Occupational Safety Procedures
Bloodborne Pathogens: Procedures and Practices
PROCEDURES WHICH REQUIRE USE OF PERSONAL PROTECTIVE EQUIPMENT
Invasive Procedures: Gowns, mask, and eye protection must be worn when a health care worker's skin or mucous membranes may come in contact with body fluids.
Phlebotomy: Gloves must be worn for performing finger and/or heel sticks on infants and children, and when persons are receiving training in phlebotomy.
Dentistry: Gloves must be worn when contact with oral mucous membranes is anticipated. Surgical masks and goggles or face shields are required for procedures resulting in spray or splashing of blood, saliva, or gingival fluids.
Laboratories: Gloves and goggles must be worn for processing body fluid and tissue specimens.
Post Mortem: Gowns, masks, goggles and gloves must be worn for postmortem procedures.
Body Fluid Spills: Gowns, masks, goggles and gloves must be worn when cleaning up body fluid spills.
Remember to use universal precautions and treat all blood or potentially infectious bodily fluids as if they are contaminated. Avoid contact whenever possible, and whenever it's not, wear personal protective equipment. If you find yourself in a situation where you have to come in contact with blood or other body fluids and you don't have any standard personal protective equipment handy, you can improvise. Use a towel, plastic bag, or some other barrier to help avoid direct contact.
Hand washing is the single most important procedure for preventing nosocomial infections. Hands or other skin surfaces must be washed thoroughly and immediately after contact with blood or body fluids AND after removing gloves.
For most routine activities, hand washing with plain soap appears to be sufficient, since soap will allow most transient microorganisms to be washed off. Absolute indications for, and the ideal frequency of, hand washing are generally not known due to the lack of well-controlled studies.
Effective hand-washing depends upon the type of product used.
-Hand washing with plain soap or detergent suspends microorganisms and allows them to be rinsed off.
-Anti-microbial products kill or inhibit the growth of microorganisms.
The indications for frequency of hand washing probably depend on the type of activity, intensity duration of the activity, and the sequence of activity. Catawba Valley Community College's policy requires that employees wash their hands immediately following any activity that may bring them into contact with a potentially infectious material, using an anti-microbial product if one is immediately available. If an anti- microbial product is not immediately available, Catawba Valley Community College requires that employees use ordinary soap and water and/or an antiseptic towelette until an anti-microbial product can be accessed.
Hands shall be washed:
- Upon reporting for duty and prior to leaving.
- Before and after cleaning an isolation room.
- After touching excretions or secretions or materials soiled by them.
- Before eating.
- Before touching a patient who is susceptible to infection.
- After personal bathroom use, eating, coughing, and sneezing.
- Before and after the use of sterile gloves.
- Whenever a task may involve the exposure to blood or body fluids.
- WHENEVER IN DOUBT!
No food or drink should be kept in refrigerators, freezers, shelves, cabinets, or on counter tops where blood or potentially infectious materials are present.
You should also try to minimize the amount of splashing, spraying, splattering, and generation of droplets when performing any procedures involving blood or potentially infectious materials, and you should NEVER pipette or suction these materials by mouth.
Procedures for Hand Washing
- For routine washing, a vigorous rubbing together of all surfaces of lathered hands for at least 15 seconds, followed by thorough rinsing under a stream of water is recommended.
- Stand away from the sink to prevent cross-contamination of your clothing.
- Remove first paper towel and discard before washing hands. This ensures a clean, non-contaminated towel is used for drying.
- Ensure that all material from under your fingernails has been removed. An orange stick may be used for this purpose. Discard orange stick immediately following use. Do not reuse.
DECONTAMINATION AND STERILIZATION
All surfaces, tools, equipment and other objects that come in contact with blood or potentially infectious materials must be decontaminated and sterilized as soon as possible. Equipment and tools must be cleaned and decontaminated before servicing or being put back to use.
Decontamination should be accomplished by using:
- A solution of 5.25% sodium hypochlorite (household bleach / Clorox) diluted between 1:10 and 1:100 with water. The standard recommendation is to use at least a quarter cup of bleach per one gallon of water.
- Lysol or some other EPA-registered tuberculocidal disinfectant. Check the label of all disinfectants to make sure they meet this requirement.
If you are cleaning up a spill of blood, you can carefully cover the spill with paper towels or rags, then gently pour the 10% solution of bleach over the towels or rags, and leave it for at least 10 minutes. This will help ensure that any bloodborne pathogens are killed before you actually begin cleaning or wiping the material up. By covering the spill with paper towels or rags, you decrease the chances of causing a splash when you pour the bleach on it.
If you are decontaminating equipment or other objects (be it scalpels, microscope slides, broken glass, saw blades, tweezers, mechanical equipment upon which someone has been cut, first aid boxes, or whatever) you should leave the disinfectant in place for at least 10 minutes before continuing the cleaning process.
Of course, any materials you use to clean up a spill of blood or potentially infectious materials must be decontaminated immediately, as well. This would include mops, sponges, re-usable gloves, buckets, pails, etc.
Far too frequently, housekeepers, custodians and others are punctured or cut by improperly disposed needles and broken glass. This, of course, exposes them to whatever infectious material may have been on the glass or needle. For this reason, it is especially important to handle and dispose of all sharps carefully in order to protect yourself as well as others. Sharps containers shall be located in all areas where needles are used for easy access by employees.
- Needles should never be recapped.
- Needles should be moved only by using a mechanical device or tool such as forceps, pliers, or broom and dust pan.
- Never break or shear needles.
- Needles shall be disposed of in labeled sharps containers only.
- Sharps containers shall be closable, puncture-resistant, leak-proof on sides and bottom, and must be labeled or color-coded.
- When sharps containers are being moved from the area of use, the containers should be closed immediately before removal or replacement to prevent spillage or protrusion of contents during handling or transport.
- Broken glassware that has been visibly contaminated with blood must be sterilized with an approved disinfectant solution before it is disturbed or cleaned up.
- Glassware that has been decontaminated may be disposed of in an appropriate sharps container: ie. closable, puncture-resistant, leak-proof on sides and bottom, with appropriate labels.
- Broken glassware shall not be picked up directly with the hands. Sweep or brush the material into a dustpan.
- Uncontaminated broken glassware may be disposed of in a closable, puncture resistant container such as a cardboard box or coffee can.
By using Universal Precautions and following these simple engineering and work practice controls, you can protect yourself and prevent transmission of bloodborne pathogens.