IFPN Guideline
for
The Use of Protective Eye Wear

INTRODUCTION:

Healthcare workers are at risk through procedures that expose them to harmful body-fluids/ pathogens and patients are at risk due to their weakened and compromised immune system. With the implementation of Standard Precautions into the health care setting, it has become the responsibility of the employee and the employer to set standards and to implement protocols that will protect the caregiver and the receiver of care against undue exposure to bloodborne pathogens.

Employers and employees should be knowledgeable on the available Health and Safety regulations, in the Country or Province where they practice. De Almeida, et.al (2005) identified the health care setting is prone to "labor accidents involving the eyes" due to the "biological, chemical and physical risks", to which employees are exposed.

DEFINITIONS:

Universal precautions

A set of precautions designed to prevent transmission of HIV, HBV, and any other bloodborne pathogens, and body fluid, when providing first aid or health care. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious. (CDC 1983)

Standard Precautions

This is isolation precaution that synthesize the major features of body substance isolation and universal precautions to prevent a variety of organisms, and was developed for use in hospitals. (CDC 1996)

The implementation of Standard Precautions will protect the caregiver and the patient against transmission, and reduce the specific risk of contamination by bloodborne pathogens. Education in these preventative measures will provide caregivers with the methodologies to protect themselves against contamination by using the appropriate protective equipment. Facilities should provide employees and those who utilize the services of their facility with the appropriate Personal Protective Equipment (PPE). PPE may include, but is not limited to the following: protective barriers or clothing such as overshoes, fluid-resistant gowns, gloves, masks and protective eyewear. When working or when exposed to blood or any body fluid, double gloving and eye-shields are recommended.

GUIDELINE FOR THE USE OF:

Protective eyewear

It is recommended that Healthcare Providers wear protective eyewear /faceshields during/when:

  • in the scrub position;
  • in the circulating position;
  • the possibility of injury is increased, for example, during laser surgery and inadvertent splashes;
  • there are exposures of mucous membranes of the mouth nose and eyes;
  • there is exposure to splashes / sprays of blood and body-fluids; or
  • during the collection of tissue, blood or body fluid specimens

Quality of Eyewear

  • Protective eyewear must meet the basic safety requirements.
  • Material must be resistant to puncturing, non-fogging, and have a lens that shapes to the contours of the face.
  • Must be free of sharp edges and fit snuggly over the eyes nose and ears of the user.
  • Fit as tightly as possible to the forehead/ brow and side of the eye.
  • Extend down and over the mask to prevent splashes going up under the eyewear.
  • Must be scratch-free and easily decontaminated.
  • Reusable (preferably).
  • If disposable, used according to manufacturer instructions.
  • Visors /faceshields must be attached to masks and extend to the users' forehead.
  • Visors/faceshields must fit snugly around the forehead and extend over the top rim of the mask

PREVENTION OF EXPOSURE

The perioperative practitioner should adhere to the following:

  • Practice general infection control principles.
  • Participate in appropriate training programs/and ongoing education programs.
  • Develop risk management programs, policies, and protocols for prevention of exposure.
  • Do continuous reporting of exposure/adverse events.
  • Have access to preventative immunization programs.
  • Be referred to follow-up counseling and treatment after exposure.
  • Have free access to anti-retroviral medication.
  • Review reporting systems regularly.
  • Review of risk management programs continuously.
  • Follow facility, region or national regulations surrounding the use, type and wearing of protective eyewear.
  • Participate in activities, program and initiatives that raise awareness of splash prevention and compliance with recommended practices.
  • Have a process for health care providers to follow when a splash does occur and implement a plan of action based on the patient assessment of risk.
  • Follow-up mechanism of incidents and support for workers who have been exposed.

Care of Eyewear

  • Regular visual inspections of eyewear to ensure that lenses clean, clear, unscratched and intact.
  • Cleaned after use, according to manufacturers instructions.
  • Stored in a safe place, where it cannot be scratched.
  • If disposable discarded following manufacturers recommendations.

REFERENCES:

  1. de Almeida, CB, Pagliuca LMF, & Leite ALA, (2005). Labor accidents involving the eyes: assessment of occupational risks involving nursing workers (Portuguese), Revista Latino-americana de Enfermagem, 13(5): 708-16.
  2. Centers for Disease Control (CDC), USA, 1983.
  3. Centers for Disease Control (CDC), USA, 1996.

BIBLIOGRAPHY:

  1. Aisien, AO &, Ujah, IA (2006). "Risk of blood splashes to masks and goggles during Cesarean section", Medical Science Monitor, 12(2):CR94-7, 2006 Feb.
  2. Department of Health and Human Services 1996 (Universal Precautions for prevention of Transmission of HIV and Other Bloodborne Infections)
  3. Hunt, J. & Murphy, C. (2004). Measurement of nursing staff occupational exposures in the operating suite following introduction of prevention programme, Australian Infection Control, 9(2): 57-60, 62-3.
  4. Salavanti, R.A. (1995). Protecting your eyes in the laser operating room, Today's OR Nurse, 17(4):23-6.
  5. SATS, (2006). South African Theatre Nurses (SATS) Basic Peri-operative Nurses Guidelines (Standard Precautions 2006)