(a)

1. (1) A practitioner shall take appropriate precautions to prevent injuries:

   1. (A) Caused by needles, scalpels, and other sharp instruments or devices during procedures;
   2. (B) When cleaning used instruments;
   3. (C) During disposal of used needles; and
   4. (D) When handling sharp instruments after procedures.

2. (2)

   1. (A) If a needle stick injury occurs, the needle or instrument involved in the incident should be removed from the sterile field.
   2. (B) To prevent needle stick injuries, needles should not be:

(i) Recapped;

1. (ii) Purposely bent or broken by hand;

   1. (iii) Removed from disposable syringes; or

      1. (iv) Otherwise manipulated by hand.
   2. (C) After they are used, disposable syringes and needles, scalpel blades, and other sharp items should be placed for disposal in puncture-resistant containers located as close as practical to the use area.
   3. (D) Large-bore reusable needles should be placed in puncture-resistant containers for transport to the reprocessing area.

(b) Resuscitation devices. To minimize the need for emergency mouth-to-mouth resuscitation, a practitioner shall ensure that mouthpieces, resuscitation bags, or other ventilation devices are available for use in areas in which the need for resuscitation is predictable.

1. (c) Sterilization and disinfection.
2. (1) Instruments or devices that enter sterile tissue or the vascular system of any patient or through which blood flows should be sterilized before reuse.
3. (2) Devices or items that contact intact mucous membranes should be sterilized or receive high-level disinfection.
4. (3) Sterile disposable needles shall be used.

5. (4) The same needle may be recapped with a single-handed recapping technique or recapping device and subsequently reused for the same patient during the same visit.

   1. (d) A practitioner who is HbeAg seropositive or HIV seropositive, or who otherwise knows or should know that he or she carries and is capable of transmitting HBV, HCV, or HIV, shall not thereafter perform or participate directly in an exposure-prone procedure except as provided in this section.

(e) A practitioner may participate in an exposure-prone procedure with a patient when each of the following four (4) conditions have been met:

1. (1) The practitioner has affirmatively advised the patient, or the patient’s lawfully authorized representative, that the practitioner has been diagnosed as HbeAg seropositive and/or HIV seropositive and/or HCV positive, as the case may be;

2. (2)

   1. (A) The patient, or the patient’s lawfully authorized representative, has been advised of the risk of the practitioner’s transmission of HBV, HCV, and/or HIV to the patient during an exposure-prone procedure.
   2. (B) The practitioner shall personally communicate such information to the patient or the patient’s representative.
   3. (C) The physician shall also communicate such information to the patient’s physician;

3. (3) The patient, or the patient’s lawfully authorized representative, has subscribed a written instrument setting forth:

   1. (A) Identification of the exposure-prone procedure to be performed by the practitioner with respect to the patient;
   2. (B) An acknowledgment that the advice required by subdivisions (e)(1) and (2) of this section have been given to and understood by the patient or the patient’s representative; and
   3. (C) The consent of the patient, or the patient’s lawfully authorized representative, to the performance of or participation in the designated procedure by the practitioner; and
4. (4) The practitioner’s HbeAg and/or HIV seropositivity and/or HCV positivity has been affirmatively disclosed to each practitioner or other healthcare personnel who participates or assists in the exposure-prone procedure.