Infection Control and Safe Injection Practices

The delivery of health care has the potential to transmit HBV and HCV to both health care workers and patients. In 2003, four large outbreaks of HBV and HCV infections occurred in the United States among patients in ambulatory care facilities. All four outbreaks could have been prevented had the basic principles of aseptic techniques for the preparation and administration of parenteral medications been adhered to by health care workers and patients.

View recommended infection controls and safe infection practices to prevent patient-to-patient transmission of bloodborne pathogens below.

Injection Safety

To ensure injection safety, health care workers should

• Use a sterile, single-use, disposable needle and syringe for each injection, and discard them intact in an appropriate sharps container after use.
• Use single-dose medication vials, prefilled syringes, and ampules when possible.
• Avoid administering medications from single-dose vials to multiple patients or combine leftover contents for later use.
• Restrict multiple-dose vials (if used) to centralized medication area or use only for a single patient. Never re-enter a vial with a needle or syringe used on one patient if that vial will be used to withdraw medication for another patient. Store vials in accordance with manufacturer’s recommendations and discard if sterility is compromised.
• Avoid using bags or bottles of intravenous solution as a common source of supply for multiple patients.
• Use aseptic technique to avoid contamination of sterile injection equipment and medications.

Hand Hygiene and Gloves

To ensure hand hygiene and proper use of gloves, health care workers should

• Wash their hands with soap and water, or use an alcohol-based hand rub before preparing and administering an injection; before and after donning gloves for obtaining blood samples; after inadvertent blood contamination; and between treating patients.
• Wear gloves for procedures that might involve contact with blood, and change gloves and wash hands between patients.

Work Environment

In maintaining a safe and sanitary work environment, health care workers should

• Dispose of used syringes and needles at the point of use in a sharps container that is puncture-resistant and leak- proof, and that can be sealed before completely full.
• Maintain physical separation between clean and contaminated equipment and supplies.
• Prepare medications in areas physically separated from those with potential blood contamination.
• Use barriers to protect surfaces from blood contamination when blood samples are obtained.
• Clean and disinfect blood-contaminated equipment and surfaces in accordance with recommended guidelines.

Patient Care Equipment

When dealing with patient care equipment, health care workers should

• Handle equipment that might be contaminated with blood in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to themselves, other patients, and surfaces.
• Evaluate equipment and devices for potential cross- contamination of blood. They should also establish procedures for the safe handling of such equipment during and after use, including cleaning and disinfecting or sterilizing as indicated.