Laboratory Safety

Direct contact transmission:

Direct contact transmission is the physical transfer of an infectious agent to a susceptible host through close or intimate contact such as touching or kissing.

Fire Class C

Electrical equipment

Red:

Fire

Safety Equipment:

Fire Extinguisher Fire Blanket First Aid Equipment Eyewash Station Chemical Hood Body Shower Sharps & Biohazard Bins Hazardous Chemical Log MSDS book

Fire Class D

Flammable metals

Personal Safety

No eating / drinking in the lab Avoid putting anything into your mouth including pens / pencils No gum chewing Do not store food / drinks in the lab refrigerator Avoid hand-eye contact in the lab Do not apply make-up or lipstick, rub your eyes or handle contact lenses Shoes must be leather or vinyl with closed toe and back Hair should be pulled back if it is shoulder length or longer No long chains, dangling earrings or loose bracelets should be worn

White:

Other / Special

Chemistry:

Panels, liver enzymes, glucose, thyroid, cholesterol, CPKs are all examples of common chemistry tests.

Blood Bank:

Processing, washing cells, storage of blood and blood products.

Contracting a blood borne pathogen infection through indirect contact from a needle stick is the primary infectious risk for a phlebotomist. Indirect contact can also result from contact with such fomites as:

Telephones Test Tubes Lab Instruments Smoking Food or Nails Contact Lenses

Hand Hygiene

The CDC has approved the use of alcohol based hand sanitizers to clean hands between patients as long as there was no apparent contamination. Make sure that any small cuts or open wounds are protected at all times. Maintain clean, short, neat nails. Artificial nails are prohibited in most hospitals and labs. Keep yourself free from offensive body odors as well as too much perfume / cologne.

Hazardous Materials

The national Fire Protection Association (NFPA) label is designed to allow for firefighters to quickly identify the location of hazardous materials in the event of a fire. (Phlebotomy, 26)

Fire Classifications

There are five classes of fire, as identified by the NFPA, based on the fire's fuel source. The class of fire corresponds to the type of extinguisher that should be used to combat the fire. (Phlebotomy, 29)

PPE

When removing PPE make sure that your gloves, which are the most likely source of infection, do not come into direct contact with your skin or clothing. All PPE should be changed when soiled or wet and after contact with each patient. Again, perform any hand hygiene procedures immediately after removing all personal protective equipment.

Fire Class A

Wood, paper, cloth

Gowns

should be worn in the nursery and in designated areas. It is common practice to never wear lab coats in the nursery.

Eye protection

should be worn when handling specimens or working in areas such as the ER when there is a lot of activity and chances of splatter may occur.

An incident report must always be filed, which includes the following information:

• Date, time, and area the incident occurred • Individuals involved • Type of accident • Detailed account of the incident • Result of the incident including any injuries • Actions taken by yourself or staff • Preventative measures taken

If there is a chemical spill

, secure the area and report it immediately. Use a spill kit to contain the spill and consult the MSDS once the solutions have been identified; for proper clean-up procedures and precautions.

Hand Washing

- Wearing gloves does not eliminate the chance of your hands carrying infection. Washing your hands significantly reduces the likelihood of passing infection on to yourself or to others. Failure to wash hands properly is the number one cause of nosocomial infections (hospital spread). 30-60 seconds of scrubbing is considered proper procedure.

The proper removal sequence for PPE is:

1. Gloves 2. Any face protection 3. Gown

Putting on PPE

1. Gown 2. Any face protection 3. Gloves

The entire clinical laboratory process can be broken down into 3 distinct phases:

1. Pre-Analytical 2. Analytical 3. Post-Analytical

Accidents in the Laboratory

Accidents always have to be reported to a supervisor, regardless if there is injury or not.

Specimen Processing:

All specimens are delivered here. They are logged / scanned in and then given to the correct department for testing. No testing is done here.

Needle Sticks:

As a phlebotomist this is the primary source of accidents. In the event that this happens, it must be reported immediately (even if the needle is clean).

You should wash your hands:

Before and after every patient Before entering and after leaving a patient's room Whenever entering or leaving the laboratory Before putting gloves on and after taking them off

Coagulation:

Bleeding time testing, including Protime (PT) and Activated partial thromboplastin time (APTT).

Universal Precautions

Blood borne pathogens are infectious agents carried in the blood. Universal precaution is the standard by which all specimens are treated as if contaminated.

Hematology:

CBCs are the most common hematology test that you will draw for. Lavender tubes will more than likely end up here for testing.

Fire Class K

Cooking oils and grease

Body Mechanics: Proper use of your body is important to prevent injuries. When you have to lift an object:

Get close to the object. Stand with your feet 6-8" apart. Keep your head up. Keeping your shoulders back and your abdomen tucked in allows you to make use of your leg muscles. Make sure to keep your back straight. Bend at the knees not the waist. Grip the object firmly and hold it close to your body. Lift smoothly with your legs, not your back.

Personal Protective Equipment (PPE)

Gloves: Specimen collection and handling, or cleaning Touching a patient's blood and body fluids, mucous membranes or intact skin Goggles / Safety Glasses / Face Shield: Regular prescription glasses are NOT considered protective eyewear Wear when procedures are likely to generate droplets of blood or body fluids Mask / Respirator: Wear when there is danger of aerosol formation or airborne transmission. Gowns or Aprons: • These should be worn when it is probable that clothing will get soiled; these are often disposable. Lab Coats: Hospitals will provide lab coats and have them professionally cleaned Lab coats should be removed before leaving the lab at the end of your shift or before going on a break

Fire Class B

Grease, Oil, flammable liquids

The more common examples of infectious diseases include:

HIV Syphilis Malaria Hepatitis B, C, and D

Blue:

Health

Common Clinical Laboratory Departments:

Laboratory departments are primarily concerned with the Analytical phase. Each department will contain specific machines used for testing or processing; including reagents and computers.

Yellow

Reactivity

Airborne transmission of blood borne pathogens can occur by:

Removing stoppers Centrifuge accidents Splashes or splatters Not wearing face / eye protection

Microbiology:

Specimens collected for culture or urinalysis

Body fluids that are known to be infectious:

may be labeled with a warning. However, when specimens are collected in sterile containers or handed to you in a sealed container, they should be handled with gloves carefully.