BLOODBORNE PATHOGENS TRAINING

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BLOODBORNE PATHOGENS TRAINING

• Melissa Davis, DSHS ERT Nurse III

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OSHA BLOODBORNE Pathogens Standard

• Created in 1991 by the Occupational Safety and
  Health Administration (OSHA)
• Purpose is to protect employees from health
  hazards associated with bloodborne pathogens
• Mandates employers provide training, equipment
  and Hepatitis B vaccine free of charge to
  employees during their scheduled work time

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OSHA Bloodborne Pathogen Standard, cont.

• The Needlestick and Safety and Prevention Act was
  signed into law on November 6, 2000.
• This act requires employers to do the following
• identify, evaluate, and implement safer medical
  devices.
• keep a log of all sharps injuries that occur.
• Involve non-managerial healthcare workers in
  evaluating and choosing devices.

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What are Bloodborne Pathogens?

• Bloodborne pathogens are microorganisms that are
  present in blood, tissue, blood products, other
  potential infectious materials (OPIM)

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Bloodborne Pathogens

• Bloodborne Pathogens (BBP) are found in
• Blood or any body fluid visibly contaminated with
  blood
• Semen
• Vaginal secretions
• Spinal, pleural, peritoneal pericardial, amniotic
  and synovial fluids
• Breast milk (not all agree)
• Saliva from dental procedures

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What Fluids ARE NOT Considered a Risk for BBP

• Urine
• Sweat
• Nasal discharge
• Saliva (non dental)
• Feces
• Tears
• Vomit
• But ALWAYS use gloves when cleaning up any of
  these fluids

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Bloodborne Pathogens (cont)

• Can be transmitted to another person
• Most significant
• Hepatitis B
• Hepatitis C
• Human Immunodeficiency Virus

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How Are They Spread?

• Through contaminated sharp objects that cut or
  puncture the skin
• Through contaminated fluids in direct contact
  with open skin (cuts, abrasions)
• Through contaminated splash with eyes, mouth, or
  nose
• Through sharing needles
• Through sexual contact

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Hepatitis B Virus

• 100 times more infectious vs. HIV
• Can live on dried surfaces for one week
• 6-30 chance of infection from an exposure
  (puncture wound)
• Symptoms include loss of appetite, nausea and/or
  vomiting, fever, abdominal pain, jaundice

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Hepatitis B Virus (contd)

• 85-90 of those infected will recover in 6-8
  weeks
• 10-15 will become carriers and develop chronic
  liver disease
• Vaccine preventable 3 doses, highly effective

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Hepatitis C Virus

• Risk for exposure from a contaminated puncture
  wound - 3.3 - 10
• Most transmission is transfusion or IV drug use
  related
• About 4 million people are infected
• Chronic infection develops in 80
• Not vaccine preventable

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Human Immunodeficiency Virus

• HIV infects the immune system and can lead to
  developing AIDS
• Very fragile virus and will not survive long
  outside the body
• Symptoms of early infection night sweats,
  weight loss, swollen glands. Most often none

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HIV Virus (contd)

• Risk of transmission through a needlestick or cut
  with HIV infected blood is 0.3. A splash to the
  eyes or nose or mouth is 0.1 Risk to non-intact
  skin to HIV infected blood is estimated to be
  less than 0.1

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Standard Precautions

• Standard Precautions are designed to reduce the
  risk of transmission of infection. Universal
  Precautions apply to
• 1) blood
• 2) all body fluids, secretions, and excretions
  except sweat, regardless of whether or not they
  contain visible blood
• 3) non-intact skin
• 4) mucous membranes

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Work Practice Controls

• Work Practice Controls help to protect you from
  exposure to bloodborne pathogens. They all try to
  break the chain of infection.

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Work Practice Controls

• OSHA requires safety to be engineered into the
  tools and workplaces
• Work practice controls are procedures that are
  followed to minimize or eliminate contact with
  BBP.

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Work Practice Controls

• 1. Avoid actions which may splash, spray or
  splatter or create droplets.
• 2. Never touch contaminated objects with bare
  hands use gloves
• 3. Never recap needles
• 4. Dispose of glass, etc in puncture resistant
  containers

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Never Touch Contaminated Objects/Broken Glass
With Your Bare Hands
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Work Practice Controls

• Never eat, drink , apply cosmetics or handle
  contact lenses where blood or other potentially
  infectious materials are present.
• All surfaces tools and equipment that come in
  contact with blood or potentially infectious
  materials must be decontaminated as soon as
  possible.

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Work Practice Controls

• Decontamination can be accomplished by
• Using a bleach solution diluted 110 or 1/4 cup
  to a gallon of water
• OR
• Using EPA (Environmental Protection Agency)
  registered products or tuberculocidal
  disinfectant- Check the label to make sure it
  meets the requirements

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Work Practice Controls

• To clean up a blood spill you can carefully cover
  the spill with paper towels or rags then gently
  pour the disinfectant over the towels and leave
  at least ten minutes.
• Mops and other reusable equipment should be
  decontaminated as well after use.

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Hand Washing

• One of the most important work practice controls!
• Hand washing is your first defense in infection
  control.
• 
  

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Hand Washing

• How to do It Right!
• 1. First wet your hands and apply liquid soap.
• 2. Next rub your hands and wrists scrubbing all
  surfaces including fingernails and area between
  fingers.

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Hand Washing (contd)

• 3. Continue for 20 seconds or about two verses of
  Happy Birthday. It is the soap combined with the
  scrubbing action that helps dislodge and remove
  germs.
• 4. Rinse well and dry completely.
• 5. Turn off faucet using disposable towels.
• You can check out this video link and web site
  for more information
• http//www.uhn.ca/Home/Bug_stops_here/video/handwa
  shing_intranet.wmv
• VIDEO LINK

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Personal Protective
Equipment (PPE)

• Personal Protective Equipment is specialized
  clothing or equipment worn or used by you for
  protection against a hazard.

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PPE (contd)

• Examples of PPE
• Latex gloves Goggles
• Gowns Lab coats
• Aprons CPR masks
• Face shields
• Selection of what to use should be based on
  the task.

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PPE (contd)

• Anytime there is a risk of splashing of
  contaminated fluids, goggles and/or other eye
  protection should be used to protect your eyes.

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Practice Safe Clean Up In All Situations

• Use gloves
• Never pick up sharps with bare hands - use tongs
  or brush and dust pan
• Put glass, etc in puncture resistant container
• Always handle trash as if a sharp might be
  present

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Labeling

• Everything that contains infectious wastes
  includes storage areas should be labeled with
  biohazard label (like the one in the corner of
  this slide)
• Containers need to be leak proof, closable,
  puncture resistant and labeled
• Biohazard waste should be separated from regular
  waste
• Bagged biohazard waste should remain in the
  container throughout disposal

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Exposure Control Protect Yourself

• Use work practice controls
• Use personal protective equipment
• Get the Hepatitis B vaccine series
• Know what to do in case of an exposure

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Post exposure evaluation and follow up

• An exposure incident is defined as
• A specific eye, mouth, or other mucous membrane,
  non-intact skin or parenteral contact with blood
  or other potentially infectious material which
  results from an employee performing their duties.
  

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Exposure and Post Exposure Procedures

• Immediately care for the site of exposure
• -Wash needlesticks and cuts with soap and water
• -Flush splashes to the nose, mouth, or skin with
  water
• -Irrigate eyes with clean water, saline, or
  sterile irrigants
• Report the incident to your supervisor
• Immediately seek medical attention
• To determine risk
• To receive treatment/ and or medication if
  indicated
• Record exposure incident

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Final Thought

• Prevention, Prevention, Prevention
• - get vaccinated against hepatitis B
• - employee training
• - safe workplace practices
• - sharps disposal

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Useful Websites

• Updated U.S. Public Service Guidelines for the
  Management of Occupational exposures to HIV, HBV,
  HCV http//www.osha.gov/SLTC/bloodbornepathogens/p
  ostexposure.html
• DSHS Bloodborne Pathogen Site http//www.dshs.stat
  e.tx.us/idcu/health/bloodborne
• 24 hour assistance Clinicians Post Exposure
  Phrophylaxis Hotline (PEPline) at 1-888-448-4911
  http//www.ucsf.edu/hivcntr

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..Useful Websites

• EPA- List D- Primary Registrants on National
  Antimicrobial Information Network
  http//ace.orst.edu/info/nain/listd99ahtm