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.'�w <br />tj FW: Proper Segregation ofs and Pharmaceutical Wastes Ask Page 2 of 2 <br />evidence of compliance by October 1, 2012. The violations included several observations of <br />inappropriately segregated pharmaceutical wastes. MOST of the smaller type sharps containers <br />(mounted on walls, at nursing/clinical stations, or on medication carts) that were inspected contained <br />medication vials and other inappropriate items. It is NOT permissible to discard medication vials into the <br />red sharps containers, and NOT permissible to discard full or partially full IV bags or pharmaceutical <br />waste in the large 17 gallon red sharps containers. IV bags were being discarded into sharps containers, <br />still with a large quantity of fluids in them even though they do not contain pharmaceuticals, rather than <br />being drained first. Please do the following: <br />Review and enforce the appropriate segregation of waste in accordance with the Stericycle <br />Nursing Factsheet (attached above and located in the Knowledge Base, Safety Management <br />section), paying particular attention to the sections on Red Sharps Containers and Blue <br />Pharmaceutical Sharps Containers). This information should be included several times during <br />huddles and staff meetings, and posted. Note: empty IV bags without a spike but with patient <br />info on them may be discarded with red medical waste, as the name is then obliterated during the <br />sterilization process; empty IV bags with a spike should be discarded in the red 17 gallon sharps <br />containers because of the sharp spike. <br />Do several, frequent audits of the contents of the different types of sharps containers and follow <br />up when there are infractions. You should establish accountability of all staff, but have front line <br />leaders involved in on-going vigilance in order to get resolution. Following is an outline of the <br />items that should be addressed during the audits: <br />Sharps waste is placed into a separate sharps container labeled with "Sharps Waste" or biohazard symbol & <br />"BIOHAZARD " <br />o Visually inspect the contents of a sharps container... is only qualified sharps waste present? <br />Pharmaceutical waste is placed into a separate container labeled `INCINERATION ONLY" on the lid and on all <br />lateral sides <br />o Visually inspect the contents of a pharmaceutical container... is only qualified pharmaceutical <br />waste present? <br />The audits that are completed periodically during environmental tours will not be enough, and will not be <br />effective in resulting in immediate compliance. Therefore, your assistance is truly needed. <br />Linda Knowles, MS, RN, CIC <br />Nurse Epidemiologist <br />Dameron Hospital Association <br />525 West Acacia Street <br />Stockton, CA 95203 <br />Phone (209) 461-3163 <br />Fax (209) 944-5429 <br />Confidentiality Notice: This E-mail and any attached documents may contain confidential <br />information which is legally privileged, confidential or otherwise protected from disclosure. <br />This information is intended only for the use of the addressee only. If you have received this <br />transmission in error, please immediately notify us (209) 242-7088 (Dameron Information Desk) <br />and destroy all copies of this message. <br />9/21/2012 <br />