Bloodborne pathogens

1. Bloodborne pathogens Bloodborne Diseases HIV HBV HCV

2. Objective • Understand the difference between HBV, HCV, and HIV • Learn effective ways to decrease risks • Understand the Exposure Control Plan • Able to identify engineering controls • Understand work practice controls • Sharps safety guidelines • Personal protective equipment • Good housekeeping practices

3. Hepatitis B • Causes serious liver disease • Half of those infected have no symptoms • Symptoms include: jaundice, abdominal pain, loss of appetite, occasional nausea and diarrhea • 10% become chronically infected • Each year – 5,000 die from chronic liver cancer • Hepatitis B vaccine is recognized as an effective defense against Hepatitis B.

4. Hepatitis C • Causes serious liver disease • Causes symptoms similar to hepatitis B • 85% of people infected with HCV have chronic infections • People with chronic infections have no symptoms for up to 30 years – but the liver is slowly being damaged • No vaccine is available to treat Hepatitis C • Newly approved antiviral drugs have been effective

5. HIV – Human Immunodeficiency Virus • Attacks the immune system • Infected person becomes symptomatic when the immune system loses its ability to fight infections. • HIV can lead to Acquired Immune deficiency - AIDS • According to the CDC – 900,000 are infected • The number of people who develop AIDS has decreased

6. Transmission • Usually spread by contact with blood • Spread by contact with other potentially infectious materials (OPIM) • Other body fluids or tissue containing visible blood • Semen and vaginal secretions • cerebrospinal, synovial , pleural, peritoneal, pericardial and amniotic fluids. • Saliva in dental procedures • Non-intact skin, organs from both living and dead humans • Cell tissue, organ cultures, biological matter from lab experiments

7. Means of Transmission • Accidental injury by a contaminated sharp object • Needles, scalpels, broken glass, exposed dental wires • Open cuts or abrasions on the skin • Indirect transmission • Needle stick injuries cause 80% of the exposures • Contaminated surfaces = HBV

8. Exposure Control Plan • Written plan to minimize occupational exposures • Identifies the job classifications that have exposure risks • Identifies job classifications that have some risk of exposure • Lists the tasks and procedures performed by those workers • Changes made to eliminate or decrease risk of exposures • Procedures to follow if an exposure occurs

9. Engineering Controls Devices that isolate or remove bloodborne pathogens hazards • Sharps disposal containers • Self-sheathing needles • Safer medical devices • Sharps with engineered sharps-injury protection • Needless systems

10. Engineering Controls The effectiveness of the controls depend on you! A sharps container provides no protection if you do not use it properly. Capping a needle by hand before using does not provide effective prevention controls.

11. Work Practice Controls • Handwashing • Decreases the chance of infection • Decreases the risk of transmission • Wash you hands • Every time you remove or change your gloves • When you come into contact with blood or body fluids • Between caring for patients • Use antiseptic hand cleaner when running water is not available. • Wash your hands as soon as possible if antiseptic cleaner is used

12. Handwashing • According to WHO (World Health Organization) • Adequate handwashing with soap and water • takes 40-60 seconds • The average time adopted by healthcare • workers is <10 seconds. • Adequate Alcohol based hand rubbing technique – 20-30 seconds.

13. Personal Hygiene • When performing procedures that involve blood • Minimize splashing or spraying of the material • Do not eat, drink, smoke, apply make-up, or contact lenses • Avoid petroleum based lubricants • Never mouth pipette or suction blood or potentially infectious material. • Don’t store food or drinks anywhere that blood products or infectious materials may be present.

14. Personal Protective Equipment (PPE) • Equipment that protects from contact with potentially infectious material. • Equipment must not allow infectious material to touch clothes, skin, or mucous membranes. • Use the appropriate PPE for the task being performed • Protective equipment is provided at no cost

15. Examples of PPE • Hazard – potential exposure to eyes, nose, and/or mouth • Mask and eye protection or face shield • Hazard – potential clothing or skin exposure • Gown, gloves, apron, or other protective clothing • Hazard – Encounter large amounts of blood • Gloves, gown, surgical cap, and shoe covers • Providing peri-care to a patient • gloves

16. General Rules for using PPE • Obtain proper training prior to using • Use the appropriate protective equipment for the task • Inspect the PPE for any defects • Make sure the PPE fits properly– including gloves • Remove soiled PPE as soon as possible • Before leaving the work area – remove all PPE • Place PPE in the designated area for disposal or decontamination.

17. Resuscitation Devices • Avoid unprotected mouth-to-mouth resuscitation • Carry pocket masks as part of your PPE kit • Use mechanical emergency respiratory devices if available in an emergency.

18. Gloves – Proper Use • Primary barrier between hands and infectious material • Use when • Anticipate contact with body fluids, excretions, or mucous membranes, open areas on a patients skin. • Change gloves after: • Contact with blood or body fluids • Completing a task with one patient before moving to another patient • Contacting a potentially contaminated site before moving to a clean site

19. Gloves – Removal • Follow safe removal procedures: • With both hands gloved, peel one glove off from the top to bottom • Hold the removed glove in the gloved hand • With ungloved hand, peel the second glove from the inside • Tuck the first glove inside the second glove • Dispose of the gloves while bundled • Wash hands properly

20. Proper Hand Washing Technique

21. Infection Control Plan • Surveillance • Identification • Prevention • Control • Reporting

22. Hepatitis B Vaccine • According to OSHA – the HBV vaccination must be offered after workers have received the required bloodborne pathogen training. • Hepatitis B vaccine is a recognized as an effective defense against HBV infection. • Exposure incidents must be reported immediately • Post-exposure evaluations and follow-up are made available.

23. Housekeeping • Everyone is responsible for good housekeeping • Clean and decontaminate at the end of each shift • Clean all equipment and work areaswhen contaminated • Replace protective coverings on equipment • Place infectious waste in proper containers • Place contaminated laundry in labeled, leak-proof bags

24. Everyone is responsible to prevent exposure to bloodborne pathogens and infectious material

25. References • OSHA FactSheet. hepatitis B vaccination protection. Occupational Safety and Health Administration; 2011. www.osha.gov [accessed 18, December 2012.] • OSHA FactSheet. OSHA bloodborne pathogens standard. Occupational Safety and Health Administration; 2011. www.osha.gov [accessed 18, December 2012.] • Occupational Safety and Health Administration. 2011. Bloodborne pathogens and needlestick prevention. www.osha.gov/SLTC/bloodbornepathogens/index. [accessed 18, December 2012]