Health and Safety

As with all Aesthetic procedures you will need to maintain a high standard of hygiene as well as health and safety, not only for yourself but also for your employees, clients, and any visitors to your business.

It is a legal requirement for employees to display an approved health and safety poster or to provide employees with an equivalent leaflet or information.

All businesses are required by law to comply with the following acts, which are monitored and managed by The Health & Safety Executive (HSE). You should also get copies of the following regulations from your local council or off the HSE website.

Health and Safety at Work Act 1974

This protects your rights as an employer or employee. The law states that the employer must provide a safe working environment, provide health and safety training for staff, produce a written policy of the company’s health and safety policy and ensure that anyone on their premises is not exposed to any health or safety risks.

Trade Descriptions Act (1968 and 1972)

These Acts prohibit the use of false descriptions of goods or services. The information must always be accurate, false comparisons must not be made, and misleading price comparisons must not be made. A product may not be described as of a ‘reduced’ price if it has not been available at a higher price for a minimum of 28 days.

General Data Protection Regulation GDPR 

If you are collecting and storing personal data as a therapist, then you will need to comply with GDPR. You will need to decide which of the six lawful bases on which you will collect and store personal data and inform your clients of how and why you will retain their data and for how long. The Independent Commissioners Office will provide you with all relevant information.

Sale and Supply of Goods Act 1994

This states that goods must be as described and of satisfactory quality. They should be fit for purpose and safe for use. It is the responsibility of the retailer to correct a problem where the goods are not as described.

COSHH Regulations and Risk Assessment (Control of Substances Hazardous to Health)

COSHH regulations cover the essential requirements for controlling exposure to hazardous substances, and for protecting people who may be affected by them. You should carry out a COSHH assessment to identify all chemicals, products or other substances which could cause harm.

A substance is hazardous if it can cause harm to the body. It poses a risk if it is inhaled, ingested, in contact with the skin, absorbed through the skin, injected into the body, or introduced to the body through cuts.

Always check the ingredients and instructions of all products to see what they contain and ensure they are correctly stored. If the product could cause harm, it should be listed on your COSHH assessment, together with what the risk is and who is at risk from it.

Next, decide on the degree of risk and who to minimise that risk. If you can, try to replace high-risk products with lower risk ones. Never leave chemicals identified as hazardous in areas accessible to the public. Do not forget, COSHH substances include both those used for treatments and cleaning.

Local Government (Miscellaneous Provisions) Act 1982

A special treatment licence will be required if you carry out any form of massage, electrolysis or ear piercing and tattooing as they may produce blood and body tissue fluid. Each borough council in the UK has different requirements, so you should contact them to see whether they require you to hold a licence for the treatments you offer.

The Management of Health and Safety at Work Regulations 1999

Employers should make formal arrangements for maintaining and improving safe working conditions and practices. This includes competency training and risk assessments.

Management of Health and Safety at Work Regulations 1999

Employers should make formal arrangements for maintaining and improving safe working conditions and practices. This includes competency training and risk assessments.

The Manual Handling Operations Regulations 1992

This is relevant wherever manual lifting occurs to prevent skeletal and muscular disorders. The employer should undertake a risk assessment for all activities involving manual lifting.

The Personal Protective Equipment at Work Regulations 2002

This requires employers to identify activities which require special protective clothing, which must then be made available.

The Health and Safety (Display Screen Equipment) Regulations 1992

This covers the use of display screens and computer screens. This specifies the acceptable levels of radiation emissions from the screen, as well as identifying the correct posture and the number of rest periods.

The Electricity at Work Regulations 1992

Electrical items are potentially hazardous and should be used and maintained properly. You should always ensure that you are fully trained on a piece of equipment before operating it.

All electrical equipment should be regularly PAT tested to ensure it is safe to use. If any equipment is deemed to be faulty or unsafe, you should stop using it immediately and report the problem. Make sure the equipment is clearly marked as faulty until the problem has been corrected to avoid it being used by other members of staff.

Health and Safety (First Aid) Regulations 1981

Whatever the size of your business, you should always make sure you have a First Aid kit on-site, as well as an eyewash bottle. You should ensure this is fully stocked at all times. You should have at least one ‘Appointed Person’ on hand to take charge in an emergency who holds an HSE-approved basic first aid qualification. You can contact the HSE on 0845 345 0055 for a list of suitable training providers.

RIDDOR-The Reporting of Injuries, Diseases & Dangerous Occurrences Regulations 1995

Employers should report any such cases to the HSE Incident Contact Centre. This includes loss of sight, amputation, fracture, and electric shock. In all cases where a personal injury of any type occurs, it should be recorded in an accident book.

The Regulatory Reform (Fire Safety) 2005

All premises must have adequate means of dealing with a fire, and all members of staff should know where these are. This can include fire extinguishers and blankets; however, you should only operate a fire extinguisher if you have been properly trained to do so. All equipment should be checked and maintained regularly.

Fire Drill notices should be clearly displayed and should inform people of what to do in case of a fire. All staff should be trained in the location of alarms, exits and meeting points.

Consumer Protection Act 1987

This Act aims to protect the customer from unsafe or defective services or products. All staff should be trained in using and maintaining products.

The Provision and Use of Work Equipment Regulations 1998

This states the duties of any users of the equipment. It identifies the requirements in selecting and maintaining suitable equipment, as well as the training and safe use of it.

Cosmetic Products (Safety) Regulations 2008

These regulations require that cosmetics and toiletries are safe for their intended purpose and comply with labelling requirements.

Disability Discrimination Act 1996

You should ensure that clients are not discriminated against on the grounds of disability. You cannot use this as a reason to refuse to provide a service, provide a service to a lesser standard or fail to make reasonable adjustments. The premises must be able to facilitate access for disabled people.

The Equality Act 2010

gives disabled people important rights of access to everyday services. Service providers have an obligation to make reasonable adjustments to premises or to the way they provide a service. Sometimes it just takes minor changes to make a service accessible. What is considered a reasonable adjustment for a large business such as a bank, may be different from what is a reasonable adjustment for a small local salon. It is about what is practical in the service provider’s individual situation and what resources the business may have. They will not be required to make adjustments that are not reasonable because they are unaffordable or impractical.

 

 

 

 

 

 

 

 

 

 

 

 

Reporting Accidents

All accidents and near misses should be recorded in an Accident Report Book, which should be kept with a first aid kit on the premises.

The following information must be recorded:

  • Full name and address of the person(s) involved in the accident.
  • Circumstances of the accident.
  • Date and time of the accident.
  • All details of what may have contributed to the accident.
  • The type of injury that occurred and treatment provided on or off-site.
  • Details of any witnesses.

The Personal Protective Equipment at Work Regulations 1992

This act covers your requirements under the COSHH regulations. You are required to wear or provide to your employee’s protective clothing or equipment (PPE) to ensure their health and safety when handling chemicals or coming into contact with bodily fluids.

What PPE will you need?

  • Powder-free non-latex Gloves that must be changed for each new client.
  • Disposable aprons.
  • Face Masks
  • Eyewear (optional)

Some therapists like to wear eye protection, although the risk is very low from spillages or splashes. However, a new apron, facemask and gloves should be worn before each new client.

Clinical Hygiene, Health & Safety

  • Your clinic should be cleaned thoroughly every day.
  • The working area must be cleaned before and after every client.
  • Fresh towels and linen should be used for every new client that has been laundered at a minimum of 60°C.
  • Couch roll, disposable plastic sheeting or waterproof bed sheets need to be used to protect the couch and keep the area as clean as possible.
  • Products should be dispensed from purpose-specific pump or spray bottles. Creams can be removed from jars or bottles with clean spatulas.
  • Replace all lids on products securely after use.
  • All tools that are non-disposable should be sterilised prior to use.
  • Bins should be metal and have foot pedal operations and be emptied every day. Bins should be collected by an appropriate commercial waste disposal company.
  • All fire exits should be clearly marked and accessible.
  • Read all labels and follow manufactures instructions.
  • Know the hazardous warning signs on products.
  • Store products safely and in accordance with safety data sheets.
  • Ensure equipment is placed on a sturdy surface and cannot fall off.
  • Check wires and plugs regularly on any electrical equipment. Ensure electrical equipment is PAT tested annually. Faulty equipment should not be used.
  • A first aid kit that complies with the Health and Safety (First Aid) Regulations 1981.

Appearance of the Practitioner

A therapist should ensure that they look well presented at all times. Therapists will be working in close contact with a client, and it is important that a professional image is observed.

A therapist should:

  • Wear clean, freshly laundered, and ironed uniform each day.
  • Wear clean, flat, closed-toe shoes.
  • Have short, clean, manicured nails.
  • Have a fresh breath.
  • Wear antiperspirant.
  • Apply modest makeup for a natural look.
  • Wear hair up and away from the face.
  • Wear minimal jewellery.

Professional Ethics and Standards of Practice

Practitioners should:

  • Maintain the highest possible standards of professional conduct.
  • Always be courteous and show respect for clients, colleagues, and other professionals.
  • Never gossip or criticise another practitioner or brand.
  • Never talk across a client to another member of staff.
  • Not to engage in conversations about politics, religion or race that may cause offence.
  • Maintain a good reputation by setting an example of good conduct in all your communication with clients, team members and visitors to the business.
  • Ensure to make the treatment or service special for every client.
  • Respect client confidentiality.
  • Explain the treatment to the client and answer any questions and queries prior to carrying out the treatment.
  • Treat all clients in a professional manner at all times regardless of their race, colour, religion, sexual orientation or ability.
  • Not to treat minors or clients with limited mental capacities, such as those with Alzheimer’s or dementia without prior written consent from a parent or carer.

Practising good ethics is essential for the reputation of the therapist and the welfare of the clients. The following is an example of standards and ethics for therapists:

  • Conduct yourself in a professional, honest, and ethical manner.
  • Promote professionalism
  • Establish a treatment plan with your client and evaluate the outcome at the end of every session.
  • Truthfully represent your credentials, qualifications and education, experience, training and competence relevant to practice.
  • Maintain the confidentiality of the client.
  • Take a full medical history of the client and ensure that they are suitable for treatment and the treatment is the best solution for their concerns.
  • Give full aftercare advice.

Precautions Taken in the Salon to Prevent Contamination and Cross-Infection

Hands

Wash with soap/disinfectant and warm water before and after each client—dry hands with a paper towel or blower.

Surfaces

Wipe over with disinfectants, e.g. Alcohol, Surgical spirits.

Treatment of Wounds

If the skin bruises or bleeds after the insertion of a needle, a small pad of dry cotton wool should be used over the area to cover it and apply pressure until the bleeding stops. Apply aftercare solution to the area and work in a different area. The same applies to extractions or any other form of skin piercing. Use disinfectant to clean area.

Disposal

Sharp metal instruments, e.g. needles, lancets, should be placed in a sharps box after use. When the box is about 3/4 full, it may be disposed of by special arrangement. Usually collected by local health office and incinerated at a local hospital.

Metal Instruments

Sterilised before and after each client in Autoclave or in Glass bead steriliser, and wipe with Chlorhexidine Gluconate or Methylated spirits.

Skin Preparation

Do not use sharp or pointed instruments on or at least near areas of a client’s skin that are obviously diseased, infected, or inflamed. Except in facial treatments during the extracting phase (a tile with a lancet and cotton wool dampened with methylated spirits and an antiseptic solution containing Chlorhexidine Gluconate must be prepared, hands should be washed before and after extractions and finger cots or gloves must be used).

Cuts on your Hands

Cover existing wounds with a waterproof dressing, wash fresh cuts and encourage bleeding under running water and then cover with a waterproof dressing. Clean with an antiseptic. Always have a box of plasters/waterproof dressing available. No salon should be without a first aid kit.

Needles

Do not test needles on yourself. Test needles on a damp of cotton wool held with tweezers. Needles should only be used once, and needles must not be used on more than one client.

Creams

Tubes are better than jars. Always use a spatula to obtain creams from containers. Never use fingers and always close a container after use. Excess product must not be returned to containers.

Blood

Anything that has come into contact with blood must be disposed of in the correct manner. Pay attention to the following: Hands, lancets, tweezers, surface, disposal gloves, bin liners, cotton wool or gauze and needles.

Colds/Flu

Wear a surgical mask. Wash your hands regularly, especially after sneezing or blowing the nose. Also, wash hands in general after touching other surface areas. General advice – stay at home when feeling ill or send employees home if they develop cold/flu symptoms at work.

Waste Bins

Bin liners. Emptied regularly. Bins should have lids.

Gloves

Surgical gloves can be used, e.g. Epilation or, to prevent contamination. Used always when performing any procedure that breaks the skin and any action that may come into touch with blood.

Instruments

Must be cleaned, sanitised, and sterilised or where appropriate disposable tools should be used.

Sterilisation Methods

Autoclave

  • Works like a pressure cooker.
  • Consists of 2 chambers. Water in the lower chamber and instruments on the upper chamber.
  • The principle of sterilisation is moist heat.
  • The water boils in the lower chamber and steam is released towards the upper chamber. Instruments are left in the unit for 10 – 20 min. Afterwards, instruments must be placed in a sterile and clean container.
  • The moist heat autoclave operates at 121°C and is considered a very effective means of sterilisation.
  • Other types available, e.g., dry heat autoclave, vacuum autoclave, flash instrument autoclave.
  • The time and temperature of dry heat autoclave is 160°C (320°F) for 2 hours or 180°C (356°F) for one hour.

Consult manufacturer’s instructions and local government laws and regulations on sterilisation times and temperatures.

Advantages of an Autoclave

  • Economical and very effective
  • Non-toxic on instruments
  • Easy to operate

Disadvantages of an Autoclave

  • Sharp instruments can become blunt.
  • Metal instruments might rust. Recommend use of stainless-steel instruments.
  • Expensive
  • Plastic instruments will be damaged.
  • Autoclaves will need to be kept clean.
  • Regular servicing and calibration are required of the device.

 

Glass Bead Steriliser

  • Operates at approximately 300°C.
  • Metal instruments will thus be completely sterilised within minutes.
  • Only the parts covered with beads will be sterilised.
  • The unit takes + 20 – 30 minutes to warm up before sterilisation can take place.
  • If more than one instrument is placed in the container, a longer time must be added for sterilisation.
  • Consult manufacturers` instructions and local government laws and regulations on sterilisation times and temperatures

 

 

 

 

 

Wet Sterilisation (Chemical)

Asepsis can be obtained by washing down all surfaces, walls, floors, treatment beds, tiles, trolleys, work surfaces, basins etc. after basic cleaning with an antiseptic solution. EG: Antiseptic solution concentrates, diluted according to manufacturers’ instructions. Towels can also be disinfected in this method. If metal tools are sterilised by this method, the liquid must contain a rust inhibitor.

UV Cabinet

  • They are used for the maintenance of your sterilisation process.
  • Basically, used as a storage unit.
  • They are not used for sterilisation only for sanitation.
  • This cabinet will keep your item as clean as it was when you first inserted it.

 

Antiseptics and Disinfectants

Antiseptic

A diluted disinfectant that is safe to apply to the skin. Its’ task is to slow down multiplication, growth and in some cases may destroy/kill micro-organisms if the strength of the solution is correct, e.g. some soaps (hands), alcohol and hydrogen peroxide etc.

Disinfectant

A chemical agent which destroys or kills all micro-organisms. Safe to apply on surfaces but too toxic to be applied directly onto the skin, e.g. Quaternary Ammonium compound/Quats, formalin, ethyl or grain alcohol.

Ergonomics

Posture is important, whether you are sitting or standing up to do a treatment. Try to find a working position that is comfortable for you and reduces the need to lean over to just one side.

Using height adjustable treatment couches and chairs. Choose a height that reduces your need for bending over the client. Ideally, your back should be at a 90-degree angle. Your chair should be comfortable to avoid pressure point sores or injury.

Try to avoid twisting the neck, keep your head upright and keep your shoulders relaxed.

Never ignore pain; look at ways to alleviate the symptoms. If you cannot take a break during treatment, then you can adopt gentle stretching techniques.

Repetitive strain injuries can be caused by using the same movements over and over again. Try to avoid repetitive flexing of the wrist and instead alternate by bending elbows or shoulders instead. Equipment should feel comfortable in your hand and have as minimal vibration as possible.

Storage

  • Make sure you receive a copy of Material Safety Data Sheets (MSDS) from your suppliers.
  • All staff must be trained on the use of products and equipment.
  • Training manuals and information leaflets should be accessible to all staff.
  • Store your products correctly by following the guidance on the MSDS.
  • Carry out a risk assessment on each product or COSHH report if required.
  • Keep products in original containers where possible and ensure any decanted products are fully labelled in smaller, purpose-built containers.
  • Keep all flammable products out of direct sunlight and at room temperature or below.
  • Mobile therapists must make suitable travel arrangements to avoid spillage and ensure safe working practice and be professional in appearance.

Insurance

There are several types of insurance that are potentially relevant to you as a therapist. The most important is the ‘Professional Indemnity Insurance’ and ‘Public Liability Insurance’. Both of these are necessary in the unlikely event that a client decided to sue you.

Public Liability Insurance – This covers you if a member of the public, i.e. a client or passer-by is injured on your premises or if their personal property is damaged in any way.

Professional Indemnity Insurance – This protects you should a client decide to sue you claiming personal injury or damage as a result of treatments carried out by you.

Employer’s Liability Insurance – This is only necessary if you hire others to work for you. This type of insurance would cover you should a member of your staff have an injury on your premises.

Product Liability Insurance – This insurance is important if you plan to use, manufacture or sell products as part of your business. This will protect you in the event that a client is dissatisfied with the product or experiences a reaction to using the product.

Car Insurance – If a car is used for business purposes, ensure that this is covered by the policy and that theft of equipment is included.

 

Aesthetics Health & Safety 

Advertisements on Prescription-Only-Medication (POM) Treatment

New enforceable guidelines for advertising Prescription-Only-Medication such as Botulinum Toxin or Vitamin Injections such as B12, C & D came into effect on the 31st January 2020. This is regulated by the Committee of Advertising Practice (CAP), who will use specialist new monitoring technology to discover non-compliant ads and take action. One such outcome may be the reporting of specific ads or posts on social media platforms like Instagram.

The Advertising Standards Authority (ASA) was established in 1963 as an industry watchdog to monitor and adjudicate any breaches of the British Code of Advertising Practice (CAP Code) with the primary objective of protecting the public from inaccurate, inappropriate, or misleading adverts, whether online, in print or via broadcast.

Any promotion of a POM to the public is a breach of the CAP Code and an offence under the Human Medicines Regulations 2012.

Code 12.12 of the CAP states that “Prescription-only medicines or prescription-only medical treatments may not be advertised to the public.”

Administration of Prescribed Products 

The Medicines and Healthcare products Regulatory Agency (MHRA) states that any person can administer certain prescribed products, i.e., Botulism Toxin, in accordance with the guidance of an appropriate practitioner. This means that according to the MHRA, Non-prescribers and non-medics can administer procedures using prescribed products following instruction from either a doctor, dentist, or appropriately qualified independent prescriber.

Beyond the administration of these products, they are prescribed drugs, and therefore there are strict guidelines as to who can prescribe the medication. Prescriptions should only be issued after adequately assessing the client and giving client-specific instructions (ideally written). Non-medics or nurses are not allowed to prescribe these products for use, but if they have been given a prescription with specific instructions by the prescriber for the client, then the non-medic or nurse may administer the treatment. Prescriptions should not be done remotely as most products used are being used ‘off-label’ for non-essential purposes. The client should be seen in person by the prescriber.

In general, products required cannot be supplied in advance but on a per-client basis. However, the MHRA does state that doctors can supply advance stocks to ‘nurses and others who are employed within the same legal entity. Even though the items can be supplied in advance stocks under these circumstances, client-specific advice must still be given to the person administering the procedure.

It is important to note that the manufacturers of many products used in aesthetic procedures state that the treatments should be administered by medical practitioners. Non-medics should consider these guidelines carefully and ensure they have the correct and appropriate training and professional indemnity insurance in place.

Medications are intended to be for the person in which they are prescribed too and should be administered as such. Full records should be kept for up to 6 years, including the prescriptions and batch numbers and full details of the treatments and outcomes

Storage of Medicines 

Practitioners should know how to correctly store the products they use and administer to clients at their clinics, and this includes the use of a dedicated medical fridge.

There are several reasons for this.

Storing products at the correct temperature:

Many of the products used in non-invasive cosmetic procedures must be stored within a certain temperature range. For Botulinum Toxin, this is between +2°C to +8°C.

The only way to accurately maintain this temperature range is by using a dedicated medical fridge, which provides unrivalled levels of temperature control and monitoring.

This is achieved by using special thermometers that can measure the temperature inside the fridge as well as the temperature of the products that are being stored.

They are also fitted with alarms that will be triggered to make noise if the temperature falls outside of the required range, allowing practitioners to intervene and save products from damage.

Added security:

Dedicated medical fridges provide greater levels of security than standard domestic fridges as they can also be locked to prevent any unauthorised access.

They can have either a glass or solid door. The former allows practitioners to look inside the fridge without the need to open the door and risk a rise in temperature.

The latter provides added security as people cannot see what is being stored inside the fridge, mitigating the risk of theft.

 

 

 

 

 

How to store products in a medical fridge

In order for the medical fridge to be work to its best ability, practitioners must store products in a certain way.

This includes:

  • Leave 1cm of space between products
  • Ensure products do not touch the back of the fridge
  • Ensure the fridge is never more than 75% full
  • Clean the outside of the fridge daily
  • Clean the inside of the fridge twice a month

Practitioners should also conduct a weekly stocktake of the products that are being stored inside the fridge and ensure that products with the shortest shelf life are at the front and used first.

Temperature monitoring is the key to correct storage:

It is good practice if practitioners monitor and log the temperature of their fridges to ensure they do not fall outside of the minimum/maximum range.

Temperature logging should be done by a qualified and experienced practitioner at least once per day. They should record min, max and current temperatures on a log and sign their name against it.

If the temperature has fallen outside of the range at any point during the day, they must intervene and take the necessary action to ensure the products inside remain safe to use.

How to choose the right medical fridge for your needs:

There are medical fridges to suit every requirement. When thinking about which best meets your needs, you will need to consider the following:

  • The space you have available
  • The amount of product you need to store
  • Your budget
  • Whether you require a glass door or a solid door

Disposal of Medicines 

All clinics should have a written policy for the safe disposal of surplus, unwanted or expired medicines.

Disposal of waste is subject to legislation and regulated by the Environment Agency. You might need to dispose of medicines when:

  • a person’s treatment changes or stops
  •  Safely dispose of remaining supplies (with the person’s consent where possible).
  • the medicine reaches its expiry date
  •  Make sure you read about expiry dates in the product information leaflet. Some medicines expire before their’ use by’ dates because you’ve opened the packaging. Other expiry dates are shortened if they’re removed from controlled temperature storage.

Risk

Clinics must dispose of unwanted medicines appropriately to avoid placing people who use services at risk.

Examples

A person who is no longer a client has previously prescribed medication. You must not administer medicine to a person if it was prescribed to another person.

A prescriber has stopped prescribing a medicine. If you continue to administer the medicine, you could place people at risk.

If you administer medicine beyond the expiry date, the product could have chemically changed. This may make it clinically ineffective or could cause actual harm.

Process

You should record the process for disposing of medicines in your medicines policy. Store medicines for disposal securely and separately to in use medicines. Control access until they are collected or taken to the pharmacy. Do not dispose of medicines on-site through the sewage system.

NICE SC1 says, “Medicines for disposal should be stored securely in a tamper-proof container within a cupboard until they are collected or taken to the pharmacy.”

You should dispose of medicines by returning them to the supplier. This would usually be the community dispensing pharmacy. The supplier should dispose of the medicines in line with current waste regulations.

Keeping records

You must keep records to ensure that medicines are handled properly during disposal. Records could include:

  • date of disposal or return to the pharmacy
  • name and strength of the medicine
  • quantity removed
  • the person for whom medicines were prescribed or purchased
  • signature of the member of staff who arranges the disposal of the medicines
  • signature of the person collecting the medicines for disposal

Providing consultations for aesthetic procedures using prescribed products

It is important to ensure that a full consultation is undertaken prior to any procedure, and the client is aware that:

  • The product used requires a prescription, and that the medicine is used off-licence.
  • Treatments provided are done so on a cosmetic basic only and not on the basis of improving health.
  • Clients should seek the advice of their GP if they are seeking a procedure for improving any aspect of their health or quality of life.
  • All risks associated with the treatment.
  • Treatments must be maintained or kept up to continue to see the results, as well as ongoing costs and outcomes for non-maintenance.

The client will need to fill in the treatment form prior to the procedure and sign the key facts to the risks, aftercare and techniques used.

Before and after photographs must be obtained and kept on record for use at later appointments in the event of a complication or claim.

What information should be recorded:

  • Clients name, address, contact number and email.
  • Clients medical history
  • Signed consent and key facts
  • Before and after images
  • Details of the prescriber, date of prescription and batch number of products used
  • Details of the site/area of administration, mix ratio, units/MLS injected
  • Date of review

Working with Sharps 

The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 Prior to the publication of European Directive 2010/32/EU, a framework agreement was developed that brought together a number of existing health and safety requirements in order to make the legal framework to protect workers from sharps injuries more explicit. The UK went down the legislative route, and The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 came into force on the 11th May 2013.

The regulations apply to employers whose primary activity is to organise, manage and provide treatment to others that involve the use of sharps. Those covered under the act include not only those that undertake the procedure but all others that may come into contact with any sharps, which will include all employees, servicemen and cleaners.

The main requirements of the regulations mean Employers need to assess the risk of sharps injuries under the COSHH regulations. Where risks are identified, the regulations require the employer to take specific risk control measures detailed below:

  • where the employer has identified a risk, steps must be taken to avoid the unnecessary use of sharps (Regulation 5 (1)(a))
  • where it is not reasonably practicable to avoid the use of medical sharps, the sharps regulations require employers to: –
  • use safe sharps (incorporating protection mechanisms) where it is reasonably practicable to do so (Regulation 5(1) (b)) –
  • prevent the recapping of needles (Regulation 5 (1) (c))
  • – place secure containers and instructions for safe disposal of medical sharps close to the work area (Regulation 5 (1) (d)
  • Provide information to employees on the risks from injuries, relevant legal duties of employers and employees; good practice in preventing injuries; the benefits and drawbacks of vaccination and the support available to an injured person from their employer.
  • Provide appropriate training to ensure employees know how to work safely. The training must cover the correct use of safe sharps, safe use and disposal of sharps, what to do in the event of an injury and the employer’s arrangements for health surveillance. (Regulation 6 (4))
  • Have arrangements in place in the event of an injury, which includes keeping a record of the incident, investigation of the circumstances of an incident and to take action to prevent a reoccurrence. The HSE advise that records of the incident should include details of the type of sharp involved, at what stage of the procedure the incident occurred and the severity of the injury.
  • ensure that injured employees who may have been exposed to a blood-borne virus have immediate access to medical advice; are offered post-exposure prophylaxis or other treatment as advised by a doctor, and offered counselling where appropriate. (Regulation 7 (2))
  • Review, at suitable periods, the effectiveness of procedures and control measures (Regulation 5 (2)).

Work practice controls

These controls aim to change the behavior of workers to reduce exposure to occupational hazards. Examples include:

  • no needle recapping or resheathing
  • safe construction of sharps containers
  • placing sharps containers at eye level and within arm’s reach
  • disposing of sharps immediately after use in designated sharps containers
  • sealing and discarding sharps containers when they are three-quarters full
  • establishing means for the safe handling and disposal of sharps devices before the beginning of a procedure.
  • Safe storage of full sharps containers, which should be stored in a safe place and carried away from the body with the lid firmly closed.

The Environmental Protection Act 1990

Under this act, anyone that disposes of waste has a duty of care to ensure that waste is disposed of safely.

Subjects covered by the Environmental Protection Act 1990 are as follows:

  • Waste management
  • Noise pollution
  • Neighbourhood pollution
  • Radioactive substances
  • Genetically Modified organisms
  • Nature Conservation

Under the Environmental Protection Act 1990, it is unlawful to deposit, recover or dispose of controlled (including clinical) waste without a waste management licence, contrary to the conditions of a licence or the terms of an exemption, or in a way which causes pollution of the environment or harm to human health. Contravention of waste controls is a criminal offence. Section 34 of the act places people concerned with controlled (including clinical) waste under a duty of care to ensure that the waste is managed properly, recovered or disposed of safely and is only transferred to someone who is authorised to keep it. Householders are exempt for their own household waste.

Hazardous healthcare waste is subject to the requirements of the Hazardous Waste Regulations 2005[Extract is taken from Gov.UK website https://www.gov.uk/healthcare-waste 30th June 2014]

All commercial businesses must have a waste removal contract with either the council or a private waste removal company. If you produce less than one bin bag full of clinical waste per collection, then you can dispose of clinical waste such as cotton wool and tissues in with a normal waste collection. If you produce more than this per collection, then a suitable clinical waste contract must be obtained.

Sharps Disposal 

Anything sharp that could pierce or has pierced skin should be put into the correct category of sharps disposal. We can give you a hand if you’re not sure what kind of sharps disposal you need. Any of the below should be disposed of in a sharps bin:

  • Needles
  • Scalpels
  • Stitch cutters
  • Glass ampoules
  • Sharp instruments
  • Shards of bone and teeth
  • Syringes
  • Lancets
  • Razor blades

Your Sharps waste needs to be disposed of in a dedicated sharps bin of a suitable size which we will provide you with as part of your contract. From there, it is incinerated.

If you’re producing hazardous waste, you have a duty of care to ensure that it’s housed and disposed of in the most appropriate way.

You will need to employ the services of a specialist waste disposal company that will safely remove your sharps boxes when full, along with any other hazardous waste.

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995

These regulations are commonly referred to as RIDDOR, and their main purpose is to alert the enforcing authorities to incidents and causes of ill health that may need further investigation. Their second role is to collate statistics and to assist in the implementation of initiatives to reduce accidents in the workplace.

If any of your employees or trainees suffer a personal injury at work that results in either;

  • Major Injury
  • Death

Then you must contact the Incident Contact Centre on 0845 3009923.

Less serious injuries have to be reported using form F2508 available on the HSE website. Less serious injuries include:

  • More than 24 hours in a hospital
  • Incapacity for more than 7 days.

Other incidences that are reportable include:

  • A member of the public or client is injured and admitted to hospital.
  • Any member of staff that is injured due to an act of violence that is work-related.

All records of injuries, minor or major, must be recorded in your accident book.

Further guidance can be found on the HSE website www.hse.gov.uk/riddor.

Health & Safety (First Aid) Regulations 1981

Your environmental health officer may ask if you have a completed First Aid training. The HSE recommends that businesses with fewer than 50 staff members should have at least one qualified and appointed First Aider.

First Aid courses can last anything from half a day to 3 days. The half-day courses are not usually accredited, so it is highly recommended to at least complete a full day of First Aid training.

These regulations also require that every employer provides equipment or facilities for providing First Aid to their employees. Even if you do not have employees, having a First Aid Kit to hand when required is good practice.

A First Aid box and an eyewash station with single-use pods should be enough, with extra items kept aside for restocking.

Your First Aid box should contain the following:

 

Number of Employees 1-5 6-10 11-50
Contents QTY QTY QTY
First Aid Guidance Notes 1 1 1
Individually wrapped sterile adhesive dressings 20 20 40
Sterile Eye Pads, with attachment 1 2 4
Sterile triangular bandages 1 2 4
Safety Pins 6 6 12
Medium sized sterile unmedicated dressings 3 6 8
Large sterile unmedicated dressings 1 2 4
Extra Large sterile unmedicated dressings 1 2 4

First Aid boxes must not include any form of medication. Such as Paracetamol or Ibuprofen

Bloodborne Pathogens

What are bloodborne pathogens?

Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV). Needle sticks and other sharps-related injuries may expose workers to bloodborne pathogens. Workers in many occupations, including first aid team members, housekeeping personnel in some industries, nurses and other healthcare personnel, may be at risk of exposure to bloodborne pathogens.

What can be done to control exposure to bloodborne pathogens?

In order to reduce or eliminate the hazards of occupational exposure to bloodborne pathogens, an employer must implement an exposure control plan for the worksite with details on employee protection measures. The plan must also describe how an employer will use a combination of good work practice and ensure the use of personal protective clothing and equipment, provide training, medical surveillance, hepatitis B vaccinations, and signs and labels, among other provisions. Engineering controls are the primary means of eliminating or minimising employee exposure and include the use of safer medical devices.

AIDS – Acquired Immune Deficiency Disease:

AIDS is caused by a human immune-deficiency virus (HIV). The virus attacks the body’s natural immune system and makes it vulnerable to infections, which will eventually cause death. Some people are known to be HIV positive, which means that they are carrying the virus without any symptoms of AIDS. HIV carriers are able to pass on the virus to someone else through infected blood or tissue fluid, for example, through cuts or broken skin.

The virus does not live for long outside the body.

Hepatitis B:

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most commonly transmitted from mother to child during birth and delivery, as well as through contact with blood or other body fluids, including sex with an infected partner, injection-drug use that involves sharing needles, syringes, or drug-preparation equipment and needle sticks or exposures to sharp instruments.

As of 2016, 27 million people (10.5% of all people estimated to be living with hepatitis B) were aware of their infection, while 4.5 million (16.7%) of the people diagnosed were on treatment. According to the latest WHO estimates, the proportion of children under five years of age chronically infected with HBV dropped to just under 1% in 2019, down from around 5% in the pre-vaccine era ranging from the 1980s to the early 2000s.

Hepatitis B can be prevented by vaccines that are safe, available and effective.

Hepatitis C: 

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.

The hepatitis C virus is a bloodborne virus: the most common modes of infection are through exposure to small quantities of blood. This may happen through injection drug use, unsafe injection practices, unsafe health care, transfusion of unscreened blood and blood products, and sexual practices that lead to exposure to blood.

Globally, an estimated 71 million people have chronic hepatitis C virus infection. A significant number of those who are chronically infected will develop cirrhosis or liver cancer.

There is currently no effective vaccine against hepatitis C; however, research in this area is ongoing.

Dealing with body fluids

If blood or body fluids have to be mopped, ensure that disposable gloves, apron and disposable paper are used. All disposable items should then be placed in a yellow plastic sack and destroyed by incineration.

Neat chlorine bleach should be used as the sterilising agent on blood spills. The bleach treatment will destroy the viruses, which will cause AIDS and Hepatitis B.

Anaphylaxis

Some allergies can lead to a severe allergic reaction – known as anaphylaxis. Anaphylaxis can be life-threatening.

Symptoms can occur quickly or within hours following contact with an allergen. Prompt treatment can save a life. If you have an adrenaline auto-injector – use it immediately.

Common causes

Common causes of anaphylaxis are wasp and bee stings as well as food, such as peanuts, nuts, sesame seed, fish and shellfish, dairy products and egg. Other causes include latex, penicillin and some other medications.

For some, fatigue or exercise may cause anaphylaxis – alone or in combination with other triggers like food or medication. Cold can also be a cause. In rare cases, a reaction can occur without apparent cause.

Symptoms

  • Itching, especially under the feet, in the hands or on the head
  • A stinging feeling in the mouth
  • Swelling in the mouth, throat, lips or eyes
  • Itching, redness or nettle-rash anywhere on the body
  • Dizziness, anxiety, cold sweating
  • Abdominal pain, nausea or vomiting
  • Shortness of breath or asthma symptoms
  • Sudden fatigue, decreased blood pressure or fainting
  • Disorientation or loss of consciousness

Critical symptoms: difficulty to breath, mouth and throat swell, sudden fatigue or dizziness, experiencing a steady worsening of symptoms.

If your client experiences these critical symptoms, inject adrenaline immediately. Call 999 and say “anaphylaxis”.

Treatment

Adrenaline is the first-line treatment for anaphylaxis. If you have an adrenaline auto-injector – use it immediately. Adrenaline injected into the outer mid-thigh muscle works rapidly to reduce throat swelling, open up the airways and maintain heart function and blood pressure. It is the only medication available for the immediate treatment of severe allergic reactions.

Antihistamine and steroid tablets. Antihistamine reduces hives, itching and irritation. Cortisone reduces the risk of late-onset reactions that can occur some hours following contact with allergens.

Who is at risk of anaphylaxis?

A person who has previously experienced anaphylaxis – irrespective of cause – is at risk in the future.

If the reaction was caused by peanuts, shellfish or fish, it should not be ignored, even if mild. This is especially important if the reaction was caused by peanuts. This is also the case for certain drugs, insect stings or latex. Your doctor will give you essential information and prescribe suitable medication.

When your client suffers from anaphylaxis

Do not underestimate the severity of an allergic reaction. Use your adrenaline auto-injector according to its instructions. If in doubt, use your adrenaline auto-injector – it can save their life. Then lay them down with their legs slightly elevated.

Call 999 and say, “anaphylaxis.” State your name, location, and telephone number.

If possible, someone should wait outside to show the ambulance crew where you are.

Let ambulance personnel know about the client’s medical history and treatment undertaken.

Managing Complications 

Anyone working in aesthetics or undertaking treatments that break the skin, i.e injectables or involve the injection of application of a product that could cause an allergic reaction, should undertake appropriate training in managing complications. Training should be taken regularly to ensure you stay up to date with current regulations and feel confident in dealing with any issues that should arise.

Complication’s training is usually in addition to first aid and anaphylaxis training.

Understanding the array of issues that could be presented from aesthetic procedures will allow you to confidently provide treatments to your clients.

Invasive procedures always carry more risk than other treatments in a salon, and it is important that we are able to identify risk and know how to avoid it.

Emergency Plan

The emergency plan is the responsibility of the regulated independent prescriber. The emergency plan includes the appropriate onsite response, healthcare referral process and access to an emergency kit suitable to deal with adverse reactions or incidents. The regulated independent prescriber has a duty of care to their patients to follow regulatory guidelines set by their Professional, Statutory and Regulated Body.

The client may contact you directly with any issues, and you must also raise any concerns to the prescriber to arrange a care plan for the client.