SAFETY IN THE HEMATOLOGY LABORATORY
UNIVERSAL PRECAUTION: original term
STANDARD PRECAUTION: current terminology
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Standard Precautions in blood (and all specimens) collection
“Potentially infectious for bloodborne pathogens”
OSHA’s Final Rule: (Occupational Safety and and Health Administration)
protection of health care workers from bloodborne pathogen exposures [Hepatitis (B, C, D),
syphilis, malaria, and HIV]
Principal modes of bloodborne pathogen transmission:
Direct percutaneous inoculation of blood or body fluids containing the pathogen via
needle-stick or other injuries from sharp instruments
Direct inoculation of blood and body fluids containing pathogen onto mucous membranes,
cutaneous scratches, abrasions, burns or other lesions
Indirect inoculation of pathogen from environmental surfaces contaminated with blood or body
fluids onto mucous membranes, cutaneous scratches, abrasions, burns or other lesions.
Note: HEPA-B virus can survive on inanimate or dried surfaces for at least 1 week
Why observe standard precautions?
Reduces the risk of healthcare exposures to blood and body fluids
Decreases the risk of injury and illnesses
APPLICABLE SAFETY PRACTICES REQUIRED BY THE OSHA STANDARD
Hand washing: most important practice to prevent the spread of infectious diseases
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Phlebotomist: practhand washing (soap & running water)
Between patients
Every after removal of gloves and between glove changes
Whenever there is visible contamination with blood or body fluids
After completion of work
Before leaving the laboratory
Before and after eating and drinking, smoking, applying cosmetics or lip balm, changing a
contact lens, and using the lavatory
Before and after all other activities that entail hand contact with mucous membranes, eyes, or
breaks in skin
Alcohol-based hand rub: may be used if no visible hand contamination
Antimicrobial wipes or towelettes: less effective for hand sanitation
Gloves: essential PPE (worn during blood collection procedures)
Note: When gloves are removed, no blood from the soiled gloves should come in contact with
the hands
Eating, drinking, smoking, and applying cosmetics or lip balm must be prohibited in the
laboratory work area.
Hands, pens, and other fomites must be kept away from the mouth and all mucous
membranes.
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Food and drink, including oral medications and tolerance-testing beverages, must not be kept
in the same refrigerator as laboratory specimens or reagents or where potentially infectious
materials are stored or tested.
Mouth pipetting must be prohibited.
Procedures (removing caps when checking for clots, filling hemocytometer chambers, making
slides, discarding specimens, making dilutions, and pouring specimens or fluids) be
performed so that splashing, spraying, or production of droplets of the specimen being
manipulated is prevented (performed behind a barrier, such as plastic shield, or protective
eyewear)
Personal protective clothing and equipment must be provided to the laboratory staff:
Outer coverings (gowns, laboratory coats, and sleeve protectors)
Made of fluid-resistant material
Long-sleeved
Remain buttoned at all times
Note: If contamination occurs, the PPE should be removed immediately and treated as
infectious material.
Contaminated sharps and infectious wastes should be placed in designated
puncture-resistant containers.
Red or red-orange biohazard sign:
A container holds potentially infectious materials
Biohazard containers should be easily accessible and should not be overfilled
SAFE USE OF SHARPS
Best practice for the safe handling and disposal of sharps includes the ff advice:
Avoid sharps usage wherever possible - consider the use of alternative devices or procedures,
needle-free devices or safer use of sharps with inbuilt protection devices.
Bevelled needle guard for safer unseathing/ reseathing
Safety lancet with retracting needle
If using scalpels - consider the use of disposable units or use of scalpel blade removal devices
Disposable scalpel blade and handle
Safe scalpel blade removal device
Sharps must not be passed directly from person to person. Handling must be kept to a
minimum.
Never leave sharps lying around.
Used needles must not be re-sheathed unless there is a safe method available for doing so.
Needles must not be re-sheathed by hand.
Re-capping device
One handed scooping method
Ensure a sharps waste container is available close at the point of use to avoid carrying
exposed sharps. Always dispose of sharps as soon as possible after use.
Syringes, cartridges and needles should be disposed of intact as a single unit whenever
possible.
Some sharps containers will have an inbuilt needle removal device which should be
considered where required.
Never put hands into sharps containers e.g. to retrieve an incorrectly disposed of item or to
press sharps down to make more room.
Close the aperture to the sharps container when carrying or if left unsupervised, to prevent
spillage or tampering.
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Never carry sharps in the hand or in the pocket - if there is a need to transport sharps they
should be placed in a rigid container or tray.
If a sharp has been accidentally dropped, it must be retrieved and disposed of properly. If
unable to retrieve the dropped sharp warn others so that care may be taken.
One-Hand Scoop Technique
Place the cap on a flat surface, then remove your hand from the cap.
With one hand, hold the syringe and use the needle to ‘scoop up’ the cap.
When the cap covers the needle completely, use the other hand to secure the cap on the
needle hub. Be careful to handle the cap at the bottom only.
The practice of safety must be uppermost in the mind of all working in the Hematology
laboratory mind
ALWAYS REMEMBER:
Accidents don’t just happen!
Causes of accidents:
Carelessness
Lack of attention to details
Lack of proper communication
Most lab. Accidents are preventable, if the following are observed:
Exercising good technique
Staying alert
Using common sense
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