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Infectious Disease Control The ability of the hospital to control infectious disease is an important element of its overall risk management efforts. All health care providers must comply with federal, state and municipal rules and regulations, in addition to the hospital's policies and procedures regarding the control of infectious disease. Some of the aspects of infectious disease control which you should familiarize yourself with include: Preventing and reporting communicable diseases Universal blood and body fluid precautions Needlestick precautions Proper medical waste disposal States and often, cities, require all physicians and hospitals to report cases, carriers or persons infected with specified communicable diseases. Several of the more common diseases include botulism, chicken pox, dysentery, encephalitis, rubella, gonorrhea, Hepatitis (A, B, Non-A, Non-B), Lyme disease, meningitis, rabies, Streptococcal sore throat, syphilis, tuberculosis, and whooping cough. Reporting procedures will vary somewhat as between the states. Patients need not consent to this reporting and in fact, may not refuse. There are penalties for the failure to report. Questions about assistance with infectious disease reporting may be directed to the hospital Department of Epidemiology and Infection Control.   Precautions Since a medical history, examination or laboratory testing cannot reliably identify all patients infected with HIV, Hepatitis B or other blood borne pathogens, health care providers must utilize universal blood and body fluid precautions in caring for all patients. These precautions include, but are not limited to: Hands must be washed before and after contact with patients, even when gloves have been used. If hands, or other parts of the body, come in contact with blood, body fluids or human tissue, they should be immediately washed with soap and water. Gloves must be worn when contact with blood, body fluids or contaminated surfaces is anticipated. Gowns or plastic aprons are indicated if blood splattering is likely. Masks and protective goggles must be worn if aerosolization or splattering is likely to occur, such as in certain dental and surgical procedures, wound irrigations, post mortem examinations and bronchoscopy. To minimize the need for emergency mouth to mouth resuscitation, mouth pieces, resuscitation bags or other ventilation devices must be available for use in areas where the need for resuscitation is predictable. Sharp objects, such as needles and glass, must be handled in a manner to prevent accidental cuts or punctures. Used needles should not be bent, broken, reinserted into their original sheaths, recapped, or unnecessarily handled. Immediately after use, they must be discarded intact in puncture resistant needle disposal containers. All needle stick accidents, mucosal splashes or contamination of open wounds must be reported immediately to Personnel Health Services. Blood spills should be cleaned up promptly with a disinfectant solution such as 1:10 dilution of bleach. All patient specimens should be considered bio-hazardous and bagged for transport to laboratories. These precautions may minimize transmission of disease from patient to health care provider and decrease the likelihood that other more easily transmitted organisms are transmitted to other patients.   Needle Sticks Occupational exposure to, and the transmission of, Hepatitis B (HBV) and human immunodeficiency virus (HIV) are of the utmost importance from a risk management standpoint because of the need to protect health care workers, patients and visitors from these viruses. Needlestick injuries are the largest source from which occupational exposures to these agents arise in the hospital workplace. Since all hospital workers are at risk of needlestick injury, adherence to the following practices is useful in preventing needlesticks: Avoid rushing when handling needles. Avoid pulling hard when encountering resistance in withdrawing needles from patients. Seek assistance when using a needle in caring for an uncooperative patient. Avoid recapping under all circumstances, but never recap a needle that has been used on a patient. Dispose of needles properly in puncture resistant containers. Never leave needles on beds, stretchers, or bedside tables since they may injure staff, patients, or visitors. Do not throw them into regular garbage containers where they may injure housekeeping staff. Never put needles in your pocket. Never try to remove anything from a needle container or force needles into a full container. Pick up improperly discarded needles with care and dispose of them in a puncture-resistant container. In the event a needlestick does occur, promptly wash the area with soap and water, record the patient's name and hospital number, prepare an incident form and report the event to Personnel Health. Attempts to "milk" the wound to express contaminants are ineffective and only damage tissues further. Personnel Health will provide you with information about or appropriate testing for hepatitis and HIV along with any recommended prophylaxis. The improper disposal of medical waste not only has the potential to cause injury to health care workers, patients and visitors, but can have widespread public health effects. A number of federal, state and local regulatory agencies, in addition to hospitals, have promulgated regulations and policies governing medical waste disposal with which all health care workers should familiarize themselves. Improper disposal of medical waste could expose the hospital to significant penalties, including fines and the suspension of services. The following guidelines will be of assistance in complying with the rules and regulations governing the disposal of medical waste. What goes in Red Bags ? Blood bags, IV bags and all tubing. Items dripping and/or saturated with blood, or caked with dried blood. Containerized body fluids greater the 20cc. What goes in Clear Bags ? Everything that is not contaminated by blood or body fluids. What goes in a Sharps Container? Anything that has a potential to cut, puncture, or pierce. For example, used and unused hypodermic needles; syringes (with or without needles attached); pipettes; scalpel blades; blood vials; slides and cover dishes; and culture dishes.