Protection Against Infectious Diseases

Introduction

In this section, you'll review ways people who work in healthcare take precautions from acquiring infectious diseases.

 

Body Fluids

Body fluids are any fluid that comes from the human body.

Here are some examples of body fluids healthcare workers may come in contact with while working with patients.

Blood

• While drawing or handling blood samples
• When changing dressings on an open wound
• When taking care of a patient with epistaxis

Vaginal Secretions

• When assisting the physician with an OB/GYN exam
• When handling any specimens 

Synovial Fluid

• When assisting the physician with any arthroscopic procedures
• When handling specimens

Semen

• When handling semen specimens

Sputum

• When handling sputum specimens
• When working with any patients who are expectorating sputum

Saliva

• When assisting with any dental or oral procedures

 

Transmission-Based Precautions

If a patient has been diagnosed or is suspected of having a highly contagious disease, then healthcare workers take extra precautions in addition to the standard precautions.

These precautions are referred to as transmission-based precautions (TBP).

The goal of TBP is to reduce the risk of airborne, droplet, and contact exposure for healthcare workers.

For example, in an ambulatory setting, a patient with suspected active tuberculosis (TB) would need to wear a surgical face mask in the waiting room and be moved into an airborne infection isolation room (AIIR) as soon as possible. A patient in the inpatient setting would be placed in an AIIR with negative pressure, which keeps air from flowing out of the room when the door is opened.

Healthcare personnel should limit transferring and moving the patient among the general population. When the patient needs to be out of isolation, the patient needs to wear a surgical mask. Depending on the patient's diagnosis, the healthcare workers may need to wear specially designed respirators for protection. All of this would be completed in addition to the standard precautions.

 

Personal Protective Equipment

Personal protective equipment (PPE) is a barrier that's used to protect healthcare workers against body fluids. However, personal protect equipment doesn't protect from needle stick injuries.

PPE consists of gloves, mask, goggles or face shield, gown, and shoe covers.

What PPE a medical assistant uses depends on the type of patient care that the assistant is providing.

Healthcare workers can be exposed to blood during an accidental needle stick injury after giving a patient an injection. The Occupational Safety and Health Administration (OSHA) mandates that employers provide the safest needle device available to protect workers.

All used sharps must be placed in a container designated for sharps. These containers are puncture-proof and have a safety device on the top that prevents the sharps from escaping once they're placed in the container.

If a needle that the healthcare worker is using doesn't have any type of safety device on it and the sharps container isn't within arm's reach, then the worker will use the scoop technique to place the cap back on and then proceed to the sharps container to dispose of the sharp.

 

OSHA Regulations

The Occupational Safety and Health Administration (OSHA) protects employees by developing and implementing regulations that employers must follow to ensure the workplace is healthy and safe for workers.

The bloodborne pathogen standard is in place to protect employees from becoming exposed to body fluids in the workplace.

Every healthcare facility must have an exposure plan. The plan must list how the employer will comply with the bloodborne pathogen standard.

 

OSHA mandates that employers be in compliance with the following precautions:

• Standard precautions—Hand washing is a focus. Employers are required to provide sinks to wash hands.
• Engineering controls/work practice controls—Employers must provide the equipment and devices necessary for employees to perform their jobs as safely as possible. A sharps container placed close to where employees give injections is an example of an engineering/work practice control.
• Personal protective equipment—Employers must provide PPE, make sure that it's accessible to the employees, and ensure they know how to use it.
• Cleanliness of work areas—It's the employer's responsibility to make sure the workplace is clean and sanitary. Employers need to have written documentation detailing the cleaning schedule.
• Hepatitis B vaccine—Employers must offer the vaccine to employees free of charge.
• Follow-up plan after exposure—If an employee has an accidental exposure, there must be a plan in place, including a medical evaluation, and that plan must be followed.
• Medical records—If an employee has an occupational exposure, then the medical record must be maintained for the length of employment plus an additional 30 years. The medical record is confidential. The employer doesn't have privilege to see the medical record.

 

Key Points

• Healthcare workers should take extra precautions when dealing with a patient who has been diagnosed or is suspected of having a highly contagious disease. These precautions are known as transmission-based precautions (TBP).
• Personal protective equipment is a barrier that's used to protect healthcare workers against body fluids, but not from needle stick injuries.
• OSHA protects employees by developing and implementing regulations to ensure a safe, healthy workplace.
• Medical asepsis techniques are used to decrease the risk of spreading infection.
• Sanitization is the actual physical washing and cleaning of equipment.
• Disinfection uses chemicals or boiling water on objects and surfaces to destroy many pathogens.