Bloodborne Pathogen Standard: Sharps and Biohazards

Sharps and Biohazards

• Sharps are items that can easily break skin and potentially transmit disease, including venipuncture needles, double-sided needles, lancets, and microscope slides.
• Use safety devices on sharps immediately after blood collection and dispose of them in a sharps container.
• NIOSH identifies incorrect sharps disposal as a significant cause of sharps injuries in the workplace.

Sharps Containers

• Sharps containers must be:
  • Leak- and puncture-resistant
  • Durable for transport
  • Of appropriate size and shape
  • Have a secure closure that protects against exposure during closing
• Containers must be upright, easy to operate, and within easy reach, with the fill level and biohazard symbol clearly visible.

Handling Sharps Containers

• Close containers after each use, during transport, and when not in use.
• Dispose of used strips, plastic blood tubes, gauze, and other non-sharp items contaminated with blood in a biohazard bag.

Transmission-Based Precautions

• Follow basic standard precautions when handling potentially infectious materials.
• Consider all body fluids from all patients as infectious and use standard precautions when handling and treating them.
• Transmission-based precautions vary with the means of transmission (droplet, contact, airborne).

Exposure Control Plans

• Each facility must have an exposure-control plan in place that includes the level of risk, precautions to take, and steps to take after accidental exposure.
• Employees must participate in annual bloodborne pathogen training and implement infection-control practices.

Accidental Exposure

• If an accidental exposure occurs, remain calm and follow correct steps to minimize the effect.
• For an accidental needlestick, decontaminate the puncture site with an antiseptic or soap and water, and notify the immediate supervisor.
• Document the incident in the sharps injury log and on the facility's incident report form.

Hand Hygiene

• Hand hygiene is the most effective means of preventing infection.
• Perform hand hygiene when entering or leaving work areas; after contact with any bodily fluid; and before and after patient procedures, eating, and using the restroom.

Standard Precautions regarding PPE

• Wear gloves when handling body fluids, and replace them between each patient encounter and when performing different procedures for the same patient.
• Wear gloves when handling specimen containers, such as vacuum tubes or urine collection containers.
• Ensure gloves are nitrile or vinyl, fit properly, and are free of holes or rips.
• Wear gloves during venipuncture, dermal puncture, and procedures that involve interaction with body fluids.
• Take specific measures to avoid personal contamination when removing gloves.
• Wear eye protection, such as goggles or safety glasses, when aliquoting blood specimens.
• Dispose of used needles promptly in appropriate sharps disposal containers.

Exposure Control Plans

• Each facility must have an exposure-control plan in place that includes the level of risk for each employee, precautions to take, and actions to follow after an accidental exposure.
• Employees must participate in annual bloodborne pathogen training to prevent accidental exposure.
• Implement infection-control practices, use safeties on devices, and properly dispose of potentially infectious material to reduce accidental exposures.
• Obtain hepatitis B immunizations and regularly review safety practices and precautions in the workplace safety manual.

Accidental Exposure Procedures

• When an accidental exposure to blood or body fluids occurs, remain calm and follow the correct steps to minimize the effect.
• Decontaminate the puncture site with an antiseptic or soap and water after a needlestick.
• Notify the immediate supervisor and document the incident in the sharps injury log and facility's incident report form.
• Have a medical examination as soon as possible after an accidental exposure.

Blood Spill Cleanup

• Discard any items that drop to the floor in a sharps container.
• Refrain from retouching the prepared site, even while wearing gloves, to prevent contamination.
• Use paper towels or other absorbent material to soak up blood, and avoid using gauze pads.
• Thoroughly disinfect the area after a blood spill, and use prepared solutions or a 1:10 mixture of sodium hypochlorite to water.

Hand Hygiene Guidelines

• Hand hygiene is the most effective means of preventing infection.
• Perform hand hygiene when entering or leaving work areas, after contact with bodily fluids, and before and after patient procedures, eating, and using the restroom.
• Infection control begins by not touching contaminated surfaces, and ensuring the water is not too cold or too hot.
• Wet hands first, apply an effective soap or hand cleanser, and scrub hands vigorously, paying attention to nails, nail beds, knuckles, and the skin between the fingers.