Guidelines on the safe and hygienic practice of skin penetration
PDF 430 KB
The purpose the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) is to assist relevant authorities and operators of premises where the practice of skin penetration procedures such as:
It is essential that proprietors and staff be fully aware of the potential dangers of their procedures and understand the precautions that need to be taken to minimise the likelihood of infection or spread of disease.
Clients are not required to tell the practitioner if they are infected with a blood-borne virus. Operators must assume that all blood and other body substances are potential sources of infection.
See below the areas that the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) addresses.
Authorised officers are not expected to assess the operator's technique. However, they can ensure that certain levels of hygiene exist.
Under the Public Health Act, Authorised Officers have the power to:
Inspections will generally be performed on a routine basis and additional inspections will occur if complaints are received or investigations are required. Random inspections may also be undertaken.
For further details, refer to section 2 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB).
To minimise transfer of micro-organisms, operators must perform all procedures in a safe and hygienic manner, following all infection control techniques and procedures to minimise the risk of transferring infections.
By adopting the risk minimisation strategies outlined in section 3 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB), operators will minimise the risk of transmission of infectious disease to clients and themselves.
It is also recommended that businesses keep a record of all client appointments for easy follow-up in disease investigation and control if an outbreak occurs. It is a requirement under Part 4 of the Summary Offences Act 1953 that tattooists, body piercers and body modification artists keep client records for two years. Details to record can include:
Hand washing is generally considered to be the most important measure in preventing the spread of infection as it can protect both the client and the operator.
Section 4 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) provides information on hygienic practices to use including:
Single-use gloves are to be worn for skin penetration procedures. They act as a physical barrier to protect the wearer’s hands from contamination and to prevent the transfer of microorganisms.
The use of single-use gloves does not substitute, or eliminate the need for hand washing. Hands must be washed thoroughly before putting on gloves and again following glove removal.
Gloves must be removed and disposed of if the operator leaves the client for any reason. Hands must be washed and new gloves must be put on before resuming the procedure, or before starting a new procedure on the same person.
For further details including cleaning gloves, see section 5 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB).
Aseptic procedures are designed to prevent the transfer of micro-organisms thereby reducing the risk of infection. Operators undertaking a skin penetration procedure must practice aseptic techniques to avoid contaminating equipment and products therefore minimising infection. Once a sterilised item has come in contact with something that is not sterile, it also becomes unsterile.
Parts of the equipment which is used to penetrate the skin must not become contaminated by touching something that is not sterile.
Section 6 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) provides further information including a number of aseptic procedures you can use relating to equipment and creams, oils, pigments and lotions.
Equipment must be reprocessed to a level appropriate for their intended use, regardless of the level of use they have had previously, or the level of contamination they have had. All equipment must be cleaned between uses and before any sterilisation process occurs.
All equipment used to penetrate the skin must be sterilised.
All staff conducting skin penetration procedures should be trained in the correct use of sterilisation equipment and the correct infection control and sterilisation procedures.
When sterilising equipment for a skin penetration procedure, documentation of the process must be recorded and available for inspection by an Authorised Officer.
Ultraviolet (UV) cabinets do not sterilise and due to the risks associated with using them, they are not recommended for use.
See section 7 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) for full details on cleaning, disinfection and sterilisation of equipment including specific requirements and processes to comply as well as minimum sterilisation details.
The client’s skin should be clean and free from infection, sores or wounds. Only a qualified acupuncturist or health care professional should carry out procedures where the skin penetrated is closer than 15 centimetres.
If shaving of the penetration site is necessary, a single unit disposable razor is recommended.
A skin disinfectant (antiseptic) should be applied to the area of skin that is to be penetrated immediately prior to the procedure. Positioning marks must occur prior to disinfection of the skin.
The site must be allowed to dry before the skin is penetrated and should not be touched by the operator's hands or any other item that may contaminate it.
Further details on skin penetration and skin disinfectants (antiseptics) are available in section 8 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB).
Section 9 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) provides detailed information on the environmental requirements. These requirements include:
It is very important that a protocol for dealing with needlestick and other blood or body fluid incidents is established by the operator.
There are a number of key steps that need to be followed at the time of the incident and directly after the incident. These steps vary depending on the exposure substance. Refer to section 10 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) for specific actions.
Pre-sterilised disposable needles should be used for all skin penetration procedures. In procedures where reusable needles are necessary, proper sterilisation procedures must be employed.
Re-usable equipment should be smooth, non-corrosive and constructed of materials that are able to withstand heat during sterilisation, for instance surgical stainless steel.
Section 11 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) provides specific requirements in relation to the following areas:
To ensure a satisfactory level of infection control at all times in a skin penetration establishment, a checklist or Hazard Analysis Critical Control Point (HACCP) plan is necessary.
These plans enable the operator to identify the potential risk involved in every activity undertaken in the course of conducting a business, and to establish a system to control that risk as far as possible. The plan also allows the operator to monitor the control systems currently in place by using a rating system.
See section 12 in the Guidelines on the Safe and Hygienic Practice of Skin Penetration (PDF 431KB) for further details on risk assessments, including examples.