1. Define a patient exposure which places you at risk of contracting HIV or HBV from an infected patient.

   Percutaneous (cut, needlestick, contact with open wound) or mucous membrane exposure to organs, unfixed tissue, or high risk body fluids (blood, sexual secretions, or fluid from a normally sterile body site)
   
   

2. When do you wear gloves?

   Whenever you are likely to be in contact with organs, unfixed tissue, or any human body fluid.
   
   

3. When do you remove gloves?

   Gloves are removed when the specific activity which potentially brought you into contact with body fluids is completed. Do not wear gloves when proceeding to another activity.
   

4. How do you dispose of sharps?

   Disposable sharps are discarded into rigid impervious containers which are labeled with a "biohazardous" sign or otherwise identified as a container for disposable sharps. Reusable sharps which are to be reprocessed are placed into a rigid container and transported with other soiled equipment.
   
   

5. When is resheathing appropriate?

   Needles should not routinely be resheathed prior to disposal, but safe disposal is mandatory. However in some situations it is appropriate to replace the cap. Examples of appropriate times include:

   • Giving serial injections to a single patient using the same syringe and needle.
   • When administering an injection to an unpredictable patient who can not be left unattended while the needle and syringe are discarded (eg, child, uncooperative psychiatric patient, someone in severe pain)
   • When the needle must be left in a hazardous area for more than a few minutes
     (e.g., surgical field, code 199, at the bedside)
   • In order to replace a contaminated needle with a new sterile needle
   • Expelling air from a syringe which contains a critical amount of blood or other body fluid is more safely accomplished if the cap loosely covers the vertical needle thereby preventing aerosolization of the fluid.
     
     
     
6. How should one be protected at time of a delivery?

   During delivery it is impossible to predict the path of body fluids. It is important to have maximum coverage. Facial protection is important using a full shield or a combination of mask and wrap-around eye protection. The hands and arms must be completely covered. If the health care worker might have the lap, legs or feet soaked with body fluids, it is important to wear barriers over these parts of the body.
   
   

7. How do you perform mouth-to-mouth resuscitation?

   Direct mouth-to-mouth contact is hazardous. Pocket resuscitation devices with non-rebreathing valves are available in patient care areas. Place the mask over the patient's nose and mouth prior to blowing air into the air tube. The mask must fit securely to the face in order to prevent leakage of air to provide effective ventilation.
   
   

8. List three situations when double gloving is beneficial.

   Two gloves provide extra protection in the event of glove disruptions. Any procedures involving friction against the gloves or where gloves may be punctured by a needle or scalpel blade are indications for double gloving.
   
   

9. Demonstrate passing a sharp.

   Sharps are most safely passed from person-to-person by placing them on a safe flat surface and allowing the receiving person to pick up the sharp by the handle (Example: Place the scalpel into a basin or tray which is passed to the receiving person while announcing its presence).
   
   

10. Demonstrate 2 safe methods of resheathing a needle.
    
    • Scooping the cap onto the needle from a horizontal surface and holding the syringe vertically while the cap is secured by a gentle pull at the base.
    • Placing the cap in a device which holds it upright in order to insert the needle and syringe using one hand only.
      
      
      
11. In the event of your exposure, what should you do?

    See body substance exposure card.
    
    

12. When should you wash your hands?
    
    • BEFORE touching patients, performing invasive procedures, eating, smoking, touching your own mucous membranes.
    • AFTER removing soiled gloves, using the bathroom, contamination with any body fluid.
      
      
      
13. When do you wear eye protection for patient care?

    Protective eyewear is used whenever there is opportunity for droplets (even minute droplets) to be splashed into the eyes. (Examples include deliveries, irrigating wounds, suctioning the respiratory tract).
    
    

14. Do you own protective eyeshields?

    Yes. If not, they can be purchased at Hospital Stores, and are available in four colors.  Prices range from $6.13 to $12.27.
    
    

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