Perioperative personnel are at risk for sharps injuries when using devices with sharp points and edges and therefore are at risk for infection from exposure to blood and other potentially infectious body fluids. The Occupational Safety and Health Administration bloodborne pathogens standard is the regulatory document that health care employers must follow to protect personnel who are at risk for sharps injuries. The AORN \"Guideline for sharps safety\" provides guidance to perioperative personnel for identifying sharps hazards and implementing best practices to prevent injuries. This article discusses the guideline recommendations for developing and implementing work practice controls and administrative controls for handling sharps. A scenario describes an interdisciplinary team\'s efforts to decrease specific sharps injuries and develop policies and procedures based on the identified risks and practice changes. Perioperative RNs should review the entire guideline for additional information when creating and updating policies and procedures for sharps safety.

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UK guidelines for HIV post-exposure prophylaxis (PEP) in adults have recently been updated. Indications for PEP have been modified and there has been a change in the recommended antiretroviral therapy for adults to a combination of raltegravir with tenofovir and emtricitabine (Truvada). Raltegravir and tenofovir are now available in paediatric formulations and offer improved safety and tolerability over previously recommended ritonavir-boosted lopinavir with zidovudine. This guideline provides recommendations for those caring for children potentially exposed to HIV and other bloodborne viruses in primary care, emergency departments, secondary care and specialist paediatric HIV centres.

Needlestick and occupational exposure to infections is a constant threat in dental practice. Many blood-borne infections, including human immunodeficiency virus (HIV) infection, hepatitis B and hepatitis C, may be contracted through this route. We provide here a useful compendium for dental practitioners on current guidelines available to obviate such threats, as well as a simple flowchart on prophylactic measures that could be taken after an accidental exposure.

BACKGROUND: The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention\'s Guidelines for Infection Control in Dental Health-Care Settings-2003.
METHODS: In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists\' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.
RESULTS: Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.
CONCLUSIONS: Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.

Health care workers are at increased risk of exposure to contaminated infectious body fluids. Guidelines exist regarding prevention of exposure and measures to take if an exposure has occurred. The goal is to evaluate the potential risk for infections with HIV, HCV and HBV rapidly, and, if necessary, to initiate an early treatment. Morbidity and the related costs may thus be lowered. The practical application of such guidelines is not always simple and will be discussed in our article.

Guideline \'Needle stick injuries\': risk assessment and post-exposure management in practice The objective of the national guideline \'Needle stick injuries\' is to make the assessment of needle stick injuries more structured and uniform. The injury is classified as high risk or low risk according to the volume of blood transmitted. For high-risk injuries measures to prevent hepatitis B, hepatitis C and HIV infection have to be considered, whereas for low-risk injuries only measures to prevent hepatitis B. The need for post-exposure prophylaxis is determined by the victim\'s immunity to hepatitis B and the presence of hepatitis B virus, hepatitis C virus or HIV in the source person. Post-exposure prophylaxis against hepatitis B consists primarily of hepatitis B vaccination; hepatitis B immunoglobulin is added in the case of a high-risk injury with a hepatitis B positive source or a source belonging to a risk group for hepatitis B. In high-risk injuries the victim is tested for hepatitis C and HIV transmission (except in case of a seronegative source). Antiretroviral postexposure prophylaxis is advised for high-risk injuries with a HIV seropositive source or a source belonging to a risk group for HIV.

This article outlines Occupational Safety and Health Administration (OSHA) guidelines for maintaining a safe dental practice workplace and covers requirements, such as education and protection for dental health care personnel. OSHA regulations aim to reduce exposure to blood-borne pathogens. Environmental infection control in dental offices and operatories is the goal of enforcement of OSHA codes of practice. Universal precautions reduce the risk for infectious disease. OSHA has a mandate to protect workers in the United States from potential workplace injuries. OSHA standards are available through online and print publications and owners of dental practices must meet OSHA standards for the workplace.