OSHA Home Health Aide Requirements

Home health aides, also known as certified nursing assistants (CNAs), must be familiar with OSHA's blood pathogen regulations, which apply to all body fluids, abrasions or open sores and mucous membranes. The only body fluid not included is sweat. CNAs should treat body fluids and mucous membranes as if they were infected with a contagious disease, because there is no way to tell, just by looking at a client, if they are infected with a disease.

Protective Equipment

• Personal protective equipment includes gloves, gowns, masks and goggles. CNAs should put gloves on before contact with blood or body substances, and change gloves between each patient procedure. Moisture-proof, disposable gowns should be worn to protect clothing from blood. CNAs should also wear a disposable facemask and goggles or safety glasses with side shields whenever blood splattering may occur to the face or eyes. Disposable CPR masks should be used to provide mouth-to-mouth resuscitation. All personal protective equipment should be disposed of according to the employer's instructions.

Washing Hands

• Hand washing reduces infection. Using gloves doesn't eliminate the need to wash hands. CNAs should wash their hands with soap and water as soon as they remove gloves. In addition to washing with soap and water, the Center for Disease Control recommends using an alcohol-based hand rub because it significantly reduces the number of micro organisms on the skin. Hand rubs should be used before and after each patient.

Handling Sharp Objects

• CNAs should minimize contact with "sharps," such as needles or scalpels. Sharp objects should be disposed of as soon as they are used. Contaminated "sharps" should not be broken. Recapping, bending or removing needles is allowed only if there is no alternative.

Regulated Waste

• OSHA defines regulated waste as liquids or semi-liquid blood and other infectious materials and contaminated "sharps" such as needles or scalpels. Regulated waste must be stored in a leak-proof, puncture-proof container that is labeled or color-coded so employees are aware of a potential hazard. If the outside of a container becomes contaminated, it must be placed inside a second container. Regulated waste must be disposed of according to state and local laws.

Post Exposure

• Employers are required to establish a procedure for employees to follow if they've been exposed to bodily fluids or mucous membranes. A Home Health Aide worker should tell her immediate supervisor that she's been exposed as soon as she knows. She will also have to fill out an incident report. The exposed area must be washed immediately. If the skin is broken, or fluid has splashed into the worker's eyes or mouth, the worker and the source patient have to be tested. The worker may be given hepatitis B immune globulin, antibiotics or HIV preventive medicines, depending on the results of the tests. Medications should be started within hours of exposure, and repeat blood tests should be done six to nine months later.