UN 2814: | |
Infectious substances affecting humans and animals | Bacillus anthracis (cultures only) |
Brucella abortus (cultures only) | |
Brucella melitensis (cultures only) | |
Brucella suis (cultures only) | |
Burkholderia mallei—Pseudomonas mallei—Glanders (cultures only) | |
Burkholderia pseudomallei—Pseudomonas pseudomallei (cultures only) | |
Chlamydia psittaci—avian strains (cultures only) | |
Clostridium botulinum (cultures only) | |
Coccidioides immitis (cultures only) | |
Coxiella burnetti (cultures only) | |
Crimean-Congo hemorrhagic fever virus | |
Dengue virus (cultures only) | |
Eastern equine encephalitis virus (cultures only) | |
Escherichia coli, verotoxigenic (cultures only) | |
Ebola virus | |
Flexal virus | |
Francisella tularensis (cultures only) | |
Guanarito virus | |
Hantaan virus | |
Hantaviruses causing hemorrhagic fever with renal syndrome | |
Hendra virus | |
Herpes B virus (cultures only) | |
Human immunodeficiency virus (cultures only) | |
Highly pathogenic avian influenza virus (cultures only) | |
Japanese Encephalitis virus (cultures only) | |
Junin virus | |
Kyasanur forest disease virus | |
Lassa virus | |
Machupo virus | |
Marburg virus | |
Monkeypox virus | |
Mycobacterium tuberculosis (cultures only) | |
Nipah virus | |
Omsk hemorrhagic fever virus | |
Poliovirus (cultures only) | |
Rabies and other lyssaviruses (cultures only) | |
Rickettsia prowazekii (cultures only) | |
Rickettsia rickettsia (cultures only) | |
Rift Valley fever virus | |
Russian spring-summer encephalitis virus (cultures only) | |
Sabia virus | |
Shigella dysenteriae type I (cultures only) | |
Tick-borne encephalitis virus (cultures only) | |
Variola virus | |
Venezuelan equine encephalitis virus | |
Vesicular stomatitis virus (cultures only) | |
West Nile virus (cultures only) | |
Yellow fever virus (cultures only) | |
Yersinia pestis (cultures only) | |
UN 2900: | African swine fever virus (cultures only) |
Infectious substances affecting animals only | Avian paramyxovirus Type 1—Velogenic Newcastle disease virus (cultures only) |
Classical swine fever virus (cultures only) | |
Foot and mouth disease virus (cultures only) | |
Lumpy skin disease virus (cultures only) | |
Mycoplasma mycoides—Contagious bovine pleuropneumonia (cultures only) | |
Peste des petits ruminants virus (cultures only) | |
Rinderpest virus (cultures only) | |
Sheep-pox virus (cultures only) | |
Goatpox virus (cultures only) | |
Swine vesicular disease virus (cultures only) |
Fear surrounds Ebola Virus Disease (EVD) because it is highly infectious. Yet members of the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital (EUH) had to overcome that fear when caring for patients with EVD.
The analysis reported here illustrates how the members of EUH's SCDU tacitly enacted high reliability (HR) principles while caring for patients with EVD.
A qualitative study was conducted to describe the experience of members of the EUH SCDU who worked with EVD patients in 2014. We completed 17 semi-structured interviews involving registered nurses, physicians, and support personnel (eg, laboratory technicians). Interview recordings were transcribed and analyzed using conventional content analysis. Exploring HR principles was not among the questions guiding this exploration, but the participants repeatedly described concepts related to HR.
The goal of the SCDU team was to save patients' lives while protecting their own lives. Rigorous training and meeting high standards were required to make the team. The fear surrounding EVD set in motion the enactment of HR principles. HR principles served to alleviate failures or breakdowns in infection prevention and control, thus keeping patients and staff safe.
These findings illustrate that it is possible to move HR principles from theory to practice in high-risk situations. HR principles were essential to safety and to infection prevention and control.
Who this is for: Hospitals and healthcare providers that care for patients under investigation (PUIs) for Ebola virus disease (EVD) or with confirmed cases of EVD.
What this is for: To help hospitals and healthcare providers safely handle, transport, and dispose of waste generated by the care of patients under investigation (PUIs) for or with confirmed Ebola virus disease (EVD).
How to use: This guidance is intended to provide key information about procedures and regulations regarding waste associated with the care of patients under investigation (PUIs) for or with confirmed Ebola virus disease (EVD).
]]>Who this is for: Hospitals and healthcare providers that care for patients under investigation (PUIs) for Ebola virus disease (EVD) or with confirmed cases of EVD.
What this is for: To help hospitals and healthcare providers safely handle, transport, and dispose of waste generated by the care of patients under investigation (PUIs) for or with confirmed Ebola virus disease (EVD).
How to use: This guidance is intended to provide key information about procedures and regulations regarding waste associated with the care of patients under investigation (PUIs) for or with confirmed Ebola virus disease (EVD).
This guidance focuses on managing waste contaminated with the Category A infectious substances that affect humans.4 These substances are identified by the United Nations (UN) identification number 2814 under an international system for identifying hazardous materials. Appendix B – Infectious Agent Categorization provides a non-exhaustive list identifying, among other categorizations, common agents classified as UN 2814 Category A infectious substances affecting humans. Medical care of a person suspected of or confirmed as having a disease caused by a Category A pathogen (i.e., germ) typically generates used healthcare products or linens that are classified as Category A waste. While this document chiefly addresses Category A waste associated with hospital care of infectious patients, it also recognizes that infected people may contaminate their homes, vehicles in which they travel, and other environments before they are hospitalized. Category A waste may also come from laboratories that work with UN 2814 Category A pathogens, including when they intentionally cultivate certain pathogens (a process known as “culturing”) that are not considered Category A (i.e., UN 2814 infectious substances) in other forms (e.g., in body fluids or tissues of an infected person).5 Where appropriate, this document addresses these additional, non-healthcare scenarios and settings from which Category A waste may arise.
Information in this guidance serves several purposes. As a whole, the document offers readers an overview of Category A waste management in the United States. The main component of this guidance addresses planning for Category A waste management activities, including considerations for developing, evaluating, and revising organizational (e.g., hospital) or jurisdictional (e.g., state, territorial, or local) plans. It is presented in sections that break down waste management activities according to responsibilities as waste is moved from its point of generation to its place of disposal. Several accompanying appendices provide users with information about pathogens classified as Category A infectious substances, decision making for waste treatment and disposal activities, communicating effectively about safe waste management and associated issues, and additional related resources. The included listing of acronyms and glossary of terms applies to the entire document. Unless otherwise noted, references to a particular appendix or section refer to parts of this document (and, in the electronic version, can be clicked to navigate to that information directly).
Note that this document intentionally repeats some information, particularly when waste management requires actions from multiple parties (e.g., overlapping responsibilities between waste generators and waste transporters). Information presented in the planning guidance is also intentionally repeated in the appendices to make it as accessible as possible for a wide variety of readers. (Page 4.)
4. This document is not intended to cover Category B infectious substances (UN 3373) nor Category A Infectious substances that affect animals only (UN 2900). Category A infectious substances that affect humans and animals are categorized as Category A Infectious substances, affecting humans (UN 2814).
5. Appendix B – Infectious Agent Categorization distinguishes these “cultures only” pathogens from other Category A pathogens. (See page 37.)
What this is for: To provide detailed step by step procedures for use with the CDC guidance on Ebola-Associated Waste Management.
]]>Who this if for: Hospital infection control, occupational health systems, and facility medical waste managers and personnel
What this is for: To provide detailed step by step procedures for use with the CDC guidance on Ebola-Associated Waste Management.