Infection Prevention and Control in Laboratory Research 2017

Infection Prevention and Control in Laboratory Research 2017 Updated January 2017 1

Infection Control Program Director: Kathy Agnes, MS, RN, CIC – Email: Kathleen. Agnes 3@va. gov – Phone: ext. 7471 Infection Preventionists (IP): Dori Heath, BSN, RN, CLSS-GB, CIC (BT) – Email: Doris. Heath@va. gov – Phone: ext. 6089 Vocera: Infection Control Chelsea Lynch, MSN, MPH, RN, CIC (BT/LR) – Email: Chelsea. Lynch@va. gov – Phone: ext. 4185 Molly Sanikop, MPH, RNC, CIC (PP) 2

Protect Yourself! • Wash your hands! • Use Standard Precautions • Get vaccinated • Know what you’re working with • Assess the containment level • Participate in initial and ongoing training • Prepare or read and understand written protocols prior to the start of a project or procedure 3

General Practices • All persons entering the lab must be advised of potential hazards and meet specific entry/exit requirements • Lab staff must be provided medical surveillance and immunizations for agents handled or potentially present in the lab • Potentially infectious materials must be placed in durable leak-proof containers during collection, handling, processing, storage or transport 4

Hand Hygiene The single most important means of preventing the spread of infection!

When to Perform Hand Hygiene With alcohol-based hand rub (Purell) or soap and water: – Before and after using gloves – Moving from a contaminated to a clean area – After contact with body fluids, excretions, mucous membranes, non-intact skin – Before handling food As needed after coughing or sneezing With soap and water: – Before eating – After using the restroom – Anytime hands are visibly soiled – When there is significant build-up of alcohol-based hand rub 6

Standard Precautions To protect yourself from blood borne pathogens, treat ALL blood and body fluids as though potentially infectious. This applies at ALL times. Perform hand hygiene frequently. If touching blood or body fluids and/or contaminated items is likely, wear gloves. If sprays/splatters are possible, add a gown or lab coat and fluid-shield mask with eye protection.

Personal Protective Equipment (PPE) • Gloves – Not a substitute for hand hygiene! – Change frequently, performing hand hygiene after removal – Follow the signs! • Remove before opening doors, using computer key boards or phones that will be used by others – NEVER wear into the restroom or conference room 8

PPE • Lab Coats and Gowns – Worn while working in the lab only – NEVER wear lab coats or gowns out of the lab area • Mask and Laboratory Safety Glasses/Goggles – Glasses are not a substitute – Worn as stated in the Research Protocol or SOP – Can be worn more frequently if deemed necessary 9

Environmental Cleaning • Equipment and lab surfaces should be cleaned and disinfected after spills, splashes or other potential contamination AND at the end of each shift/work day • Disinfectants – Use an appropriate disinfectant for what you’re working with – Check the expiration date – Follow the contact time • Equipment must be disinfected: – Before being sent for repair or maintenance – Before being removed from the lab • Remove unused supplies from the lab after the project is complete. 10

Food and Drink • Should only be stored and consumed in designated locations • Never throw food or beverage waste in lab trash • Incidents that may result in exposure must be immediately evaluated and treated according to procedures described in the Laboratory Biosafety Manual. All such incidents must be reported to the Lab supervisor. 11

Biohazard Waste • Dispose of lab trash appropriately – Place in a biohazard waste container – Do not allow to overflow – Lab personnel are responsible for transporting and placing waste in red biohazard bins 12

Blood-borne Pathogens (BBP) Infectious microorganisms in blood that can cause disease in humans including: • Hepatitis B – Average risk of transmission without vaccination or PEP is 6%-30% – Vaccine available from Employee Health at no cost (series of 3 -4 injections over 6 months) • Hepatitis C – Estimated average risk of transmission after a percutaneous exposure: 1. 8% – No vaccine available • HIV – Estimated average risk of transmission after a percutaneous exposure: 0. 3% (0. 09% post-mucous membrane exposure) – No vaccine available but can take PEP if applicable 13

Sharps Containers • Don’t leave sharps (needles, razors, etc. ) laying on the bench! • All sharps must be placed in approved sharps containers. • Don’t overfill sharps containers Exchange once it is ¾ full. 14

Sharps Safety Use safety devices. Avoid recapping needles. If necessary, use safe procedures such as a one-handed technique or using a cap holder. 15

Accidents Happen: BBP Post-Exposure Management • Wash or flush the exposed area thoroughly – Use soap and water for exposed skin (intact or broken) • If bleeding, allow to bleed – Flush eyes/mucous membranes with water or saline – Do not use bleach, rubbing alcohol or peroxide 16

BBP Post-Exposure Management Call the Needle Stick Hotline 24/7: 410 -605 -STIK (7485) They will perform a post-exposure evaluation and help coordinate any required testing and other follow-up, if necessary. Includes working with a veterinarian, if applicable. 17

Questions? 18

Additional Resources • VA Research Service Laboratory Safety Manual • VA Research Service Infection Control Plan • Biosafety in Microbiological and Biomedical Laboratories, CDC/NIH • Bloodborne Pathogens Regulations, OSHA • Occupational Health and Safety in the Care and Use of Research Animals, ILAR 19