2 Safety and Infection Control
Learn how to prevent infection during phlebotomy, use protective equipment and sharps safely, respond to exposures, and reduce other workplace hazards.
Why precautions matter
Phlebotomists may encounter bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV, along with other infectious agents and workplace hazards. apply to every patient, whether or not an infection is known or suspected. They treat blood, body fluids, nonintact skin, and mucous membranes as potential routes of infection; select precautions according to the task and anticipated exposure.
In the United States, OSHA’s requires covered employers to maintain an exposure control plan and provide appropriate protective measures, training, and post-exposure evaluation. Follow the facility’s written procedures and applicable state or local requirements.
and clean technique
Clean hands before touching a patient or beginning an aseptic task; after contact with blood, body fluids, contaminated surfaces, or the patient’s immediate environment; immediately after removing gloves; between patients; and when moving from a contaminated task or body site to a clean one. For routine care, alcohol-based hand rub is generally preferred when hands are not visibly soiled. Wash with soap and water when they are visibly soiled.
Use aseptic technique during collection. Prepare a clean work area, disinfect the venipuncture site with the approved antiseptic, and let it dry as directed. Use sterile, single-use needles and devices for each patient. Never reuse a needle or syringe, even if the needle has been changed.
Clean and disinfect reusable equipment and surfaces between patients, following facility policy and the disinfectant’s directions. Handle used equipment and specimens so blood does not contact skin, mucous membranes, clothing, or clean supplies. Keep food and drink out of areas where blood or potentially infectious materials are handled, and never mouth-pipette specimens. Put specimens in appropriate, closed containers and package them to prevent leakage during transport.
Choose and use protective equipment
Choose based on a risk assessment: consider what could splash, spray, or contact skin, clothing, eyes, nose, or mouth during the task.
Gloves: Wear clean, single-use gloves for venipuncture and whenever contact with blood, body fluids, nonintact skin, or contaminated items is reasonably anticipated. Change gloves between patients and if they are torn or heavily contaminated. Remove them without letting the contaminated exterior touch bare skin, then clean hands.
Eye and face protection: Use goggles or a face shield when splashing or spraying is reasonably anticipated.
Gown or other protective clothing: Wear it when clothing or exposed skin could be contaminated.
Mask or respirator: Use one when indicated by anticipated exposure and the facility’s transmission-based precautions. A respirator requires the applicable workplace respiratory-protection program.
Don and remove PPE in the order and manner taught by the facility so contaminated surfaces do not touch skin or clothing. Dispose of or reprocess PPE according to policy.
Prevent sharps injuries
Plan for safe disposal before beginning the draw. Use safety-engineered collection devices when available, and activate the safety feature immediately after use according to the device instructions. Keep the sharp pointed away from yourself and others; do not pass a used sharp from hand to hand. Do not recap, bend, break, or remove a contaminated needle.
Discard used needles and other contaminated sharps immediately, or as soon as feasible, into an accessible, closable, puncture-resistant, leak-resistant, appropriately labeled sharps container. Do not overfill it; close and replace it according to facility policy. Never reach into a sharps container or try to retrieve an item.
For example, after withdrawing the needle, activate its safety mechanism without setting it down, then place the device directly into the nearby sharps container. Do not carry it across the room or recap it while looking for a container.
Respond to an exposure
An may involve a needlestick or cut with a contaminated sharp, or blood or other potentially infectious material contacting the eyes, mouth, nose, or nonintact skin. Respond in this order:
Act immediately. Wash punctures and cuts with soap and water. Flush exposed skin or mucous membranes with water; irrigate eyes with clean water, saline, or sterile eyewash.
Report promptly. Notify the supervisor or designated occupational-health contact, following the facility’s exposure-control plan.
Obtain immediate, confidential medical evaluation and follow-up. Do not wait for symptoms. The clinician assesses the exposure and source, reviews vaccination status, and determines whether testing, treatment, or post-exposure prophylaxis is indicated. Timely assessment matters because some preventive treatment is time-sensitive.
Document the incident as required. Include the route and circumstances of exposure and the device involved. Keep medical information confidential and follow instructions for follow-up testing and care.
Do not squeeze or scrub a wound or apply caustic chemicals to it. Follow facility procedures rather than deciding on your own whether an exposure is serious enough to report.
Manage other workplace hazards
Before collection, confirm the patient’s identity and explain the procedure. Position the patient safely and support an arm appropriately. Stay alert for fainting, falls, agitation, or sudden movement. If a patient becomes faint, stop the draw safely, secure the sharp in the sharps container, and assist the patient according to training and facility protocol.
Keep the work area orderly, with supplies and sharps containers within easy reach. Clean blood spills promptly using the facility’s approved spill procedure and disinfectant. Follow workplace procedures for broken glass, chemical hazards, and waste segregation; never pick up contaminated broken glass by hand. Report unsafe equipment, near misses, and injuries so hazards can be corrected.