Severe Acute Respiratory Syndrome SARS

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Severe Acute Respiratory Syndrome (SARS)

• Laundry Waste Management
• Cleaning Disinfection

WHO Western Pacific Regional Office April 17,
2003
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Linen LaundryWaste Management

• Health care and laundry workers must understand
  the importance of handling linen correctly to
  prevent the spread of potentially infectious
  microorganisms
• Linen can be washed using routine laundry
  practices.
• The health care facility should follow routine
  waste management practices but all waste must be
  incinerated.

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Linen

• All contaminated or
• soiled linen is potentially
• highly infectious therefore
• Wear full PPE when handling linen.
• Separate grossly contaminated linen from non-
  contaminated linen in the patients room for ease
  of handling in the laundry

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Laundry

• Laundry
• Place in color-coded bags and double bag for
  transport
• Do not sort linen in the laundry to avoid the
  creation of aerosols
• Staff handling linen should wear full PPE as per
  standard procedures
• Use standard detergents
• Bleach may be added if desired, and compatible
  with the detergent being used.

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Waste

• Wear full PPE when handling waste
• Clinical waste all items from treatment areas
• Soiled surgical dressings
• Swabs
• Masks
• Gowns
• Other contaminated waste

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Waste

• Sharps Containers
• Collect waste in designated color-coded plastic
  bags for incineration.
• Double bag for transport
• Contact the local authorities for assistance if
  the health care facility does not have
  incineration facilities

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Sharps Disposal
Disposal containers should be puncture-resistant
and leak- proof.

• Do not overfill container
• Do not reach into container
• Disposal containers should be puncture-resistant
  and leak- proof
• Dispose of used sharps into the sharps container

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Cleaning Disinfecting the Hospital Environment
and Equipment

• Cleaning is usually sufficient for prevention and
  control of infection, but for SARS infection the
  use of a disinfectant following cleaning is
  essential.
• It is essential to clean thoroughly before
  disinfecting the environment or equipment.
• Cleaning and disinfection must be carried out at
  least daily and particularly when gross
  contamination occurs.
• In some instances it may be necessary to
  disinfect to render the item safe to handle.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• Cleaning and disinfecting patient
• rooms and equipment is the best way
• to reduce transmission of infection
• Wear full PPE when cleaning and
• disinfecting

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Cleaning Disinfecting the Hospital Environment
and Equipment

• To communicate infection risk, use signs.
• SARS Isolation
• Protect patients staff by
• - Cleaning and disinfecting equipment.
• - Cleaning and disinfecting the room and
  anteroom.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• The immediate area around patients must be
  considered heavily contaminated.
• Bedside table, bed stand, and accessible areas of
  bed and floors must be cleaned with detergent and
  warm water at least daily (preferably twice a
  day).
• In addition, disinfect all surfaces after
  cleaning.
• Use disinfectant first if surfaces are grossly
  contaminated before cleaning to reduce the viral
  load.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• Contain and dispose of infectious materials in
  waste containers
• Put waste containers near entrance / exit to
  patient room.
• Provide dedicated patient equipment when
  possible.
• Clean and disinfect patient care equipment
  immediately after use depending on the type of
  equipment.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• Use standard procedures and agents for cleaning
  and
• disinfecting environmental surfaces and patient
  care
• equipment.
• Use detergent and warm water, rinse in hot water
  and dry.
• Use disinfectant afterwards.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• When areas and inanimate objects are grossly
  contaminated use
• 1100 sodium hypochlorite (bleach) solution to
  disinfect (before cleaning)
• it will reduce the viral load and the potential
  for infection to spread.
• Then use the standard cleaning and disinfecting
  procedures mentioned previously.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• All reusable patient items such as basins and
• bedpans should be
• Cleaned and disinfected before being used on
  another patient
• Taken to the dirty utility room for cleaning
• Staff should wear full PPE when handling
• contaminated equipment.

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Cleaning Disinfecting the Hospital Environment
and Equipment

• DO NOT spray clean the room / area.
• Why?
• Because it
• Spreads droplets
• Spreads aerosols
• Is not effective as a surface disinfectant
  

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Can You Now Answer These Questions?

• Laundry
• How should you manage linen used by a patient
  with SARS? Why?
• How should you transport the linen to the
  laundry?
• What protection should laundry staff use when
  handling linen from SARS patients?
• Should the linen be soaked in any solution before
  being washed? Why or why not?
• If you said yes to the previous question for how
  long would you soak the linen? Why?

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Can You Now Answer These Questions?

• Laundry
• At what temperature should linen be washed?
• At what temperature should linen be dried?
• At what temperature should linen be ironed?

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Can You Now Answer These Questions?

• Waste
• How should you manage waste from the room of a
  patient with SARS? Why?
• How should you transport the waste?
• What should you do with the waste? Why?
• What should you do if there is no waste disposal
  facility?
• What protection should staff use when handling
  waste from SARS patients?

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Can You Now Answer These Questions?

• Cleaning Disinfecting
• What is the appropriate method for cleaning the
  patients room?
• How should you manage a spill of body fluids or
  secretions in the room?
• How often should you clean the patients room?
• What should you do to clean and disinfect the
  room after the patient is discharged? Why?
• What protection should the person cleaning the
  room use?

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Can You Now Answer These Questions?

• Cleaning Disinfecting
• Should you use disposable equipment for SARS
  patients? Why?
• What should you do with other equipment needed to
  care for a SARS patient? Why?
• How should you clean equipment that has been
  used by a SARS patient? Why?
• What protection should the person cleaning
  patient care equipment use?

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Take Home Messages

• Cleaning is essential.
• For SARS cases, disinfect after cleaning.
• Wear full PPE when performing all cleaning and
  disinfecting tasks.

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Laundry Waste ManagementCleaning Disinfection

• We hope YOU have learnt something about the
• management of linen, other wastes and the
  cleaning
• and disinfection of the hospital environment and
• equipment used by SARS patients and
• the role this management plays in infection
  control
• and the prevention of transmission of the
• SARS virus.
• Thank you for listening.