Environment & Logistics
These protocols govern what happens behind the scenes — when you perform a procedure, take a sample, clean a room, or process instruments.
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1. Waste Disposal
Mental sort at the point of generation. When in doubt, treat as clinical waste.
| Stream | Container | Colour | Examples |
|---|---|---|---|
| Clinical waste | Biohazard bag | Yellow | Blood, tissue, swabs, used dressings, contaminated PPE |
| Sharps | Sharps bin | Yellow | Needles, syringes, blades, lancets, broken glass |
| General waste | Standard bin bag | Black or blue | Paper, packaging, non-contaminated items |
| Pharmaceutical waste | Separate container | — | Expired drugs, cytotoxic waste (follow pharmacy SOP) |
Needles and syringes must be disposed of as a single unit. Separating the needle increases needlestick risk and is a direct violation of injection safety protocols.
2. Sharps Safety
The Golden Rule
Disposal Workflow
- Use the needle/syringe once.
- Immediately drop the entire assembly into the sharps bin at the point of use.
- Do not walk with uncapped needles.
- Do not pass sharps hand-to-hand — use a tray.
Bin Replacement
| Condition | Action |
|---|---|
| Contents reach 3/4 full | Seal bin and start a new one |
| 7 days since opening | Seal and replace (even if not full) |
| Bin damaged | Replace immediately |
3. Spill Management
What Constitutes a Spill
Any visible blood or body fluid on floors, walls, furniture, or equipment.
Step-by-Step Response
Quarantine
Place a warning sign. Prevent foot traffic.
Don PPE
Gloves, apron, mask, eye protection.
Apply granules
Cover spill with sodium hypochlorite granules from the spillage kit.
Wait
Allow 5–10 minutes for absorption.
Scoop
Use disposable scoop/cardboard into a yellow biohazard bag.
Disinfect
Mop area with 1:10 sodium hypochlorite solution (0.5%) using a green-coded mop.
Dispose
PPE, scoop, and mop head into clinical waste.
Document
Log in the spill register. [1]
Your clinic spillage kit should contain: sodium hypochlorite granules, disposable scoop/scraper, disposable apron, gloves, surgical mask, eye protection, biohazard bags, and warning sign. Check weekly.
4. Environmental Cleaning
Routine Cleaning
- Use a double-bucket system: one for detergent, one for rinse water.
- Change mop water when visibly dirty — do not spread contamination.
Mop Colour Coding
| Colour | Zone |
|---|---|
| Yellow | General corridors and public areas |
| Blue | Consultation rooms, treatment rooms, waiting areas |
| Green | High-risk areas, procedure rooms, spill cleanup |
| Red | Toilets, dirty utility areas |
| White | Polishable floors |
Terminal Cleaning
Required after treating high-risk or infectious patients (e.g., TB, MRSA, norovirus).
- Top-to-bottom sequence: light fittings → shelves → counters → beds → chairs → floors.
- Use appropriate disinfectant for surface type.
- Allow adequate contact time (follow product label — usually 5–10 minutes).
- Clean and disinfect all reusable equipment before returning to service.
5. Linen Handling
| Condition | Container | Processing |
|---|---|---|
| Used, non-contaminated | White linen bag | Standard wash cycle |
| Contaminated with blood or body fluids | Red container / bag | Soak in 0.5% sodium hypochlorite for 30 minutes, then wash |
- Do not sort contaminated linen by hand without gloves.
- Do not place contaminated linen on clean surfaces.
- Transport in covered bags to prevent aerosolisation.
6. Instrument Processing
Medical equipment is categorised by the risk of infection transmission if the item is contaminated.
| Category | Risk | Examples | Processing Required |
|---|---|---|---|
| Non-critical | Touches intact skin only | Stethoscope, BP cuff, bed rail | Low-level disinfection (wipe with disinfectant) |
| Semi-critical | Touches mucous membranes or non-intact skin | Speculum, tongue depressor, thermometer | High-level disinfection |
| Critical | Enters sterile tissue or bloodstream | Needles, surgical blades, suture material | Sterilisation (autoclave) |
Autoclave Monitoring
Daily checks before first use:
| Test | Purpose | Frequency |
|---|---|---|
| Dummy Run | Run autoclave empty to verify cycle | Every morning |
| Bowie-Dick Test | Detect air leaks / incomplete vacuum | Every morning |
| Biological Indicator | Verify sterilisation efficacy | Weekly or per protocol |
Never load instruments into an autoclave that has not passed the dummy run and Bowie-Dick test. A failed test means the machine cannot guarantee sterilisation.
End-of-Shift Checklist
- All sharps bins sealed if 3/4 full
- Spillage kit restocked
- Soiled linen in correct bags
- High-touch surfaces wiped down
- Autoclave log completed
- Cleaning supplies replenished