1st container – 1 ml• 2nd container – 1.5 ml• 3rd container – 2 ml• 4th container – 5 ml
– Let it stand for 30 minutes and measure residual free chlorine concentration with test trip
– Choose the sample with 0.4 – 0.5 mg/litre of free residual chlorine
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Preparation of 1%, 0.5% and 0.05% chlorine stock solution
Chemical product%
Available chlorine
1% chlorine For disinfecting:Water (to come up with 0.4—0.5 mg/ l of free residual chlorine)
0.5% chlorine For disinfecting:CadaversBody fluids
0.05% chlorine For disinfecting:Gloved hands, bare hands and skinFloorsClothing and equipment, beddings
Required amount
Approximatemeasurements
Required amount
Approximatemeasurements
Required amount
Approximatemeasurements
Bleaching powder(Chlorine of lime) 35 30 g 2 tablespoons 16 g 1 tablespoon 16 g 1 tablespoon
Stabilized/tropical 25 40 g 3 tablespoons 20 g 1 ½ tablespoons 20 g 1 ½
tablespoons
High-test hypochlorite(HTH or Calcium
hypochlorite)70 14 g 1 tablespoon 7 g ½ tablespoon 7 g ½ tablespoon
Liquid laundry bleach 5 200 ml 1 teacup or 6 oz tin 100 ml ½ teacup or
3 oz tin 100 ml ½ teacup or 3 oz tin
Liquid laundry bleach 7 145 ml 10 tablespoons 73 ml 5 tablespoons 73 ml 5 tablespoons
Javelle water 1 500 ml 2 ½ teacups or 15 oz 500 ml 2 ½ teacups
or 15 oz
Total amount of stock solution 1 litre 1 litre 10 litres
Mix the required amount of one of the given chemical products with clean water, making up to the total amount of stock solution (1 litre, 10 litres) in an airtight, opaque and non-metallic container.
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Some tips
• Handle the dry product with care. Avoid shaking and exposure to high temperatures or flames.
• Avoid direct contact with the chemical product. • Use clean water in preparing the stock solution.• Use non-metallic containers in preparing and storing
the solution.• Prepare and store stock solution in a well ventilated
area. • Avoid inhaling vapours and dust when opening or
handling the containers.• Solutions must be prepared daily and protected from
heat, light and moisture.
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Dispose sharp material in bio-hazard sharps containers
• If no sharps container: improvise one and collect sharps immediately to prevent needle-stick injury
• Have first aid kit readily accessible
• Do not reuse contaminated equipment
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Items Requiring Disposal
• Infectious blood, body fluids, leftover biological samples
• Disposable needles and syringes*
• Disposable or non-reusable protective clothing*
• Disposable or non-reusable gloves
• Used laboratory supplies*
• Used disinfectants
* Incineration recommended
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Building an Incinerator1. Cut out one end of a 220
liter drum
2. Cut out 3 half-moon openings
3. Cut 4 side holes and insert metal rods to form an X
4. Cut away half of other end of drum to form lid
5. Insert first end cut as a waste platform
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
How to burn waste in an Incinerator
1. Place waste on platform inside of the drum
2. Soak waste in one liter of fuel3. Light the fire carefully4. Watch the fire and frequently mix the
waste with the metal bars to be sure all of the waste is burned
5. When the fire has gone out, empty the ashes into a pit
Note: You must replace the incinerator if large holes burn through the sides.
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Disposal Using a Pit
• Can be used for disposal of:– Liquids, if no isolation latrine or toilet is
available– All other flammable items such as clothing
• Building a Pit:– Locate pit far from foot traffic flow– Dig 2 meters deep, wide enough to hold all
contaminated waste material
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
How to Burn Waste in a Pit
1. Place disinfected waste in the pit2. Pour fuel over waste3. Carefully start fire4. Observe burning process5. Repeat fire if waste remains after burning6. Cover ashes with soil7. Bury a nearly full pit with ½ meter of soil8. Dig a new pit for more waste
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation
Disposal Safety Precautions• Use safe handling practices for infectious
material
• Locate disposal site on health facility grounds, away from traffic flow and public view
• Maintain disposal site security by roping off, posting signs, and stationing a guard
• Do not leave unburned waste in an incinerator or pit
Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation