Currently, there is no governing body implementing a universal licensing system, however, under section 15 of the Local Government (Miscellaneous Provisions) Act of 1982 (2004 revisions) councils are required to implement specific codes of conduct and requirements to be licensed. However, this means each council area has its own rules, regulations and applications known as ‘bye-laws’. These can be found either on your local council’s website or by contacting your local licensing department.
Below is a list of the most common requirements – it is not exhaustive:
Prevention of infection is the core responsibility of you as a technician. Implementation of universal precautions is the basis of safe practice, protecting both staff and clients from infection. To minimise the risk of infection, always adhere to best practice:
Bacteria are all around us, both airborne and on surfaces. Whilst some are good bacteria and help with our immunity, others are harmful. Bacteria, viruses and other microorganisms that cause infection and disease are called pathogens. To protect both clients and staff from harmful bacteria, it is vital to work using the Aseptic Technique.
The Aseptic Technique requires strict adherence to practices, procedures and protocols to prevent contamination from pathogens. It is the effort used to keep clients as free as possible from pathogens and minimise the risk of any contamination of wounds, compromised skin and any other susceptible sites by which infection can occur. It should be used during any clinical procedure that bypasses the body’s natural defences. Using the principles of asepsis minimises the spread of organisms from one person to another.
Aycliffe et al. (2000) suggests that there are two types of asepsis, Medical and Surgical.
Medical (clean) Asepsis reduces the number of organisms and prevents their spread, also known as the ‘No-Touch Technique’. We should implement this technique during any invasive procedure that breaks the skin or mucus membrane, therefore, bypassing the body’s natural defence system.
Surgical (sterile) Asepsis includes procedures to eliminate micro-organisms through the sterilisation of an area, surface and equipment. This is practised by doctors and nurses in surgical operating theatres.
Hand hygiene is the single most important way to prevent the spread or transmission of infection. Hand washing is vital and should be completed before any contact with clients and after any activity that may contaminate the hands, including after the removal of protective gloves. Alcohol hand rubs are practical for day to day life but are not a substitute for handwashing as alcohol is not considered a cleaning agent.
Liquid soap and water effectively remove visible dirt and transient micro-organisms by suspending them in the solution allowing them to be rinsed away. Anti-microbial soaps are effective in removing both visible and physical dirt but are more effective in removing resident micro-organisms by killing and inhibiting the growth. Alcohol-based hand rubs, whilst not effective in removing visible dirt, are more effective in destroying remaining transient bacteria. A combination of both methods of cleaning should be used to reach maximum cleanliness, washing hands thoroughly with anti-microbial soaps to remove micro-organisms should be the first step, with the hands then sanitised and the majority of remaining micro-organisms destroyed through alcohol hand rubs.
Good practices of hand hygiene include:
It is essential that your treatment area should be thoroughly cleaned in preparation before and after each client. This includes work surfaces, machines, cords, trolleys and all related instruments used or possibly contaminated during the treatment. To comply with local authority regulations, you should follow the cleaning product requirements advised in your local byelaws. Only cleaning products with the appropriate biocidal defence should be used, we recommend Clinell Universal wipes which are used throughout the NHS in the UK with a secondary clean of Barbecide spray. You should implement a strict cleaning schedule; this is sometimes required as evidence during a health inspection.
Personal protective equipment is vital to protect both yourself and your clients from cross infection. PPE includes disposable gloves, aprons, masks, goggles, shields and covers. Gloves must be worn at all times when there is contact with broken skin, blood, body fluids, non-intact skin and contaminated surfaces. A surgical mask is used to cover your nose and mouth and serves as protection against germs entering or leaving. Goggles and face shields may be used to prevent body fluids from contact with the mucous membranes of the eyes and may be recommended depending on the procedure you are performing.
It is vital that all surfaces and equipment are thoroughly cleaned before setting up for a new client. Any surfaces that will be touched during the procedure should be protected by surface sheets included in wound care packs, protection bags or with barrier film. Nothing non disposable should be left on the trolley during procedure. If an item is left on the trolley during procedure, that item is therefore contaminated and must be disposed of.
*Technician should take photos of station set up during training*
List of items to be included in trolley set up:
Clinical waste is any kind of waste containing infectious (or potentially infectious) materials. Clinical waste is a form of biomedical waste composed of anything (not sharps) contaminated or potentially contaminated by blood or body fluids. Biomedical waste is distinct from normal trash or general waste, and differs from other types of hazardous waste, such as chemical, radioactive, universal or industrial waste and has to be professionally disposed of. Gloves must always be worn when in contact with any clinical waste and extreme care must be taken when handling and disposing.
Sharps waste is a form of biomedical waste composed of used “sharps”, which includes any device or object used to puncture or lacerate the skin. Sharps waste is classified as biohazardous waste and must be carefully handled. As a biohazardous material, injuries from sharps waste can pose a large public health concern. By penetrating the skin, it is possible for this waste to spread blood-borne pathogens. The spread of these pathogens is directly responsible for the transmission of blood-borne diseases, such as hepatitis B (HBV), hepatitis C (HCV), and HIV. Extreme care must be taken in the management and disposal of sharps waste. You must have a sharps box, which is a solid, plastic container (often yellow) which is used for the safe disposal of needles. Always keep handling to a minimum and never re-sheath or reuse a needle.
It is vital to have a clinical waste and sharps waste disposal collection service in place.
You can get infected with Hepatitis B if you have contact with an infected person’s blood or other body fluids. The Hepatitis B virus can survive outside the body for at least 7 days. During that time, the virus is still capable of causing infection. It is recommended and sometimes required by local governing bodies that you should be inoculated against the Hepatitis B virus. Some doctors’ surgeries may provide this free of charge whereas others may charge a fee.
In the UK, technicians are only legally allowed to use over the counter purchasable anaesthetics which have a maximum of 5% ‘Caine’ content. The Medicines and Healthcare Products Regulatory Authority (MHRA) have confirmed that Cosmetic Tattooists are legally allowed to purchase wholesale pharmaceutical products to be applied to and used for clients during cosmetic procedures (effectively being used ‘off label’). These anaesthetics must be in either category GSL/OTC (General Sale List / Over the counter), or P (Pharmacy – meaning it is at the discretion of each pharmacy whether to sell with or without prescription).
List of acceptable anaesthetics:
The full name of MRSA is methicillin-resistant Staphylococcus aureus. You might have heard it called a “superbug”. It has been given this name due to its high resistance to commonly used antibiotics. This means infections with MRSA can be harder to treat than other bacterial infections. MRSA lives harmlessly on the skin of around 1 in 30 people – usually in the nose, armpits, groin or buttocks. This state is known as “colonisation” or “carrying” MRSA. You can get MRSA through contact with somebody, surfaces or shared products carrying the virus, but the virus will lie dormant and only cause possible infection in sites of broken or compromised skin.
Exogenous Spread: occurs when the bacteria is transferred from one person to another through contact with contaminated products, surfaces or environments. It is the highest responsibility of the technician to minimise any risk of this through working with aseptic techniques.
Endogenous Spread: occurs when a person with MRSA spreads the bacteria from one part of their own body to another, for example touching different body parts and touching wounds. This is where your client is most highly at risk of causing infection and why informed and strict aftercare protocols must be followed throughout healing.