CLINICAL LAB SCIENEC

152
ESSENTIALS OF CLINICAL LABORATORY SCIENCE
the question of whether an incident has occurred is primary. A situation in which
a worker has been spattered with blood or OPIM that might have entered mucous
membranes such as the eyes, mouth, and nose would constitute an exposure. A
worker with chapped or abraded skin and torn nail cuticles whose hands become
contaminated with blood would be deemed an exposure. Needle sticks from used
needles and cuts by glass with blood or other body fluids on the glass would also
constitute a definite exposure. A worker who performed procedures on or even
interviewed a patient who was later found to have active TB would be classified
as having experienced an exposure.
Postexposure considerations should be attended to as quickly as possible.
A medical laboratory student or worker should first contact his or her clinical
preceptor or supervisor. In the classroom, the student would inform the instructor
of a possible exposure. Steps to be taken are contained in policies in either
the medical facility or in the educational facility manuals. In most facilities, the
worker or student is interviewed by a medical professional and often by a representative
from the Infection Control Committee. An airborne pathogen exposure
would require, at a minimum, a PPD skin test. Another test would be performed
at a later date, and if either test is positive, a chest radiograph would follow and
appropriate antibiotic therapy would be initiated for an active case. Students and
workers who are found to have contracted TB are assigned other duties until the
case is resolved and a physician clears the person for return to previous duties.
In the case of a blood exposure, the results of the source patient’s testing
are considered, if available. The source patient cannot normally be required to
undergo testing except in states where nonvoluntary testing is mandatory following
an exposure incident. The worker or student will have the medical records on
file from prior physical examinations, if such tests were performed. These results
are then compared with repeat testing. A worker who was previously negative
for HIV or HBV infection and who later shows a positive result will have most
likely been exposed and at the time of exposure have contracted the disease.
Laboratory tests may be performed if in the opinion of the medical professional
there was a possibility of exposure to a disease. Records of these interviews,
laboratory tests, skin tests, and medical examinations are kept in a confidential
file, usually for 30 years following the end of the worker’s or student’s affiliation
with the facility.
Guidelines for Infectious Exposure
Guidelines should be in place to follow for precautions for possible exposure
to infectious diseases in any situation that a medical worker or student may
experience. There is a potential for exposure when a student or worker comes in
contact with infectious patients, wastes, and body fluids. Specimens from hospital
patients are often used in classroom and college laboratory practice sessions.
Instructors should monitor a student’s work, ensuring the use of proper protective
equipment and safe practices. Clinical rotations for medical laboratory
students afford the most potential for exposure. Students should be taught at the
beginning of education and training to practice safety, report exposure incidents,
and receive treatment for affected patients and workers.
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