Bloodborne pathogen safety standards have long been in place to reduce the likelihood of exposure involving blood and bodily fluids, but many healthcare organizations continue to experience employee injuries. Knowledge of bloodborne pathogen exposure risks, exposure sources and safety standards are essential to help protect employees and reduce the likelihood of a claim.
Bloodborne Pathogen Exposure Risks
Caregivers face the risk of being exposed to serious diseases due to workplace exposure involving blood and bodily fluids. Bloodborne pathogens are infectious microorganisms in human blood that may cause disease in humans. Key pathogen risks include hepatitis B (HBV), hepatitis C (HCV) and HIV. Exposure may occur due to cuts, punctures and other contact with contaminated fluids.
Bloodborne Pathogen Sources of Exposure
The most common sources for exposure to a bloodborne pathogen are needlesticks and other sharps-related injuries. Injuries occur:
- While handling syringes during injection
- During the injection
- Before disposal of a syringe
- While recapping a syringe
Exposure sources not involving sharps may involve eye, nose or mouth contact with human bodily fluids or blood from:
Contact may also occur due to exposure to contaminated work surfaces, waste receptacles, pails or bins. There is also the potential for exposure due to bites from aggressive patients if the bite breaks the skin and the patient’s saliva mixes with the caregiver’s blood.
Occupational Safety and Health Administration (OSHA) guidance has led to exposure control plans and work practice controls that are effective, if they are followed. However, caregiver exposures continue to occur across the country for a number of reasons, including:
- Improper or inconsistent use of personal protective equipment (PPE), such as gloves.
- Rapid pace of work or a high client workload.
- Lack of proper disposal of sharps.
- Distractions from the client or the client home setting.
- Patients who become combative or aggressive.
Bloodborne Pathogen Guidance Considerations
To minimize the risk of an caregiver injury, the OSHA standard recommends the following for sharps handling:
- Operate safety syringe devices the proper way.
- Report issues with syringes to a supervisor promptly.
- Dispose of used sharps promptly.
- Replace disposal containers nearing the fill line.
- Discard broken glass only in appropriate containers.
- Recap only if your guidance allows recapping.
- Follow training to use only the one-hand method for any recapping.
- Check bedding and clothing for improperly discarded sharps.
Follow company policy regarding universal precautions, where caregivers treat all blood and bodily fluids as if they are infectious, to help reduce the risk of an injury. To protect against non-sharp exposure to bloodborne pathogens, ensure caregivers follow OSHA guidance:
- Wear the provided PPE (gloves, eyewear, facewear, etc.)
- Wash hands properly between clients.
- Wash hands properly after removing gloves.
- Follow universal precaution, handling all blood, tissue and bodily fluids as though contaminated.
- Use correctly sized latex-free or other disposable gloves.
- Consider double gloving when working with patients with a suspected or diagnosed disease.
- Clean and disinfect all possibly contaminated surfaces.
- Handle laundry items as though contaminated by following universal precautions.
- Consult with your doctor about Hepatitis B vaccination before an injury occurs.
- Take any prescribed medication as directed after an injury occurs.
Training is also key to minimizing risk. Ensure all caregivers are trained at hire and annually and note changes and additions to training that may be new or different. Ensure training addresses what caregivers must do if an exposure occurs:
- Wash needlesticks and cuts with soap and water.
- Flush splashes to nose, mouth or skin with running water.
- Irrigate eyes with clean water, saline or sterile irrigates.
- Report the incident to the supervisor.
- Seek immediate medical attention.
- Follow the company policy on post-exposure and follow-up treatment.
Healthcare organizations and caregivers can work together to minimize the risk of exposure to bloodborne pathogens. OSHA guidance is effective, if safety standards are followed. Ensuring that caregivers are trained and follow guidance can reduce both injuries and claims.