Phlebotomy 101: Infection Control

What is Infection Control?

Infection control refers to the practices and procedures used to prevent the transmission of infectious diseases within healthcare settings. Infection control is a critical aspect of healthcare, and phlebotomists play a vital role in preventing the spread of infections. 

An infection occurs when harmful microorganisms, such as bacteria, viruses, fungi, or parasites, invade the body and multiply.

Why is it Important?

Hospitals are environments where vulnerable individuals are concentrated. Patients may have weakened immune systems due to illness, surgery, or medications. This makes them more susceptible to infections. 

• Patient Safety: The primary goal of infection control is to protect patients from acquiring infections while receiving healthcare. This includes preventing the spread of infections within the hospital, such as from other patients, healthcare workers, or contaminated equipment.

• Healthcare Worker Safety: Infection control measures also protect healthcare workers from exposure to infectious diseases, such as those transmitted through blood or other bodily fluids.  

• Public Health: Helps prevent the spread of infectious diseases within the community.

Bloodborne pathogens are infectious microorganisms found in human blood that can cause serious diseases, such as Hepatitis B, Hepatitis C, and HIV. Phlebotomists are at risk of exposure to these pathogens due to their frequent contact with blood. Strict infection control measures are crucial to protect phlebotomists. 

How Phlebotomists Practice Infection Control:

Phlebotomists adhere to strict infection control protocols, including:

• Hand Hygiene: Frequent handwashing with soap and water or using alcohol-based hand sanitizer is the single most important infection control measure. Hand hygiene prevents the spread of microorganisms through contact. Phlebotomists prioritize hand hygiene by washing hands with soap and water or using alcohol-based hand sanitizer frequently throughout their workday. This includes washing before and after patient contact, before and after gloving, after removing gloves, before and after touching patient equipment, and whenever hands are visibly soiled. Handwashing with soap and water is generally more effective against certain germs, while alcohol-based hand sanitizers are suitable when hands are not visibly soiled. By diligently practicing these hand hygiene measures, phlebotomists significantly reduce the risk of transmitting infections to patients and themselves. 

• Universal Precautions: Treating all patients as potentially infectious, regardless of known infection status. Universal precautions are a set of infection control guidelines that treat all human blood and certain body fluids as potentially infectious. This approach is crucial in healthcare settings to minimize the risk of transmitting bloodborne pathogens.

• Safe Needle Handling Practices: Using needle safety devices, never recapping needles and proper disposal of needles in sharps containers.  

• Decontamination and Disinfection: Proper cleaning and disinfection of equipment and surfaces.  

• Biohazard Waste Disposal: Proper disposal of all contaminated materials (gloves, gauze, etc.) in designated biohazard waste containers.

• Personal Protective Equipment (PPE): Wearing gloves, gowns, masks, and eye protection when there is a risk of exposure to blood or bodily fluids. Protects from contact with blood and bodily fluids. Phlebotomists utilize PPE to minimize the risk of exposure to bloodborne pathogens and other infectious materials. This includes wearing gloves for every patient contact to prevent direct contact with blood and bodily fluids. In situations where there is a risk of splashes or sprays of blood or bodily fluids, phlebotomists will also wear eye protection, such as goggles or a face shield. Gowns or lab coats can be worn to protect clothing from contamination. Proper donning (putting on) and doffing (taking off) of PPE, as well as proper disposal of contaminated materials, are crucial for effective infection control.  

The Chain of Infection:

The chain of infection describes the six key steps in the spread of an infectious disease: 

• 1. Infectious Agent: The pathogen (e.g., bacteria, virus).  

  2. Reservoir: Where the pathogen lives (e.g., humans, animals).

  3. Portal of Exit: How the pathogen leaves the reservoir (e.g., coughing, open wounds).  

  4. Mode of Transmission: How the pathogen is spread (e.g., direct contact, airborne).  

  5. Portal of Entry: How the pathogen enters a new host (e.g., broken skin, mucous membranes).  

  6. Susceptible Host: An individual who is vulnerable to infection.   

• Modes of Transmission:

Contact: Direct (skin-to-skin) or indirect (touching contaminated objects).

Direct Contact:

• Skin-to-skin: HIV, Hepatitis B, Hepatitis C, STIs (like gonorrhea, and chlamydia), mononucleosis, impetigo, scabies, head lice.

• Mucous Membrane Contact: Influenza, colds, conjunctivitis ("pink eye"), herpes simplex (cold sores).

Indirect Contact:

• Touching contaminated surfaces (doorknobs, shared utensils) and then touching your mouth, nose, or eyes: Many respiratory infections, gastrointestinal illnesses (such as norovirus, Salmonella), and some skin infections.

Droplet: Transmission through respiratory droplets (e.g., coughing, sneezing).  

• Influenza, cold, pertussis (whooping cough), meningitis, some types of pneumonia

Airborne: Transmission through small particles suspended in the air.

• Tuberculosis, measles, chickenpox, shingles (in some cases), some fungal infections

Vehicle: Transmission through contaminated food, water, or blood.

• Foodborne: Salmonella, E. coli, Hepatitis A, norovirus

• Waterborne: Cholera, Legionnaries's disease, Giardia

• Bloodborne: Hepatitis B, Hepatitis C, HIV

Vector-borne: Transmission through insects (e.g., mosquitoes, ticks).

• Mosquito-borne: Malaria, Zika, West Nile virus, dengue fever

• Tick-borne: Lyme disease, Rocky Mountian Spotted Fever

Why Hand Hygiene is So Important:

Handwashing is the single most effective way to prevent the spread of infection. It removes transient bacteria from the hands, significantly reducing the risk of transmitting pathogens to patients or other healthcare workers.