Piercing of the skin. Code of practice summary

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1 BC2768 Piercing of the skin Code of practice summary The following information is for commercial services such as body piercing, tatting, traditional tls tatting, acupuncture, electrolysis, extractions, red vein treatment and derma rolling/stamping which pierce the skin. As these services can sometimes carry a risk of transmitting diseases such as Hepatitis B, C and HIV,and Septicaemia, it is important to avoid any risk to the customer through high health standards. Your business premises Premises should be clean and hygienic and instruments should be single-use and disposable or able to be readily sterilised. Operators must keep surfaces clean, and wear gloves and protective equipment. Appropriate aftercare instructions should be given to the customer, and check they understand these instructions. There are minimum standards you must comply with if you have a shop (premises) or are a mobile operation and you must obtain a Health Protection Licence to operate. Information on premises, the conduct required of all operators and the relevant commercial service that you provide are included in this pack. Working with your customer When providing a health service, it is a gd idea to have a conversation with the customer before commencing any treatment so they are aware of what the process will be and you, the operator, are aware of any potential risk to their health. Appropriate aftercare instructions should be given to the customer, and check they understand these instructions.

2 Customer information first Before you begin any service that may pierce the skin, there are things that you need to know about your customer. Age restriction No operator may carry out any commercial skin piercing service on any person under 16 years of age unless the parent or guardian gives written permission. This does not apply to tatting. No operator may carry out tatting on any person under 18 years of age unless the parent or guardian gives written permission. Consent Any customer who wishes to under-go a commercial skin piercing service must complete and sign a written consent form outlining their medical history that will inform the operator at the start if they have or suspect they have: a communicable disease or skin disease haemophilia or are taking medications that thin the bld allergies or adverse reactions to dyes and pigments; or epilepsy or seizures. The operator may decline to carry out any commercial service based on such information or may agree to carry out the commercial service with appropriate conditions and safeguards. Advice on precautions Before the start of any commercial skin piercing service, the operator must: advise the customer of the risks associated with the service and the potential for infection during and after the service; and must give written advice, concerning precautions and after-care procedures that should be taken by the customer. Aftercare Aftercare instructions should cover wound cleaning, drying and dressing, avoidance of dirt, chemicals, irritants and sunlight, recognition of infection (pain, redness, swelling and heat) and what to do, and specific instructions for mouth and genital piercings. A medical practitioner should be consulted in the case of any complications. Record keeping All operators must keep records of: a customer consent form for the procedure to be undertaken listing any medical conditions and signed consent the names and addresses of any customer who undergoes any skin piercing service the date on which the skin piercing service was undertaken the nature of the skin piercing service; and the location on the body where the skin piercing service was undertaken. Such records must be kept secure and confidential for a minimum of two years and made available to council for inspection on request.

3 How to provide a safe service First Aid At least one operator on the premises must hold a current St John s or Red Cross First Aid Workplace Certificate or an approved equivalent. Hand-washing and gloves Operators must thoroughly wash his or her hands up to the wrist with soap/anti-bacterial cleansing agent before putting on single-use disposable gloves and commencing any skin piercing process. To also maintain a high level of cleanliness, use a clean nail-brush when necessary for the hands and nails and single-use paper towel or other approved hand-drying equipment to dry hands. All operators must cover their hands with clean, single-use disposable gloves: before preparing the area for the skin piercing process before starting the skin piercing process after touching any object that has not been subject to a process of cleaning and sterilisation unless an effective sterile barrier has been used. Skin preparation The skin site should be evaluated before service and any skin condition that may lead to skin irritation should be discussed. Before starting any skin piercing activity, all operators must cleanse the customer s skin by swabbing with an antiseptic using a clean, single-use swab. Product-specific contact time should be maintained. Instruments used All instruments or similar articles used for piercing the skin must be either single use disposable or cleaned and sterilised in accordance with the procedures outlined below and kept in such a manner as to maintain their sterility. No marker pen or similar device used to mark any mucous membrane of any customer must be used to mark any mucous membrane of any other person An instrument or like article with a hollow lumen must be single-use and disposable An instrument or similar article may be used for piercing the skin on any customer if it has been taken out of a package from the manufacturer in the presence of the customer and the package is in an: undamaged condition the manufacturer has affixed a label stating that the contents have been sterilised the contents, if steam sterilised, have been packaged according to standards AS/NZS 4187:2003 it has not been subjected to any contamination during storage. After piercing the skin All operators must ensure that, after the completing piercing the skin: all single-use needles/razors are immediately disposed of to waste in a dry puncture resistant container; and any reusable instrument, appliance or like article used in that process is thoroughly cleansed, rinsed and sterilised in accordance with the provisions of Sterilisation below and stored in an appropriate manner, so as to maintain its sterility before use on any other customer or the same customer at a later time. All sharps containers and bio hazard waste bins must comply with standard AS/NZS 4031:1992, and all operators must demonstrate that they have made appropriate arrangements to dispose of sharps and bio hazard wastes.

4 Sterilisation All operators must display written instructions adjacent to every place in the premises where cleaning and/ or sterilising of instruments is undertaken. These instructions should set out clearly the processes to be followed to ensure compliance with sterilisation and ultrasonic cleaning. All instruments used for piercing the skin must be sterilised after each use, by way of thoroughly cleansing by washing in warm water and detergent or within an ultrasonic cleaner and exposed to steam in accordance with the following requirements: exposure to steam must occur within a steriliser (autoclave) under appropriate time, temperature and pressure parameters every steriliser (autoclave) must be fitted with time, temperature and pressure gauges each time the steriliser (autoclave) is used chemical indicator strips must be inserted. If the chemical indicator / integrator fails to change colour, all of the load contents must be reprocessed during each use the gauges must be viewed to ensure that the correct times, temperatures and pressures are reached time, temperature and pressure readings must be recorded and noted after each usage regular spore testing must be undertaken and the results recorded o o the steriliser (autoclave) must be serviced at no less than six monthly intervals, or according to manufacturer s instructions and the results recorded. These records must be maintained for a minimum of two years and made available to council for inspection on request; or thoroughly cleansed by washing in warm water and detergent and exposed to dry heat for at least 60 minutes at not less than 170 degrees Celsius; or thoroughly cleansed by washing in cold water and detergent and then totally immersed in a glass bead steriliser operating at 250 degrees Celsius for a minimum of 5 minutes; or thoroughly cleansed by a method appropriate to the nature of the article concerned and then submitted to a process of sterilisation approved by council. (Note: This may include ethylene oxide treatment and gamma irradiation) all instruments or similar articles must be individually packaged and marked sterile or display a sterility indicator tape. The packaging must be intact and the items stored to preserve the sterility of the instruments. Ultrasonic cleaners should comply with recognisable standards such as Australian Standard AS :1998 and AS :1999 as appropriate. The cleaning, disinfection and sterilising requirements within this code of practice are based on AS/NZS 4187:2003 standards.

5 Best Practice: additional recommendations Operators information for your protection Immunisation against Hepatitis B is highly recommended. A protective apron or garment is recommended where it is likely that the operator s clothing may be contaminated by bld or bodily fluids. Eye protection / face shields should be worn when performing close-up procedures that may cause aerosols of bld or body fluids. Accidents It is recommended that there be written procedures for dealing with bleeding, sharps injuries and contact with bld and body fluids. The Ministry of Health Guidelines for the Safe Piercing of Skin outlines procedures to deal with bleeding, sharp injuries and contact with bld or body fluids. Cleaning Industry standard cleansers and detergents should be used. Alkaline detergents are much more effective at removing bld and fat than plain surfactant based detergents. Note that chlorine solutions may corrode metals. Gluteraldehyde and phenol are not recommended as disinfectants because of the health risks involved in their usage. To reduce the risk of cross contamination cleaning and decontamination activities should not take place at the same time as packaging and/or sterilisation activities. Sterilisation Holding times must be adhered to for autoclaves. Bench top steam sterilisers without a drying cycle are only appropriate for the sterilisation of unwrapped items. Autoclaves should comply with a recognised national or international standard. Ultrasonic cleaners clean but do not disinfect instruments and equipment. They should be operated with the lid closed, and ideally in a separate work area that is well ventilated. Reusable equipment that is to be autoclaved should have chemical integrator/indicator tape or some other product on or within the packaging to identify when the equipment has been properly sterilised. This is to prevent non-sterile equipment being used by mistake. Please note that chemical integrator/ indicator tape may not be UV stable, so should be stored in a cl, dry, dark place. Find out more: This information is from the Health & Hygiene Code of Practice 2013 and is relevant to your business. For a full copy of the Code of Practice please see A listing of all relevant NZ Health Standards is contained in this pack for your reference.

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