UNCONTROLLED WHEN PRINTED
Introduction

It is the responsibility of all St John WA staff to manage clinical and related wastes generated during patient care. Management of waste is outlined within the Environmental Protection Act 1986, related regulations, and the Environmental Protection Controlled Waste Regulations 2004. As a contracted service of the WA Department of Health, the organisation and all staff must comply with this legislation.

This guideline outlines each type of healthcare waste and how to responsibly manage each type in a way that minimises the risk to the environment, to staff and the community. Standard Precautions apply when handling any healthcare waste, with a risk assessment performed to ensure transmission precautions are used as necessary. Clinical staff should have received education and training before handling healthcare waste to ensure appropriate handling of each type of waste.

Types of waste managed at St John WA include:

General waste

Care provided in the home mostly produces general waste, which can be disposed of with other household or general waste. Any high-risk waste, such as clinical waste or sharps, should be appropriately handled and disposed as outlined in the respective guidelines.

Clinical waste

Clinical waste is defined as waste that has potential to cause disease or injury and includes sharps, tissue waste and products contaminated with blood or bodily fluids.

Clinical waste should be segregated from all other waste at the point of generation, ensuring safe handling and disposal to minimise harm to staff and the community.

Clinical waste should be sealed in a clearly labelled, leakproof bag or container and transported to a central disposal area (e.g hospital), at the earliest opportunity. Ideally it should be collected into the provided yellow clinical waste bags, with displayed biohazard symbol. Once it has been transported into the central disposal area it should not require any further individual handling.

Central disposal areas differ based on geographical location and the resources available. In the metropolitan area and larger country towns, all hospitals have clinical waste disposal areas. In regional areas, creation of a Memorandum of Understanding between the local subcentre and small healthcare facilities (e.g. GP, Pharmacy and Nursing Post) may be required to ensure clinical waste is disposed of in appropriate central disposal area. If there is no available facility with a clinical waste disposal area, regions should ensure there is a suitable sized yellow clinical waste bin at an appropriate subcentre/depot.

Personal Protective Equipment (PPE)

PPE used during treatment can be disposed of in the general waste stream. 

PPE that has blood or body fluid contamination, should be placed in clinical waste. Follow local protocol for your specific hospital site for access to clinical waste bins.

Please note that some Health Service Providers (HSP) are still using clinical waste stream to dispose of PPE so please follow the local procedures as relevant at your site and seek clarification from the Hospital Liaison Manager or hospital staff.

Handling and disposal of sharps

To handle, transport and dispose of sharps safely so as to prevent exposure to staff, patients and the public from any risk of transmission of pathogens.

Process

The safe handling and immediate disposal of sharps at the point of use is the responsibility of the person who has used the sharp.

Handling and Disposal of Sharps

  • Use Safety Engineered Medical Devices (SEMDs)/needle-less systems wherever available.
  • Read and understand the instructions for use prior to using sharp devices.
  • Ensure safe distance between other people before exposing a sharp.
  • Never pass an exposed needle to another person.
  • Never accept a used sharp from a patient/bystander or other health care provider.
  • Never re-cap or re-sheath used needles by hand, remove from disposable syringes by hand,  or purposely bend, break or otherwise manipulate by hand.
  • Immediately dispose of sharps post use into a sharps container by the user.
  • SJWA provides sharps collectors that are specific for use at the scene and within the ambulance.
  • Ensure sharps containers are stored and transported securely within the vehicle until ready for disposal.
  • Dispose of sharps containers when they are 3/4 full (As displayed on container)
  • Full sharps containers are disposed of at major hospitals in the designated clinical/sharps waste system.
Other types of waste

Healthcare related waste is any waste that requires specific disposal including pharmaceutical waste and cytotoxic waste.

Cytotoxic Waste:

Material that may be contaminated with cytotoxic medication as a result of cytotoxic therapy. Whilst rare in the ambulance setting, situations may arise where there will be exposure to cytotoxic waste.

Cytotoxic waste must be collected in purple coloured, leakproof bags or containers (the patient or facility will likely have these available).

Cytotoxic waste should then be disposed of at the appropriate designated area of the receiving facility for this transfer.

Pharmaceutical Waste:

Materials that arise from the clinical use of pharmaceutical products, including used discarded medications, syringes, intravenous giving sets and discarded intravenous solutions.

Pharmaceutical waste must be stored so access is prohibited from unauthorised persons, until it can be disposed of appropriately. Schedule 8 & High-Risk medications have special restrictions, and only authorised/responsible staff can handle and dispose of Schedule 8 medications. There are also requirements for documentation of disposal of Schedule 8 & High-Risk medications as outlined in relevant St John medication handling Policies & Procedures and the Medicines and Poisons Act 1994 and the Medicines and Poisons Regulations 2016.

Key Terms & Links


References

Department of Health Government of Western Australia (2021). Code of Practice for Clinical and Related Waste Management. Public Health Act 2016.

National Health & Medical Research Council and the Australian Commission on Safety and Quality in Healthcare.  (2021).  Australian Guidelines for the Prevention and Control of Infection in Healthcare.  Canberra, Australia:  Commonwealth of Australia.

Standards Australia.  AS 4031-1992 and Amendment 1 (1996).  Non-reusable containers for the collection of sharp medical items in health care areas.  Sydney, Australia:  Standards Australia International Limited. 

Standards Australia/Standards New Zealand. AS/NZS 3816:2018.  Management of clinical and related wastes.  Sydney, Australia:  Standards Australia International Limited. 


Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Version

Published Date

Review Date

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