IMSE 311 Laboratory

Rochelle D. Darlucio-Yabut, RMT, MPH

College of Medical Laboratory Science
Our Lady of Fatima University
 SAFETY

▰ To work safely in this environment,

laboratory personnel must learn
what hazards exist, the basic safety
precautions associated with them,
and how to apply the basic rules of
common sense required for
everyday safety for patients, co-
workers, and themselves.
 BIOLOGIC HAZARDS

▰ According to the CDC concept of Standard Precautions,

“All human blood and other body fluids are treated as

potentially infectious for human immunodeficiency virus (HIV),
hepatitis B virus (HBV), and other blood-borne microorganisms
that can cause disease in human beings.”
 Biologic Hazards

▰ Understanding CHAIN OF INFECTION

how
microorganisms
are transmitted •INFECTIOUS AGENTS
(chain of •RESERVOIR
infection) is
essential to
•PORTAL OF EXIT
preventing •MODE OF TRANSMISSION
infection. •PORTAL OF ENTRY
•SUSCEPTIBLE HOST
 Biologic Hazards

▰ Proper hand hygiene, correct disposal of contaminated

materials, and wearing personal protective equipment (PPE) are
of major importance in the laboratory.
 HANDWASHING
1. Stand in front of the sink. Do not lean on the sink with clothes.
2. Use paper towel to cover the water control and turn on the water.
3. Wet hands thoroughly. Allow the water to flow from arms to
fingertips.
4. Apply soap to hands.
5. Wash the palm, back, and wrist of each hand using strong, frictional,
circular movements.
6. Interlace fingers and thumbs and move hands back and forth for ten
seconds.
7. Rub nails against the palm
8. Rinse hands thoroughly
9. Dry hands well
10. Use paper towel to turn the water off.
SOILED GLOVE REMOVAL
STANDARD PRECAUTIONS

▰ Hand hygiene includes both hand washing and the use of

alcohol-based antiseptic cleansers.
▰ Personal protective equipment
▰ Patient care equipment
▰ Environmental control
▰ Prevent injuries when using needles, scalpels, and other sharp
instruments or devices
▰ Respiratory hygiene/cough etiquette
Engineering Controls

▰ 1. Providing sharps disposal containers and needles with safety

devices.
▰ 2. Requiring discarding of needles with the safety device
activated and the holder attached.
▰ 3. Labeling all biohazardous materials and containers.
Work Practice Controls
▰ 4. Requiring all employees to practice Standard Precautions and
documenting training on an annual basis.
▰ 5. Prohibiting eating, drinking, smoking, and applying cosmetics
in the work area.
▰ 6. Establishing a daily work surface disinfection protocol.

Personal Protective Equipment

▰ 7. Providing laboratory coats, gowns, face shields, and gloves to
employees and laundry facilities for nondisposable protective
clothing.
Medical
▰ 8. Providing immunization for the hepatitis B virus free of charge.
▰ 9. Providing medical follow-up to employees who have been accidentally
exposed to blood-borne pathogens.

Documentation
▰ 10. Documenting annual training of employees in safety
standards.
▰ 11. Documenting evaluations and implementation of safer
needle devices.
▰ 12. Involving employees in the selection and evaluation of
new devices and maintaining a list of those employees and the evaluations.
▰ 13. Maintaining a sharps injury log including the type and brand of safety device,
location and description of the incident, and confidential employee follow-up.
Biologic Waste Disposal

▰ All biologic waste, except urine, must be placed in appropriate

containers labeled with the biohazard symbol

▰ Disinfection of the sink using a 1:5 or 1:10 dilution of sodium

hypochlorite should be performed daily.
▰ Sodium hypochlorite dilutions stored in plastic bottles are
effective for 1 month if protected from light after
preparation.
Sharp Hazards

▰ includes needles, lancets, and broken

glassware

▰ All sharp objects must be disposed in puncture-resistant, leak-

proof container with the biohazard symbol.

▰ The biohazard sharp containers should not be overfilled and

must always be replaced when the safe capacity mark is reached.
Chemical Hazards

▰ Every chemical in the workplace should be presumed

hazardous.

▰ When skin contact occurs, the best first aid is to flush the area
with large amounts of water for at least 15 minutes, then seek
medical attention.
▰ The National Fire Protection Association (NFPA) has developed
the Standard System for the Identification of the Fire Hazards
of Materials, NFPA 704.14

▰ This symbol system is used to inform firefighters of the hazards

they may encounter with fires in a particular area.

▰ The diamond-shaped, color-coded symbol contains information

relating to health, flammability, reactivity, and personal
protection/special precautions.
Material Safety Data Sheets

▰ Information contained in an MSDS includes the following:

1. Physical and chemical characteristics
2. Fire and explosion potential
3. Reactivity potential
4. Health hazards and emergency first aid procedures
5. Methods for safe handling and disposal
6. Primary routes of entry
7. Exposure limits and carcinogenic potential
Chemical Hygiene Plan

▰ The purpose of the plan is to detail the following:

▰ Appropriate work practices
▰ Standard operating procedures
▰ Personal protective equipment
▰ Engineering controls, such as fume hoods and safety
cabinets for flammables
▰ Employee training requirements
▰ Medical consultation guidelines
Radioactive Hazards

▰ Radioactivity may be encountered in the clinical laboratory

when procedures using radioisotopes are performed.

▰ Exposure to radiation during pregnancy presents a danger to the

fetus; personnel who are pregnant or think they may be should
avoid areas with this symbol.
Electrical Hazards

▰ Equipment should not be operated with wet hands.

▰ Designated hospital personnel monitor electrical equipment
closely; however, laboratory personnel should continually
observe for any dangerous conditions, such as frayed cords
and overloaded circuits, and report them to the supervisor.
▰ Equipment that has become wet should be unplugged and
allowed to dry completely before reusing. Equipment also
should be unplugged before cleaning.
Electrical Hazards
Electrical Hazards

▰ When an accident involving electrical shock occurs, the

electrical source must be removed immediately.
▰ This must be done without touching the person or the
equipment involved to avoid transferring the current.
▰ Turning off the circuit breaker, unplugging the equipment, or
moving the equipment using a nonconductive glass or wood
object are safe procedures to follow.
Fire/Explosive Hazards

▰ When a fire is discovered, all employees are expected to take

the actions in the acronym RACE:
▰ Rescue—rescue anyone in immediate danger
▰ Alarm—activate the institutional fire alarm system
▰ Contain—close all doors to potentially affected areas
▰ Extinguish/Evacuate—attempt to extinguish the fire, if
possible or evacuate, closing the door
 Agencies regulating the laboratory
include:

▰ Clinical Laboratory Improvement Amendments (CLIA)

▰ Clinical and Laboratory Standards Institute (CLSI)
▰ The Joint Commission (TJC)
▰ College of American Pathologists (CAP)