Blood-borne infections advice
The Osteopathic Practice Standards require osteopaths to consider how best to safeguard their own health and the health of others. The relevant standards state:
D10 Ensure that any problems with your own health do not affect your patients.
D11 Be aware of your role as a healthcare provider to promote public health.
For the associated guidance in full see theme D in the Osteopathic Practice Standards.
Why we have produced this advice
We have produced this advice in response to enquiries from osteopaths who are aware that they have a blood-borne infection, but it provides information that may be of relevance to all osteopaths.
The advice is set out below, or you can download it as an advice note in PDF format, which includes references to additional sources of guidance.
What is a blood-borne infection?
For the purposes of this document a blood-borne infection is one of the following:
- Hepatitis B virus (HBV)
- Hepatitis C virus (HCV)
- Human immunodeficiency virus (HIV).
Guidance from Public Health England in this area refers extensively to Exposure Prone Procedures (EPP). EPPs are defined as ‘invasive procedures where there is a risk that injury to the worker may result in exposure of the patient’s open tissues to the blood of the worker. These include procedures where the worker’s gloved hands may be in contact with sharp instruments, needle tips, or sharp tissues (e.g. spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be complete visible at all times. Such procedures occur mainly in surgery, obstetrics and gynaecology, dentistry and some aspects of midwifery.’
Osteopaths and exposure prone procedures
The GOsC has sought advice from the UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses (UKAP) in relation to the use by osteopaths of the following procedures:
- Intraoral examination or technique
- Vaginal or rectal examination or technique
- Acupuncture or dry needling
- Any other procedure requiring the use of needles or other sharps.
The advice of UKAP is that:
- Intraoral examination of the mouth is now not an EPP
- Vaginal or rectal examination or technique is only an EPP when sharp instruments or tissues are involved
- Acupuncture or dry needling are not EPPs as hands are visible
- Any other procedure requiring the use of needles or other sharps should only be considered an EPP if the hands are not visible.
Therefore, UKAP’s official advice (as at 28 July 2015) is that osteopaths do not perform EPPs.
Adhering to routine infection-control procedures
Regardless of whether or not these procedures are considered to be exposure prone, it is essential that osteopaths undertaking them adhere to routine infection-control procedures at all times.
Any osteopath who is undertaking: intraoral examination or technique; vaginal or rectal examination or technique, acupuncture or dry needling or any other procedure requiring the use of needles or other sharps should ensure that they have received appropriate training in infection control, adhere to routine infection control procedures, and keep their knowledge and skills in this area up to date through appropriate CPD.
The risk of infection of a patient is extremely low, as is the risk of infection of an osteopath by a patient.
Osteopaths who are concerned about the risks of infection from a patient should consult the relevant occupational guidance from the Health and Safety Executive.