Which of the following is the first step a phlebotomist should take to prevent the spread of infection?
Wearing gloves for any patient contact
Washing hands with antimicrobial soap and water
Applying antiseptic to the puncture sites prior to venipuncture
Decontaminating the equipment before use
The Correct Answer is B
Choice A reason:
Wearing gloves is an important step in preventing the spread of infection, but it is not the first step. Gloves provide a barrier between the phlebotomist's hands and the patient, which can help prevent the transmission of pathogens. However, gloves can still become contaminated, and if hand hygiene is not performed before donning gloves, pathogens can be transmitted when gloves are changed or removed.
Choice B reason:
Hand hygiene is widely recognized as the single most important practice in preventing the spread of infections. It is the first line of defense against the transmission of infectious agents. Washing hands with antimicrobial soap and water mechanically removes pathogens, and the antimicrobial agents in the soap can kill or inhibit the growth of microorganisms. This step is crucial before any patient contact, especially before invasive procedures like venipuncture.
Choice C reason:
Applying antiseptic to the puncture sites prior to venipuncture is a critical step in the prevention of infection at the site of the blood draw. This practice is essential for eliminating skin flora that could potentially enter the bloodstream during venipuncture. However, this is not the first step, as effective hand hygiene should precede any patient contact or procedure.
Choice D reason:
Decontaminating equipment before use is a necessary step to ensure that no infectious agents are transmitted via medical instruments. This includes cleaning and sterilizing equipment that comes into direct contact with the patient. While this is a vital part of infection control, it follows hand hygiene in the sequence of steps a phlebotomist should take.
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Correct Answer is A
Explanation
Choice A reason:
Reporting the exposure to the supervisor is the immediate and required action after experiencing a needlestick injury. The supervisor will then guide the phlebotomist through the institution's post-exposure protocol, which includes immediate care of the wound, evaluation of the exposure, and initiation of post-exposure prophylaxis (PEP) if necessary. This step is crucial to ensure that the risk of HIV transmission is minimized and that the phlebotomist receives appropriate medical attention and follow-up.
Choice B reason:
Reporting the exposure to the Centers for Disease Control and Prevention (CDC) is not the immediate action required. The CDC provides guidelines and recommendations for handling such incidents, but the initial report and response are managed at the healthcare facility level. The CDC may be involved in the tracking of such incidents on a larger scale or providing statistical data, but they are not the first point of contact.
Choice C reason:
Sending the patient for further sexually transmitted infection (STI) testing is not an immediate action required following a needlestick injury. The patient's HIV status is already known, and the focus should be on the treatment and protection of the healthcare worker who experienced the needlestick. Any additional testing of the patient would be unrelated to the immediate management of the injury.
Choice D reason:
Saving the collection device for future evaluation is not a standard procedure. While the device may be retained as part of the incident investigation to determine how the injury occurred and to improve safety measures, the immediate concern is the treatment of the injured healthcare worker. The device itself does not play a role in the post-exposure management of the worker.
Correct Answer is B
Explanation
Choice A Reason:
Hemostasis is the process of blood clotting and the cessation of bleeding. While it is a desired outcome following any puncture, squeezing the puncture site would not typically cause hemostasis as a complication. It is the body's natural response to injury to prevent excessive blood loss.
Choice B Reason:
Hemolysis refers to the rupture of red blood cells, which can occur when excessive pressure is applied to a puncture site during a capillary blood collection. This pressure can cause the cells to burst, releasing their contents into the plasma, which can interfere with various laboratory tests and lead to inaccurate results.
Choice C Reason:
Homeostasis is the body's ability to maintain a stable internal environment despite changes in external conditions. It is not a complication but rather a regulatory process. Squeezing a puncture site does not directly relate to homeostasis as a complication.
Choice D Reason:
Hypobilirubinemia is a condition where there is less than the normal amount of bilirubin in the blood. It is not a complication associated with squeezing a puncture site. Bilirubin levels are typically affected by liver function and red blood cell breakdown, not by the mechanical action of squeezing a site.
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