NCPT

Infection Control and Safety accounts for 15 of the 100 scored items. Questions ask how infections spread and how each link of the chain is broken, which precautions a given diagnosis requires, how hepatitis and other bloodborne pathogens are transmitted, what the OSHA Bloodborne Pathogens Standard requires of employers and workers, the correct order for putting on and removing PPE, what to do immediately after a needlestick or splash, and how to dispose of sharps, clean equipment and spills, and respond to chemical, fire, and electrical hazards. Many items describe a situation and ask for the first or best action.

Infection control is every measure used to prevent the transmission of infectious agents in a healthcare setting. Phlebotomists handle blood at every encounter, so they are responsible for protecting the patient, their coworkers, and themselves. The chain of infection describes the six conditions that must all be present for an infection to spread; breaking any one link stops transmission.

Link	WhatItIs	HowtheLinkIsBroken
1 Infectiousagent .	Thepathogen:bacteria viruses fungi orparasites; , , ,	Promptdiagnosisandtreatment;cleaning ,
	agentsdifferinvirulence infectiousdose andsurvival , ,	disinfection andsterilization ,
	outsidethebody
2 Reservoir .	Wheretheagentlivesandmultiplies:infectedor colonizedpatients healthcareworkers contaminated , , surfaces equipment andwater , ,	Environmentalcleaninganddisinfection; usesupplies;stayinghomewhenill	s 1ingle-

Thesixlinksandhoweachisbroken(Continued)

Link	WhatItIs	HowtheLinkIsBroken
3 Portalofexit .	Howtheagentleavesthereservoir:blood bodyfluids , ,	Coveringwounds respiratoryhygiene maskson , ,
	breaksinskin respiratorysecretionsfromcoughing , ,	symptomaticpatients containingspecimens ,
	sneezing andtalking ,
4 Modeof .	Howtheagenttravels:contact(directorindirect) ,	Handhygiene PPE isolationprecautions safe , , ,
transmission	droplet airborne vehicle vector andbloodborne , , , ,	sharpshandling
	(percutaneousormucousmembrane)
5 Portalofentry .	Howtheagententersthenewhost:nonintactskin ,	Aseptictechnique sterileneedles gloves face , , ,
	needlepunctures mucousmembranesoftheeyes , ,	protection safetydevices ,
	nose andmouth andtherespiratory GI andurinary , , , ,
	tracts
6 Susceptiblehost .	Apersonwhocannotresisttheagent:theveryyoung	Vaccination(hepatitisB influenza) protective , ,
	andveryold immunosuppressed chronicallyill , , ,	isolation goodhealthpractices ,
	poorlynourished orthosewithinvasivedevices ,

Healthcare-Associated Infections

A healthcare-associated infection (HAI), formerly called a nosocomial infection, is one the patient acquires while receiving care and that was not present or incubating on admission. Common HAIs include catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. A communicable disease is one that spreads from person to person; an iatrogenic condition is one caused by a treatment or procedure. Many HAIs are preventable with consistent hand hygiene and aseptic technique.

Patient Safety During Collection

Preventing infection is only part of keeping the patient safe at the bedside or drawing station. The phlebotomy technician performs hand hygiene and puts on fresh gloves in the patient's view, cleans the site and does not touch it again, and uses only sterile, single-use needles and lancets. The environment around the draw must also be controlled.

SafetyMeasure	WhatItPrevents
Drawingchairwithalocking	Fallsandinjuryifthepatientfaints;outpatientsneversitonastoolorchairwithoutarmsupport
armrest Bedpositionandrails Trayplacement	1 Loweraraisedbedandreturnsiderailstotheiroriginalpositionbeforeleavingtheroom Neversetthetrayorsuppliesonthepatient'sbed;placeitonaclean stablesurfacewithin , reach

SafetyMeasure	WhatItPrevents
Latexandadhesivecheck	Ask about allergies before applying a tourniquet or bandage; use latex-free supplies
Nothingleftbehind	Removeneedlecaps wrappers gauze andtheusedtourniquetsonothingisleftinthebedor , , ,
	onthefloor

When a question asks which action best breaks the chain of infection in routine practice, the answer is hand hygiene: it interrupts the mode of transmission, the link that connects every reservoir to every new host.