1 - LAB SAFETY Flashcards
A general state of physical, mental and emotional well-being
Health
Condition in which the physical well-being of people is protected.
Safety
Protection of employees and organizational facilities.
Security
established the National Patient Safety Goals
Joint Commission
have published numerous safety standards and regulations that are applicable to clinical laboratories.
OSHA and CDC
What 3 measures is included to ensure safety in the clinical laboratory according to CDC and OSHA?
- A formal safety program
- Specifically mandated plans (e.g., chemical hygiene, bloodborne pathogens)
- Identification of various hazards (e.g., chemical, biological)
OSHA
Occupational Safety and Health Administration
CLSI
Clinical and Laboratory Standards Institute
CDC
Centers for Disease Control and Prevention
JCAHO
The Joint Commission on Accreditation of Healthcare Oraganizations
This individual has any duties affecting staff including compliance with existing regulations affecting the laboratory and staff.
Safety Officer
contains a comprehensive listing of approved policies, acceptable practices, and precautions including standard precautions
Safety Manual
This word is posted throughout the laboratory to denote infectious materials or agents that present a risk or even a potential risk to the health of humans or animals in the laboratory
“Biohazard”
are also included in a laboratory reference manual that is available to all hospital personnel
Laboratory policies
The _______________ can be either through direct infection or through the environment.
potential risk
can occur during the process of specimen collection or from handling, transporting, or testing the specimen.
Infection
are intended to prevent occupational exposures to bloodborne pathogens.
Standard Precautions
CDC concept of Standard Precautions
All human blood and other body fluids are treated as potentially infectious for HIV, HBV, and other bloodborne microorganisms that can cause disease in humans.
is an important safety precaution. It must be performed after contact with patients and laboratory specimens. Gloves should be used as an adjunct to, not a substitute for it.
Handwashing
Guidelines for Handwashing and Hand Antisepsis in Healthcare Settings
- Wash hands with a nonantimicrobial soap and water or an antimicrobial soap and water when hands are visibly dirty or contaminated with proteinaceous material.
- Use an alcohol-based waterless antiseptic agent for routine decontamination of hands, if not visibly soiled.
- Waterless antiseptic agents are highly preferable, but hand antisepsis using antimicrobial soap may be considered in certain circumstances.
- Decontaminate hands after contact with the patient’s skin.
- Decontaminate hands after contact with blood and body fluids.
- Decontaminate hands if moving from a contaminated area to clean body site during patient care.
- Decontaminate hands after contact with inanimate objects in the immediate vicinity of a patient.
- Decontaminate hands after removing gloves.
If an adequate volume of an alcohol based handrub is used, it should take ________ seconds for hands to dry
15 to 25 secs
When washing with a non antimicrobial or antimicrobial soap, wet hands first with warm
water, apply _________ of detergent to hands, and rub hands together vigorously for at least
_________, covering all surfaces of the hands and fingers.
3-5 mL; 15 seconds
PPE is consist of:
- Eye protection
- Protective clothing
- Foot Protection
- Hand protection
Goggles and face shield
Eye Protection
Laboratory coat
Protective clothing
is designed to prevent injury from corrosive chemicals or heavy objects. If a corrosive chemical or heavy object were to fall on the
floor, the most vulnerable portion of the body would be the feet.
Foot protection
Heat-resistant gloves for handling hot or cold objects (e.g., dry ice) and latex or nitrile gloves to prevent exposure to biological hazards
must be available
Hand protection
Safety Equipments
- Individual storage containers
- Eye wash stations
- Safety Showers
- Refrigerators
- Alarms
- Chemical spill kits
(Hazard)
- : Handling toxic substances can cause irritation and carcinogenicity.
Chemical Hazard
(Hazard)
- include hazards from working with small
animals, working with bloodborne pathogens and working with biological agents,
such as viruses and bacteria
Biological Hazard
(Hazard)
- include exposure to noise, poor posture and the explosibility and flammability of substances.
Physical hazards
(Hazard)
- include unbalanced centrifuges, danger when
handling hot sterilized items and electrical hazards, such as shock, explosions, blasts and electrocutions
Safety hazards
(Hazard)
- A common _________ in the laboratory setting is a latex allergy, as many of the materials used in a laboratory setting are latex
Allergy Hazard
Dangers in the laboratory setting can also come from unsafe practices, including:
- Working alone in the laboratory
- Neglecting to wear a lab coat
- Lack of safety training
Risk of infection depends on
✓The pathogen involved
✓Type of exposure
✓Amount of blood involved
✓Amount of virus in the exposed blood
If exposed to blood immediately
✓Wash with soap and water
✓Flush splashes to nose, mouth or skin with
water
✓Irrigate eyes with clean water, saline or
sterile irrigants
What is the risk after an exposure if:
Unvaccinated against Hepa B =
risk factor of 6-30%
What is the risk after an exposure if:
✓Vaccinated against Hepa B =
No risk
What is the risk after an exposure if:
✓Exposure to Hepa C =
risk is 1.8%
What is the risk after an exposure if:
✓HIV needlestick /cut exposure =
0.3 %
What is the risk after an exposure if:
✓HIV exposure to eyes, nose or mouth =
0.1%
What is the risk after an exposure if:
✓HIV exposure to non-intact skin =
0.1%
What is the risk after an exposure if:
✓HIV exposure to intact skin =
no risk
Treatment for HBV
all healthcare workers should receive vaccination
Treatment for HCV
no vaccine available and no treatment to prevent infection
Treatment for HIV
Antiretroviral drugs are available if appropriate.
Post exposure treatment ( if appropriate) should begin within 24 hours and no later than 7 days.
are the most widely used of the chlorine disinfectants.
Hypochlorites
The most prevalent chlorine products in the United States are aqueous solutions of _____________ sodiumhypochlorite, usually called household bleach.
5.25% to 6.15%
a broad spectrum of antimicrobial activity, does not leave a toxic residue and is unaffected by water hardness. In addition, it is inexpensive and fast acting, removes dried or fixed microorganisms from surfaces, and has a low incidence of serious toxicity.
Bleach
dilution of household bleach needed for sanitizing all work surfaces
1:10 dilution
Recommended protocol for managing spills in clinical laboratory
- Wear gloves and a laboratory coat.
- Absorb the blood with disposable towels. Remove as much liquid blood or serum as
possible before decontamination. - Using a diluted bleach (1:10) solution, clean the spill site of all visible blood.
- Wipe down the spill site with paper towels soaked with diluted bleach.
- Place all disposable materials used for decontamination into a biohazard container.
- Decontaminate non disposable equipment by soaking overnight in a dilute bleach (1:10)
solution and rinsing with methyl alcohol and water before reuse. Disposable glassware
or supplies that have come in contact with the blood should be autoclaved or
incinerated.
occur prior to specimen testing and may include variables involving the process of obtaining a specimen.
Preanalytical variables
variables that occur during actual testing of the specimen. Performance of tests in the laboratory is rigorously controlled, with quality control procedures in place that markedly reduce errors in the analytic phase of testing.
Analytical variables
variables that occur after a test result is generated. In general, such postanalytical errors occur with entry, manipulation, and reporting of test data
Postanalytical variables
Preanalytical ERRORS
- Specimen obtained from the wrong patient
- Specimen procured at the wrong time
- Specimen collected in the wrong tube or container
- Blood specimens collected in the wrong order
- Incorrect labeling of specimen
Analytical Errors
- Oversight of instrument flags
- Out-of-control QC results
- Wrong assay performed
Postanalytical errors
- Verbal reporting of results
- Instrument: Laboratory Information System (LIS) incompatibility error
- Confusion about reference ranges
- Failure to report critical values immediately
