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Bloodborne Pathogen Training. Introduction to the problem of Bloodborne Pathogens. Healthcare Providers and those working with potentially infectious fluids need to be especially concerned with three major bloodborne pathogens: Hepatitis B Virus: HBV Hepatitis C Virus: HCV

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Bloodborne Pathogen Training

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Bloodborne PathogenTraining


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Introduction to the problemof Bloodborne Pathogens

  • Healthcare Providers and those working with potentially infectious fluids need to be especially concerned with three major bloodborne pathogens:

  • Hepatitis B Virus: HBV

  • Hepatitis C Virus: HCV

  • Human immunodeficiency virus: HIV


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Facts about HBV

  • Definitely a risk for healthcare providers

  • The risk is directly related to the degree of contact with blood

  • The greatest risk is with percutaneous exposure (needlestick)

  • The risk of developing “clinical hepatitis” is approximately 22-31%

  • The risk of developing serologic evidence of HBV is approximately 37-62%


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HBV (cont.)

  • HBV can survive on environmental surfaces, in dried blood, for at least one (1) week.

  • Therefore, percutaneous exposure is not the ONLY way to contract HBV

  • Other means of exposure: through the mucous membranes &/or non-intact skin.

  • Approximately 5,000 people each year die due to HBV

  • Approximately 10% of those exposed develop chronic infection


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HBV (cont.)

  • Up to 50% of those infected have no symptoms

  • Signs/Symptoms of HBV:

    • Jaundice, fatigue

    • Abdominal pain, loss of appetite

    • Occasional nausea or vomiting

      *** There IS a vaccine for HBV


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HCV Facts

  • NOT efficiently transmitted by way of occupational exposures to blood

  • The incidence of HCV seroconversion after and accidental percutaneous exposure from a positive HCV source is approximatey 1.8 %

  • There is no documentation, to date, of transmission of HCV to a healthcare worker from blood exposure with INTACT skin.


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HCV (cont.)

  • Approximately 75% of those infected with HCV have no signs or symptoms

  • Approximately 10,000 people die each year from HCV infection

  • Approximately 85% of those that are exposed develop chronic infection

  • HCV is the leading indicator for liver transplants

  • There IS NO VACCINE for HCV


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Facts about HIV

  • Approximately 900,000 people are infected with HIV in the U. S.

  • The average risk of HIV transmission after a percutaneous exposure to HIV infected blood is 0.3%

  • The average risk of HIV transmission after mucous membrane exposure is approximately 0.09%

  • There IS NO VACCINE for HIV


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Exposure Facts

  • HBV, HCV, and HIV are most easily spread via contact with infected blood.

  • Can also spread with contact through other potentially infected materials (OPIM)

  • OPIM include: semen, vaginal secretions, other body tissues or fluids that contain visible blood


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Examples of OPIM

  • Cerebrospinal fluid, synovial fluid

  • Pleural, peritoneal, pericardial fluids

  • Amniotic fluid

  • Saliva in dental procedures

  • Non-intact skin or organs from living or dead humans

  • Cell tissue or organ cultures or other biological matter from lab. experiments


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Workplace Exposures

  • Exposure to a bloodborne pathogen occurs when a contaminated needle or other sharp punctures the skin

  • Can also occur if blood or OPIM splashes in the mucous membranes of the nose, eyes, or mouth


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Exposure Control Plan

  • The exposure control plan details safety precautions that are taken to decrease chances of exposure.

  • The exposure control plan also details a method of identifying and evaluating safety devices


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  • The exposure control plan is based on the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standards and Centers for Disease Control (CDC) Guidelines


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Example of a Safety Precaution:

  • HBV Vaccination series was promoted in 1985. Since then, exposure has dropped from 1200/year to 800/ year in 1995.

  • To be effective, one must complete the full series must be completed.


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Standard Precautions

  • Means to treat all blood, body fluids, excretions, secretions, non-intact skin, mucous membranes as though infected.

  • To follow the Standard Precaution, use personal protective equipment (PPE) when touching blood, body fluids, secretions, excretions, and contaminated surfaces


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Personal Protective EquipmentPPE

  • PPE include: gowns, gloves, face shields or masks, lab. coats, eye protection, resuscitation equipment, pocket masks, mouth pieces, or other ventilatory devises

  • Disposable gloves are the most common type of PPE

  • You should wear PPE that is appropriate for the job at hand


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PPE: Gloves

  • With gloves: cover open areas with a bandaid first before putting on gloves

  • Gloves should fit snug and the cuff should extend above the wrists.

  • Wear disposable gloves only once

  • Change gloves between patients

  • If a glove becomes torn or ripped, remove it as soon as possible and discard

  • Never reuse gloves


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PPE

  • Do not touch the outside of the gloves when removing used gloves.

  • Always wash hands after glove removal

  • Wear surgical cap and shoe covers when large amounts of blood or bodily fluids are expected; such as surgery

  • Use PPE during resuscitation of patients


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PPE

  • Make sure PPE fit properly, are free of tears and blood or bodily fluids

  • Always discard of PPE before leaving the work area

  • Wash hands immediately after PPE removal


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PPE (cont.)

  • If work activities could possibly generate splatters of blood or other potentially infectious materials (OPI), a mask, eye protection and gown should be used.

  • If your skin is punctured by a contaminated sharp (even through a glove), wash the area well with soap and water only and report the incident according to your institution’s policy.


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Handwashing

  • THE SINGLE MOST important precaution for preventing the spread of infection.

  • The worker MUST wash their hands before putting on gloves AND after removing gloves-even if there is no visible secretions.

  • The worker MUST wash their hands before and after every patient contact.


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Handwashing

  • Wash hands thoroughly with soap and running water for 10-15 seconds

  • Dry thoroughly, use a dry paper towel to turn faucet off

  • Use a waterless handwashing solution as a temporary measure, wash with soap and water as soon as possible


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Engineering Controls

  • Engineering controls attempt to design safety into the tools of everyday work and the workplace.

  • Using appropriate equipment, as provided, is an example of engineering controls:

    *Ex. use of PPE, use of sharps containers, use of needleless devices


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Other Safety Precautions

  • Do Not eat, drink, handle contact lenses, use cosmetics, store food or drinks in areas where exposure is possible

  • Never mouth pipette or mouth suction blood or OPIM

  • Minimize splashes when handling blood or OPIM

  • Transport blood or OPIM in closed leak-proof containers and wear gloves


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Other Safety Precautions

  • Do not let contaminated patient equipment touch you, other people or objects.

  • After use, make sure equipment is properly cleaned or discarded before using on another patient

  • Clean all blood/fluid spills promptly according to your facilities policy

  • Wear gloves when handling dirty laundry, and keep laundry away from your body


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Other Safety Precautions

  • Do not use hands or feet to push trash down in disposal can. Shake trash down from top, carry from the top and away from your body

  • Red labels, bags, containers, and warning signs ALERT you that they contain contaminated blood or OPIM


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Needle Safety

  • Never reuse sharps, Never recap needles

  • If recapping is required, use hands off re-sheathing devices

  • Place sharps in an easy to reach and slightly below eye level, puncture proof container

  • Never reach in the container or overfill

  • Clean broken glass with broom and dust pan or forceps


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Exposures

  • If exposure occurs: immediately wash area with soap and water, or flush eyes with large amounts of water.

  • Exposures should be reported immediately to immediate supervisors, noting date, time, and type of sharp

  • Evaluation should be made as to type of safety device used and if injury could have been prevented


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