New South Wales Consolidated Regulations New South Wales Consolidated Regulations(Clause 5)
Note : The infection control standards set out in this Schedule apply to all relevant health practitioners (see clause 4). However, certain infection control standards refer to activities or procedures that would only be undertaken by health practitioners registered in a particular health profession and therefore would not apply to relevant health practitioners who do not practice in that health profession.
(1) In this Schedule--
"AS/NZS 4187" means AS/NZS 4187:2014, Reprocessing of reusable medical devices in health service organizations , as in force from time to time.
"AS/NZS 4815" means AS/NZS 4815:2006, Office-based health care facilities--Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment , as in force from time to time.
"body substance" includes any human bodily secretion or substance other than blood.
"invasive procedure" means any one or more of the following--(a) surgical entry into body tissue, cavities or organs,(b) surgical repair of injuries,(c) cardiac catheterisation and angiographic procedures,(d) vaginal or caesarean delivery or any other obstetric procedure during which bleeding may occur,(e) the manipulation, cutting, or removal of any oral or peri-oral tissue, including tooth structure, during which bleeding may occur,(f) any other procedure during which a patient's skin is penetrated, cut or otherwise rendered non-intact,(g) any other treatment of a wound.
"sharps" means any object capable of inflicting penetrating injury, and includes hollow bore needles, suture needles, scalpel blades, wires, trocars, auto lancets, stitch cutters and broken glassware.
(2) The requirements set out in this Schedule apply to a relevant health practitioner who is assisting in performing a procedure in the same way as they apply to a relevant health practitioner who is actually performing the procedure.
(1) Precautions must be taken to avoid direct exposure to a patient's blood or body substance.
(2) The requirement in subclause (1) applies regardless of whether there is any perceived risk of infection.
(3) Aseptic techniques must be used in the course of complying with the requirements of this Schedule.
(1) A relevant health practitioner, other than a pharmacist, must clean the health practitioner's hands--(a) immediately before and after any direct patient care, and(b) immediately after handling blood or body substances.
(2) A pharmacist must clean the pharmacist's hands--(a) immediately before and after performing an invasive procedure, and(b) immediately before and after performing a procedure during which direct contact is anticipated or occurs with a patient's blood or body substances, mucous membranes or non-intact skin, and(c) immediately after handling blood or body substances.
(3) Subclauses (1) and (2) do not apply in circumstances in which treatment is required to be performed urgently and cleaning facilities are not readily available.
(4) Hands may be cleaned by--(a) using washing facilities involving water and a soap or antiseptic, or(b) using non-water cleansers or antiseptics.
(5) Hands or other skin surfaces that are contaminated with a patient's blood or body substance must be cleaned as soon as it is practicable to clean them.
(6) The requirement to clean hands applies regardless of whether gloves are also required to be worn.
A gown or apron made of impervious material must be worn during any procedure where there is a likelihood of clothing being splashed or contaminated with blood or body substances.
(1) Gloves must be worn while handling blood or body substances or if there is a risk of contact with blood or body substances.
(2) In particular, gloves must be worn--(a) during a procedure where direct contact is anticipated with a patient's blood or body substances, mucous membranes or skin that is not intact, and(b) while suctioning a patient, and(c) while handling items or surfaces that have come into contact with blood or body substances, and(d) while performing an invasive procedure, venipuncture or a finger or heel stick.
(3) Sterile gloves must be worn if the procedure involves contact with tissue that would be sterile under normal circumstances.
(4) Gloves must be discarded--(a) as soon as they are torn or punctured, and(b) after contact with each patient.
(5) Subclause (4) does not affect the operation of subclauses (1)-(3).
(6) Gloves must be changed if separate procedures are being performed on the same patient and there is a risk of infection from one part of the body to another.
(1) A fluid repellent mask and protective eye wear must be worn while performing any procedure where there is a likelihood of splashing or splattering of blood or body substances.
(2) A mask must be worn when in close contact with patients known or suspected by the relevant health practitioner to have an infectious disease if the disease is capable of being transmitted by the airborne or droplet route.
(3) If the disease is tuberculosis, the mask must be a particulate mask that is capable of filtering to 0.3µm.
(4) If a mask is required to be worn, it must be worn and fitted in accordance with the manufacturer's instructions.
(5) A mask must be discarded once it has been worn and it must not be used again.
(6) In cases where protective eye wear is required to be worn, it must be worn and fitted in accordance with the manufacturer's instructions.
(7) Protective eye wear must be discarded once it has been worn and not used again unless it is reusable (in which case it is to be cleaned in accordance with the manufacturer's instructions).
(1) Sharps must not be passed by hand between a relevant health practitioner and any other person.
(2) However, the requirement in subclause (1) does not apply if, in any case involving an invasive procedure, the proper conduct of the procedure would be adversely affected.
(3) A puncture resistant tray must be used to transfer sharps.
(4) A needle must not be removed from a disposable syringe for disposal, or be purposely broken or otherwise manipulated by hand, unless--(a) it is necessary to remove the needle for technical reasons, or(b) the relevant health practitioner is performing a procedure in which the needle is required to be bent.
(5) A needle must not be bent after it is contaminated with blood or body substances.
(6) If resheathing of a needle is required--(a) the needle must be properly recapped, and(b) the sheath must not be held in the fingers, and(c) a single handed technique or forceps, or a suitable protective guard designed for the purpose, must be used.
(7) Reusable sharps must, immediately after being used, be placed in a puncture resistant container specially kept for that purpose and labelled as such.
(8) Non-reusable sharps must, immediately after being used, be disposed of in a puncture resistant container.
(1) Clinical waste must be properly packaged to protect against potential exposure to infectious agents and to facilitate the proper handling, storage and treatment or disposal of the waste.Note : The disposal of clinical waste is regulated by the Protection of the Environment Operations Act 1997 and the regulations under that Act.
(2) Splashing or contamination of skin while disposing of blood or body substances must be avoided as far as practicable.
(3) Nothing in this clause limits any other requirement under this Part.
(1) A sterile needle and syringe must be used to withdraw any medication or solution from a vial, ampoule or similar container.
(2) The needle and syringe must be discarded once the needle and syringe have been used.
(3) A medication or solution may be taken from a multi-dose vial, multi-dose ampoule or similar container only if the medication or solution is not reasonably available in another form.
(4) Precautions must be taken to ensure that contaminated material or fluid is not injected into a multi-dose vial, multi-dose ampoule or similar container.
(1) Anaesthetic apparatus that comes into contact with a patient or is contaminated with blood or body substances must be discarded, or cleaned and disinfected, after each patient.
(2) If the anaesthetic apparatus is a breathing circuit and the breathing circuit uses a filter--(a) the filter must be discarded after each patient, and(b) the part of the breathing circuit between the patient and the filter must be discarded, or cleaned and disinfected, after each patient, and(c) if a carbon dioxide absorber is also used--the part of the breathing circuit between the carbon dioxide absorber and the filter must be discarded, or cleaned and disinfected, at the end of each procedure list or operation list (as applicable), and(d) if a carbon dioxide absorber is not used--the breathing circuit tubing that conducts the gas to and from the filter must be discarded, or cleaned and disinfected, at the end of each procedure list or operation list (as applicable).
(1) Respiratory equipment that is designed for single use must be discarded once it is used.
(2) Any other respiratory equipment must be cleaned and disinfected after each time the equipment is used.
(1) If it is technically feasible, retractors must be used for exposure and access during an invasive procedure.
(2) Fingers must be placed in a position that minimises the risk of injury from any sharps used during an invasive procedure.
(3) Only one sharp at a time is to be placed in a puncture resistant tray that is being used in connection with an invasive procedure.
(4) Forceps or a needle holder must be used when carrying out suturing both to pick up the suture needle and to draw it through tissue.
(1) An instrument or equipment that comes into contact with intact skin must be cleaned before it is used.
(2) An instrument or equipment that is required under this Part to be sterilised or disinfected must be cleaned before it is sterilised or disinfected.
(3) The process of cleaning--(a) must involve water and mechanical or physical action (such as washing machines) and a cleaning agent (with the cleaning agent being removed from instruments and equipment by rinsing), and(b) must be consistent with AS/NZS 4187 or, for an office-based practice, AS/NZS 4815.
(4) In this clause--
"cleaning agent" means a detergent and includes proteolytic enzyme substances.
(1) An instrument or equipment that comes into contact with non-sterile tissue (other than intact skin) must, before it is used, be disinfected with a disinfectant specified in the Australian Register of Therapeutic Goods that is maintained under the Therapeutic Goods Act 1989 of the Commonwealth, and the relevant manufacturer's instructions must be followed.
(2) The process of disinfection--(a) must involve either thermal methods or, if thermal methods are unsuitable, chemical methods, and(b) must be consistent with AS/NZS 4187 or, for an office-based practice, AS/NZS 4815.
(1) An instrument or equipment used to enter, or that is capable of entering, tissue that would be sterile under normal circumstances, or the vascular system of a patient, must be sterilised before it is used.
(2) The method of sterilisation must be--(a) compatible with the particular type of instrument or equipment concerned, and(b) consistent with AS/NZS 4187 or, for an office-based practice, AS/NZS 4815.
(3) If a steriliser is used (whether it is a benchtop or portable steriliser or a permanently plumbed or wired steriliser), the following criteria must be met--(a) the relevant manufacturer's instructions must be followed,(b) an ongoing monitoring program must be followed which reflects the requirements of Table 7.1 Calibration, Monitoring and Maintenance of Sterilizers of AS/NZS 4187 or, for an office-based practice, Table 7.1 Performance Testing, Monitoring, Calibration and Maintenance of Sterilizers of AS/NZS 4815.