Infection Control Today

APR 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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14 ICT April 2019 By Nancy Chobin SPD dialogue RN, AAS, ACSP, CSPM, CFER Q Q: Our department was recently cited by surveyors for the way we transport used instruments and devices. We have always placed a cover over the item (i.e., a drape or towels) and bring the sets on a cart to the decontamination area. We were also told we were non-compliant with OSHA standards. What were we doing wrong? A: In December 1991, the Occupational Safety and Health Administration (OSHA) issued a regulatory standard intended to eliminate or minimize occupational exposure to bloodborne pathogens (29 CFR 1910.1030). This standard requires employers to write and enforce an Exposure Control Plan for their facilities and to review the plan annually and whenever changes are made in the workplace that could affect exposure to bloodborne pathogens. The Exposure Control Plan should include a step-by-step procedure for reporting exposure incidents 24 hours a day. As part of OSHA's Bloodborne Pathogens Act, exposure control is a major component meant to protect healthcare workers from contact with blood and body fl uids. OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030) as amended pursuant to the Needlestick Safety and Prevention Act of 2000, prescribes safeguards to protect workers against the health hazards caused by bloodborne pathogens. Its requirements address items such as exposure control plans, universal precautions, engineering and work practice controls, personal protective equipment, housekeeping, laboratories, hepatitis B vaccination, post- exposure follow-up, hazard communication and training, and recordkeeping. The standard places requirements on employers whose workers can be reasonably anticipated to contact blood or other potentially infectious materials (OPIM), such as unfi xed human tissues and certain body fl uids. The term "reasonably anticipated contact" includes the potential for contact as well as actual contact with blood or OPIM. "Reasonably anticipated contact" includes, among others, contact with blood or OPIM Transporting Contaminated Items (including regulated waste) as well as incidents of needlesticks. OSHA's Bloodborne Pathogens standard, including its 2001 revisions, applies to all employers who have an employee(s) with occupational exposure (i.e., reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials (OPIM) that may result from the performance of the employee's duties). These employers must implement the requirements set forth in the standard. Some of the new and clarifi ed provisions in the standard apply only to healthcare settings, but other provisions, particularly the requirements to update the Exposure Control Plan and to keep a sharps injury log, apply to non-healthcare as well as healthcare settings. As part of this regulation, employers must determine which work practices could lead to an exposure and to identify which employees which would be at risk for an exposure. Employers are required to develop a list of all tasks and procedures or groups of closely related task and procedures in which occupational exposure occurs and that are performed by employees in job classifi cations listed. This exposure determination shall be made without regard to the use of personal protective equipment. The standard states, "engineering and work practice controls shall be used to eliminate or minimize employee exposure." The 2001 revision defi nes engineering controls as "controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazard from the workplace." Employers who have employees exposed to contaminated sharps must consider and implement appropriate commercially available and effective safer medical devices designed to eliminate or minimize occupational exposure. Also, employees with occupational exposure must be trained in the use and limitations of methods that will prevent or reduce exposure, including appropriate engineering controls, work practices and personal protective equipment. Therefore, training must include instruction on any new techniques and practices associated with new engineering controls. Under the law, universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. In circumstances in which differentiation between body fluid types is difficult or impossible, all body fl uids shall be considered potentially infectious materials. How does this affect you? Bloodborne pathogens are microorganisms that can be present in human blood and body fl uids and Labeling of Transport carts Closed transport cart

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