 Occupational Health and Safety Administration (OSHA) is a federal agency that works to promote safety in all health care environments.  OSHA creates and promotes safety and health standards for all occupations.  OSHA conducts inspections and investigations of places of employment to check for their compliance with OSHA standards and regulations.  If a place of employment is not following OSHA’s guidelines they will receive citations and pay penalties for their lack of compliance.

 OSHA is not responsible for taking care of the patient.  OSHA is concerned with the workers in a profession.  Every health care facility should have an exposure control plan in place that is compatible with OSHA’s guidelines incase an employee is injured.  OSHA has put into place numerous standards and guidelines to keep phlebotomists safe.  Phlebotomists will be responsible for handling blood and body fluids collected from patients.  They will also be responsible for taking blood which involves the use of needles.  Exposure to blood and body fluids can also happen through open cuts or contact with mucus membranes.

 OSHA put into place the standard precautions system.  Standard precautions were put into place to help prevent a health care worker from direct contact with blood and body fluids.  Employees can accomplish this by using barrier protection and work control practices.  Standard precautions assume that ALL blood and ALL body fluids on any patient are potentially infectious.  Standard precautions are to be used when there is a chance for contact with any of the following…..  Blood  Any body fluid  Non-intact skin  Mucus membranes

Standard Precautions Personal Protective Equipment  Examples of PPE include…..  Gloves  Gowns  Masks  Safety glasses  Face shields

Transmission-Based Precautions  For patients that are known or suspected to be infected with highly contagious pathogens  There are 3 types of transmission-based precautions… 1. Airborne precautions 2. Droplet precautions 3. Contact precautions  Each precaution has its own equipment to be used on top of the standard precautions (PPE).

 Airborne precautions are designed to reduce the risk of transmission of infectious agents through the air.  Special air handling and ventilation precautions are required to prevent any airborne transmission.

Droplet Precautions  Droplet precautions are designed to reduce the risk of droplet transmission of infectious agents.  Droplet transmission is when the conjunctivae or mucus membranes of the nose or mouth are exposed to large droplets coming from an infected source.  Droplets form during coughing, sneezing, and talking.  Special air ventilation is not required.

Contact precautions are designed to reduce the risk of transmission of infectious agents by direct or indirect contact. Direct contact means skin-to-skin contact and physical transfer of an infectious agent. Indirect contact involves contact with a contaminated object in the patient’s environment.

A blood-borne pathogen (BBP) is any infectious microorganism present in blood, body fluids, and tissues. These pathogens may be present in a patient with no signs or symptoms of disease. Phlebotomists must be aware of these microorganisms and be wearing their proper PPE and following the standard precautions to keep themselves safe. The blood-borne pathogen standard was put into place to protect health care workers from exposure to these BBP while on the job. Common BBP include….. HIV HBV HCV

Requires employers to implement engineering controls and work practice controls to prevent accidental exposure. The standard also requires the use and availability of PPE, preventative vaccination, as well as special training for the employees at risk of contracting a BBP. Engineering controls are devices designed to eliminate or reduce the hazard of infection by a BBP. Examples of engineering controls include….. Blood collection tubes Sharps containers Safety shields Biological safety cabinets Autoclaves

Work practice controls are changing the way the job is performed to reduce the chance of being infected with a BBP. Examples of work practice controls are….. Washing hands often Use of devices with safety features Never recapping a needle Using transfer devices instead of a needle to transfer blood Not reusing tube holders Participating in special training Vaccinating against HBV

 Signed into law in 2000  The act encouraged the use of safer medical devices, especially needles.  The best needle used for phlebotomy that meets the requirements of the act should include such features as: A barrier between the needle and hand after completion Ease of operation Allowing the phlebotomist’s fingers to be behind the needle at all times Ensuring the safety feature is in effect before and after the venipuncture Not interfering with the delivery of the venipuncture during the process Remember: Needles and any other sharp objects need to be disposed of in a puncture-proof container. Needles should NEVER be recapped!

 Why is it important to practice specific precautionary measures depending on the risk factor?  What is PPE?  Why do employees in the medical profession have to protect themselves in the work place?  What are some precautions that would protect against catching an infection from a patient?  Name some examples of the following:  Airborne Transmission  Droplet Transmission  Blood-born Pathogen Transmission  Contact Transmission