Blood Borne Virus Guidelines

[Ian Wilde]

Is it just me or has there not been a revision for 10 years now?

Most recent one I can find is 2009.  Anyone have anything different?

MRSA doesn't even appear to get a mention?

[Garry]

Hi Ian,

I seem to have a small collection with one update being slightly more up to date.

DOH - Good practice guidelines for renal dialysis/transplantation units - 2002
RA Guideline - Blood borne Virus infection - 2009
DOH - Good practice guidelines for renal dialysis/transplantation units-addendum 2010

[fraser gilmour]

The RA guideline has been revised and is currently being reviewed by the committee, due to be released within the next few months.  

[fraser gilmour]

FINAL-BBV-Guideline-June-2019.pdf

https://renal.org/wp-content/uploads/2019/06/FINAL-BBV-Guideline-June-2019.pdf

[Chris Pearson]

"External cleaning After each session, the exterior of the dialysis machine should be cleaned with a low-level disinfectant if not visibly contaminated. If   a   blood   spillage   has   occurred,   the   exterior   should   be   disinfected   with   a   commercially   available tuberculocidal  germicide  or  a  solution  containing  at  least  500  p.p.m.  hypochlorite  (a  1:100  dilution  of  5% household  bleach)  if  this  is  not  detrimental  to  the  surface  of  dialysis  machines.  Advice  on  suitable disinfectants, and the concentration and contact time required, should be provided by the manufacturer."

Is that correct in my COBE manual it says 1:9 dilution giving 0.5% solution ,that's what we have been recommending for our branded bleach ?

[fraser gilmour]

This seems to have been taken from and old KDIGO guideline for prevention of Hep C transmission, I can't see that the updated (2018) guideline gives any recommendation of hypochlorite level.
Our IPC would say 10000ppm for a blood spillage anyway, and I don't think any equipment manufacturer would sanction this strength. We moved a away from bleach a long time ago.  

[Chris Pearson]

The para I've quoted is from the document you linked to Fraser.

[fraser gilmour]

Yes Chris, the new RA guideline is quoting an old KDIGO document. I assume this has been missed in the review

[Roger Moore]

Our Trust IP department also state 10,000 ppm when dealing with blood contamination.

This is also stated by HSE http://www.hse.gov.uk/biosafety/blood-borne-viruses/methods-of-decontamination.htm under 'Chemical disinfection of blood or body fluid spillage'.

This is also useful https://www.infectionpreventioncontrol.co.uk/content/uploads/2015/05/06-Decontamination-Cleaning-and-Disinfection-May-2015-Version-1.01.pdf

[Chris Pearson]

Hi Roger,
A hypochlorite product of 10,000 ppm.  This can be in the form of granules, e.g.,Haz tabs, or a solution, i.e.,Milton 2%,using 1 part Milton to 2 parts water.  (Household bleach can be used –usually 1 part bleach to 10 parts water –but check manufacturer’s instructions.

I agree, but still think it should be 1:9 ratio to give a 0.5% solution rather than 1:10 stated or is my maths wrong ?

Cheers,
Chris

[Roger Moore]

My maths agrees with yours Chris as 1 part to 9 parts.