Keeping an Eye Out: Protecting the Eyes of Healthcare Staff
The eyes are a gateway for infection to enter the body. So it is critical to protect your eyes, especially in environments where infection risks are present. In hospitals the risk for infection can be higher due to the chance of splatter from blood or other bodily fluids.
According to one study of medical students, those observed touched their face an average of 23 times an hour. Nearly half involved touching a mucous membrane, and a quarter of those were the eyes. Given how frequently the average person touches their face, hospital staff have good reason to be concerned with the risk of infections.
There are many studies looking at the prevalence of splatter on surgeons’ goggles, most observing similar rates of blood and other fluid splashes on goggles. Therefore, it is critical for healthcare workers to protect their eyes, and for hospitals to have well-established infection prevention protocols in place to keep staff safe.
Following these best practices can help your facility protect staff and patients.
- Let regulations be your guide: Multiple regulatory bodies, including the Centers for Disease Control and Prevention (CDC), the American National Standards Institute (ANSI) and the Occupational Safety and Health Administration (OSHA), recommend consistent use of eye protection as a barrier to prevent infectious material from entering the eye in conjunction with other personal protective equipment (PPE) such as gloves, gowns, masks or respirators.
OSHA’s regulations state “Masks in combination with eye protection devices, such as goggles or glasses with solid side shields, or chin-length face shields, shall be worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated.” In other words, when there is any potential risk to a healthcare workers eyes, their employer is required to provide the appropriate personal protective equipment (PPE).
- Eliminate risks if possible following OSHA’s hierarchy of controls: Do not neglect a strong attempt to eliminate risks entirely ahead of a reliance on PPE. The facility should use OSHA’s hierarchy of controls to reduce the staff exposure by attempting to eliminate the hazard entirely or using engineering or work practices to improve control of risk scenarios.
- Choose the right PPE: There are many choices when it comes to PPE your staff will wear, and some combinations are better than others. For example, prescription eye glasses and contact lenses are not considered sufficient PPE for infection control. Face shields that are open at the bottom or safety goggles alone are also not considered sufficient. Face shields provide secondary protection, so primary eye protection, such as safety goggles, should also be worn.
According to the Association of Surgical Technologists (AST), the recommended protective -eyewear consists of goggles that are indirectly vented and have an anti-fog coating. This will maximize protection from sprays, splashes, droplets and debris such as bone. In addition, there are options that allow wearing goggles over prescription eyewear.
- Follow manufacturer IFUs and doff (remove) carefully: As with all medical equipment, remember to always follow the manufacturers’ instructions for use (IFUs) as they pertain to storing and inspecting your equipment. Pay special attention to how and when you remove your protective eyewear, doffing carefully to minimize the transfer of any blood or other fluid into a mucous membrane. Also consider:
- Doffing eye PPE last, as splatter can take place when removing gloves;
- Training staff to remove eyewear from the part that secures it to the head rather than the goggles themselves; and
- Having a labeled container for dirty goggles if you do not use disposable eyewear
- Review your protocol annually: Staff turns over often and regulations change, so make it a practice to review eye protection policies annually with surgeons, certified surgical technologists (CSTs), nurses, risk management and infection prevention.
- Have a strong training program: Surgical staff, especially CSTs, and any staff regularly working in areas or procedures with risk of splatter should participate in continuing education to remain up to date on best practices in eye protection. That training should include proper use of PPE, cleaning, disinfection, and disposal, maintaining and storing products, and defining what, if any, limitations exist.
The risk of surgical staff being exposed to dangerous splatter from blood and other bodily fluids is inevitable. Having clear protocol, a solid training program and the right PPE can improve the safety of your employees by minimizing the risk of spreading infection.