**Module 6: Safety at the HIV Rapid Testing Site**

+----------------+-----------------------------------------------------+
| **Purpose**    | To provide the participants with necessary          |
|                | attitudes, knowledge, and skills about lab safety   |
|                | so they will take precautions to prevent infections |
|                | at the HIV rapid testing site.                      |
+----------------+-----------------------------------------------------+
| **P            | Module 5: Assuring the Quality of HIV Rapid Testing |
| re-requisite** |                                                     |
|                |                                                     |
| **Modules**    |                                                     |
+----------------+-----------------------------------------------------+
| **Module       | 45 minutes                                          |
| Time**         |                                                     |
+----------------+-----------------------------------------------------+
| **Learning     | At the end of this module, participants will be     |
| Objectives**   | able to:                                            |
|                |                                                     |
|                | -   Adhere to personal health and safety practices  |
|                |                                                     |
|                | -   Maintain a clean and organized workspace        |
|                |                                                     |
|                | -   Disinfect and dispose of infectious materials   |
|                |                                                     |
|                | -   Take appropriate actions following accidental   |
|                |     exposure to potentially infectious specimen     |
|                |                                                     |
|                | -   Follow written safety procedures and keep       |
|                |     proper safety records                           |
+----------------+-----------------------------------------------------+

**Module Overview**

+-----+-------+------------+--------------------+----------------------+
| **  | **T   | **         | **Content**        | **Resources\         |
| Ste | ime** | Activity/\ |                    | Needed**             |
| p** |       | Method**   |                    |                      |
+-----+-------+------------+--------------------+----------------------+
| **  | 10    | > Pr       | Module             | Slides 1-6; prepared |
| 1** | min   | esentation | introduction       | flipchart -- content |
|     |       |            |                    | outline              |
+-----+-------+------------+--------------------+----------------------+
| **  | 20    | > Pre      | Safety practices   | Slides 7-26; eye     |
| 2** | min   | sentation; |                    | wash units;          |
|     |       | >          |                    | Bio-hazard poster;   |
|     |       | >          |                    | sharp containers;    |
|     |       | Discussion |                    | Materials required   |
|     |       |            |                    | for demonstrating    |
|     |       |            |                    | how to handle a      |
|     |       |            |                    | spill                |
+-----+-------+------------+--------------------+----------------------+
| **  | 5 min | > Q&A      | Summary            | Slide 27             |
| 3** |       |            |                    |                      |
+-----+-------+------------+--------------------+----------------------+
| **  | 10    | >          | Safety practices   | Flipchart            |
| 4** | min   | Discussion | and you            |                      |
+-----+-------+------------+--------------------+----------------------+

**Material/Equipment Checklists**

-   PowerPoint slides or transparencies

-   Overhead projector or computer w/LCD projector

-   Prepared flipchart -- content outline, discussion questions

-   Eye wash units

-   Bio-Hazard poster or sticker

-   Sharp containers

-   Materials required for demonstrating how to handle a spill

-   Handouts:

    -   [Guidelines for Post Exposure Prophylaxis (PEP)]{.underline}

    -   [Example: Emergency Contact List]{.underline}

    -   [Log of Work Related Injuries and Illnesses]{.underline}

**Teaching Guide**

+-----------------+-----------------------------------------------------+
| **Slide         | **Teaching Points**                                 |
| Number**        |                                                     |
+=================+=====================================================+
| **1**           | **[Module 6: Safety at the HIV Rapid Testing        |
|                 | Site]{.underline}**                                 |
|                 |                                                     |
|                 | DISPLAY this slide before you begin the module.     |
|                 | Make sure participants are aware of the transition  |
|                 | into a new module.                                  |
+-----------------+-----------------------------------------------------+
| **2**           | **[The Lab Quality System]{.underline}**            |
|                 |                                                     |
|                 | REMIND participants that site safety is one         |
|                 | component of the lab quality system.                |
+-----------------+-----------------------------------------------------+
| **3**           | **[Why Is Safety Important?]{.underline}**          |
|                 |                                                     |
|                 | DISCUSS why performing HIV tests poses a potential  |
|                 | health hazard to the tester. ENCOURAGE participants |
|                 | to share their thoughts.                            |
|                 |                                                     |
|                 | > ASK, "What is it about performing rapid testing   |
|                 | > on a client that could put the tester at risk?"   |
|                 | > (Answer -- The tester may come into contact with  |
|                 | > blood from the client, and all specimens should   |
|                 | > be treated as though potentially hazardous).      |
|                 | >                                                   |
|                 | > ASK, "What might be present in the client's blood |
|                 | > that would be dangerous to others?" (Answer --    |
|                 | > Agents that can cause infection. Such agents may  |
|                 | > also be called pathogens, and since these         |
|                 | > pathogens live in blood, they are called          |
|                 | > blood-borne pathogens.                            |
|                 | >                                                   |
|                 | > ASK participants to give some examples (e.g. HIV, |
|                 | > Hepatitis).                                       |
+-----------------+-----------------------------------------------------+
|                 | TELL true stories or relay your personal            |
|                 | experiences about what happened when someone did    |
|                 | not take safety precautions.                        |
+-----------------+-----------------------------------------------------+
| ![](m           | Stories or scenarios that evoke emotions (fear,     |
| edia/image1.gif | shock, sympathy, sorrow, etc.) are excellent ways   |
| ){width="0.4479 | in getting participants to pay attention and        |
| 166666666667in" | adopting the right attitudes about lab safety. This |
| height="0.54166 | is especially important when teaching participants  |
| 66666666666in"} | without medical or lab experience.                  |
| ***TIPS***      |                                                     |
+-----------------+-----------------------------------------------------+
| **4**           | **[What Else Needs Protection?]{.underline}**       |
|                 |                                                     |
|                 | EXPLAIN that besides tester and client, we also     |
|                 | need to:                                            |
|                 |                                                     |
|                 | -   Protect other people from infection             |
|                 |                                                     |
|                 |     -   Never leave blood spills that could infect  |
|                 |         others.                                     |
|                 |                                                     |
|                 |     -   Never leave used lancets lying around for   |
|                 |         anyone else to pick up -- they could prick  |
|                 |         themselves with HIV contaminated lancets.   |
|                 |                                                     |
|                 |     -   Always seal contaminated waste -- you don't |
|                 |         want to risk infecting the person who       |
|                 |         removes contaminated waste from the rapid   |
|                 |         testing site.                               |
|                 |                                                     |
|                 | -   Protect integrity of test products              |
|                 |                                                     |
|                 |     -   It is important not to contaminate unused   |
|                 |         tests.                                      |
|                 |                                                     |
|                 |     -   If a new unused test is contaminated by a   |
|                 |         drop of blood from a previous client, the   |
|                 |         test may not yield accurate result when     |
|                 |         used on the next client.                    |
|                 |                                                     |
|                 | -   Protect the environment from hazardous material |
|                 |                                                     |
|                 |     -   Care should be taken to avoid transferring  |
|                 |         contaminated materials into areas outside   |
|                 |         of the testing area.                        |
+-----------------+-----------------------------------------------------+
| **5**           | **[Learning Objectives]{.underline}**               |
|                 |                                                     |
|                 | STATE the objectives on the slide.                  |
+-----------------+-----------------------------------------------------+
| **6**           | **[Content Overview]{.underline}**                  |
|                 |                                                     |
|                 | EXPLAIN the topics that will be covered in this     |
|                 | module.                                             |
+-----------------+-----------------------------------------------------+
| **Flipchart**   | REFER to the previously prepared flipchart to       |
|                 | orient participants to where they are in the        |
| ![](m           | module.                                             |
| edia/image2.wmf |                                                     |
| ){width="0.8423 |                                                     |
| 611111111111in" |                                                     |
| height="0.84236 |                                                     |
| 11111111111in"} |                                                     |
+-----------------+-----------------------------------------------------+
| **7**           | **[Universal or Standard Precautions]{.underline}** |
|                 |                                                     |
|                 | DISCUSS the implications of the text on the slide.  |
|                 | ENCOURAGE participants to share their thoughts.     |
|                 |                                                     |
|                 | > ASK, "Why should every blood sample be treated as |
|                 | > though it is infectious?" (Answer: Harmful        |
|                 | > agents/organisms may be present in a client's     |
|                 | > blood. If a person comes into direct contact with |
|                 | > the blood, that person could be infected.)        |
|                 |                                                     |
|                 | CONCLUDE that as a result, we must follow safety    |
|                 | practices in every step of the testing process.     |
+-----------------+-----------------------------------------------------+
| **8**           | **[Apply Safety Practices Throughout the Testing    |
|                 | Process]{.underline}**                              |
|                 |                                                     |
|                 | HIGHLIGHT the safety practices within each phase of |
|                 | testing.                                            |
|                 |                                                     |
|                 | -   Before testing - specimens shall be transported |
|                 |     in a manner to prevent contamination of         |
|                 |     workers, patients, environment                  |
|                 |                                                     |
|                 |     -   Use appropriate packing containers          |
|                 |                                                     |
|                 |     ```{=html}                                      |
|                 |     <!-- -->                                        |
|                 |     ```                                             |
|                 |     -   Follow national and international postal    |
|                 |         and transport regulations                   |
|                 |                                                     |
|                 | -   During testing -- Apply safety rules when       |
|                 |     performing finger-prick and actual testing of   |
|                 |     the client's blood.                             |
|                 |                                                     |
|                 | -   After testing                                   |
|                 |                                                     |
|                 |     -   Clean up working area                       |
|                 |                                                     |
|                 |     -   Properly dispose of contaminated waste      |
+-----------------+-----------------------------------------------------+
| **9**           | **[Develop Personal Safe Work Habits]{.underline}** |
|                 |                                                     |
|                 | DISCUSS each personal safe work habit. ENCOURAGE    |
|                 | participants to share their thoughts.               |
|                 |                                                     |
|                 | > ASK, "Why do testers need to wash their hands     |
|                 | > between testing each client?" (Answer: To wash    |
|                 | > away any germs that might be present on the       |
|                 | > tester's hands -- this will ensure that no        |
|                 | > infections are passed from the tester or previous |
|                 | > client onto the next new client.)                 |
|                 | >                                                   |
|                 | > ASK, "Why do we need to wear fresh gloves for     |
|                 | > each new client?" (Answer: To protect the client  |
|                 | > and tester from cross-infection -- the transfer   |
|                 | > of infection from one person to another.)         |
|                 | >                                                   |
|                 | > ASK, "Why wear lab coat or apron?" (Answer: This  |
|                 | > is to protect the tester from reagent spills,     |
|                 | > client's blood.                                   |
|                 | >                                                   |
|                 | > ASK, "Why do we need to get rid (or not re-use)   |
|                 | > of used sharp objects such as needles or          |
|                 | > lancets?" (Answer: Sharp objects can cut human    |
|                 | > skin. Any germs or pathogens present on the       |
|                 | > lancet can be passed from the lancet into that    |
|                 | > person's blood through the cut.)                  |
+-----------------+-----------------------------------------------------+
| **10**          | **[Develop Personal Safe Work Habits                |
|                 | (Cont'd)]{.underline}**                             |
|                 |                                                     |
|                 | CONTINUE the discussion of personal safe work       |
|                 | habit. ENCOURAGE participants to share their        |
|                 | thoughts.                                           |
|                 |                                                     |
|                 | > ASK, "Why is pipetting by mouth strictly          |
|                 | > forbidden?" (Answer: You run the risk of          |
|                 | > accidentally swallowing or coming into direct     |
|                 | > contact with harmful materials.)                  |
|                 | >                                                   |
|                 | > ASK, "Why is eating, drinking, or smoking not     |
|                 | > allowed in the test site?" (Answer: Harmful germs |
|                 | > or pathogens can be an entry point to the from    |
|                 | > touching contaminated objects followed by contact |
|                 | > with your mouth.)                                 |
|                 | >                                                   |
|                 | > ASK, "Why is it important to keep food away from  |
|                 | > the testing area or a refrigerator that contains  |
|                 | > blood samples?" (Answer: Infectious               |
|                 | > agents/pathogens can be carried in food and       |
|                 | > transmitted to people.)                           |
+-----------------+-----------------------------------------------------+
|                 | STRESS the importance of "Never let your mouth      |
|                 | touch anything from work, such as pens, pencils,    |
|                 | etc."                                               |
+-----------------+-----------------------------------------------------+
| ![](m           | Again, sharing personal stories or experiences will |
| edia/image1.gif | increase participants' motivation to adopt these    |
| ){width="0.4479 | personal safety routines.                           |
| 166666666667in" |                                                     |
| height="0.54166 |                                                     |
| 66666666666in"} |                                                     |
| ***TIPS***      |                                                     |
+-----------------+-----------------------------------------------------+
| **11**          | **[Maintain Clean & Orderly Work                    |
|                 | Space]{.underline}**                                |
|                 |                                                     |
|                 | DISCUSS each safe work habit. ENCOURAGE             |
|                 | participants to share their thoughts.               |
|                 |                                                     |
|                 | > ASK, "Why keep work areas uncluttered?" (Answer:  |
|                 | > So there is less chance for accidents.)           |
|                 | >                                                   |
|                 | > ASK, what does disinfect mean? (Answer: To kill   |
|                 | > any harmful germs/pathogens).                     |
|                 | >                                                   |
|                 | > ASK, "Why disinfect daily?" (Answer: Just because |
|                 | > a work area was disinfected yesterday, it does    |
|                 | > not mean it is still free of germs today.)        |
|                 | >                                                   |
|                 | > ASK, "Why limit access to the lab?" (Answer: It   |
|                 | > is important to prevent other people from risk of |
|                 | > infection, as well as to protect the client's     |
|                 | > confidentiality. Limiting access also prevents    |
|                 | > distractions).                                    |
|                 | >                                                   |
|                 | > ASK, "Why keep supplies locked?" (Answer: To      |
|                 | > prevent unauthorized persons having access to     |
|                 | > potentially dangerous objects such as lancets)    |
+-----------------+-----------------------------------------------------+
|                 | EXPLAIN the eye wash unit: its purpose and how to   |
|                 | use.                                                |
|                 |                                                     |
|                 | > STATE that the eye wash unit is used to clean     |
|                 | > one's eyes when they are accidentally splashed    |
|                 | > with any type of specimen; for example from       |
|                 | > patients, controls, reagents, etc.                |
|                 | >                                                   |
|                 | > EXHIBIT an eye wash bottle and pass it around for |
|                 | > everyone to see.                                  |
|                 | >                                                   |
|                 | > SHOW how to use the unit.                         |
|                 | >                                                   |
|                 | > *Note: If an eye wash unit is not available,      |
|                 | > please consult your local infection control       |
|                 | > personnel for alternate procedures to follow in   |
|                 | > the event of an accidental splash.*               |
+-----------------+-----------------------------------------------------+
|                 | EXPLAIN the term "bio-hazard."                      |
|                 |                                                     |
|                 | -   "Bio" means life and "Hazard" means danger.     |
|                 |     "Bio-hazard" means something is dangerous to    |
|                 |     life.                                           |
|                 |                                                     |
|                 | -   Examples of bio-hazard materials include:       |
|                 |     client's blood, used test kits, anything that   |
|                 |     comes into contact with client's blood, etc.    |
|                 |                                                     |
|                 | -   It is a good practice to put a Bio-Hazard sign  |
|                 |     on any containers holding the waste from your   |
|                 |     tests.                                          |
|                 |                                                     |
|                 | SHOW a "Bio-hazard" poster or sticker from your     |
|                 | country.                                            |
+-----------------+-----------------------------------------------------+
|                 | SHARE a personal story or experience to illustrate  |
|                 | the importance of these practices.                  |
+-----------------+-----------------------------------------------------+
| **Transition**  | SUMMARIZE safe work habits -- personal, work space, |
|                 | and material.                                       |
|                 |                                                     |
|                 | ASK participants if they have any questions before  |
|                 | moving on to the next topic.                        |
+-----------------+-----------------------------------------------------+
| **12**          | **[Take Precautions to Avoid Needle Stick           |
|                 | Injury]{.underline}**                               |
|                 |                                                     |
|                 | STATE that needle-stick injury can be dangerous     |
|                 | because infected blood containing pathogens can be  |
|                 | transferred to the person and cause infection.      |
|                 |                                                     |
|                 | DISCUSS ways to avoid needle stick injury due to:   |
|                 |                                                     |
|                 | -   Lack of concentration -- One should focus on    |
|                 |     where the needle is, one's hand, and client's   |
|                 |     hand. Don't let yourself be distracted.         |
|                 |                                                     |
|                 | -   Inexperience -- Only people who have received   |
|                 |     appropriate training should perform the         |
|                 |     finger-stick procedure.                         |
|                 |                                                     |
|                 | -   Lack of concern for others                      |
|                 |                                                     |
|                 |     -   Always get rid of used needles or lancets   |
|                 |         according to proper procedures. Place used  |
|                 |         lancets in the sharps disposal container.   |
|                 |                                                     |
|                 |     -   Do not leave used needles or lancets lying  |
|                 |         around.                                     |
|                 |                                                     |
|                 |     -   Clean up after each client.                 |
|                 |                                                     |
|                 | STATE that special measures are required for        |
|                 | disposing of needles and sharps. Transition to next |
|                 | slide.                                              |
+-----------------+-----------------------------------------------------+
| **13**          | **[Drop Used Sharps in Special                      |
|                 | Containers]{.underline}**                           |
|                 |                                                     |
|                 | STATE that there are many makes, shapes and sizes   |
|                 | of sharp bins. However, all sharp containers should |
|                 | have:                                               |
|                 |                                                     |
|                 | -   A lid                                           |
|                 |                                                     |
|                 | -   Puncture-proof or thick walls                   |
|                 |                                                     |
|                 | -   A large enough hole for lancets and needles     |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Leakproof sides and bottom                      |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   A label or color code indicating bio-hazard     |
|                 |     material                                        |
|                 |                                                     |
|                 | -   Sufficient quantity available at each testing   |
|                 |     site                                            |
|                 |                                                     |
|                 | > HIGHLIGHT not all sharps containers need be       |
|                 | > purchased commercially. An empty bleach container |
|                 | > will suffice such as seen on the right. This type |
|                 | > container meets all previously mentioned          |
|                 | > specification. Additionally, the opening is small |
|                 | > so that you cannot insert your hand.              |
|                 |                                                     |
|                 | .                                                   |
+-----------------+-----------------------------------------------------+
| **14**          | **[Do's and Don'ts: Sharps and Waste                |
|                 | Containers]{.underline}**                           |
|                 |                                                     |
|                 | EXPLAIN the bullet points on the slide:             |
|                 |                                                     |
|                 | -   You could injure yourself if you try to bend    |
|                 |     needles or lancets.                             |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Never shake sharps containers to create space   |
|                 |     because this leads to formation of aerosols.    |
|                 |     Aerosols are tiny invisible droplets in the air |
|                 |     that can also carry infectious                  |
|                 |     agents/pathogens.                               |
|                 |                                                     |
|                 | EXPLAIN the two different types of containers on    |
|                 | the slide:                                          |
|                 |                                                     |
|                 | -   The left one is a plastic bag for contaminated  |
|                 |     waste. It should not be used for sharp objects  |
|                 |     as they can pierce the bag and injure someone.  |
|                 |                                                     |
|                 | -   The red plastic container on the right is       |
|                 |     suitable for sharp objects as the plastic is    |
|                 |     thick enough so that sharp objects cannot       |
|                 |     puncture the container. It also has a lid.      |
+-----------------+-----------------------------------------------------+
| **15**          | **[Do's and Don'ts: Sharps and Waste                |
|                 | Containers]{.underline}**                           |
|                 |                                                     |
|                 | FACILITATE a discussion of the picture on the left. |
|                 | What's wrong about it? ENSURE the following points  |
|                 | are brought up.                                     |
|                 |                                                     |
|                 | -   Open container containing a mixture of blood,   |
|                 |     sharps, and other contaminated waste            |
|                 |                                                     |
|                 | -   No lid                                          |
|                 |                                                     |
|                 | -   No label to warn people of bio-hazard waste     |
|                 |                                                     |
|                 | -   Placed on the floor and prone to spill          |
|                 |                                                     |
|                 | NOTE: Consider replacing the left picture with a    |
|                 | real example from your country.                     |
+-----------------+-----------------------------------------------------+
|                 | FACILITATE a discussion of the picture on the       |
|                 | right. What's right about it? ENSURE the following  |
|                 | points are brought up.                              |
|                 |                                                     |
|                 | -   Container made of thick plastic. This is        |
|                 |     appropriate for disposing of sharps.            |
|                 |                                                     |
|                 | -   Bottle has a lid and sealed                     |
|                 |                                                     |
|                 | Plastic bag will be securely tied once filled. This |
|                 | is appropriate for disposing of contaminated waste  |
|                 | such as used gauze. This type of container is NOT   |
|                 | appropriate for disposal of sharps.                 |
+-----------------+-----------------------------------------------------+
| **16**          | **[Never Place Needles or Sharps in Office Waste    |
|                 | Containers]{.underline}**                           |
|                 |                                                     |
|                 | DISCUSS why one should never place needles or       |
|                 | sharps in office waste containers and what the      |
|                 | consequences might be.                              |
|                 |                                                     |
|                 | EMPHASIZE that contaminated waste should be kept    |
|                 | separate for office waste. It is the tester's       |
|                 | responsibility not to put any other persons at risk |
|                 | of infection.                                       |
|                 |                                                     |
|                 | POINT OUT the image of the right illustrates        |
|                 | improper disposal of objects. Sharps are mixed with |
|                 | non-sharp items and opening exposed posng a         |
|                 | potential hazard.                                   |
|                 |                                                     |
|                 | SHARE a story or personal experience of improper    |
|                 | handling of sharps and consequences                 |
+-----------------+-----------------------------------------------------+
| **17**          | **[Sharps Containers Must Be...]{.underline}**      |
|                 |                                                     |
|                 | STATE the points on the slide.                      |
+-----------------+-----------------------------------------------------+
| **18**          | **[Policy for Handling Sharps]{.underline}**        |
|                 |                                                     |
|                 | SUMMARIZE key points about handling/disposing of    |
|                 | sharps with this slide.                             |
+-----------------+-----------------------------------------------------+
| ![](me          | Customize the slide with the following information: |
| dia/image3.wmf) |                                                     |
| {width="0.49166 | -   National policy on handling bio-hazard waste,   |
| 666666666664in" |     if available                                    |
| heigh           |                                                     |
| t="0.4416666666 | -   Local procedures for disposing of contaminated  |
| 6666665in"}***C |     waste                                           |
| ustomization*** |                                                     |
|                 |                                                     |
| ***Notes***     |                                                     |
|                 |                                                     |
| **19**          |                                                     |
+-----------------+-----------------------------------------------------+
| **19**          | **[Incineration of Waste]{.underline}**             |
|                 |                                                     |
|                 | DEFINE Incineration. Incineration is the burning of |
|                 | contaminated waste to destroy and kill              |
|                 | micro-organisms                                     |
|                 |                                                     |
|                 | STATE points on the slide                           |
|                 |                                                     |
|                 | Also POINT OUT that contaminated waste should be    |
|                 | burned to completion. By completion we mean burned  |
|                 | beyond re-use.                                      |
|                 |                                                     |
|                 | EXPLAIN local procedures for disposing of           |
|                 | contaminated waste if incineration is not available |
|                 | at the test site.                                   |
|                 |                                                     |
|                 | EMPHASIZE care should be taken in transporting      |
|                 | waste from one site to another for incineration.    |
|                 |                                                     |
|                 | ASK "Does your procedure include burying waste in a |
|                 | pit?"                                               |
|                 |                                                     |
|                 | DISCUSS pits vs. incineration.                      |
+-----------------+-----------------------------------------------------+
| **Transition**  | ASK participants if they have any questions before  |
|                 | moving on to the next topic.                        |
+-----------------+-----------------------------------------------------+
| **20**          | **[Disinfect Work Areas with Bleach]{.underline}**  |
|                 |                                                     |
|                 | REMIND participants that daily disinfection of work |
|                 | surface is part of the general safe practice that   |
|                 | participants need to follow to keep a clean and     |
|                 | orderly work area.                                  |
+-----------------+-----------------------------------------------------+
| **21**          | **[Different Cleaning Jobs Require Different Bleach |
|                 | Solutions]{.underline}**                            |
|                 |                                                     |
|                 | EXPLAIN that for spills, you should a 10% bleach    |
|                 | solution. The larger the spill, the longer the      |
|                 | contact with the 10% bleach solution.               |
|                 |                                                     |
|                 | EXPLAIN that for general disinfection purposes use  |
|                 | a 1% solution. For example, wiping down all         |
|                 | surfaces at the end of the day.                     |
+-----------------+-----------------------------------------------------+
| ![](me          | If local bleach list the concentration sodium       |
| dia/image3.wmf) | hypochlorite in parts per million (ppm), explain    |
| {width="0.49166 | how to make a 10% or 1% solution.                   |
| 666666666664in" |                                                     |
| heigh           |                                                     |
| t="0.4416666666 |                                                     |
| 6666665in"}***C |                                                     |
| ustomization*** |                                                     |
|                 |                                                     |
| ***Notes***     |                                                     |
|                 |                                                     |
| **22**          |                                                     |
+-----------------+-----------------------------------------------------+
| **22**          | **[Making a 10% Bleach Solution]{.underline}**      |
|                 |                                                     |
|                 | EXPLAIN the key points on the slide.                |
|                 |                                                     |
|                 | DEMONSTRATE how to prepare a 10% bleach. Take a     |
|                 | 1litre empty bottle that has been marked with 100   |
|                 | mls = 1 part. Explain the bleach should reach this  |
|                 | level, then fill up to the next mark with water,    |
|                 | this 900mls = 9 parts.                              |
|                 |                                                     |
|                 | EMPHASIZE bleach solutions should be made at the    |
|                 | beginning of each week.                             |
|                 |                                                     |
|                 | Work surfaces should be disinfected, at a minimum,  |
|                 | at the end of each day.                             |
+-----------------+-----------------------------------------------------+
| **23**          | **[In Case of A Spill or Splash]{.underline}**      |
|                 |                                                     |
|                 | STATE the points on the slide.                      |
|                 |                                                     |
|                 | EMPHASIZE that one should never leave any spills    |
|                 | unattended.                                         |
+-----------------+-----------------------------------------------------+
| **24**          | **[In Case of an Accident]{.underline}**            |
|                 |                                                     |
|                 | STATE the points on the slide.                      |
|                 |                                                     |
|                 | REFER participant to handout "Guidelines for Post   |
|                 | Exposure Prophylaxis"                               |
+-----------------+-----------------------------------------------------+
| **Transition**  | SUMMARIZE general safety practice (work habits,     |
|                 | handling sharps, and disinfecting work areas).      |
|                 |                                                     |
|                 | ASK if participants have any questions before       |
|                 | moving on to the next topic.                        |
+-----------------+-----------------------------------------------------+
| **25**          | **[Action Plan for Implementing Safety              |
|                 | Practices]{.underline}**                            |
|                 |                                                     |
|                 | EXPLAIN the points on the slide.                    |
|                 |                                                     |
|                 | REMIND participants that everyone has               |
|                 | responsibility for implementing safety practices.   |
+-----------------+-----------------------------------------------------+
| **26**          | **[Consult In-Country Safety Manuals for Policy and |
|                 | Guidelines]{.underline}**                           |
|                 |                                                     |
|                 | SHOW and pass around the country's safety manuals.  |
|                 | If one is not available, indicate there are several |
|                 | reference manuals that can serve as a resource.     |
|                 | SHOW the CDC, WHO, or ISO copies.                   |
|                 |                                                     |
|                 | EXPLAIN what SOP (Standard Operating Procedures) is |
|                 | and why it is important to follow SOP.              |
|                 |                                                     |
|                 | REFER to the procedures related to safety that are  |
|                 | found in a test site. Walk participants through so  |
|                 | they get an idea what is covered in it.             |
|                 |                                                     |
|                 | -   Housekeeping                                    |
|                 |                                                     |
|                 | -   Personal protection                             |
|                 |                                                     |
|                 | -   Personnel responsibilities                      |
|                 |                                                     |
|                 | -   Decontamination & Waste Disposal                |
|                 |                                                     |
|                 | -   Emergency procedures                            |
|                 |                                                     |
|                 |     -   In-lab first aid                            |
|                 |                                                     |
|                 |     -   Accidental injury                           |
|                 |                                                     |
|                 |     -   Post exposure prophylaxis                   |
|                 |                                                     |
|                 |     -   Contacts                                    |
+-----------------+-----------------------------------------------------+
| **27**          | **[Summary]{.underline}**                           |
|                 |                                                     |
|                 | ASK participants to answer the questions on the     |
|                 | slide.                                              |
|                 |                                                     |
|                 | ANSWER any questions participants may have.         |
+-----------------+-----------------------------------------------------+
| **Flipchart**   | **[Discussion]{.underline}**                        |
|                 |                                                     |
| ![](m           | REFER to the previously prepared flipchart          |
| edia/image2.wmf |                                                     |
| ){width="0.8423 | ASK participants to reflect on these questions:     |
| 611111111111in" |                                                     |
| height="0.84236 | -   Which of the lab safety practices do you think  |
| 11111111111in"} |     will NOT be easy for you to do and why not?     |
|                 |                                                     |
|                 | -   What are some possible challenges that will     |
|                 |     prevent you from adhering to the safety         |
|                 |     guidelines?                                     |
|                 |                                                     |
|                 | -   Can you think of ways to overcome that          |
|                 |     challenge?                                      |
|                 |                                                     |
|                 | FACILITATE a group discussion for participants to   |
|                 | share their thoughts on these questions.            |
+-----------------+-----------------------------------------------------+
| ![](m           | The purpose for this discussion is to discover any  |
| edia/image1.gif | hidden issues related to adopting the right         |
| ){width="0.4479 | attitudes toward lab safety. The trainer should     |
| 166666666667in" | also help participants work out plans to work       |
| height="0.54166 | around those challenges.                            |
| 66666666666in"} |                                                     |
| ***TIPS***      |                                                     |
+-----------------+-----------------------------------------------------+