The recommended infection-control concept called "universal precautions" advocates everyone's blood and body fluids be considered potentially infectious. It is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens. This eliminates the difficulty in determining risk individually.
Bloodborne Pathogen Standard 29 CFR 1910.1030(d)(1) requires:
In the previous section we learned that two essential strategies OSHA specifically requires to eliminate or reduce injuries due to exposure to bloodborne pathogens are: changing hazards and changing behaviors.
Each of the two basic strategies include unique control methods, and together they form the Hierarchy of Controls.
In healthcare, engineering, work practice, and PPE controls are generally the most widely used methods to protect healthcare employees from exposure, so those methods are in bold type.
The image to the right is a good example of how engineering, work practice, and PPE control methods work together to protect healthcare workers.
Engineering controls minimize exposure in the workplace either by designing equipment to physically isolate the hazard from the worker, such as:
Work practice controls focus on behaviors: the way tasks are performed. Each of the following is an example of a safe work practice control:
Work practice controls are all about how tasks are performed to minimize exposure.
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.