3. Objectives
• To prevent transmission of infection and outbreak
of diseases through proper handling and safe
disposal of waste within the nursing home.
• To provide a safe and hygienic environment in
nursing home.
5. Colour coded Waste
Disposal
Types of Waste
YELLOW BIOHAZARD BAG
• Gauze, Dressing soiled with large amount of blood and body
fluid
• Cytotoxic drug or waste placed in double white bag/ bin liner
SHARP BOX
• Used syringe, needles, lancets, glass vials, used ampules and
razor blades.
BLACK BAG AND BIN LINER
• General Waste- Office waste, foods, household waste, waste
items used by residents* (e.g. diapers, emptied urine bag, PD
Bags, dressings, gauze, and cotton swabs, general solid or
semi- solid pharmaceutical waste e.g tablets, capsules, creams
and ointment)
• *Residents include persons with colonized MDROs
6. Safe Disposal of Sharps
DOs DON’Ts
Keep safe working distance
from colleagues using
sharps
Place all sharps (needles,
ampoules, vials, shaving
blades, glass) intact into
sharp box
Locked and secure sharp
box once reach sharps
container’s marking or 2/3
filled.
Do NOT recap, purposely
bend or manipulate
needles.
Do NOT remove needle
from disposable syringes
Do NOT retrieve items
from sharp box.
Do NOT press down
sharps to make room in
sharp box.
Do NOT fill beyond
designated mark on
container.
7. Proper Waste Handling
1. Proper Hand Hygiene
2. Appropriate PPE
3. Waste Disposal Bags
4. Wastes bags and containers must be in good quality
5. All staff must not transfer contents in waste disposal
bags.
6. All waste bags shall be tied or secured when 3/4 full.
7. Waste bags shall be sealed with secure knot.
8. Safe Disposal of Pharmaceutical Waste
Medications should be disposed of promptly when:
a) Expired or when there is doubt about the expiry
date
b) Signs of deterioration
c) The treatment is discontinued and the medications
are no longer required by the resident
d) The resident is no longer residing in the nursing
home.
9. Transportation of Waste
1. Staff shall use designated wheeled trolleys to transport
waste bags/ sharps containers from service or care area to
sluice room.
2. Wheeled trolleys shall not be used for other purposes and
should be regularly cleaned with water and detergent.
3. Non-hazardous waste and hazardous should always be
transported separately.
4. All waste bags shall be intact and secured at the end of
transportation and place at designated area.
Wastes are collected, transported, disposed or incinerated by
the licensed toxic and industrial waste collectors, SEMBWASTE
Pte. Ltd. (68612874).
11. Types of Cleaning and Disinfection
Definitions
• Cleaning refers to physical removal of foreign material (e.g. dust, soil) and organic
material (e.g. blood, secretions, excretions, microorganisms) from objects and
surfaces.
• It is accomplished with water, detergents and mechanical action.
• Cleaning removes but nor does not kill microorganisms (ICA, 2014).
•Decontamination refers
to the process of cleaning
that removes pathogenic
microorganisms from
objects so that they are
safe to handle, use or
discard (ICA, 2014).
Disinfection refers to a
process that kills most
disease-producing
microorganisms.
Disinfection does not
destroy all bacterial spores.
Usually accomplished by
using liquid chemicals (ICA,
2014).
•Terminal cleaning refers to a procedure
required to ensure that an area has been
cleaned/ decontaminated following
discharge of a patient with an infection (i.e.
alert organism or communicable disease)
to ensure a safe environment for the next
resident.
12. Frequency of Routine Cleaning
SN Cleaning Method High Touch Area Low Touch Area Minimum Cleaning Frequency
1. Routine Cleaning Bed Rails At least once daily
Call Bell
Bedside table
Chair
Switches
Telephone
2. Routine Bed
Cleaning
(On Contact
Precaution)
Bed Rails At least once daily
Call bells
Bedside locker
Chair
Switches
Telephone
Main door knob
13. Frequency of Routine Cleaning
SN Cleaning Method High Touch Area Low Touch Area Minimum Cleaning Frequency
3. Discharge Bed
Cleaning
Bed Rails Bed frames Upon bed discharge
Call bells
Bedside tables/
lockers
Mattress
Chairs
Switches Walls
Telephone
4. Discharge Bed
Cleaning
(Contact
Precautions)
Bed Rails Bed Frames Upon bed discharge
Mattress
14. 1 • Remove all bed linen and curtains and placed in appropriate linen bags.
2. • Open the windows to air the room before cleaning and disinfection
3
• Isolation rooms/ cohort areas should be decontaminated from the highest to lowest
(ceiling to floor); least contaminated to the most contaminated area.
4. • Clean with neutral detergent before disinfection.
5.
• Constitute 4 tablets of Biospot 0.5gram in 1 litre of water for disinfection with at least
15mins contact time.
6. • Change cleaning equipment / solutions when they become soiled.
7. • Clean and follow by disinfect all surface areas, including bed frame and mattress
8. • Remake bed
9. • Replace the necessary items
10. • Dispose waste appropriately and replace liner
Steps in Terminal Cleaning
16. Sharps Management
• To promote safe practice to reduce/ prevent
accidental sharp injuries and exposure to blood
and body fluids.
• To protect Care Staff against possible infection
acquired through needle stick/sharp injuries
and/ or exposure to blood and body fluids.
17. Sharps Management
Blood and Body Fluids Exposure Prevention
• Wear appropriate PPE
• cover open wounds/ lesions
• Immunization Program (e.g Hep B Vaccine)
18. Management of a Needle-stick/ Exposure to Body Fluids Flowchart
Annex A
Management of a Needle-stick / Sharp Injury / Exposure to Body Fluids
Flowchart
First Aid
Encourage bleeding
Wash punctured /cut
wound with soap and
water under running
water
Dry and apply band aid
Exposure to
potentially
infected body
fluids
Inform SN / Nurse In-charge and DNM / NM
Ensure staff seeks medical
Attention at A&E
immediately
Retrieve resident’s
name and NRIC details
Obtain relevant
resident’s medical
History
Perform Risk
Assessment
Inform HR within 24 hours
(Raise Staff Incident Report)
First Aid
Irrigate affected areas (e.g.
eyes or hand cuts/ wounds)
with large amount of normal
saline solution or water
Body Fluid ExposureNeedle-Stick Injury
Inform Attending
Doctor
Ensure appropriate review and follow-up
actions are done
(e.g. Blood laboratories, Post-exposure
prophylaxis, Counselling for HIV potential
exposure)
20. Objectives
• To ensure proper handling, transporting
and storage of soiled and contaminated
linen to prevent cross contamination /
infection.
21. Types of Linen Segregation
Linen Management
Clean:
Not used or
contaminated
Soiled:
contaminated
and no known
infectious
condition
Infectious:
clothing-
contaminated
linens from a
person with a
known infectious
condition
Used:
Used but not
contaminated
22. Handling and Transportation of Linen
a)Staff shall rinse off solid waste from soiled linens at designated areas.
b)Transportation of clean and used/ soiled/ infectious linen shall use
different trolleys.
c)Clean linen shall be transported by the lift from 4 to 5pm.
d)All staff shall strictly observe hand hygiene before and after handling
linen and cover all skin lesions.
e)All staff shall wear gloves and apron, mask is not required.
f)All sharps and resident’s possessions shall be removed from linen.
g)Once 2/3 filled, linen bag shall be secured.
h)Staff shall not shake, sort or rinse used/ soiled linen in clinical areas
to aerosolization of any micro-organisms contaminating linen.
23. Handling used and soiled linen
USED LINEN SOILED LINEN
Place in small White bag and Bring to sluice room
Wash off solid in sluice room ’s sink
Place in small WHITE bag and label “Soiled with <Feces/urine>”
Place in Large WHITE laundry bags accordingly:
•Bedsheets/ Blankets/ Pillow cases
•OV Towels
•Resident’s Clothes
When ¾ full, secure with a knot.
Double bag and secure again, Bring to Sluice Room, Ensure NO LEAKAGE.
Label <Branch> <level> <Date>
Place in large Blue Bin.
Place in Dumbwaiter at designated time
Place Linen into appropriate trolley and send to laundry department
24. Handling of infectious linen
INFECTIOUS LINEN
Remove feces/ vomitus by wiping it out
Put inside a red bag, secure with a knot
Double bag and tie with s cable tie, label with Feces/ Vomitus/ body fluids.
Ensure no leakage
Place in Dumbwaiter at designated time
Place in Linen into appropriate trolley and send to laundry department
25. Linen Storage
o Linen shall be folded/ arranged in a clean
area and stored in a designated clean
covered area or residents’ cupboards.
