CENTRAL PIEDMONT COMMUNITY COLLEGE OSHA TRAINING FOR Human Services STUDENTS

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CENTRAL PIEDMONT COMMUNITY COLLEGE OSHA TRAINING
FOR Human Services STUDENTS
Revised 2008
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OSHAS DEFINITIONS

• BLOOD Human blood, human blood components, and
  products made from human blood.
• BLOODBORNE PATHOGENS Pathogenic microorganisms
  that are present in human blood and can cause
  disease in humans. These pathogens include, but
  are not limited to Hep. B virus Hep. C virus
  and HIV.
• ENGINEERING CONTROLS Controls (e.g. sharps
  disposal containers, self-sheathing needles,
  safer medical devices, such as sharps with
  engineered sharps injury protections and
  needleless systems) that isolate or remove the
  bloodborne pathogens hazard from the workplace.
• EXPOSURE INCIDENT A specific eye, mouth, other
  mucous membrane, non-intake skin, or parenteral
  contact with blood or other potentially
  infectious materials that results from the
  performance of an employees duties.

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OSHAS DEFINITIONS

• SOURCE INDIVIDUAL Any individual, living or
  dead, whose blood or other potentially infectious
  materials may be a source of occupational
  exposure to the employee.
• UNIVERSAL PRECAUTIONS Is an approach to
  infection control. According to the concept of
  Universal Precautions, all human blood and
  certain human body fluids are treated as if known
  to be infectious for HIV, HBV, HCV, and other
  bloodborne pathogens/infectious diseases.
• WORK PRACTICE CONTROLS Controls that reduce the
  likelihood of exposure by altering the manner in
  which a task is performed (e.g., handwashing,
  etc.)

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EXPOSURE CONTROL PLAN

• THE EXPOSURE CONTROL PLAN IS THE EMPLOYERS
  WRITTEN EXPLAINATION ON HOW THE FACILITY COMPLIES
  WITH OSHAS BLOODBORNE PATHOGENS. STANDARD. THE
  PLAN MUST BE MADE AVAILABLE TO ALL EMPLOYEES AT
  RISK OF EXPOSURE.

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OSHA REQUIREMENTS

• ANNUAL REVIEW OF EXPOSURE CONTROL PLAN TO ENSURE
  THAT THE PLAN REFLECTS CONSIDERATION AND A SAFE
  WORKING ENVIRONMENT .
• EMPLOYER MUST MONITOR ENGINEERING CONTROLS TO
  ENSURE THEIR EFFECTIVENESS.

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OSHAS UNIVERSAL PRECAUTIONS APPLY TO

• BLOOD
• SEMEN/VAGINAL SECRETIONS
• SALIVA
• ANY BODY FLUID WITH VISIBLE BLOOD

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UNLESS BLOOD IS PRESENT OSHAS UNIVERSAL
PRECAUTIONS DO NOT APPLY TO

• FECES
• NASAL SECRETIONS
• SPUTUM
• SWEAT
• TEARS
• URINE
• VOMITUS

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CDCS STANDARD PRECAUTIONS APPLY TO

• ALL BODY FLUIDS WHETHER THERE IS VISIBLE BLOOD OR
  NOT.
• THE ONLY EXCEPTION IS SWEAT SWEAT IS THE ONLY
  BODY FLUID NOT CONSIDERED INFECTIOUS.
• STANDARD PRECAUTIONS IS THE COMBINATION OF
  UNIVERSAL PRECAUTIONS AND BODY SUBSTANCE
  ISOLATION AND ARE STRICTER THAN OSHAS
  REQUIREMENT.

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HAND HYGIENE

• THE MOST COMMON MODE OF TRANSMISSION OF PATHOGENS
  IS VIA THE HANDS
• DO NOT TOP-OFF PARTIALLY EMPTY DISPENSERS
• DO NOT USE PRODUCT BEYOND EXPIRATION DATE

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HAND HYGIENE DEFINITIONS

• HAND HYGIENE
• Performing handwashing, antiseptic handwash,
  alcohol-based handrub, surgical hand
  hygiene/antisepsis
• HANDWASHING
• Washing hands with plain soap and water
• ANTISEPTIC HANDWASH
• Washing hands with water and soap or other
  detergents containing an antiseptic agent
• Guideline for Hand Hygiene in Health-care
  Settings. MMWR 2002 vol. 51, no. RR-16.

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INDICATIONS FOR HAND HYGIENE

• When hands are visibly dirty, contaminated, or
  soiled, wash with non-antimicrobial or
  antimicrobial soap and water.
• If hands are not visibly soiled, use an
  alcohol-based handrub for routinely
  decontaminating hands.
• Guideline for Hand Hygiene in Health-care
  Settings. MMWR 2002 vol. 51, no. RR-16.

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RECOMMENDED HAND HYGIENE TECHNIQUE

• HANDRUBS
• Apply to palm of one hand, rub hands together
  covering all surfaces of hands and fingers until
  dry
• Volume based on manufacturer recommendations
• HANDWASHING
• Wet hands with water, apply soap, rub hands and
  fingers together for at least 15-20 seconds
• Rinse and dry with disposable towel
• Use towel to turn off faucet
• Guideline for Hand Hygiene in Health-care
  Settings. MMWR 2002 vol. 51, no. RR-16.

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ALCOHOL-BASE HANDRUBS

• Require less time
• More effective for standard handwashing than soap
  
• More accessible than sinks
• Reduce bacterial counts on hands
• Improve skin condition
• Guideline for Hand Hygiene in Health-care
  Settings. MMWR 2002 vol. 51, no. RR-16.

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ALCOHOL-BASE HANDRUBS

• CANNOT BE USED IF HANDS ARE VISIBLY SOILED
• EMOLLIENTS MAY BUILD-UP (SOME RECOMMEND AFTER 10
  HANDWASHINGS WITH ALCOHOL BASED HANDRUBS THAT
  HANDS SHOULD BE WASHED WITH ANTIMICROBIAL SOAP)
• Guideline for Hand Hygiene in Health-care
  Settings. MMWR 2002 vol. 51, no. RR-16.

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FIRST AID
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FIRST AID MEASURES

• SCRUB FOR MINIMUM OF 5 10 MINUTES
• APPLY ANTISEPTIC IF APPROPRIATE
• OBTAIN OTHER FIRST AID IF NECESSARY (e.g. Td
  booster, sutures, etc.)
• EYES AND MUCOUS MEMBRANES MUST BE FLUSHED WITH
  PLENTY OF RUNNING WATER 5-10 MINUTES
• IMMEDIATELY REPORT INCIDENT
• FILL-OUT FORMS (CPCC MUST RECEIVE A COPY OF THE
  INCIDENT REPORT)

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CPCC STUDENT REPORTING

• IMMEDIATELY REPORT EXPOSURE TO THE AFFILIATING
  FACILITY AND CPCCS CLINICAL SUPERVISIOR
• REPORT EXPOSURE TO PROGRAM CHAIR DIVISION
  DIRECTOR CPCCS HEALTH SAFETY OFFICER (Bob
  Patterson 704-330-5492 or
  704-400-9951)

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BLOODBORNE DISEASES

• HIV/AIDS
• HEPATITIS B
• HEPATITIS C

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HIV/AIDS

• HIV is spread by sexual contact with an infected
  person, by sharing needles and/or syringes
  (primarily for drug injection) with someone who
  is infected, or, less commonly (and now very
  rarely in countries where blood is screened for
  HIV antibodies), through transfusions of infected
  blood or blood clotting factors. Babies born to
  HIV-infected women may become infected before or
  during birth or through breast-feeding after
  birth.
• HIV or Human Immunodeficiency Virus , attacks the
  bodys immune system, reducing its ability to
  fight disease.
• Early symptoms include fever, loss of appetite,
  weight loss, chronic fatigue, skin rashes. Later
  the victim may develop unusual types of cancer of
  infections, including pneumonia, that the body
  can no longer fight off.

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HIV/AIDS PREVENTION FOR HCW

• Personnel should assume that the blood and
  other body fluids from all patients are
  potentially infectious. They should therefore
  follow infection control precautions at all
  times. These precautions include
• The routine use of barriers (such as gloves
  and/or goggles) when anticipating contact with
  blood or body fluids
• Washing hands and other skin surfaces immediately
  after contact with blood or body fluids, and

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HEPATITIS B

• Concentration of Hepatitis B Virus in Various
  Body Fluids
• High blood
  serum wound exudates
• Moderate semen
  vaginal fluid saliva Low/Not Detectable
  urine feces sweat tears breastmilk
• HBV is transmitted by percutaneous or
  permucosal exposure to infectious blood or body
  fluids from persons who have either acute or
  chronic HBV infection. The highest concentrations
  of virus are in blood and serous fluids lower
  concentrations are found in semen, vaginal fluid,
  and saliva. Therefore, blood exposure and sex
  contact are relatively efficient modes of
  transmission. Saliva can be a vehicle of
  transmission through bites however, transmission
  has not been documented to occur as a result of
  other types of exposure to saliva, including
  kissing. HBsAg has also been detected in low
  concentrations in other body fluids, including
  tears, sweat, urine, feces, breast milk,
  cerebrospinal fluid, and synovial fluid however,
  these fluids have not been associated with
  transmission.

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HEPATITIS B

• Hepatitis B Virus Modes of Transmission
• Sexual
• Parenteral
• Perinatal
• In the United States, the most important
  route of HBV transmission is by sex contact,
  either heterosexual or homosexual, with an
  infected person. Direct parenteral inoculation of
  HBV by needles during injecting drug use is also
  an important mode of transmission. Transmission
  of HBV may also occur by other percutaneous
  exposures, including tattooing, ear piercing, and
  acupuncture, and by needlesticks or other
  injuries from sharp instruments sustained by
  medical personnel however, these exposures
  account for only a small proportion of reported
  cases in the United States. In addition,
  transmission can occur perinatally from a
  chronically infected mother to her infant, most
  commonly by contact of maternal blood to the
  infants mucous membranes at the time of
  delivery.

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HEPATITIS B VACCINE SAFETY

• Medical, scientific and public health communities
  strongly endorse using hepatitis B vaccine as
  a safe and effective way to prevent disease and
  death.
• Scientific data show that hepatitis B vaccines
  are
• very safe for infants, children, and adults.
• There is no confirmed evidence which indicates
  
• that hepatitis B vaccine can cause chronic
• illnesses.
• To assure a high standard of safety with
  vaccines, several federal agencies continually
  assess and research possible or potential
  health effects that
• could be associated with vaccines.

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HEPATITIS B VACCINE

• Vaccination Schedule Initial first dose 1 month
  
• later second dose 6 months from first dose
  third
• dose.
• Post-vaccination testing should be completed 1-2
  months after the third vaccine dose for results
  to be meaningful.

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HEPATITIS C

• Exposures Known to be Associated With HCV
  Infection in the United States
• Injecting drug use
• Transfusion, transplant from infected donor
• Occupational exposure to blood- Mostly needle
  sticks
• Iatrogenic (unsafe injections)
• Birth to HCV-infected mother
• Sex with infected partner - Multiple sex
  partners

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HEPATITIS C

• Occupational Transmission of HCV
• Inefficient by occupational exposures
• Average incidence 1.8 following needle stick
  from HCV-positive source
• Case reports of transmission from blood splash to
  eye one from exposure to non-intact skin
• Prevalence 1-2 among health care workers
• Lower than adults in the general population
• 10 times lower than for HBV infection

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HEPATITIS C

• HCV Testing Routinely Recommended Based On
  Increased Risk For Infection
• Ever injected illegal drugs
• Received clotting factors made before 1987
• Received blood/organs before July 1992
• Ever on chronic hemodialysis
• Evidence of liver disease
• Based On Need For Exposure Management
• Healthcare, emergency, public safety workers
  after needle stick/mucosal exposures to
  HCV-positive blood
• Children born to HCV-positive women

 
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HEPATITIS C
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AIRBORNE/DROPLET DISEASES

• TUBERCULOSIS AIRBORNE
• SARS (SEVERE ACUTE RESPIRATORY SYNDROME) DROPLET
  AND OTHER MEANS OF TRANSMISSION ARE POSSIBLE
• PANDEMIC INFLUENZA

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TUBERCULOSIS

• TB, or tuberculosis, is a disease caused by
  bacteria. The bacteria can attack any part of
  your body, but they usually attack the lungs. TB
  disease was once the leading cause of death in
  the United States. It is now on the rise again in
  this country.

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TUBERCULOSIS

• TB is spread through the air from one person to
  another. The bacteria are put into the air when
  a person with TB disease of the lungs or throat
  coughs or sneezes. People nearby may breathe in
  these bacteria and become infected.
• People with TB disease can be treated and cured
  if they seek medical help. Even better, people
  who have latent TB infection but are not yet sick
  can take medicine so that they will never develop
  TB disease.

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TUBERCULOSIS

• When a person breathes in TB bacteria, the
  bacteria can settle in the lungs and begin to
  grow. From there, they can move through the
  blood to other parts of the body, such as the
  kidney, spine, and brain.
• TB in the lungs or throat can be infectious.
  This means that the bacteria can be spread to
  other people. TB in other parts of the body,
  such as the kidney or spine, is usually not
  infectious.

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TUBERCULOSIS

• Symptoms of TB depend on where in the body
  the TB bacteria are growing. TB bacteria usually
  grow in the lungs. TB in the lungs may cause
• A bad cough that lasts longer than 2 weeks
• Pain in the chest
• Coughing up blood or sputum (phlegm from deep
  inside the lungs)

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SARS
The Centers for Disease Control and Prevention
(CDC) and the World Health Organization have
received reports of patients with severe acute
respiratory syndrome (SARS). Some close contacts
of infected patients, including health-care
workers, have developed similar illnesses. In
response to these developments, CDC is issuing
revised interim guidance concerning infection
control precautions in the health-care and
community setting. To minimize the potential for
transmission, these precautions are recommended,
as feasible given available resources, until the
epidemiology of disease transmission is better
understood.
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SARS AND HCWS
Worldwide, several health-care workers have been
reported to develop Severe Acute Respiratory
Syndrome (SARS) after caring for patients with
SARS. Transmission to health-care workers appears
to have occurred after close contact with
symptomatic individuals (e.g., persons with fever
or respiratory symptoms) before recommended
infection control precautions for SARS were
implemented (i.e., unprotected exposures).
Personal protective equipment appropriate for
standard, contact, and airborne precautions
(e.g., hand hygiene, gown, gloves, and N95
respirator) in addition to eye protection, have
been recommended for health-care workers to
prevent transmission of SARS in health-care
settings.
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SARS ENVIRONMENTAL ISSUES

• UNDER INVESTIGATION WITH ENVIRONMENTAL SAMPLING
  OF THE AIR AND SURFACES
• EXAMPLES OF SURFACES THAT WERE POSITIVE INCLUDE
• BED TABLE
• BATHROOM DOOR HANDLE
• MEDICATION REFRIGERATOR HANDLE
• TV CONTROL MODULE

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SARS INFECTION CONTROL

• HAND HYGINE
• EMPHASIZE CLEANING AND DISINFECTING SURFACES
• FOLLOW TB GUIDELINES
• THERE ARE NO EPA REGISTERED GERMICIDAL PRODUCTS
  WITH SARS INACTIVATION CLAIMS

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INFLUENZA PANDEMIC

• All personal protective equipment cleared by FDA
  must be able to block the passage of small
  particles the size of most infectious materials.
  FDA is not aware of any studies that specifically
  test PPE with any influenza virus, and no such
  data have been submitted to FDA by manufacturers.
  Thus neither FDA, nor a manufacturer, knows to
  what extent PPE will protect you against bird or
  swine flu. Keep in mind that other infection
  control practices, such as hand-washing,
  isolating sick patients, and using appropriate
  coughing etiquette, are also important to
  minimize your risk of infection.

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INFLUENZA PANDEMIC

• CDC (Centers for Disease Control and Prevention),
  not FDA, makes recommendations for infection
  control practices, including recommendations
  specific to influenza.
• As part of its overall infection control
  recommendations, CDC recommends that healthcare
  workers wear the following personal protective
  equipment during the care of a patient with
  suspected or confirmed flu (influenza)
• surgical masks
• medical gloves
• surgical gowns

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Safety on the Job

• Bring good housekeeping to work
• OSHA regulations state that All places of
  employment, passageways, storerooms and service
  rooms should be kept clean and orderly and in a
  sanitary condition

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Safety continued

• The most common workplace accidents occur from
  slips, trips, and falls. They can be prevented.
• Watch our for slippery floors, obstructed
  stairs, loose or worn flooring, unsafe ladders,
  poor lighting

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Cleanliness and good health

• Practice good personal hygiene
• Keep work clothes clean
• Keep food, beverages and tobacco products out of
  the work area.

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How to prevent back problems

• Back injuries are the second leading cause of
  missed workdays.
• More the 400,000 become disabled each year from
  these injuries
• You can prevent many back injuries by learning
  the best ways to sit, stand and lift

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What causes back pain?

• Back pain may be caused or aggravated by
• Incorrect lifting
• Strain from poor sitting or standing
• Muscle strains
• Sudden twisting
• Being overweight
• Improper use of equipment

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Prevention is the best cure

• Sit up straight!
• Lift correctly!
• Take care of your back. A strong, flexible health
  back does its job.

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Workplace Fire Safety

• Fire claims the lives of over 5,000 people each
  year in the US. Fire also causes thousands of
  disabling injuries, millions of dollars of
  property damage and countless lost jobs each year

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Know the dangers

• Flame, heat, and smoke are the obvious fire
  dangers. Others include
• Suffocation
• Toxic vapors
• explosions

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You can prevent fire

• When you
• Eliminate fire hazards
• Learn how to respond quickly and properly to a
  fire
• Know your escape route
• Have fire drills
• Act fast

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CDCS HAND HYGIENE GUIDELINES AND OTHER WEBSITES

• http//www.cdc.gov/handhygiene/materials.htm
• http//www.cdc.gov
• http//www.cdc.gov/ncidod/hip/enviro/guide.htm

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THE END-THANK YOU!