Health and Safety in a Hospital Lab Importance

• Natalie Pigott

M1/D1: Explain and evaluate the need for health, safety and security requirements in the hospital lab you have chosen

In the haematology lab, nearly every sample being analysis contains some form of pathogenic organisms. Due to this, it is essential that certain precautions are put in place in order to avoid the risk of infection and cross contamination. One of these precautions is the use of PPE or ‘personal protective equipment’. As a health and safety concern, all employees should be provided with the appropriate PPE in order to protect them from any potential hazards in the labs. Lab coats or aprons are one example of PPE that must be provided to employees working in the lab. These should be worn at all times in the lab, especially if there is a chance of substances spilling or splashing onto work clothing. For example; blood or bodily fluids. The outer material of the coat should be made of a fluid resistant material, have long sleeves and must stay buttoned at all times. If any type of contamination occurs then the lab coat should be removed immediately and treated as infectious material. Lab coats worn as PPE must not be into public or designated “clean” areas such as; bathrooms, staff rooms, offices and canteens when working with potentially infectious material or chemicals. If leaving the lab then all coats must be removed. If a lab coat is needed to be worn outside then a second clean coat, which has not been exposed to any form of blood or bodily fluids should be provided in order to accommodate this. Under no circumstances should lab coats be taken home to be cleaned. They should also be changed roughly once every week in order to ensure cleanliness. Within the laboratory, there should be a designated area provided for the handling of both “clean” and “dirty” lab coats. Although this only applies to staff who remove their PPE and wear a clean lab coat outside of the labs. It is essential that all disposable PPE is disposed of correctly. For example; any disposable PPE which is visibly contaminated should be disposed of in the nearest biohazard bin. If an employee’s own personal clothing is contaminated then the clothing should be removed. The workplace should provide scrubs and showers for the employee and contaminated clothing should be placed in a plastic bag with the employee’s name and department clearly written on it. This should then be taken to the hospitals laundry service in order to be cleaned and therefore preventing infection.

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Within the laboratory, employee’s are also required to wear the appropriate eye and face protection when there is a potential exposure risk to them due to the use of biological or chemical hazards. If a biohazard face shield is inaccessible, a bench shield could be used as an alternative. When carrying out tasks such as; heating flasks and test tubes, using apparatus where the contents are under pressure, handling specimen samples or using certain chemicals, safety goggles must be worn. If any blood was to spill onto a worktop or counter within the labs then it can easily contaminate it. Contamination can be in the form of either splashes, droplets of blood on work surfaces or poor working practice. In order to prevent contamination, all work areas and surfaces should be cleaned correctly regarding procedures that may be in place.

With regards to hazardous chemicals, blood and bodily fluid precautions gloves must be worn and removed before leaving the labs. Gloves must be able to accommodate laboratory workers who may have a latex allergy and alternative gloves must be readily available for those who do. After handling one sample, gloves must be removed and replaced with a clean pair before handling anything else. This helps to prevent contamination within the lab. Gloves must be worn at all times when;

• Handling blood, body fluids or hazardous chemicals
• Cleaning equipment
• Performing veni-puncture
• Touching a patient’s non-intact skin
• Cleaning up spills of blood, body fluids or chemical substances

If gloves come into contact with blood, bodily fluids or get torn then they must be replaced. and hand hygiene procedures must be performed. When removing gloves, hands must be washed immediately after and gloves disposed of correctly. When removing PPE such as gloves, there are certain techniques that must be used by employees in order to prevent contamination of themselves or other objects. One way this can be done is by grasping the cuff of the gloves and pulling the gloves inside out whilst pulling it off the hand in order to avoid contact with the skin.

When finished with disposable gloves, they should be placed in a non biohazard bin and should not be washed or reused. If they are visibly contaminated with blood or other bodily fluids then they should be placed in a biohazard bin once removed. Health and safety requirements could also be improved in order to help decrease the risk of cross contamination or the spread of infection. For example; one way in which this could be done would be by changing lab coats more regularly. This could be every other day instead of once a week. Another improvement that could be made is more signs and posters around the lab in order to remind staff to wash their hands after handling samples and also before and after using disposable gloves. Within the laboratory, there should be at least to spillage kits encase a spillage does occur. This then means that staff can deal with it quickly and effectively rather than having to take time to obtain a spillage kit if it is not nearby. Before staff leave the labs to go home, they should change their clothes so that they do not run the risk of carrying infection into their homes and around their families where it can be easily spread. Especially to young children, elderly, pregnant woman and those already sick. This should apply to all staff within the lab, even if the clothes they are wearing are under a lab coat.

Arrangements must be put in place within all organisations in order to manage all aspects of health and safety including a prepared written statement of their health and safety policy. This statement should consist of their aim to provide and maintain a safe and healthy working environment, and to also enlist the support of employees towards achieving these ends. It should also include detailed responsibilities in the organisation and the arrangements for ensuring health and safety in the workplace. It should also discuss the procedures in place for maintaining and ensuring employees’ health and safety. Spillage kits should be made available to staff in the lab in the event that a accident occurs and specimens spill out of their containers. If this was to happen, employees should put on gloves and obtain the spillage kit. Using the appropriate material from this, the spillage should be covered. Under no circumstances should a mop be used to clean up spillages as this would only further the risk of cross contamination and allow the infection to spread further. Only authorised staff should be in the lab at any time. A key fob entry system should be used to ensure that no unauthorised personnel has access into the lab. Authorised staff must scan their key fobs in order to unlock the doors and gain access into the labs. Intercom systems are another effective way in keeping unwanted people out of the labs. For example; if someone was to forget or did not have a key pass to the lab then they would have to use the intercom system in order to communicate with staff. Staff inside would then be able to see the individual on a camera and verbally communicate with them. This can then help staff to make an informed decision as to whether or not they grant them access to the laboratory. By having these measures in place, it ensures that only authorised staff have access to and from the labs. This is essential as there are a lot of potentially hazardous chemicals, biohazards and confidential information contained and stored within the lab.

Before any samples arrive at the labs, staff must ensure that they have obtained tracking sheets. On these sheets there should be information regarding each patients name and how many samples of each colour tube to expect. Once the samples arrive at the labs, they are removed from their bags in the plastic boxes. When the boxes are opened, biohazard bags should be present. These will be assigned one per patient with urine as an exception as it is normally packaged in its own bag. There should also be a detailed piece of paper which includes information such as; the patient’s order number and the various tests their sample require. Upon the removal of the samples, test tube racks should be present to place the samples in once the technologist has confirmed that both the orders and the tracking sheet match. After this, samples are confirmed by using the computer system. This confirms that the samples arrived successfully and their collection times are keyed in to the computer system. Labels are then printed and placed onto samples carefully in order to avoid covering previous labels that may have been present on the tubes. The sample tubes are cross checked for a second time with the tracking sheet before both are saved and stored for a specified time to ensure patient confidentiality.

Bibliography

http://www.pathology.med.umich.edu/Safety Manual/PPE Final.pdf