Question

When working in a hospital, there are many risks/hazards that you will be confronted with on a daily basis. The following table identifies four (4) infection risks/hazards that may be present in a hospital environment. These hazards always need to be to be reported to a senior staff member or manager, documented correctly and control measures initiated.
Build on this table by identifying the likelihood and severity of harm from each hazard/risk by using the risk ranking matrix below, immediate steps that will need to be taken to manage the situation and possible procedures that will need to be put in place (minimum one point in each section).

Infection/Hazard

Risk rating

Severity of harm

Likelihood

Immediate actions

Risk Management Procedures

3.1)     Needle stick injury

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3.2)     Blood spill on the corridor

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3.3)     Exposure to blood/body fluids

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3.4)     Contamination of materials, equipment and instruments by aerosols and splatter in an active TB client's hospital room

Answer 1

Needle stick injury management

encourage the wound to bleed, ideally by holding it under running water

wash the wound using running water and plenty of soap

do not scrub the wound while you're washing it

do not suck the wound

dry the wound and cover it with a waterproof plaster or dressing

Blood spill on corridor

appropriate leak-proof bags and containers for disposal of waste material

a designated, sturdy scraper and pan for spills (similar to a ‘pooper scooper’)

about five sachets of a granular formulation containing 10,000 ppm available chlorine or equivalent (each sachet should contain sufficient granules to cover a 10-cm diameter spill)

disposable rubber gloves suitable for cleaning (vinyl gloves are not recommended for handling blood)

eye protection (disposable or reusable)

a plastic apron

a respiratory protection device, for protection against inhalation of powder from the disinfectant granules or aerosols (which may be generated from high-risk spills during the cleaning process).

destroyed by incineration

immersed in sodium hydroxide or sodium hypochlorite for 1 hour, rinsed and placed in a pan of clean water, and sterilised on an 18-minute cycle.

Exposure to Body fluids

Document the incident and include:

date, time and type of exposure

how the incident occurred

name of the source individual (if known).

The source individual should be tested for, as follows, at the time of injury:

HIV antibody

HBV surface antigen (HBsAg)

HCV antibody.

If the HCV antibody test is positive, then HCV polymerase chain reaction (PCR) should be performed to test for HCV RNA. Transmission is much less likely to occur from a source who is PCR negative. The status of the source individual may be known at the time of the incident. In this case the affected person should be managed as described below under ‘Immediate management’. If the source is unknown, the case should be managed as described in ‘Management of the exposed person’.

the physician, medical officer or other suitably qualified professional to be contacted

the laboratory that will process emergency specimens

the pharmacy that stocks prophylactic medication

procedures for investigating the circumstances of the incident and measures to prevent recurrence (this may include changes to work practices, changes to equipment and/or training)

details for prompt reporting, evaluation, counselling, treatment and follow-up of occupational exposures to bloodborne viruses.

3.4

Contaminated instruments should be handled as little as possible at the point of use and should be immediately contained and transported to the decontamination area. Immediate containment and transport reduces the risk of surgical personnel's contact with the contaminated instruments.