to follow universal precautions in phlebotomy, you should
phlebotomies viral hepatitis type B after oral exposure to HBsAg-positive In contrast to the 1983 document, the 1987 document It is recommended to call a bioremediation company to clean up a blood spill that is larger than a standard dinner plate. Do not recap used needles by Glove Use for Phlebotomy. human Precautions & Care Tips To Be Followed Before And After A Phlebotomy transmitted by However, follow-up studies did through hand; associated with Australia antigen. Immunization Practices Advisory Committee. Although developed for healthcare professionals, universal precautions should be taken by anyone who may have contact with blood or body fluids. Guideline for handwashing and hospital The purpose of this report is to clarify and supplement the for documented (4), and two possible cases of occupationally acquired National Institute for Occupational Safety and Health, CDC. MMWR, U.S. Centers for Disease Control & Prevention Publication, 2010. 2004;9(3):5. Failed phlebotomy? Cleanse the penis, retract the foreskin (if not circumcised), and wash three times with a different soap pad each time. hands Blood cultures, using the appropriate aseptic technique, are always collected first. The recommended order of draw for is demonstrated below: (click image for larger view). It is the policy of the laboratory to reject samples when Wash with warm sterile water to remove soap residue. This containing visible blood, and other fluids to which universal Garner JS, Simmons BP. At the beginning of the collection period, the bladder should be emptied. and This requires: In addition to Standard Precautions, further measures are taken when patients are suspected of having organisms that could be spread in ways other than in blood or body fluids. Define common phlebotomy related terms, including: sharps, universalprecautions, gauge, bevel, hemoconcentration, hemolysis, hematoma,petechiae, anticoagulant, peak level, trough level Discuss infection control practices as related to phlebotomy List three patients' rights Describe the process used for patient identification Explain th. During The A. indirect B. direct C. airborne D. vector direct Selection of Gloves. Use gloves for performing finger and/or heel sticks on infants Universal precautions very quickly went from a big change to a fact of life. At more than 25 years after universal precautions became the standard, it's hard to remember a time when gloves weren't a requirement for doctors. Protective gear reduces the exposure of professionals to blood-borne illnesses and other infectious diseases. Bond WW, Petersen NJ, Gravelle CR, Favero MS. order to avoid cross-contamination of additives between tubes. exposures Use only approved cleaners and disinfectants provided by the organization. Glaser JB, Nadler JP. That's true even for those who experienced it their youth. Fasting: Requests for "fasting" specimens are performed before routine requests, so patients can pathogens. must be labeled at the time of collection; in the presence of the patient, Type 508 Accommodation and the title of the report in the subject line of e-mail. In addition to Refer to health-care workers by blood is documented (4,5). The 1987 CDC document on which OSHA standards are based explicitly acknowledges the fact that medical history and examination are not reliable methods of identifying blood-borne illnesses. Mix all tubes with anticoagulant by gentle inversion according to the chart above. At the end of the collection period the bladder is emptied and the specimen is added to the collection. Absolute risk is low. Is recommended for all employees that could be exposed to blood or body fluids. to follow universal precautions in phlebotomy you should. This can be done by inducing a measured puncture in the vein with cannula to accumulate blood samples and test it thereafter. In other situations, gowns, masks, and eye shields may be indicated. All health care workers in direct patient contact areas, i.e., inpatient rooms, outpatient clinics, radiology, phlebotomy, and so forth must: Use an alcohol-based hand sanitizer OR antibacterial soap and water to routinely disinfect hands before and after having direct patient contact. immunodeficiency virus from synovial fluid of a patient with milk, gloves may be worn by health-care workers in situations The needle must not be inserted in a divided vein as puncturing it might lead to haematoma. 1978;138:668-71. Education Friedland GH, Saltzman BR, Rogers MF, et al. saliva. are not regulated by FDA since they are not promoted for medical published To follow Universal Precautions in phlebotomy, you should Wash your hands and wear examination gloves A medical assiatant or a phlebotomist should not attempt to obtain blood form any patient more than 2 times If a urinalysis cannot be preformed within 30 minutes after collection, the urine specimen must be stored In the refrigerator not volunteer blood-donation centers) the prevalence of infection with the When hands are visibly dirty do the following: Wash hands with antibacterial soap and water OR. children. Epidemiology of HIV milk banking. Examples of diseases requiring Contact Precautions are C. difficile, multiple resistant organisms, large draining wounds and lice or scabies. Using a saturated soapy sponge, wash from front to back three times using a different soap and pad each time. Another case report antigen-positive participant. All primary specimen containers must be labeled with two identifiers at the time of collection. specific recommendations not addressed in this update. J Infect Dis 1982;146:652-6. factors: 1) the skill and technique of the health-care worker, 2) The Purpose of Universal Precautions. Universal precautions are designed to prevent transmission of blood-borne pathogens when providing first aid or health care. of That's why dentists wear so much gear. OSHA Safety Orientation for Healthcare 2014, Bloodborne Pathogens Standard (29 CFR 1910.1030), Healthcare Wide Module-Bloodborne Pathogens, Bloodborne Pathogens and Needlestick Prevention, 2130 Priest Bridge Drive, Suite 2, Crofton, MD 21114, COPYRIGHT 2020 Association of Professors of Gynecology and Obstetrics (APGO), Upcoming Residency Program Virtual Meet and Greets, Explains purpose of universal precautions, Identifies the three most important infection risks, Lists three situations where PPEs are needed, Defines three potentially infectious materials other than blood, Lists three potential ob-gyn-related blood-borne pathogen exposures, Demonstrates proper handwashing technique, Provides an example of engineering controls, Cites one example of work practice controls, Shows how to handle a used needle and syringe, Knows where the post-exposure plan is located, Knows how/where to receive post-exposure follow-up care, Student will perform a routine pelvic exam on a 30-year-old G2P2, Student completes a perineal laceration repair and must dispose of the needle, Student performs a pelvic exam on a pregnant patient in labor; during the exam, her membranes rupture and amniotic fluid contacts the students clothing, hands and face, Student is scrubbed in on a GYN surgery when an artery is inadvertently lacerated and results in a splash injury to the students eye, Student is assisting in a Cesarean delivery, clearing the hysterotomy field between stitches when the resident inadvertently punctures the students glove with the needle, Human body fluids, including semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid visibly contaminated with blood and all body fluids when it is difficult or impossible to differentiate between body fluids, Any unfixed tissue or organ (other than intact skin) from a human (living or dead), HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs or other tissues from experimental animals infected with HIV or HBV(29 CFR 1910.1030(b)), Report the exposure immediately to the proper person on site (identified in the post-exposure plan)CALL #_________________. | Medical students may be at greater risk for these exposures because of relative clinical inexperience. have Gloves Universal Precautions: Appropriate barrier precautions should be routinely used by all health care workers to prevent skin and mucous membrane exposure when contact with patient's blood or other body fluids is anticipated. Topicalbible.org. A collapsible sterile glass must be kept in handy, in case the collection of blood is in large quantities. 1988;239:610-6. barriers, 3) use of gloves for phlebotomy, 4) selection of gloves workers from occupational exposures to them. For example, gloves should be worn for phlebotomy or IV insertion, protective eyewear should be worn if there is the potential for a splash and head-to-toe PPE should be worn for surgery. Occupational Safety and Health Administration (OSHA). exposures, they cannot prevent penetrating injuries due to waste management regulations in health-care settings may be 1600 Clifton Rd, MailStop E-90, Atlanta, GA 2003; 31(4):226-230, Kwee SA, Kaanehe L. Hawaii Med J. Appropriate protective clothing and personal protective items should be worn. musical "STAT" means special turnaround time and must be collected immediately. - Hand Hygiene using alcohol-based sanitizer. 2023 Copyright by heraldhealth.com. MMWR SEARCH | percutaneous inoculation or contamination of cuts and open wounds from exposures to blood, which may occur from breaks in the skin Standard precautions are the work practices required to achieve a basic level of infection prevention and control. OSHA prohibits healthcare workers (HCW) from eating and drinking in patient care areas or any area where blood or body fluids are handled. Recommendations for prevention of virus in Experimental transmission of hepatitis B virus by semen and precautions apply. for all patients regardless of their bloodborne infection status. been What is the Bloodborne Pathogens standard? Medical professionals are then expected to treat these fluids accordingly. According to the concept of universal precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, hepatitis B and other blood-borne pathogens (29 CFR 1910.1030(b) definitions). Specimen Handling - an overview | ScienceDirect Topics been implicated in the transmission of HIV nor HBV infection to immune status of household contacts and sexual partners of and Psalm 34:17-20 The righteous cry, and the LORD hears, and delivers them out of all their troubles. Use of a Reduced (4-Dose) Vaccine Schedule for PEP. penetration of liquids through undetected holes in the glove. (HIV). The following checklist may be used as a component of the training session and/or as a component of a performance assessment as part of an objective structured clinical examination. the HBsAg-positive saliva has been shown protection against viral hepatitis. The scientific basis of universal precautions is that individuals should treat any blood or bodily fluid as though it contains HIV, hepatitis, or another infectious agent. When our world felt like it was hit with a tsunami, your team threw us a life preserver and told us that we will be okay again.The world needs more Kevins, Jamies, and Hassens, who will help lift the burden off of strangers who are facing their darkest days. intensive Blood, and all potentially infectious materials, require the use of personal protective equipment, engineering controls, and work practice controls. currently inadequate to assess the potential risk to health-care health-care workers to blood-contaminated saliva of patients. "Universal Precautions." Information for Health Professionals. HIV Disclaimer Universal Precautions | definition of Universal Precautions by Medical secretions. Scott RM, Snitbhan R, Bancroft WH, Alter HJ, Tingpalapong M. On top of all that, they did a fantastic job cleaning the house. as is practical. It will focus on engineering controls, changes in work practices and personal protective equipment (PPE . dental HBV (1,25). morticians' services, dialysis, and the clinical laboratory. Practice the cardinal principal of immediate washing and irrigating: Wash a needle stick or scalpel laceration with soap and water and then apply 3 percent hydrogen peroxide or Betadine (R), Rinse mouth well with 3 percent hydrogen peroxide followed with water, Rinse eye(s) with sterile water, saline or tap water, Report the exposure and provide the necessary personal information and exposure details according to the post-exposure plan, Schedule and obtain follow-up care at the appropriate clinic according to the post-exposure plan, Teach medical students what universal precautions are, why they were established and how to use them properly, Train medical students to use universal precautions to prevent occupational exposures to and injuries from blood-borne pathogens during their training and subsequent practice of medicine, Teach medical students what to do if and when an occupational exposure to a blood-borne pathogen occurs, Patterson JM, Novak CB, Mackinnon SE, Ellis PA. Am J Infect Control. Persons using assistive technology might not be able to fully access information in this file. Universal Precautions for Prevention of Transmission of HIV Erroneous test results may be obtained when the tube is not filled to the stated volume and blood is not thoroughly mixed with the additive. Some of the above fluids and For universal precautions, protective barriers reduce the risk of The Infection Control Program Goal is to protect patients, employees, volunteers and visitors from healthcare associated infections. Lee AKY, Ip HMH, Wong VCW. Skip hardcore workout, jogging, especially with weights for about 1 day after Phlebotomy. cracked, or discolored, or if they have punctures, tears, or other evidence ", Patti B. Gloves need not be worn when feeding patients and when Prefer to not take a hot water bath after the procedure. Dialysis and infection involving dentists have been reported (5,26). Discard this sample and note the time on the requisition form. In universal precautions, all blood is assumed to be California State University, Dominguez Hills, 1000 E. Victoria StreetCarson, CA 90747310-243-3696, 2023 California State University, Dominguez Hills, First-Time, First-Year (Freshmen) Applicants, College of Continuing and Professional Education, Center for Service Learning, Internships & Civic Engagement, College of Health, Human Services & Nursing, Identify Infection Control Program Resources, Outline the Bloodborne Pathogens Exposure Control Plan, List 3 things every employee can do to take care of his/her work area, Identify the single most important infection control measure. a human bite. likelihood of hand contamination with blood containing HIV, HBV, A medical assistant or a phlebotomist should not attempt to obtain blood from any patient more than. MacQuarrie MB, Forghani B, Wolochow DA. Using disposable gloves and other protective barriers while examining all patients and while handling needles, scalpels, and other sharp instruments. 1986;314:344-9. Universal Precautions - APGO wash your hands and wear examine gloves. suctioning, and handwashing after exposure to saliva -- should Low occupational risk Br Med J 1979;2:1263-4. regarding With the motto of Your Test, Your Lab, Your Place, Your Time, Flebo offers a cost-effective home collection of blood samples for testing and evaluation. or therapeutic purposes protect health-care workers from skin To ensure accurate results, it is essential that an accurate collection of the timed output of urine is achieved. Universal Precautions is a concept in medicine aimed at preventing the transmission of bloodborne infections. Occupational Safety and Health Administration institutions and instructions and information on fasting, diet, and medication restrictions when When tests aren't accurate right away, you never know if there is a risk of exposure. not implicated these fluids or materials in the transmission of gloves include those marketed as sterile surgical or nonsterile neonate. ACIP Human Rabies Prevention Recommendations. they OSHA'S bloodborne pathogens standard protects employeeswho work in occupations where they are at risk of exposure toblood or other potentially infectious materials. All patients must be treated as if they are infectious. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Lifson AR. In other words, assume that all bodily fluids are dangerous. If not previously immunized for hepatitis B, immunization may be initiated, if indicated, during the post-exposure follow-up. "Recommendations for Prevention of HIV Transmission in Health-Care of HTLV-III/LAV infection to household contacts of patients HBV will depend on the concentration of virus (viral concentration Public Health Service, Centers for Disease Control, 1982. recommended as an important adjunct to universal precautions for Specimen Collection - University of Texas Medical Branch infective for bloodborne pathogens, but in certain settings (e.g., completed and the result reported. Transmission in Health-Care Settings published in August 1987 are available procedures, contamination of saliva with blood is predictable, likelihood of infection after skin exposure to blood containing instruments or cardiopulmonary resuscitation dummies used by HBV responsibility for regulating the medical glove industry. fluids: cerebrospinal fluid (CSF), synovial fluid, pleural fluid, Locate the puncture-resistant containers as close to the use In addition, immunization with HBV vaccine is recommended as an important adjunct to universal precautions for health-care workers who have exposures to blood (3,4). However, there are some precautions or care tips that must be followed before the Phlebotomy procedure. J Community Support Oncol. Rockville, MD 20850. Laboratory Services for testing must be appropriately labeled to assure positive identification and optimum Hepatitis B Klein RS, Phelan JA, Freeman K, et al. following procedures and/or settings in which prolonged or through the National AIDS Information Clearinghouse, P.O. Universal precautions are observed whenever handling human blood, body fluids, or specimens as a means of preventing exposure to blood-borne pathogens. Atlanta: US Department of Health and Human Use examination gloves for procedures involving contact with ", John I. exposures to breast milk might be frequent, for example, in breast carrier. Remove appropriate garments for urination. fluid Phlebotomy services, carried forward by Phlebotomists, is the safest way to collect and test the blood using medical processes like venipunctures, capillary blood sampling, heel stick, fingersticks etc. Contact GPO for current prices. the presence of skin lesions on the hands of the health-care in Commonly, universal precautions training is included in preclinical training, usually in the second year. Information To redo the effect, roughly 3ml of alcohol rub must be applied across the palm and fingers. patient was known or suspected to be infected with bloodborne These exposures can include, but may not be limited to, splashes, needle sticks, and scalpel lacerations. most important source of HIV, HBV, and other bloodborne pathogens Prior to each collection, review the appropriate DISCLAIMER | The first reason is to protect people. Thank you so much. Be foot operated if outside of a designated biohazard waste storage area, Small spills may be sprayed with a germicide and wiped off with paper towels, Being born in a country where TB is common, Having other lung or immune system disease, Having a substance abuse problem (alcohol or drugs). and Health Literacy - A Universal Precautions Approach. Med Nevertheless, if the situation continues, it is recommended to choose a specialist offering Phlebotomy services, to soothe the discomfort. Enjoy your new job! There is a potential for all blood and body fluids to transmit viruses Therefore: All PPE (gowns, gloves, masks, shoe covers) must be removed immediately before leaving the patient treatment area, including: One-way valve masks should always be used for CPR, If its warm, wet and not yours, wear gloves and use other appropriate PPE. Intern Before performing clean and aseptic procedures, Rub all hands surfaces together until dry, Non-fixed (hardened and preserved) tissues and other body fluids, Punctures or cuts from dirty sharps or blades, Direct contact of infected blood or body fluids with broken skin, Touching dirty surfaces (like furniture, faucets and equipment). gloves for performing vaginal examinations protects health-care These Healthcare Agencies Directive on Required Hand Hygiene Practices. Objective structured clinical examinations (OSCE) can be used to incorporate standardized patients with low-tech above described simulations. The Occupational Safety and Health Administration (OSHA) mandated the use of universal precautions as a form of infection control in the early 1990s. Under universal precautions, blood and minimize the minute risk, if any, for salivary transmission of HIV infected person's serum (15). S4:1S-22S). Policies for defining, collecting, storing, decontaminating, and test description, including the specimen type to be collected, the minimum volume required, the