Idaho Admin. Code r. 16.03.14.550

Current through September 2, 2024

Section 16.03.14.550 - ENVIRONMENTAL SANITATION

The hospital shall be responsible for the prevention of disease and the maintenance of sanitary conditions.

01.Water Supply. The water supply of a hospital shall meet the following requirements:

a. An approved public or municipal water supply shall be used whenever available; and

b. In areas where an approved public or municipal water supply is not available, a private water supply shall be provided, and it shall meet the standards approved by the Department; and

c. Public or private water supplies shall meet the Idaho Department of Environmental Quality Rules, IDAPA 58.01.08, "Idaho Rules for Public Drinking Water Systems"; and

d. If water is from a private supply, water samples shall be submitted to an approved laboratory for bacteriological examination at least quarterly. Copies of the laboratory reports shall be kept on file in the facility; and

e. There shall be a sufficient amount of water under adequate pressure to meet the sanitary requirements of the facility at all times.

02.Sewage Disposal. All sewage and liquid wastes shall be discharged into a municipal sewerage system where such a system is available. Where a municipal sewerage system is not available, sewage and liquid wastes shall be collected, treated, and disposed of in a manner approved by the Department.

03.Garbage and Refuse Disposal. All garbage from the hospital shall be disposed of as follows:

a. All garbage and refuse shall be collected, stored, and disposed of in a manner that shall not permit the transmission of communicable disease, create a nuisance or fire hazard, or provide a breeding place for insects or rodents; and

b. When municipal garbage collection and disposal services are not available, garbage shall be disposed of by garbage grinders, incineration, burial sanitary fill, or other methods approved by the Department.

04.Garbage Containers. Hospital garbage containers shall meet the following requirements:

a. All containers used for storage of garbage and refuse shall be constructed of durable nonabsorbent material and shall not leak or absorb liquids. Containers shall be provided with tight-fitting lids unless stored in vermin-proof rooms or enclosures; and

b. Garbage containers outside the facility shall be stored at least twelve (12) inches above the ground, if not stored in a dumpster.

c. Garbage containers shall be maintained in a sanitary manner.

05.Insect and Rodent Control. Every hospital shall have a pest control program in effect at all times.

a. This program shall effectively prevent insects, rodents and other pests from entrance to, or infestation of, the facility.

b. Chemicals (pesticides) used in the control program shall be selected, used, and stored, in the following manner:

i. The chemical shall be selected on the basis of the pest involved and used only in the manner described by the manufacturer, who shall be registered with the Idaho Department of Agriculture; and

ii. All toxic chemicals shall be properly labeled and stored under lock and key; and

iii. No toxic chemicals shall be stored in patient areas, with drugs, or in any area where food is stored, prepared, or served; and

iv. The storage and use of pesticides shall be in accordance with local, state, or federal directives.

06.Storage, Transportation, Treatment and Disposal of Infectious Waste.

a. For purposes of this section, the following definitions shall apply:

i. Storage shall mean the containment of infectious waste in such a manner as not to constitute treatment of such waste.

ii. Transport shall mean the movement of infectious waste from the point of generation to any intermediate point and finally to the point of treatment and such waste must be transported by haulers knowledgeable in handling of infectious waste.

iii. Treatment shall mean any method, technique or process used to change the character or composition of any infectious waste so as to render such waste noninfectious. Effective treatment may include, but is not limited to, one (1) of the following methods:

(1) Incineration in an incineration facility approved and permitted in accordance with the current requirements of the Idaho Air Quality Bureau. Incinerators shall be capable of providing proper temperatures and residence time to ensure destruction of all pathogenic organisms.

(2) Sterilization by heating in a steam sterilizer utilizing saturated steam within a pressure vessel (known as a steam sterilizer, autoclave or retort) at time lengths and temperatures sufficient to kill infectious agents within the waste. Operating procedures shall include, but are not limited to, standards for temperature settings, residence times, recording or operational procedures and results, and periodic testing by treatment indicators.

(3) Discharge of liquid or semi-solid waste into a sanitary sewer that provides secondary treatment of waste.

(4) One (1) of several less commonly used methods such as chemical disinfection, thermal inactivation, gas/vapor sterilization or irradiation. Efficacy of the method shall be demonstrated by the development of a biological testing program, e.g., spore strips. Monitoring shall be conducted on a periodic basis using appropriate indicators.

iv. Disposal shall mean the final placement of treated waste in a properly permitted landfill.

b. Storage and transport of infectious waste. The following shall apply:

i. Containment of infectious waste shall be in a manner and location that affords protection from animals, rain and wind; does not provide a breeding place or a food source for insects and rodents; and minimizes exposure to the waste by the public. Enclosures used for containment of infectious waste shall be secured so as to deny access by unauthorized persons and shall be marked with prominent warning signs.

ii. Infectious waste, except for sharps, shall be contained in disposable containers/bags that are impervious to moisture and have a strength sufficient to preclude ripping, tearing or busting under normal conditions of use. The bags shall be securely tied so as to prevent leakage or expulsion of solid or liquid waste during storage, handling or transport. The containment system shall have a tight-fitting cover and be kept clean and in good repair.

iii. Sharps shall be disposed of in impervious, rigid, puncture-resistant containers immediately after use. Needles shall not be bent, clipped or broken by hand.

iv. All bags used for containment of infectious waste shall be clearly identified by label or color, or both. Rigid containers of discarded sharps shall be labeled in the same way or placed in the disposable bags used for other infectious waste.

v. Reusable containers for infectious waste shall be thoroughly washed and decontaminated each time they are emptied by an approved method for decontamination as described in Subsection 550.06.b.v.(1), unless the surfaces of the containers have been protected from contamination by disposable liners, bags or other devices removed with the waste except for that waste outlined in Subsection 550.06.b.ii.

(1) Approved methods of decontamination include, but are not limited to, agitation to remove visible soil combined with exposure to hot water of at least one hundred eighty (180) degrees Fahrenheit for a minimum of fifteen (15) seconds; or exposure to a chemical sanitizer by rinsing with or immersion in one (1) of the following for a minimum of three (3) minutes: hypochlorite solution (five hundred (500) ppm available chlorine), phenolic solution (five hundred (500) ppm active agent), iodophor solution (one hundred (100) ppm available iodine), or quaternary ammonium solution (four hundred (400) ppm active agent).

(2) Reusable pails, drums, dumpsters or bins used for containment of infectious waste shall not be used for containment of waste to be disposed of as noninfectious waste or for other purposes except after being decontaminated by procedures as described in Subsection 550.06.

vi. Trash chutes shall not be used to transfer infectious waste between locations where the waste is contained.

vii. Storage of infectious waste shall not exceed seven (7) days unless stored at a temperature below thirty-two (32) degrees Fahrenheit, but no longer than ninety (90) days.

c. Treatment and disposal of infectious waste. Except as otherwise provided in these rules, infectious waste shall be treated prior to disposal using a process defined in Subsection 550.06.

d. Alternate Methods. Where on-site treatment of infectious waste is demonstrated to be economically or technically unfeasible, by petition to the licensing agency, alternate methods of on-site or off-site treatment or disposal may be used with the approval of the licensing agency.

07.Plumbing. The hospital plumbing system shall be free from cross-connections and interconnections between a safe water supply and one that is subject to contamination.

08.Heating and Ventilation. The heating and ventilation system in a hospital shall meet the following:

a. The systems shall be so designed and maintained as to provide sufficient capacity for the demands of the hospital; and

b. Patient's rooms shall be so ventilated by natural or mechanical means to assure a fresh air supply.

09.Housekeeping. Each hospital shall establish an organized housekeeping service with sufficient personnel to maintain and provide a pleasant, safe, and sanitary environment.

a. The service shall be under the supervision of a person competent in environmental sanitation and management; and

b. There shall be specific written procedures for appropriate cleaning of all service areas in the hospital, giving special emphasis to procedures applying to infection control; and

c. All mop heads shall be removable and changed daily; and

d. Suitable equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition; and

e. Selection of germicides shall be under the supervision of the infection committee; and

f. Solutions, cleaning compounds, and hazardous substances shall be labeled properly and stored in safe places; and

g. Dry dusting and sweeping are prohibited; and

h. Surgeries, nurseries, delivery rooms, dietary, and laundry shall have separate housekeeping equipment; and

i. There shall be evidence of orientation training for all new employees and continuing education for all employees.

10.Laundry. Where laundry facilities are provided within the hospital, the following shall apply:

a. There shall be space provided for the processing of laundry. Isolation linens shall be processed separately. All linens and garments used for newborn infants shall be processed separately from other hospital laundry; and

b. Space separate from the laundry processing area shall be provided for the storing and mending of clean linen; and

c. Handwashing facilities with hot and cold running water, soap, soap dispenser, disposable towels, and waste receptacles shall be provided for laundry personnel; and

d. Carts, bags, hampers, or other devices for the transporting and handling of soiled laundry shall not be used to distribute clean linen; and

e. All soiled laundry or clean linens shall be covered during transportation throughout the hospital; and

f. Isolation linen shall be bagged and identified separately; and

g. Provisions shall be made for mechanical ventilation in the laundry area. Special care shall be taken to prevent the recirculation of air from these areas through the heating and/or air conditioning system of the hospital; and

h. Soiled linen carts shall be constructed of impervious material and cleaned after each use; and

i. There shall be evidence of continuing education related to infection control.

Idaho Admin. Code r. 16.03.14.550

Effective March 17, 2022