Methods to Prevent Exposure By Occupational Safety and Health Administration (OSHA)

The Methods to Prevent Exposure By Occupational Safety and Health Administration (OSHA) for medical assistants are,
There are seven major strategies mandated by OSHA for the prevention of exposure to bloodborne pathogens and OPIM.

1. Standard Precautions
Adherence to the CDCs Standard precautions is required; i.e., treating ALL bodily fluids and materials as if they are infectious. Handwashing is stressed and employers must provide handwashing facilities and must ascertain that employees use them frequently and especially following exposure to blood or OPIM.

2. Engineering Controls and Work Practice Controls
Engineering controls and work practice controls consist of the physical equipment and mechanical devices an employer provides in an attempt to safeguard and minimize employee exposure. A common example of an engineering control is sharps disposal containers (Figure 4-16). Others are mechanical pipettes, fume hoods, and splash guards. If and when occupational exposure continues after the engineering controls are in place, PPE must be used. Handwashing facilities or appropriate antiseptic hand cleanser (when handwashing facilities are unavailable) must be readily available. If antiseptic hand cleanser is used, hands must be washed with running water and soap as soon as possible. Employers must ascertain that employees wash their hands as soon as possible following the removal of gloves or other PPE, that employees wash hands and other skin surfaces with soap and water, flush eyes at the eyewash station, and flush mucous membranes with water as soon as possible following contact of these body parts with blood or OPIM.

3. Personal Protective Equipment (PPE)
When workplace exposure still exists after using engineering and work practice controls, employers must provide PPE at no cost to the employee. PPE is used to place a barrier between the employee and blood and/or OPIM that can contaminate skin, mucous membranes, or non-intact skin. PPE consists of such items as latex gloves, masks, goggles, face shields, gowns, laboratory coats, and plastic mouthpieces used during cardiopulmonary resuscitation (Figure 4-18). PPE provides protection only if it prevents blood or OPIM from permeating through it onto clothes, eyes, skin, mouth or other mucous membranes.

4. Cleanliness of Work Areas
The employer must maintain a work site that is clean and sanitary and have a written schedule for cleaning and decontaminating the work area after contact with blood and/or OPIM. Work surfaces that can become contaminated with blood or OPIM must be decontaminated after the work procedures are completed, after surfaces are contaminated, or at the end of the work shift. Some of the areas include counter tops, floors, examination tables, and wastepaper baskets. When cleaning a work surface where there is the possibility of blood or OPIM present, latex gloves must be worn. A 10 percent solution of household bleach is used; alcohol is ineffective. Gloves should be worn when the spill is wiped with paper towels.

5. Hepatitis B Vaccine
Hepatitis B vaccine must be made available free of charge to every employee, full-time, part-time, or temporary within ten days of work assignment. (This refers to employees who have the potential for occupational exposure, and who can "reasonably" be expected to have skin, eye, mucous membrane, or parenteral contact with blood or OPIM. The vaccine is given in three doses over a six-month time period and is used to protect the employee from infection with the hepatitis B virus. It is an intramuscular injection with an approximate 96 percent rate of effectiveness. An employee has the right to decline taking the vaccine, but must sign a declination form. There is the option to reconsider receiving the vaccine at a later time.

6. Follow Up After Exposure
An accidental exposure is broadly defined as one in which blood, blood-contaminated body fluids, or body fluids or tissues to which standard precautions apply are introduced onto a mucous surface, onto nonintact skin, or to the conjunctiva via a needlestick, skin cut, or direct splash. If an incident exposes an employee to any of these, the employer must make available a confidential medical evaluation in which is documented:
1) The circumstances surrounding the event
2) The route or routes of exposure
3) The identification of the person who was the source of the exposure

7. Medical Records
Medical records of an employee who has suffered an occupational exposure must be kept for the length of employment plus thirty years and confidentiality must be guaranteed. The following information is to be included in the employee's record: name and social security number, HB vaccination status with dates, results of any examinations or tests, a copy of the health care provider's written opinion, and a copy of the information that was provided to the health care provider. The records must be available to the employee, to OSHA, and anyone with the written consent of the employee, but not the employer.