Blood borne Pathogens and Prevention of Infection

1. Blood borne Pathogensand Prevention of Infection

2. Objectives • Identify common bloodborne pathogens. • Describe the risk of bloodborne pathogens to health care workers. • List potentially infectious substances and their modes of transmission. • Describe how personal protective equipment and work practice controls can be implemented. • Describe the health care worker’s role in evaluation of workplace practices and devices. • Describe post-exposure care.

3. Bloodborne Pathogens HIV HBV HCV Others

4. Risks to Health Care Workers HIV – small HCV – 900 annually HBV – 9,000 annually

5. Infectious Fluids • Blood • Body fluids that contain blood • Semen • Vaginal secretions • Fluid from around an unborn baby • Spinal fluid • Fluid around the heart

6. Infectious Fluids(continued) • Fluid around the lungs • Fluid around joints • Tissue removed from the body

7. Other Body Fluids Potentially Infectious • Tears • Saliva • Sputum/nasal secretions • Emesis • Urine • Feces Not Infectious • Sweat

8. Transmission • Sexual contact • Sharing needles • Transfusions • Mom  baby

9. Transmission in the Workplace • Puncture wounds • Contact with non-intact skin • Mucous membranes

10. Prevention of Infection Universal Precautions – OSHA Standard Precautions - CDC

11. Hand Decontamination • After touching blood, body fluids, secretions, excretions, contaminated items • After gloves removed • Between patient contacts • Waterless antiseptic agents

12. Considered an Exposure • When: • Blood, blood products, cerebral spinal fluid, semen, vaginal secretions or synovial fluid has had contact with NON-INTACT skin or mucous membranes.

13. Considered an Exposure • When • You have been stuck by a contaminated needle or sharp object

14. Not an Exposure • The following is NOT an exposure (unless visible blood noted in the following) • Feces, saliva, vomitus, sputum, sweat, urine, nasal secretions, tears, blood on INTACT skin

15. Personal Protective Equipment (PPE) • Provided by employer • Application, removal, disposal

16. Gloves • Handling blood/body fluids • Performing invasive procedure • Touching non-intact skin

17. Gloves • Correct size • Change if contaminated • Remove inside out • Utility gloves

18. Masks, Shields, Eyewear • Used when splashing expected • Replace when wet • Wash hands before removing • Handle by side pieces • Protective resuscitation equipment

19. Protective Clothing • Used when splashing expected • Remove if soiled • Remove from inside and roll • Nondisposable laundered by employer

20. Work Practice Controls • Sharps • Lab materials • Decontamination • Laundry • Waste

21. Safer Medical Devices • Sharps with engineered sharp injury protectors • Needleless systems

22. If Needle Must Be Used… • Immediately discard in sharps containers • Do not bend or break • Do not recap • Do not fill container past designated fill line

23. Documentation of Needlestick Injuries • The type and brand of device involved • The department or area where the exposure occurred • An explanation of how the exposure occurred

24. Other Work Practice Controls • Transport specimens in leak proof containers labeled biological hazard • Place warning labels on containers with hazardous materials • Do not eat, drink, smoke, apply cosmetics, or handle contact lenses where exposure likely • Never use pipettes with mouth suction

25. Spills • Put on gloves • Wipe up with towel • Dispose of contaminated towel • Apply bleach solution

26. Linens • Wear gloves • Place in impervious container if linen is to be transported • Label appropriately

27. Waste • Label as biohazard

28. Post-Exposure • Wash area • Notify supervisor • Consult physician ASAP • Report incident • Obtain medical counseling • Keep records confidential

29. C-Diff • CLostridiumdifficile (klos-TRID-e-uhmdif-uh-SEEL), often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Most commonly affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotic medications. • May require isolation of persons affected

30. Prevention • Hand washing: Health care workers should practice good hand hygiene before and after treating each person in their care. • In the event of a C. difficile outbreak, using soap and warm water is a better choice for hand hygiene, as alcohol-based hand sanitizers may not effectively destroy C. difficile spores. Teach visitors to practice good hand washing as well.

31. MRSA • Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult-to-treat infections in humans. • To prevent the spread of staph or MRSA in the workplace, employers should encourage proper hand washing and sanitizing of environmental surfaces and contaminated equipment with EPA registered disinfectives.

32. Prevention • Although alcohol-based rubs remain somewhat effective, a more effective strategy is to wash hands with running water and an anti-microbial cleanser with persistent killing action. • Proper disposal of isolation gowns is also necessary • MRSA can survive on surfaces and fabrics, including privacy curtains or garments worn by care providers

33. Prevention • Hospital staff and visitors wear disposable gloves and gowns while in the room • In any setting, all surfaces should be carefully disinfected with a product that contains chlorine bleach • People who are hospitalized with C. difficile should have a private room or share a room with someone who has the same illness

34. Policies/Procedures • Be familiar with your facilities policies and procedures regarding issues of safety and infection control. Ask whenever you are uncertain or have a question regarding these issues. • Be Safe • Practice Safety in the workplace

35. Summary • Bloodborne pathogen risks • Modes of transmission • Personal protective equipment • Work practice controls • Evaluation of practices/devices • Post-exposure care