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Occupational
Safety & Health Administration:
OSHA, Infection Control and
Phlebotomy
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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.
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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.
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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
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Standard Precautions
Personal Protective Equipment
Examples of PPE include…..
 Gloves
 Gowns
 Masks
 Safety glasses
 Face shields
Transmission-Based Precautions
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For patients that are known or suspected to be infected with
highly contagious pathogens
There are 3 types of transmission-based precautions…
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2.
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Airborne precautions
Droplet precautions
Contact precautions
Each precaution has its own equipment to be used on top of
the standard precautions (PPE).
Airborne Precautions
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Airborne precautions are designed to reduce the risk
of transmission of infectious agents through the air.
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Special air handling and ventilation precautions are
required to prevent any airborne transmission.
Droplet Precautions
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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
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.
Blood-borne Pathogens
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
The blood-borne pathogen standard
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
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
The Needlestick Safety
& Prevention Act
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
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Remember: Needles and any other sharp objects need to be
disposed of in a puncture-proof container.
Needles should NEVER be recapped!
To Summarize..
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