Question

DISCUSS safety issues regarding capillary puncture. Consider safety for both the patient and health professional. Consider proper handling of sharps, skin prep, post puncture care, disposal of contaminated supplies, exposure to blood born pathogens and OPIM, etc.

Answer 1

The following are the safety issues regarding the capillary puncture:

1. Safety recommendations include choosing the proper equipment (such as an appropriate lancet), knowing the best puncture sites, and following all the correct procedures to ensure not just the safety of all involved, but the integrity of the sample and resultant data.

2.Switching to capillary blood collection devices can help us avoid some of the more frightening dangers associated with wet blood sample shipping and storage. However, improper use of capillary blood collection techiques can create hazards of its own. To assume the procedure is totally safe can make us more vulnerable.

3. Chief among the risks is exposure to bloodborne pathogens, particularly hepatitis B. "In finger-sticks, the blood flowing freely from the site of the puncture exposes both the healthcare worker taking the sample and the environment to blood-borne infectious agents that the patient.

Safety for the patient and health professionals Include the following:

SAFETY

1. Observe universal (standard) safety precautions. Observe all applicable isolation procedures.

2. PPE’s will be worn at all time.

3. Wash hands in warm, running water with an appropriate hand washing product, or if not visibly contaminated, with a commercial foaming hand wash product before and after each patient collection.

4. Gloves are to be worn during all blood collection procedures, and changed between patient collections.

5. A lab coat or gown must be worn during blood collection procedures.

6. Lancets are disposed of in an appropriate ‘sharps’ container as one unit.

7. Gloves are to be discarded in the appropriate container immediately after the blood collection procedure.

8. All other items used for the procedure must be disposed of according to proper biohazardous waste disposal policy.

9. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. All surfaces are cleaned daily with bleach.

10. In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor.

Proper Handling of the following:

1. Follow these guidelines when you work with sharps.

1. DO NOT uncover or unwrap the sharp object until it is time to use it.
2. Keep the object pointed away from yourself and other people at all times.
3. Never recap or bend a sharp object.
4. Keep your fingers away from the tip of the object.

​​​​​2. Skin pre and post Puncture;

A.The healthcare worker performing the skin puncture should identify him- or herself to the patient, establish communication, gain the patient’s confidence and explain the procedure.

B.The skin puncture procedure must not be conducted without the consent of the patient or accompanying person. In that case, the attending physician should be notified and this must be recorded according to facility policy.

C. If the patient is a legal minor or is unable to communicate, the worker should obtain consent from the parent or accompanying person and explain the procedure to him or her.

3. DISPOSAL OF Contaminated supplies:

A. You must wear protective gloves when handling waste.

B. Cleaning contaminated surfaces.

C. Proper sanitization and disposal.

D. Minimise contact.

E. Discard materials into a suitable container or bag.

F. Use bags that are marked or coloured for infectious waste.

G.Transfer non-disposable infectious materials safely .

H.Always use puncture-resistant containers sharps, as they will not leak.

I.Use pierce-proof waste containers.

J.Never over fill waste receptacles.

K. Remove waste in accordance with local clinical waste disposal policy.

4. BLOOD BORN PATHOGENS:

A. Wear appropriate personal protective equipment: gloves, goggles, etc. as required by the accident. When performing CPR, always use a pocket mask equipped with a one way valve to prevent contact with potentially infectious body fluids. Contain spills immediately, then clean up and disinfect the area.

5. OPIM:

OPIM handling rules to follow at all times:

Rule #1: OPIM is NOT Regular Trash

Contaminated materials must never be thrown away in the regular trash bins. It’s important that all staff and employees understand this main rule.

Rule #2: Use the Right Containers at All Times

OPIMs, which are regulated waste, must always be contained, stored, and disposed of in their proper containers. These containers are made from special materials that will not allow leaks. Containers must also be labeled or properly color-coded according to OSHA’s bloodborne pathogens standard.

Also, Sharp objects must be stored in their own sharps containers that are puncture resistant. This ensures they can be safely handled during transport.

Rule #3: Know Your State’s Regulations

While OSHA has set forth standardized guidelines for the disposal of OPIMS, each state typically has their own rules and regulations, so be sure you understand exactly what those are.