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Addressing safety and security while delivering an effective microbiology service. Brian I. Duerden & Sam Gillanders Inspector of Microbiology and Infection Control, Department of Health. Management Responsibilities. Do the job! Clinical diagnosis Public health investigations Do it safely
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Addressing safety and security while delivering an effective microbiology service Brian I. Duerden & Sam Gillanders Inspector of Microbiology and Infection Control, Department of Health
Management Responsibilities • Do the job! • Clinical diagnosis • Public health investigations • Do it safely • Staff doing the work • Visitors, students, the public • Keep pathogens secure • In the laboratory • In transit
Inspector of Microbiology • Champion & promote high quality clinical & public health microbiology • all labs in NHS contribute to surveillance • promote standards & quality • identify gaps in specialist & reference micro. • achieve adherence to SOPs • protocols to reduce the risk of loss/misuse • compliance with security • Links with devolved administrations and internationally
Who is responsible? • Laboratory management • Building security • People – safety and security • Staff, visitors, students, couriers, public • Pathogen security (bioterrorism risk) • Senior appointment(s) • Safety • Security
Elements in safety & security • Laboratory facilities • Buildings and access • Equipment • Methods and procedures • Staff • Appointment (screening, selection) • Training; supervision • Pathogens • Storage, transport, disposal
Legal framework • Health & Safety at Work Act 1974 • Anti-Terrorism, Crime and Security Act (ATCSA) 2001 • Control of Substances Hazardous to Health Regulations 2002
Guidance and advice • Home office • Security standards for laboratories 2003 (restricted but available on request) • Personnel security measures for laboratories • ACDP • HSE • CPA
Security and safety • Security • Control of dangerous substances • Specified pathogens (Schedule 5) • Prevent access to these substances by those who seek to use them for terrorist purposes • Safety • Any pathogens that could affect staff/public • Hazard groups • Risk assessment
Buildings/laboratory security • 3 Ds – Deter, Detect, Delay • BUT do not compromise staff safety • Secure doors, windows • Physically robust • Locked • Alarms/cameras • Access • restrict to specified staff/official visitors • Electronic locks (keypads not ideal) • No public thoroughfare
Key areas • Category 4 - Safety and security priority • Safety • Category 3 laboratories • Restricted staff access • Registered with HSE • Security • Schedule 5 pathogens • List of staff with access • Register any stocks held with Home Office
Transport • Safety • Courier, public, receiving laboratory • Required packaging, labelling • Protection from leakage and deterioration • Report adverse incidents/failures • 2005 changes • From hazard group to Categories A & B • Security – avoid risk of theft • Tracking and traceability
Data security • Patient confidentiality • Caldicot etc • Prevent terrorist access • Hard copy and computer records • Stocks held • Methods of preparation
Staff security • Register of all staff • Specific list of all staff with access to ‘dangerous substances’ (Schedule 5) • List of staff with access to Category 3 laboratories (HSE) • HO requires address and contact details for all staff with Schedule 5 pathogen access • Full records – accessible BUT confidential
Recruitment procedures • Check identity, address etc • Registration proof (not photocopy) • Qualifications • Employment history – verified • Unspent convictions • References checked
….not just new employees!! • Existing staff • Locums • Visitors • Students • Non-laboratory staff with access
Personnel responsibilities • Training • Records • Supervision • Formal statement and ensure it happens • CPD, training updates
Pathogen classification • ACDP/COSHH • Hazard group (Category) 1 – 4 • Category 4 – all agree highest level for safety and security • ATCSA • Schedule 5 organisms (Australia list) • Transport • Categories A & B
Transport regulation 2005 • UN classification • Category A (dangerous substances) • Packaging, labelling, secure hand-over, tracking, recording • Category B • Packaging • M. tuberculosis, VTEC, Sh. dysenteriae type 1 • Cat. Abut may be treated as Cat. B if for clinical and diagnostic purposes
Transport aim • Keep the ‘may be transported as Cat B’ option • Produce specific guidance • Ensure packaging and tracking • Remain Cat. A pathogens • Report adverse incidents/inappropriate consignment to HSE
Consolidation • Single package of advice to incorporate • Home Office • HSE • ACDP • Transport • Examples/templates • Support CPA assessments ……….we will try to help!!