The recommended infection-control concept called "universal precautions" advocates everyone's blood and body fluids be considered potentially infectious. This eliminates the difficulty in determining risk individually. Remember, although some body fluids have not been documented to transmit pathogens, it is sometimes impossible to tell if blood or another potentially infectious fluid is present.
The strategies to eliminate or reduce injuries due to exposure to bloodborne pathogens include two basic strategies: changing hazards and changing behaviors.
Elimination and substitution controls may be impractical hazard control methods to minimize exposure to bloodborne pathogens. therefore, engineering, work practice, and PPE controls are generally the most widely used methods to protect healthcare employees from exposure.
Engineering controls minimize exposure in the workplace either by designing equipment to isolate the hazard, such as:
Engineering controls focus on the design equipment to minimize exposure. The Sharps container for needles is a good example of an engineering control that is widely used. Healthcare employers need to examine and maintain or replace engineering controls on a regularly scheduled basis.
Work practice controls focus on the way tasks are performed. For example, using disposable gloves when performing emergency care is considered a work practice control. Another example of work practice controls is to perform all actions involving potentially infectious material in a way as to minimize splattering, splashing, and spraying. Proper handling and disposal of needles or sharps, contaminated bandages, gauze, or linens is also essential.
Work practice controls are all about how tasks are performed to minimize exposure.
Safe work practices include eliminating eating, drinking, smoking, applying make-up or lip balm, or handling contact lenses in locations with potentially infectious material. In healthcare facilities, employees are prohibited from wearing artificial nails. Food and drink must not be kept in a refrigerator, freezer, shelf, or in the general area of where blood or other potentially infectious materials are kept.
Hand washing after an exposure can reduce your risk of infection.
Your employer must provide readily accessible hand-washing facilities or antiseptic hand cleanser or wipes if hand-washing facilities are not available.
Perform hand washing immediately after any exposure, even if you were wearing gloves. Vigorous scrubbing with soap or alcohol-based foam or gel and warm water is considered the most effective technique. This will further reduce your risk of infection resulting from an exposure.
Practices that are completely prohibited in the workplace include: bending, recapping, and removing contaminated needles, shearing or breaking needles, and mouth pipetting or suctioning of potentially infectious material.
These practices significantly increase the risk of exposure. As a result, they should never be performed by employees.
Antiseptic hand cleaner in conjunction with clean cloth/paper towels or antiseptic towelettes are examples of acceptable alternatives to running water.
However, when these types of alternatives are used, employees must wash their hands (or other affected areas) with soap and running water as soon as feasible.
This alternative would only be acceptable at worksites where soap and running water are not feasible.
Dr. Kramer owns and operates a small dental clinic in San Francisco, CA. As part of her exposure control plan, she requires her employees to wash their hands before and after working with any patients. She also requires new gloves be used with every patient.
Dr. Kramer is requiring her employees to do something to reduce the risk of occupational exposure. Work practice controls focus on the actions taken to minimize exposure.
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