Chapter 2: Workplace Protection
As you work with clients you must be able to react to situations, such as proper infection control, and workplace exposure. This section will give you practical workplace advice, legal leverage and what you should expect from your supervisors. Sources of contamination are also touched on.
In order to safely protect employees, Occupation Safety & Health Administration (OSHA) requires that employers follow certain policies. These policies explain who is in charge when an accident occurs, what must be done to help the employee and what is required ahead of time to safeguard their welfare. Here is a summary of standard workplace protocol.
– Dr. Peter Piot, Executive Director, UNAIDS
Elements of an Exposure Control Plan
Every medical establishment has a control plan that distributes responsibilities in the event of a contamination breach. Each control plan usually consists of these following OSHA standards:
- Defined infectious material employees are exposed to.
- Designated first aid attendant (can be a supervisor or a trained staff member). First aid and blood borne certification is required to avoid legal complications.
- Documented injury report log.
- Documentation regarding the types of devices used to prevent infection.
- A minimal yearly update policy, which includes reviewing the exposure control plan and changing it as developments arise. This must be accessible to all staff members.
Exposure Control Plan Terms
Universal precautions - all contaminants are considered dangerous.
Standard precautions - equipment such as masks, gloves, gowns and facemasks must be used when treating patients. Equipment use varies on the risks. For example, blood sprays can contaminate eyes, hence a face mask; open wounds with gloves; protective gowns when there is an unpredictable chance of being contaminated. Gloves are used most often in day to day patient treatment because they provide an adequate skin barrier for the hands.
Exposure Control Precautions for Health Care Workers
Employers are required by law to implement safety policies which meet or exceed OSHA expectations. Employees who work around blood must have training to protect themselves from incidental exposure. If this is not accounted for, employment facilities are typically cited and fined.
Employee Job Definition
Employers must define the scopes of each person's job. This is to prevent untrained people from contaminating themselves. For example, medical workers use gloves when they are handling bodily fluids. Alternatively, if bio products spill, it may not be the job of the healthcare worker to clean and neutralize the threat. This task may be delegated to a professionally trained janitor. The same can be said of employees who are responsible for disposing and sterilizing equipment. These procedures prevent blood borne pathogens from infecting people. Policies differ; you may just as easily be responsible for cleaning the mess, so refer to your medical facility guidelines.
Employee Policy Updates and Changes
Once a year employers are required to update and review safety policies with their staff. This may mean training people in safer methods, as opposed to using equipment. Protective equipment is usually added protection; however, if medical procedures can be safely done without it, it is preferred.
- All plans must include a hand washing procedure, as it is a surefire way to prevent disease.
- All plans must take into account uniforms standards. The CDC prefers that health workers wear minimal amounts of jewelry, to avoid fake nails, and to keep nails short. Bacteria and other pathogens can be a threat if the area under jewelry is missed during washing.
Note: If allergic to latex, employers are required to provide non-latex gloves.
How it Impacts the Workplace
- Exposure control plans explain how to handle personnel clean equipment, bio hazardous waste removal, laundry services, and specimen collection.
- When cleaning contaminants, medical workers must wear gloves. Any waste (such as gloves or briefs) must be disposed of in a red puncture-proof biohazard bag. State laws differ, so refer to your facilities trash policy.
- Bed pan waste should be placed in the toilet.
- A 1:10 ratio of bleach and water is a widely accepted cleaning solution when other cleaning solutions are not available.
- The EPA has an approved list of disinfectant sprays which are effective against the HIV and hepatitis B virus. In addition, anti-microbial soaps, used for hand washing, must have approved pathogen destruction guarantee (99.9% bacteria guarantee for example.)
- Specimens must be clearly labeled and placed in the middle to avoid confusion.
- Instruments, blades and needles must be disposed in a sharp container. This prevents blades from cutting people, which in turn infects people.
- Laundry workers must wear gloves and protective equipment when they do laundry. They are exposed to bodily fluids and sharp objects. Laundry must never be done near patients, and there must be a color code system to distinguish bio hazard material from clean clothes. This is usually a red colored bio-hazard sign. Furtherly, clothes must be held away from your uniform, whether the clothes are clean or not.
Run lukewarm water and let it get it through your hands and wrists. Apply soap and lather it through your hands, fingers and wrists without touching the sink; do this for a minimum of 20 seconds. With the palm of your hand rub your nails downward in the opposite hand and repeat for the other (after cleaning nails). Rinse with your hands pointed downward. Grab a dry towel and pat dry. Throw away your wet towel, grab a new one, and turn off the faucet. It helps to have two dry towel lengths ready to avoid recontamination by touching the lever.