Unit 1: Safety, Compliance, and Professional Practice

• Topic 01

  Infection Control — Standard Precautions, PPE, and Hand Hygiene

  42 questions
• Topic 02

  Bloodborne Pathogens — OSHA Standard, Exposure Incidents, and Post-Exposure Protocol

  39 questions
• Topic 03

  Sharps Safety Devices and Safe Disposal

  45 questions
• Topic 04

  Patient Rights, Informed Consent, and Refusal of Treatment

  44 questions
• Topic 05

  HIPAA and Confidentiality in the Laboratory

  45 questions
• Topic 06

  Professional Communication and Bedside Manner

  45 questions

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

1. A phlebotomist notices that a refrigerator in the laboratory storing blood specimens has no biohazard label. Which OSHA BBP Standard requirement has been violated, and what is the correct action?

   • A
     The phlebotomist should move all specimens to a properly labeled refrigerator and discard the unlabeled one.
   • B
     Refrigerator labeling is optional if the laboratory has a posted sign indicating all refrigerators contain blood specimens.
   • C
     The BBP Standard requires biohazard labels on refrigerators and freezers containing blood or OPIM. The correct action is to affix an appropriate orange or orange-red biohazard label to the refrigerator.
     Correct answer
   • D
     No violation has occurred because refrigerators are not considered containers of OPIM under the standard.
   Explanation

   The OSHA BBP Standard explicitly requires biohazard labels (orange or orange-red with the biohazard symbol) on refrigerators and freezers used to store blood or OPIM. This requirement applies regardless of the individual patients' infection status, because all blood is treated as potentially infectious under standard precautions. The correct action is to label the refrigerator immediately. Key takeaway: Refrigerators and freezers containing blood or OPIM must be labeled with the biohazard symbol under the OSHA BBP Standard.

2. A facility's infection control committee argues that because they have no documented needlestick injuries in the past year, they are not required to evaluate or adopt new safety-engineered sharps devices. Is this position defensible under OSHA?

   • A
     No; the OSHA BBP Standard requires annual review and update of the Exposure Control Plan including evaluation of new safety devices, regardless of current injury rates
     Correct answer
   • B
     No; however, the facility must only document that they considered new devices — they are not required to adopt them if the committee votes against it
   • C
     Yes; the Needlestick Safety and Prevention Act only applies to facilities with documented occupational sharps injuries in the prior 12 months
   • D
     Yes; OSHA only requires safety device evaluation when an OSHA inspector specifically identifies a hazard during a site visit
   Explanation

   The OSHA BBP Standard requires that the Exposure Control Plan be reviewed and updated at least annually and whenever new or revised employee tasks or procedures are introduced. The Needlestick Safety and Prevention Act further requires that the annual review include consideration of safer devices, with documentation of non-managerial employee input. Zero injuries does not excuse facilities from these proactive evaluation obligations. Key takeaway: annual evaluation of safety devices is a continuous regulatory obligation, not triggered only by injuries.

3. A phlebotomist shares their laboratory system login credentials with a co-worker who forgot their password. The co-worker accesses a patient record that was not part of their assigned work. What Security Rule violations are present in this scenario?

   • A
     No Security Rule violation exists because the access was within the same facility and both employees are authorized users.
   • B
     Only the Privacy Rule is violated because the co-worker viewed records they had no clinical need to access.
   • C
     Two violations: unique user identification is violated (credential sharing), and the resulting record access violates audit control integrity because the access is logged under the wrong employee's ID, preventing accurate accountability.
     Correct answer
   • D
     The violation is only the co-worker's, not the phlebotomist's, because the phlebotomist acted in good faith.
   Explanation

   The HIPAA Security Rule requires each user to have a unique user identification so that all ePHI access can be attributed to a specific individual. Sharing credentials violates this requirement and creates two compounding problems:

   • Unique user identification is compromised because the access is misattributed
   • Audit control integrity is undermined because there is no accurate record of who actually accessed the patient data

   Both the phlebotomist (who shared credentials) and the co-worker (who used them to access unauthorized records) may be held liable. Key takeaway: Credential sharing violates the Security Rule's unique user identification and audit control requirements and creates accountability failures for ePHI access.