Immediate response protocol for needlestick injuries and other bloodborne pathogen exposures. Time-sensitive - initiate within minutes of the exposure event.
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Add this checklist Browse moreWash the wound immediately with soap and water. For mucous membrane exposure, flush with water.
Immediate washing reduces viral load at the exposure site. This is the single most important first step.
1. For puncture wounds or cuts: wash with soap and running water for at least 30 seconds. 2. For splash to eyes: flush at the eyewash station for at least 5 minutes. 3. For splash to mouth or nose: rinse thoroughly with water. 4. Do NOT squeeze the wound. 5. Apply a bandage.
Notify the office manager and doctor of the exposure event right away.
Timely reporting initiates the protocol and ensures prompt medical evaluation. PEP for HIV must be started within 72 hours (ideally within 2 hours).
1. Inform the office manager and doctor immediately. 2. Provide basic details. 3. The manager should begin this checklist. 4. If PEP may be needed, send the employee for evaluation within 2 hours.
Complete a detailed written report of the exposure event.
Detailed documentation is required by OSHA and protects both the employee and the practice.
1. Record date, time, and location. 2. Describe the exposure. 3. Identify the source patient. 4. Describe the wound/exposure. 5. Identify the device involved. 6. List PPE worn. 7. Have employee and witness sign.
Send the employee to a designated healthcare provider for post-exposure medical evaluation.
OSHA requires employers to make available a confidential medical evaluation. This must happen the same day.
1. Contact the designated QHCP. 2. Provide the QHCP with the BBP standard, incident report, source patient status, and employee vaccination records. 3. Send the employee immediately. 4. The visit is at no cost to the employee.
Ask the source patient to consent to blood testing for HBV, HCV, and HIV.
Testing the source patient allows accurate risk assessment and determines whether prophylaxis is needed.
1. Have the doctor speak with the source patient privately. 2. Request consent for blood testing. 3. If the patient consents, draw blood and send to the lab. 4. If the patient declines, document the refusal. 5. Check state laws. 6. Results must be kept confidential.
Set up the follow-up blood testing schedule for the exposed employee.
Follow-up testing monitors for seroconversion at defined intervals. Missing follow-up tests means missing the window to detect early infection.
1. Obtain the follow-up schedule from the QHCP. 2. Schedule all follow-up appointments. 3. Calendar the appointments. 4. Ensure the employee understands the importance. 5. All testing is at no cost to the employee.
Call the National Clinicians Post-Exposure Prophylaxis Hotline (PEPLine) for guidance.
PEPLine (1-888-448-4911) provides expert guidance on whether PEP is indicated. PEP must be started within 72 hours (ideally within 2 hours).
1. Call PEPLine: 1-888-448-4911. 2. Have exposure details ready. 3. Follow the PEPLine recommendations. 4. If PEP is recommended, start as soon as possible. 5. Document the consultation.
Record the incident on the OSHA Sharps Injury Log as required by the Needlestick Safety and Prevention Act.
The Sharps Injury Log is a separate record specifically for sharps injuries and must be maintained for 5 years.
1. Obtain the OSHA Sharps Injury Log. 2. Record: date, type of device, department, and description. 3. Do NOT include employee name. 4. File the log with OSHA records. 5. Review during annual Exposure Control Plan review.
Determine if the incident is OSHA-recordable and update the OSHA 300 Log if required.
OSHA recordability depends on whether the exposure results in medical treatment beyond first aid, lost work days, or job restrictions.
1. Determine if the incident is OSHA-recordable. 2. If recordable, enter on the OSHA 300 Log within 7 calendar days. 3. Include required information. 4. Do NOT include medical details on the 300 Log.
Investigate the circumstances of the exposure to identify the root cause.
Root cause analysis turns an incident into a learning opportunity and feeds the annual safer sharps device review.
1. Interview the exposed employee in a non-punitive tone. 2. Interview witnesses. 3. Examine the device involved. 4. Identify contributing factors. 5. Determine root cause(s). 6. Document findings.
Based on root cause analysis, implement specific changes to prevent similar exposures.
Corrective actions demonstrate commitment to employee safety and satisfy OSHA expectations.
1. Based on root cause, identify corrective actions. 2. Implement changes with a timeline. 3. Communicate changes to all staff. 4. Update the Exposure Control Plan if procedures change.
Ensure the exposed employee has medical clearance before returning to patient care duties.
Return-to-work clearance protects both the employee and patients.
1. Request a written opinion from the QHCP per OSHA requirements. 2. The opinion should include evaluation results and any limitations. 3. The opinion should NOT include medical diagnoses or test results. 4. File the written opinion. 5. Support any work modifications recommended.