Best Practices for Creating a Regulated Medical Waste Packaging Process

Healthcare organizations that generate medical or other biohazardous waste must package it appropriately for disposal to ensure staff, patient, and environmental safety, as well as maintain compliance with federal, provincial, and local regulations. While this may seem straightforward, organizations sometimes struggle to consistently and correctly segregate, package, and dispose of biomedical waste.

Best practices involve developing clear packaging procedures and making sure staff are aware and reliably follow them. The list below can guide the process of creating procedures and yield a comprehensive and compliant approach.

Understand What Biomedical Waste Is and Why Proper Waste Segregation Is Important

The first step in establishing biomedical packaging procedures is deciding what constitutes biomedical waste. Biomedical waste is any waste saturated with liquid or semi-liquid blood or other potentially infectious material (OPIM) that has the potential to cause harm or infect humans. Although there is no universally accepted definition, most provincial agencies differentiate wastes that have the potential to cause infection with regulations around the collection, transportation, treatment, and disposal.

Some examples may include contaminated disposable gowns, used gauze and procedural drapes. In addition, due to the COVID-19 public health crisis, some organizations are starting to treat used personal protective equipment (PPE) as biomedical waste when treating COVID patients.

Contaminated sharps, including used needles, scalpels, or syringes, would also qualify. Sharps should be placed in specially designed, leak- and puncture-proof sharps containers after use. These containers should also be clearly labeled biomedical to ensure proper handling.

Once an organization determines the biomedical waste it generates, guidelines must be created for segregating that waste. Proper segregation of biomedical includes separating waste streams for biohazardous waste, sharps, pathological waste, chemotherapeutic waste, and pharmaceutical waste. This ensures that each type of waste is properly disposed of and does not pose a threat to health or environmental safety.

Know Which Regulating Agencies Govern Biomedical Disposal

There are several regulatory bodies that oversee the disposal of biomedical waste and, depending on the agency, their focus varies. For instance, through the Environmental Protection Act, the Ministry of the Environment regulates biomedical waste stating the waste must be properly segregated and handled to prevent contaminates from entering the environment, whereas, Transport Canada oversees how the waste is transported from the waste generator to the treatment for final disposal facility.

Other governing bodies include, Health Canada, Environment Canada, Provincial Environment Ministries, Canada Labour Code, and Provincial Labour Ministries. While some requirements overlap, there are variances between local, provincial, and federal regulations. So, when drafting biomedical waste policies, it is critical to look at provincial and local requirements first as these may supersede others.

Delineate Proper Biomedical Waste Packaging Steps

After gathering information about the what and why of biomedical disposal, organizations must address the how. The following are the key steps involved in the packaging process:

• Step 1: Choose a suitable regulated medical waste container. Organizations can either use corrugated boxes or specially designed reusable containers to hold biomedical waste. Corrugated boxes should be sealed on the bottom with two-inch wide, clear, packing tape. Printed text and arrows should differentiate the receptacle’s top and bottom. Reusable containers typically do not require special set up. For both disposable and reusable containers appropriate marking and colour-coding are required.
   
• Step 2: Line the medical waste container with a biohazard bag. Be sure to use a biohazardous waste bag as it is designed for biomedical waste items. Not only are they meant to effectively contain the waste, they also indicate by their labeling that the waste is biohazardous. The bag must line the inside of the receptacle, overlapping its four outer sides. Note that different provinces may have different requirements for bag thickness and weight limitations.
   
• Step 3: Place the appropriate biomedical waste in the lined container. In addition to outlining what should go in the container, it’s equally important to indicate what should not. Medications, loose needles, syringes, general trash, and recycling should not be disposed of in the same way; waste must be segregated prior to disposal in the appropriately marked container.

Please note: Sharps should be disposed of in a closed, puncture-resistant container, and pharmaceutical waste should be placed in its own designated, colour-coded receptacle. Trace chemotherapy waste and pathological waste, although forms of biomedical waste, should be further segregated as well and marked for incineration.

• Step 4: Tie the bag. Make sure there is room at the top of the bag before tying it. Staff must wear gloves when securing the bag, gathering its edges, and twisting the top to seal the contents. They then should make a strong, hand-tied single or gooseneck knot to prevent any leakage. Staff can also use a zip tie or tape to secure the knot, although different facilities may have different rules as to which is used.
   
• Step 5: Prepare the waste for pickup. Once secured, the bag should be placed in a transport container, which should be sealed. If using a reusable transport container, staff should engage the auto-locking flaps or secure the lid depending on the receptacle design. For corrugated transport containers, staff should seal the top of the box with two-inch wide, clear packing tape. Closed bags should not be visible once the outer container is closed and sealed.
   
• Step 6: Check the markings. The outer box should have appropriate labeling that meets federal, provincial, and local requirements. It also should include any bar codes or other information the organization’s waste hauler requires. 

Develop and Implement Staff Training

Staff members that work in areas where biomedical waste is generated should receive training on how to properly handle and dispose of contaminated materials. Similarly, staff in charge of preparing waste for pickup should receive training as well. Topics to cover include what items should be segregated, how to package waste, and the risks if biomedical waste is managed incorrectly.

Training should occur during orientation and as part of annual refresher events. Online modules can be especially beneficial because staff can access them at their convenience and training is documented once completed. If policies or procedures have changed due to COVID-19, providing refresher training could be beneficial.

Periodically “Audit” the Process to Make Sure Practice Follows Policy

Organizational leaders should observe whether staff are following defined biomedical waste procedures. If they notice lapses, it may indicate the need for further education and training. This could range from a mention in the next staff meeting to on-the-spot course correction and additional training.

Monitoring whether employees are strictly adhering to policies and procedures is especially critical now given that some staff have been away from the daily operations they were once accustomed to. Observing the behaviour of staff is one of the best ways to correct mistakes as they happen and to form habits that promote safety and compliance. 

Ensure Your Organization Has a Compliant Biomedical Waste Disposal Process

While good processes are essential for proper biomedical waste disposal, a reliable waste management partner is key. Learn more about how Stericycle can help you maintain a safe and compliant biomedical medical waste program.