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Hospital eTool - HealthCare Wide Hazards Module
(Lack of) Universal Precautions
Potential Hazard
Employee exposure to bloodborne pathogens from blood and
Other Potentially
Infectious Materials (OPIM) because employees are not using Universal Precautions.
- Bloodborne pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans.
- Some infections that can be transmitted through contact with blood and body fluids include:
- HIV,
Hepatitis A,
B,
C, Staph and Strep
infections, Gastroenteritis-salmonella, and shigella, Pneumonia, Syphilis, TB, Malaria, Measles, Chicken Pox, Herpes, Urinary tract
infections, and Blood infections. The greatest risks are from HIV and Hepatitis B and C.
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Possible Solutions
Use Universal Precautions. Universal precautions is an approach to infection control to treat all human
blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens, (Bloodborne
Pathogens Standard 1910.1030(b)
definitions).
- Bloodborne Pathogen Standard
1910.1030(d)(1)
requires:
- Employees to observe Universal Precautions to prevent contact with blood or other potentially infectious materials (OPIM).
- Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be
considered potentially infectious materials.
- Treat all blood and other potentially infectious materials with appropriate precautions such as:
- Use gloves, masks, and gowns if blood or OPIM exposure is anticipated.
- Use engineering and work practice controls to limit exposure.
OPIM is defined in
1910.1030(b) as:
- The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid,
peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body
fluids in situations where it is difficult or impossible to differentiate between body fluids;
- Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and
- HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood,
organs, or other tissues from experimental animals infected with HIV or HBV.
The Bloodborne Pathogens Standard allows for hospitals to use acceptable alternatives [OSHA Directive
CPL 2-2.69] to universal precautions:
- Alternative concepts in infection control are called Body Substance Isolation (BSI) and Standard Precautions. These methods define
all body fluids and substances as infectious. These methods incorporate not only the fluids and materials
covered by the Bloodborne Pathogens Standard but expands coverage to include all body fluids and substances.
- These concepts are acceptable alternatives to universal precautions, provided that facilities utilizing them adhere to all other
provisions of the standard.
- For compliance with OSHA Standards, the use of either Universal Precautions or Standard Precautions are acceptable.
The CDC recommends Standard Precautions for the care of all patients, regardless of their diagnosis or
presumed infection status.
- Standard Precautions apply to 1) blood; 2) all body fluids, secretions, and excretions,
except sweat, regardless of whether or not they contain visible blood; 3) non-intact skin; and 4) mucous
membranes. Standard precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized
sources of infection in hospitals.
- Standard precautions includes the use of: hand washing, appropriate personal protective equipment such as gloves, gowns, masks,
whenever touching or exposure to patients' body fluids is anticipated.
- Transmission-Based Precautions (i.e., Airborne Precautions, Droplet Precautions, and
Contact Precautions), are recommended to provide additional precautions beyond Standard Precautions to interrupt transmission of
pathogens in hospitals.
- Transmission-based precautions can be used for patients with known or suspected to be infected or colonized with epidemiologically
important pathogens that can be transmitted by airborne or droplet transmission or by contact with dry skin or contaminated surfaces.
These precautions should be used in addition to standard precautions.
- Airborne Precautions used for infections spread in small particles in the air such as chicken pox.
- Droplet Precautions used for infections spread in large droplets by coughing, talking, or sneezing such
as influenza.
- Contact Precautions used for infections spread by skin to skin contact or contact with other surfaces such
as herpes simplex virus.
- Airborne Precautions, Droplet Precautions, and Contact Precautions. May be combined for diseases that have multiple routes of
transmission. When used either singularly or in combination, they are to be used in addition to Standard Precautions.
For additional information, see HealthCare Wide Hazards -
Needlesticks.
Additional Information:
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