Lab I:Laboratory safety Prof Gülden Çelik,MD MDCN247 At the end of this session the student should be able to list – Principles and Procedures of Laboratory Safety: • Informed Consent Form for The Rules and Regulations in Practice Laboratory • Standard (Universal) Safety Precautions • First Aid Procedures after Accidental Exposure to Infectious Material • Hand Hygiene (Hand washing, Hand rubbing, Surgical Hand Preparation) -Devices in the microbiology lab and their functions OSHA: Occupational safety and health administration regulations Workplace Transmission Professions at risk of exposure: contact with someone bleeding or responsible for the cleanup of blood and other infections materials. • physicians and nurses (health center), • police officers, • athletic trainers, • maintenance workers • environmental services workers. • Universal Precautions • Employee exposure to bloodborne pathogens from blood and Other Potentially Infectious Materials (OPIM) • 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, Gastroenteritissalmonella, 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. http://www.osha.gov First Aid Procedures after Accidental Exposure to Infectious Material Accidental sharps injury • What should you know? A significant exposure risk is present in any accidental sharps injury, even if no blood is visible and the skin does not appear to be broken. • What should you do? • Flush the area well in clean running water and wash thoroughly with soap. • Cover with a dressing if necessary. • Report the incident to a supervisor or the physician-in-charge immediately. • Corrective action is required if a procedural cause of the accident is identified. Accidental contact with infectious material • What should you know? This includes any unprotected contact between potentially infectious material and broken skin, the mouth, nose or eye. • What should you do? -Flush the area with soap and clean water. Use water or sterile saline alone for splashes to the eye or mouth. -Report the incident to a supervisor or the physician-incharge immediately. -Corrective action is required if a procedural cause of the accident is identified. Immediate actions after accidental exposure What should you know? • Certain procedures must be followed after exposure to potentially infectious material. • Hepatitis B and C virus, HIV. • What should you do? • A baseline blood specimen should be collected immediately from the exposed health care worker and, if feasible, from the source. • Prophylactic measures should be initiated immediately for all of the workers exposed. • If there is a risk for outbreak, procedures for possible treatment and for the longer term follow-up of exposed health care workers should be established. • Corrective action is required if a procedural cause of the accident is identified. label with biohazard insignia Decontamination of surfaces • Wear an apron, heavy-duty gloves, and other barrier protection if needed. • Wipe clean with an absorbent material. • Disinfect surface by wiping clean with the disinfectant given. • Then discard all absorbent material in heavy duty “hazardous waste” with a red bag. Decontamination of blood or body fluid spills • Learn the location and how to use the equipment in case of an accidental spill. • Put an absorbent tissue with a disinfectant on the spillage or splash and left for at least 30 minutes. Equipment to be used in case of contamination Hand Hygiene • Hand washing (plain soap and water, paper towel) • Hand rubbing (alcohol, no water, no towel) • Surgical Hand Preparation Normal skin has aerobic microorganisms in flora Different number of organism in different region of the skin: • Scalp 1x106 • Axillary 5x105 • Abdomen 4x104 • Forearm 1x104 CFU/cm2 • Bacterial counts on healthcare workers’ (HCW) hands range from 104 to 106/cm2. Skin Flora Resident microorganisms; • attached to deeper layers of the skin more resistant to removal less likely to be associated with healthcare associated infections (HAIs). Transient microorganisms; • acquired by direct contact with patients or contaminated environmental surfaces • colonize the superficial layers of skin • amenable to removal • frequently associated with HAIs Reference: WHO Global Patient Safety Challenge, 2006, WHO, Geneva. (http://www.who.int/gpsc/tools/GPSC-HandRub-Wash.pdf) WHO Risk Groups for Infectious Disease Agents • 4 risk groups: Risk group 1: A microorganism that is unlikely cause disease in humans and animals Biosafety level 1: open bench http://www.who.int/csr/resources/publications/biosafety/Biosafet y7.pdf Hands and other skin surfaces • must be washed immediately and thoroughly if contact with blood or other body fluids occurs. • Hands must be washed immediately after gloves are removed and after completing laboratory activities. • All personal protective equipment should be removed before leaving the laboratory. Health care workers • who have exudative lesions or weeping dermatitis should refrain from all direct patient care and from handling patient-care equipment until the condition is resolved. Bloodborne pathogens may be present in – – – – – – – – – – – Blood Semen saliva vaginal secretions cerebrospinal fluid synovial fluid pleural fluid peritoneal fluid pericardial fluid amniotic fluid any body fluid visibly contaminated with blood – any unidentifiable body fluid. Entrance of these pathogens • by an accidental injury with a sharp object contaminated with infectious materials such as – needles, glass, or anything which can pierce, puncture, or cut skin. • Transmission may also occur by – transferring the infectious material to the mouth, eyes, nose, or open skin. EXPOSURE CONTROL PLAN A. Purpose • The purpose of the Exposure Control Plan is to eliminate workplace exposure to contaminated blood and other infectious body fluids. B. Definitions 1. Engineering Controls are physical or mechanical systems provided to eliminate hazards at their source. • providing • handwashing facilities, • eye stations • sharps containers, • waste containers, • biohazard labels in designated locations. 2. Work Practice Controls Work practice controls are specific procedures to be followed to reduce exposure to bloodborne pathogens or infectious materials. Devices • Autoclave:sterilization with moist heat • Incubater: for cultivation at 37 C For lab report II • Next lab one will • You will chose and demonstrate proper write down the most hand washing important 5 rules for • The devices we have and their functions safety in the laboratory in the • Thank you informed consent • Biosafety level we will work • The barriers we use
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