Pete picked up his rack of specimens that needed to be delivered to the serology lab across the hall. He wore gloves because he was handling specimens, and he pushed the lab exit door open using the knob. He walked across the hallway in his PPE, and he opened the door to the serology lab to deliver the specimens. Minutes later, Angie washed her hands at the lab sink and exited the department using the same doorknob Pete used. Angie went to her locker that was located in the hallway to get her jacket and purse.
The set-up of the laboratory described above is not uncommon. Hallways (supposed clean areas) between departments create issues which interfere with the day-to-day operations of the lab and safety regulations. OSHA’s Bloodborne Pathogens standard states that PPE used in a lab department cannot be worn outside the area or into a clean area like an office, rest room, or hallway. There are surface contamination problems in the scenario above as well. Some staff are touching entry and exit doors with gloves, and others are touching the same doors after performing hand hygiene. So how should a lab handle these strange (but all-too-common) concerns? Here are some secrets you should know.
The first secret to remember is that laboratory surfaces (or any other for that matter) can never be treated both as contaminated and uncontaminated. Lab safety should make a decision about that and stick with it. There are some labs where staff is asked to answer the telephone only after removing gloves so that the phones can be uncontaminated for all. In a lab setting, that doesn’t make sense, and having staff remove gloves is not a convenient process that will be readily followed. Consider lab phones and computer terminals to be contaminated and always handle them with gloves. PPE is worn most of the time when working in the lab. If a phone call comes in for the manager who is walking through the department without PPE, the call should be transferred to a clean office, or the manager should don gloves before touching the phone.
The second secret is that lab doors and door handles should be considered uncontaminated and never touched while wearing gloves. Staff are required to wash hands before leaving the department, and they need to be able to touch the doors to exit. Staff entering the labs do not wear PPE, and they must touch entry doors. That means people transporting specimens into the lab should not wear gloves, and they shouldn’t need to if specimens are packaged properly for transport. If specimens need to be transported through a hallway to another lab, the specimens need to be packaged properly and gloves should not be worn. If the hallway is a designated clean area, lab coats should also be removed before transport.
The third secret about lab contamination involves separation between clean and dirty spaces. Clean areas should be completely separated from contaminated areas from floor to ceiling. The only place this is written is in lab safety ISO standards (ISO 15190), but it applies to all laboratory settings. Some labs have offices, break rooms, and rest rooms attached. PPE should always be removed before entering these clean spaces. Food and drink can be transported through the lab directly to the clean space as long as it is covered.
Using a safe process, Pete packed his samples for transport and placed them in a cooler. He removed his lab coat and gloves, washed his hands and carried the cooler through the hallway into the serology lab. The hallway was designated as clean, so placing the staff lockers there was acceptable. Angie was able to touch the lab exit door after performing hand hygiene and leave for home with uncontaminated hands.
Thinking about contaminated surfaces might seem like a puzzle with secret pieces. However, once people understand how contamination occurs, and once they are educated about how to prevent it, everyone will be more diligent about following these practices. These are key pieces to keeping everyone who enters and exits the department safe.