Both regulations and science impact infection control practice. Whichever is stricter must be followed. Regulation is often more specific than science.
Law is a broad term that refers to legally binding rules of conduct adopted by a legislative or other government body at the international, federal, state, or local level. The most common laws are statutes enacted by a legislature. A regulation is an official policy issued by an agency of the executive branch in response to statutory authority. Regulations have binding legal force and are intended to implement the administrative policies of an agency. Regulations govern professional conduct and establish acceptable conduct for those regulated by the agency (Pain & Policy Studies Group, 2008).
Legal issues first began to impact IC practices at the beginning of the AIDS epidemic in the early 1980s. The need to protect healthcare workers from bloodborne exposures resulted in the publication of the Bloodborne Pathogens Standard by the Occupational Safety and Health Administration (OSHA) in 1991. The OSHA Standard requires employers whose employees have exposure to blood to provide safe work practices, education, and barriers to exposure. The standards were later amended to cover the safe use of sharps.
Part of the OSHA Bloodborne Pathogens Standard is the requirement that every healthcare worker who may have contact with body fluids on the job must receive specific annual education. This education includes instruction in the basics of infection control and prevention, bloodborne pathogens training, and instruction in modes of transmission, needlestick precautions, and contact precautions.
Since 1991 other laws and regulations have been enacted, some at the federal and some at the state level. The Conditions of Participation, published by the CMS is an important source of legal guidance for the infection control community. The Conditions of Participation must be met for a hospital to receive Medicare funding, which is typically about half their income for most facilities. Inspection for compliance with the Conditions of Participation is generally carried out by survey teams from either the Joint Commission or the American Osteopathic Association (AOA). Validation surveys may also be made by state health department staff.
In most jurisdictions healthcare facilities are responsible for establishing and maintaining written infection control policies and procedures and implementing them according to published guidelines. They must ensure that these policies and procedures are reviewed and updated regularly and that staff members are familiar with them.
In many cases state laws and national and state professional associations require standards of professional conduct that specify requirements and actions for healthcare workers regarding healthcare associated infections or infectious material handling. Such laws and codes may also define professional misconduct and and punishement for incidents of misconduct. It is important to familiarize yourself with state and local laws and regulations and applicable codes of professional conduct that apply to your practice area.
New York State’s listing of scientifically accepted infection prevention techniques (2011) includes: