Section 33-03-11.1-10 - Infection control and safety Written policies and procedures must be established and implemented by the licensed electrologist for infection control and safety and shall include at a minimum the following:
1. Handwashing and glove use. a. Hands must be washed before treatment of each client, before donning gloves, and immediately after gloves are removed. b. Handwashing must include the use of antibacterial soaps: (1) Bar soaps must be kept on a rack to allow water to drain. (2) Liquid soap containers must be disposable; or (3) Reusable liquid soap containers must be cleaned and refilled with fresh soap at least once a month. c. The handwashing technique used must include: (1) Use of antibacterial soap and water; (2) A vigorous rubbing together of all surfaces of lathered hands, especially between fingers and fingernail areas, for at least fifteen to twenty seconds; (3) A thorough rinsing under a stream of water; and (4) Hands dried thoroughly with a clean disposable paper towel, then faucets turned off with the paper towel. d. A new pair of nonsterile disposable examination gloves must be worn during the treatment of each client. e. When a treatment session is interrupted, gloves must be removed and discarded. When gloves are removed during a treatment session, hands must be washed as provided in subdivision c and a fresh pair of gloves used prior to continuing the treatment session. f. Gloves must be worn during the procedures of mechanical precleaning, cleaning, rinsing, and drying of needles or probes and forceps or tweezers. g. To r n o r p erforated gloves must be removed immediately, and hands must be washed as provided in subdivision c after the gloves are removed. 2. Cleaning and sterilizing instruments or items and other safety precautions. a. Needles or probes and forceps or tweezers must either be presterilized disposable or thoroughly cleaned and sterilized between clients. b. Reusable instruments and containers must be cleaned and then sterilized consistent with the following: (1) New reusable instruments must be cleaned and then sterilized before initial use. (2) All containers including the container lids used to hold contaminated needles or probes and forceps or tweezers must be cleaned and sterilized at least daily or whenever overtly contaminated on days the electrologist is practicing electrology. (3) Pickup hemostats, forceps, or tweezers and holding cylinder must be cleaned and sterilized at least daily or whenever overtly contaminated on the days the electrologist is practicing electrology. (4) Unused instruments in containers that have been opened must be resterilized after a twenty-four-hour period. (5) Instruments contaminated before use, for example, dropping or touching a soiled surface, must be resterilized before use. (6) Needles or probes that have been used to treat a client must be: (a) Mechanically precleaned using a clean cottonball or swab moistened with a solution of low-residue detergent or a protein dissolving enzyme detergent and cool water; (b) Accumulated in a holding container by submersion in a solution of low-residue detergent or a protein dissolving enzyme detergent and cool water; (c) Thoroughly rinsed with warm water and drained; (d) Cleaned by soaking in a protein dissolving enzyme detergent used according to manufacturer's instructions cleaned in an ultrasonic cleaning unit or used according to manufacturer's instructions; and (7) Needles or probes and forceps or tweezers must be packaged individually or in small multiples, or unpackaged and placed in cleaned and dried stainless steel or heat-tempered glass containers. All containers must have well-fitting lids that are clean and dry. (8) Cleaned instruments or items must be sterilized by one of the following methods: (a) Dry heat. The following temperatures relate to the time of exposure after attainment of the specific temperature and do not include a heat-up lag time. 1 Three hundred forty degrees Fahrenheit [170 degrees Celsius] for one hour; or 2 Three hundred twenty degrees Fahrenheit [160 degrees Celsius] for two hours. (b) Moist heat - autoclave. The following exposure times relate only to the time the material is at temperature and does not include a penetration or heat-up lag time. 1 Fifteen minutes at two hundred fifty degrees Fahrenheit [121 degrees Celsius]; fifteen pounds per square inch [103.5 kilopascals] for unpackaged instruments or items; or 2 Thirty minutes at two hundred fifty degrees Fahrenheit [121 degrees Celsius]; fifteen pounds per square inch [103.5 kilopascals] for packaged instruments or items. (c) Other time-temperature relationships recommended by the manufacturer for a specific instrument. (9) Dry heat ovens and autoclaves (steam under pressure) must be approved by the United States food and drug administration and must be cleaned, used, and maintained according to the manufacturer's instructions. (10) Sterilizers must have visible physical indicators, for example, thermometers, timers. (11) Chemical (i.e., color change) indicators must be used on or in each package or container to indicate items have been exposed to a sterilization process. (12) Biological indicators must be used no less than once a month per sterilizer according to manufacturer's instructions to assure mechanical function and operator's technique and to determine sterilization efficiency and recorded in permanent sterility assurancefile. c. Aseptic technique must be followed when handling sterilized instruments or items. d. To prevent accidental needle-stick injuries, disposable or damaged needles or probes must not be recapped, bent, or otherwise manipulated by hand prior to disposal. Disposable or damaged needles or probes must be placed in a sturdy puncture-resistant container. Disposal of the container must be as follows: (1) The contents must be disinfected with a freshly prepared dilution of household bleach and water consisting of one part bleach and nine parts water; allowed to sit for thirty minutes; solution poured off; and the container securely sealed and disposed into the regular trash disposal, unless otherwise specified by department and local health regulations; or (2) Needles or probes may be decontaminated for handling by cleaning and sterilizing consistent with the requirements in this section and placed in a puncture-resistant container. The container must be securely sealed and disposed into the regular trash disposal. e. Removable tip of epilator needle or probe holder must be removed after each treatment and cleaned with soap or detergent and water, rinsed, dried, and disinfected by submersion in seventy percent isopropyl alcohol for a minimum of ten minutes. The covered container used to hold the alcohol should be emptied at least daily or whenever visibly contaminated, then cleaned, dried, and refilled with fresh alcohol. Nonremovable tip of epilator needle or probe holders must be wiped with a detergent-germicide or disinfectant after each treatment. 3. Environmental control and housekeeping. a. Offices and treatment rooms must be clean, well-lighted, and well-ventilated. b. A sink with hot and cold running water must be accessible to each treatment room. c. Toilet facilities must be available. d. A hospital-grade disinfectant-detergent registered by the environmental protection agency must be used for all cleaning unless otherwise specifically stated in this chapter. e. Fresh disposable paper drapes must be used on the treatment table or chair for each client, or the treatment table or chair must be wiped down with detergent-germicide or disinfectant or a bleach solution after each client. f. Soiled disposable items must be discarded into a container lined with a plastic bag, securely fastened, and disposed daily into the regular trash disposal. g. Epilator needle or probe holder and the portion of the cord in direct contact with the client or electrologist must be wiped with a detergent-germicide or disinfectant after each treatment. h. Magnifier or treatment lamps must be wiped with a detergent-germicide or disinfectant after each treatment. i. After each use, client eyeshields must be cleaned using a brush and soap or detergent and water, then rinsed and dried. j. Blood spills on environmental surfaces must be cleaned as follows: (1) Disposable gloves must be worn; (2) Paper towels used to blot up the visible material; (3) Paper towels then discarded into a plastic bag, securely fastened and disposed into the regular trash disposal; (4) Area wiped down with paper towels and an environmental protection agency-registered disinfectant-detergent or a freshly prepared one to one hundred parts dilution of household bleach and water (one-fourth cup bleach and one gallon [3.79 liters] water); (5) Area allowed to air dry; and (6) Paper towels and gloves discarded into a plastic bag, securely fastened and disposed into the regular trash disposal. 4. Client infection control considerations. a. Blood and body fluid precautions must be consistently used for all clients. b. The skin site must be evaluated prior to each treatment. c. Before treatment, the skin site must be cleansed of visible soil using soap and water or a germicidal skin preparation, then wiped with an antiseptic product. Skin sites not visibly soiled must be wiped with an acceptable antiseptic product. d. After treatment, the skin site must be wiped with an acceptable antiseptic product. e. Application of ice in a fresh disposable paper towel in a fresh plastic bag or healing cream, lotion, or ointment, or a combination of these things, may be applied to the treated skin site at the discretion of the electrologist. Creams, lotions, and ointments must be kept in clean, covered containers and handled in a sanitary manner. f. Client must be instructed on the appropriate posttreatment care to promote healing of the treated skin site. 5. Exposures to hepatitis B virus (HBV), HIV, and other bloodborne pathogens. a. Electrologists should be immunized against hepatitis B virus. b. Universal precautions must be implemented with all clients. c. The following steps should be taken when a needle or probe stick, puncture injury, or mucous membrane exposure has occurred: (1) Remove and discard gloves. (2) Wash exposed surface with running water, soap or germicidal handwashing solution. If wound is bleeding, allow to bleed. After thoroughly cleaning the wound, apply alcohol, betadine, or hydrogen peroxide. If there is mucous membrane exposure, flush exposed area thoroughly with water. (3) Immediate contact should be made with electrologist's personal physician forappropriate consultation, for example, for necessary postexposure strategies. (4) Documentation of the exposure should be made, including: date, route of exposure, circumstance under which exposure occurred, name of source client, followup testing, and any necessary postexposure prophylaxis. N.D. Admin Code 33-03-11.1-10
Effective February 1, 1992; amended effective May 1, 1994.General Authority: NDCC 43-38-03
Law Implemented: NDCC 43-38-03