Current through Register Vol. 42, No. 11, August 30, 2024
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
Statutory Authority:
Code
of Ala. 1975,
§§
22-21-20,
et
seq.
