protect yourself and protect others biosafety in specimen collection and transport

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SEARO – CSR Training on Outbreak Investigation Laboratory specimen: collection, safe transport and biosafety 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 Presentation

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Page 1: Protect yourself and protect others Biosafety in specimen collection and transport

SEARO – CSR Training on Outbreak Investigation

Laboratory specimen: collection, safe transport and biosafety

Protect yourself and protect othersBiosafety in specimen collection and

transport

Page 2: Protect yourself and protect others Biosafety 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

Page 3: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 4: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 5: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 6: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 7: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 8: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 9: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 10: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 11: Protect yourself and protect others Biosafety in specimen collection and transport

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%

Page 12: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 13: Protect yourself and protect others Biosafety in specimen collection and transport

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)

Page 14: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 15: Protect yourself and protect others Biosafety in specimen collection and transport

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.

Page 16: Protect yourself and protect others Biosafety in specimen collection and transport

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.

Page 17: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 18: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 19: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 20: Protect yourself and protect others Biosafety in specimen collection and transport

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.

Page 21: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 22: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 23: Protect yourself and protect others Biosafety in specimen collection and transport

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

Page 24: Protect yourself and protect others Biosafety in specimen collection and transport

Laboratory specimen: biosafety in specimen collection and transport SEARO – CSR Training on Outbreak Investigation