Narrabri Shire Council

Skin Penetration Premises

What is a Skin Penetration Procedure?
• Acupuncture
• Tattooing
• Ear piercing
• Hair removal (with wax, shaving or electrolysis)
• Cosmetic enhancement or semi permanent/permanent makeup
• Colonic Lavage

What is Councils' role?
To protect public health by ensuring all operators are registered, conduct inspections of premises to ensure compliance with regulations and guidelines, maintain a public register.

Why do Inspections?
• Minimise the potential to spread disease such as Hepatitis
• Infection control techniques and procedures are followed
• Premises are clean and fitted out correctly
• Articles and equipment are clean and appropriate for the procedure
• Single use items are used only once
• Personal Protective Equipment is used
• Records are kept
• Premises are registered with Council

Best Practice for Skin Penetration Premises

Single use equipment:
Pre-sterilised single use items are recommended for each skin penetration procedure. Using pre-sterilised single use equipment with the correct infection control techniques will ensure micro-organisms are not being transferred from person to person.

Hand Washing:
Hand washing and hand care are the first steps in any infection control program. Cuts and abrasions on exposed skin should be covered by a waterproof dressing and hands should always be washed before and after a treatment.
The following method is recommended for hand cleaning:
• Wet hands
• Use soap and running water
• Rub hands vigorously
• Wash hands all over including backs of hands and between fingers for at least 15-20 seconds
• Rinse hands well
• Dry hands thoroughly on single use paper towel

Gloves are worn as a physical barrier to protect the wearer's hands from contamination. Single use gloves must be worn at all times during a skin penetration procedure to protect both the operator and the client. The use of single use gloves does not substitute or eliminate the need to wash hands.

When not to perform skin penetration:
Skin penetration should not be performed on persons under the age of 18 without the written consent of the parent or legal guardian. It is illegal under the Children (Care and Protection) Act 1998 to tattoo a person under the age of 18 years without consent. It is also not permitted to carry out a skin penetration procedure if a person appears to be under the influence of drugs or alcohol.

Record Keeping:
In addition to any sterilisation of equipment records must be kept and should include the following information.
• Date and time
• Procedure performed
• Name and address of person
• Name of operator who performed the procedure
• Aftercare information provided

Skin preparation:
Before commencing a skin penetration procedure, skin should be wiped with a suitable antiseptic and allowed to air dry. Suitable solutions include:
• 70% W/W ethyl alcohol
• 80% V/V ethyl alcohol
• 70% V/V isopropyl alcohol
• Alcoholic (isopropyl and ethyl) formulations of 0.5 - 4% W/V chlorhexidine
• Aqueous or alcoholic formulations of povidine iodine (1% W/V available iodine)

A clean washable garment should be worn daily. Protective over clothes are required to be worn by all skin penetration operators and should be removed and stored in the work area before breaks for lunch, smoking, drinking and using the toilet.

Eating and drinking:
Operators must not eat or drink while attending to clients.

It is recommended that animals not be in rooms where skin penetration procedures are performed. An exemption may be granted for companion animals used by a person with a disability.

Clean linen, towels or garments should be used on each client. Single use paper towelling or liners can be used on benches instead of linen.

In August 2000 the NSW Government passed legislation that bans smoking in certain enclosed public places.
Equipment - Cleaning / Disinfection / Sterilisation
All re-useable equipment must be cleaned before it is reused. Cleaning greatly reduces the microbial load on the dirty item, it is essential to clean before disinfection or sterilisation to remove all visible matter.

Good cleaning processes include:
• Moving equipment directly to an area set aside for cleaning
• Pulling equipment apart disposing of all non re-useable pieces
• Immersing equipment in warm water and detergent and scrub carefully with a clean brush to remove visible soil
• Rinse equipment in warm to hot water and allow to air dry
• Store equipment in sealed containers

All re-useable equipment that penetrates the skin must be cleaned, disinfected and sterilised, disinfection helps to remove micro-organisms but is not effective unless equipment has been cleaned.

The ability of a chemical disinfectant to work properly will depend on:
• Contact time
• Chemical concentration

All re-useable equipment that penetrates the skin must be firstly cleaned, disinfected and then sterilised. Sterilisation is the killing of all micro-organisms including spores.
The recommended method for sterilisation of equipment is autoclaving, equipment must meet the requirements of AS 2182 'Sterilisers - Steam - Bench top' and be operated in accordance with AS 4815:2001.

Sterilisation depends on the following factors:
• Temperature - the correct temperature shall be maintained for the specified time
• Cleanliness - the equipment must be clean to enable sterilisation
• Circulation - the chamber must be designed to allow steam to circulate around the equipment.

It is important to remember that the following sterilisation methods should not be used:
• Boiling
• Wiping or soaking with disinfectant
• Ultraviolet light
• Pressure cookers
• Ultrasonic cleaners
• Dishwashers
• Microwave ovens

Waste Disposal
Sharps must be disposed of into an approved sharps container and when full taken to an approved collection site. Operators should:
• Ensure that there is an accessible sharps container for the disposal of sharps as close as practical to the point of generation
• Immediately dispose of sharps
• Ensure sharps container is not accessible to the public
• Ensure sharps containers are not overfilled
• Ensure sharps containers are sealed. 
 Application for Skin Penetration Premises