Ala. Admin. Code r. 420-5-17-.23

Current through Register Vol. 43, No. 1, October 31, 2024

Section 420-5-17-.23 - Infection Control

All hospices shall establish an infection control policy. The inpatient hospice shall also comply with the following:

(1)Reasonable Accommodations. Reasonable accommodations shall be made for all patients with contagious disease. The nature and extent of said accommodations shall be determined by the interdisciplinary team.

(2)Housekeeping. The hospice employs sufficient housekeeping personnel and provides all necessary equipment to maintain a safe, clean, and orderly interior. An employee is designated as responsible for the services and for supervision and training of personnel. Nursing personnel are not assigned housekeeping duties. A hospice contracting with an outside source for housekeeping may be found to be in compliance with this section provided the hospice and/or outside resources meet the requirements of this section. Cleaning carts shall not be carried into patient rooms.

(3)Linen. The inpatient hospice has available at all times a quantity of linen essential for proper care and comfort of patients.

(a) Linens are handled, stored, processed, and transported in such a manner as to prevent the spread of infection.

(b) Linens on patients beds shall be free of tears and stains and shall be removed from linen storage when it is no longer suitable for patient use.

(c) Linens shall be washed in a final wash cycle of 160 degree F. unless chemicals are used.

(4)Pest Control. The hospice is maintained essentially free from insects and rodents through operation of a pest control program.

(5)Premises. The premises shall be kept neat and clean, and free from accumulated rubbish, weeds, ponded water or other conditions of a similar nature which would have a tendency to create a health hazard.

(6)Infectious Waste. Each hospice shall develop, maintain and implement written policies and procedures for the definition and handling of its infectious wastes. For the purposes of this rule, the following wastes shall be considered to be infectious wastes:

(a) Wastes contaminated by patients who may be infected with communicable diseases.

(b) Any cultures or stocks or microorganisms.

(c) Waste human blood and blood products such as serum, plasma, and other blood components.

(d) All discarded sharps (e.g., hypodermic needles, syringes, broken glass, scalpel blades, etc.).

(e) Other wastes determined to be infectious by the hospice, which should be set forth in a written policy.

(7)Standards for Handling Infectious Waste Within a Hospice.

(a) Segregation. Infectious wastes should be isolated from other waste at the point of generation within the hospice.

(b) Packaging infectious waste must be packaged in a manner that will protect waste handlers and the public from possible injury and disease that may result from exposure to the waste. Such packaging should provide for containment of the infectious waste from the point of generation up to the point of proper treatment or disposal. Packaging must be selected and utilized for the type of infectious waste the package will contain, how the waste will be treated and disposed, and how it will be handled and transported prior to treatment and disposal.

1. Contaminated sharps should be directly placed in leakproof, rigid, and puncture-resistant containers which must then be tightly sealed (e.g., taped closed or tightly lidded).

2. All containers, bags, and boxes used for containment and disposal of infectious wastes must be conspicuously identified.

3. Reusable containers for infectious wastes must be thoroughly sanitized each time they are emptied, unless the surfaces of the containers have been completely protected from contamination by disposable liners or other devices removed with the waste.

(c) Handling and transporting. After packaging, infectious wastes must be handled and transported to ensure and preserve by appropriate methods the integrity of the packaging, including the use of secondary containment where necessary.

1. Infectious wastes must not be compacted or ground (i.e., in a mechanical grinder) prior to treatment, except that pathological wastes may be ground to disposal.

2. Plastic bags of infectious wastes must not be transported by chute, dumbwaiter, conveyor belt, or similar device.

(d) Storage. Infectious waste must be stored in a manner which preserves the integrity of the packaging, inhibits rapid microbial growth and putrefaction, and minimizes the potential of exposure or access by unknowing persons.

1. Infectious waste must be stored in a manner and location which affords protection from animals, precipitation, and wind. It must be stored in a manner which does not provide a breeding place or food source for insects or rodents and does not create a nuisance.

(e) Managing incidents of noncontainment. In the event of spills, ruptured packaging, or other incidents where there is a loss of containment of infectious wastes, the hospice must ensure that proper actions are immediately taken to:

1. Isolate the area from the public and all non-essential personnel.

2. Repackage all spilled waste and containment debris to the extent practicable in accordance with the recommendations of sub paragraph (b) of this paragraph.

3. Sanitize all containment equipment and surfaces appropriately.

4. Complete incident report.

5. Written policies and procedures must specify how this will be done.

(f) Disposing of infectious wastes. Infectious wastes are disposed of in accordance with acceptable state regulations.

(8)Standards for Handling of Non-infectious Wastes. All garbage, trash, and other non-infectious wastes shall be stored and disposed of in a manner that must not permit the transmission of disease, create a nuisance, provide a breeding place for insects and rodents, or constitute a safety hazard. All containers for waste shall be water tight with tight fitting covers and shall be kept on elevated platforms constructed of easily-cleanable material. A hospice may incinerate non-infectious wastes in an on-site incinerator which is authorized to incinerate infectious/non-infectious waste in accordance with state regulations.

Author: Jimmy D. Prince

Ala. Admin. Code r. 420-5-17-.23

New Rule: Filed August 20, 1993; effective September 23, 1993. Repealed and New Rule: Filed June 14, 2000; effective July 19, 2000.

Statutory Authority:Codeof Ala. 1975, §§ 22-21-20, etseq.