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what are universal precautions
What are Universal Precautions

Universal precaution are control guidelines designed to protect workers

from exposure to Diseases spread by Blood and other Body fluids.

CDC

universal precautions means
Universal precautions means

Observing “Universal Precautions” means you consider all human blood and certain human fluids infectious for all blood borne pathogens.

why universal health precautions
Why Universal HealthPrecautions.

The concept of Universal Health Precautions emphasizes that all our patients should be treated as though they have potential blood born infections, and can infect the caring health care workers. ( CDC )

the blood borne pathogens that pose the most serious health risks
The blood borne pathogens that pose the most serious health risks
  • Hepatitis B virus (HBV)
  • Hepatitis C virus (HCV)
  • Human Immunodeficiency Virus (HIV)
human materials tissues considered highly infectious
Human Materials/Tissues considered Highly Infectious

1 Blood

2 Semen

3 Vaginal secretions

4 C S F

5 Synovial fluids

6 Amniotic fluid

7 All other body fluids

our role to protect follow universal precautions
Our Role to protect follow Universal Precautions
  • Perform all tasks using safe work practices
  • Use appropriate personal protective equipment.
  • Use engineering controls
who is at risk for sharps injury
Who is at risk for sharps injury?
  • Workers performing finger sticks
  • Lab workers
  • Housekeepers/janitorial staff
  • Medical waste contractor
not infectious unless contaminated with blood or body fluids
Not Infectious unless contaminated with Blood or Body fluids.
  • Feces,
  • Nasal secretions,
  • Sputum,
  • Sweat,
  • Tears,
  • Urine / Vomitus,
  • Saliva unless blood stained.
these body fluids include
Blood

Vomit

Saliva

Stool (feces)

Urine

Drainage from nose

or sinuses

Drainage from cuts, scrapes, wounds or sores

Secretions from mucous membranes

Sputum (mucus from lungs)

Vaginal secretions

Semen

These Body Fluids Include:
protect yourself
Universally, treat every child’s body fluid as if it were infected.

Precaution – Use foresight and plan ahead to avoid exposure

Protect Yourself…
work practices that increase the risk of a sharps injury
Work practices that increase the risk of a sharps injury
  • Recapping needles
  • Transferring a body fluid between containers
  • Opening blood tubes
  • Failing to dispose of used sharps properly in a puncture-proof sharps container
universal precaution steps
Universal Precaution Steps
  • Gloves (Personal Protective Equipment)
  • Decontamination
  • Hand Washing
  • Waste Disposal
use of gloves
Use of Gloves

Use of a pair of disposable plastic gloves can protect if chances of contact with Blood or Body fluid is anticipated / inevitable.

step 1 gloves
Step 1: Gloves...

Always wear gloves when …

  • Direct contact with body fluids is anticipated (nosebleeds, bleeding abrasions, etc.)
  • Handling clothes soiled by urine, feces, vomit or blood
  • Diapering children
step 2 handwashing
Step 2: Handwashing
  • The MOST IMPORTANT STEP in Preventing the spread of disease!
  • Use liquid soap and warm water.
  • Wash vigorously for 10 – 15 seconds.
  • Rinse under warm running water.
  • Turn off faucet with paper towel.
why hand washing
Why HAND WASHING ?
  • There is no Health precaution like Hand washing.
  • Washing with simple toilet soap - reduces the rate of transmission of common infections including the HIV.
indications for hand washing
Indications for Hand Washing
  • In prolonged contact with patient.
  • Before taking care of Immune supressed,New born infants, patients in ICU / ICCU, Dialysis Units, Burn’s Units.
  • Before and after touching wounds.
  • When Microbial contamination of Hands, likely to occur when in contact with mucous membranes, body fluids, and other secretions contaminated with Blood, and serous fluids.
what to be used for hand washing
What to be used for hand washing
  • In most circumstances Non medicated soaps and detergents are effective in removing most transient contaminants.
  • In demanding circumstances, in handling potentially harmful infections, use Ethyl or Isopropyl alcohol.
  • Detergent formulations containing Chlorhexidine Povidone,or Hexachlorophene are effective in prevention of spread of infections.
words of wisdom on hand washing
Words of Wisdom on HandWashing

Soap, water and

Common sense are still be Best Antiseptics

William Osler

use of mask cap eye wear
Use of Mask, Cap, Eye Wear
  • Will certainly protect us from splashes of Blood or Body fluids.
  • Don't underestimate the importance of Use of Cap and Mask.
  • It equally protects our patients.
uses of cap and mask
Uses of Cap and Mask

Stringent use of Mask and Cap can save several Lives in the Hospital

use of foot wear
Use of Foot wear
  • Wearing foot wear covering entire sole protects the entry of Microbes from the contaminated floors with Blood and Body fluids.
  • Remember many of us have cracks on our feet.
use of impervious gown
Use of Impervious Gown

A simple thin Plastic apron underneath the linen is of great help in preventing the soaking our inner clothes and exposure to harmful microbes.

disposal of needles and sharps
Disposal of Needles and Sharps
  • All used needles and sharps should be deposited in thick walled puncture resistant containers.
  • Bending, Reshaping, should be prohibited.
  • Do not recap the needles to avoid needle stick injures,
  • All used Disposable syringes and needles should be discarded into Bleach solution at the work station before final disposal.
dealing with used needle
Dealing with Used Needle

Shredding continues to be Important Method

Of dealing with used

Needle

dealing with needle stick injuries
Dealing with Needle stickInjuries
  • Consider all Needle stick injuries as a serious health hazard in the era of AIDS
  • All events of Needle stick injuries to be reported to the supervisory staff.
  • Wash the injured areas with soap and water.
  • Encourage bleeding if any.
  • Prophylaxis for prevention of HIV/HBV is top priority.
  • Anti retroviral prophylaxis, if necessary should started within 2 hours, ( if injury is from HIV positive or high risk group).
protect yourself continued
Protect Yourself (continued)
  • Promptly dispose of used sharps in appropriate sharps disposal containers
  • Report all occupational exposures promptly to ensure that you receive appropriate follow-up care
  • Tell your employer about real or potential hazards you observe
  • Participate in training related to infection prevention
  • Get a Hepatitis B vaccination
accidental exposure
Accidental Exposure
  • Alert your supervisor.
  • Complete employee injury report.
  • Follow-up with District’s Worker’s Comp medical provider for confidential evaluation.
handling occupational exposures
Handling Occupational Exposures
  • Employee should immediately report the expose to a supervisor
  • Immediately wash skin with soap and water
  • Apply first aid to the wound
hazards of needle stick injuries
Hazards of Needle stickInjuries

HIV , HBV and HCV viral infections can spread by Needle stick Injuries

Nursing staff are at greater risk

Several Injuries are preventable

decontamination of hospital linen
Decontamination of Hospital Linen
  • All the linen contaminated with Blood or Body fluids should be soaked in 1: 100 bleach solution for 30 minutes.
  • Advised Autoclaving, as the most ideal procedure for decontaminating Linen
spillage of blood body fluids
Spillage of Blood/Body fluids
  • A common health hazard in the working environment.
  • Never wipe the spillage with working wet mop.

Always cover the spills with paper and pour 1 % Hypochlorite or Bleaching powder to decontaminate the spills with HIV/HBV virus.

care of endoscopes
Care of Endoscopes
  • Endoscopes are delicate/precious instruments.
  • Follow the instruction of Manufacturers.
  • It is commonly cleaned with 2 % Glutaraldehyde solution.
  • Specified time schedules to be followed to decontaminate for HIV.
  • Mycobacterium needs even > 2 hours for decontmination.
decontamination of metal instruments
Decontamination of Metal Instruments
  • Hold all contaminated instruments with Gloved hands.
  • Subject all metal instruments to washing with soap and water.
  • Treat all contaminated instruments with 2% Glutaraldehyde. For at least 30 minutes.
  • Many consider sterilizing in Hot air oven if not sharp instruments.
anesthetic tubing s and other equipment s
Anesthetic Tubing's and otherEquipment's
  • Since they are in intimate contact with Human secretion need utmost attention in decontamination.
  • Treat all Non disposable as highly hazardous, if used without safe practices can infect the next patient undergoing procedures.
  • Soaking in 2 % Glutaraldehyde is common practice in Developing world.
pregnant health care workers
Pregnant Health Care Workers
  • Not at more risk than other, Health care workers.
  • Should adopt Universal Health Precautions with more dedication,
  • If neglected the Unborn is at grave risk of attaining congenital infections.
  • The Laboratory supervisors should monitor/ guide the HCW’s for adherence to scientific practices.
safe work habits continued
Safe Work Habits (continued)
  • Place all contaminated waste in an appropriately labeled container and transport in a leak proof, puncture-proof outer container
  • Disinfect all work surfaces and items before and after testing with 10% bleach solution or EPA approved disinfect
operating on hiv high risk groups
Operating on HIV/High risk groups
  • It is a concern all should be cared equally.
  • HIV infected carries the risk of being neglected at the time of crisis.
  • Law many not change for equality but motivated health workers should bring in change of attitude.
  • Adherence of Universal Health precaution bring in safety to all HCW.
  • Follow the precautions even in Non HIV patients as some of our patients are in window period and more dangerous than truly positive with Serotesting.
caution on operating hiv sero negative patients
Caution on Operating HIVSero Negative Patients
  • Universal precaution apply to all our patients irrespective of Blood tests we undertake.
  • We handle so many patients in emergency situation with out any details.
  • Education on Universal precautions participation of you and educating your subordinates/Juniors will make a lot of Difference in the work Environment.
precaution for invasive procedures
Precaution for Invasive Procedures
  • All HCW’s who participate in invasive procedures must routinely use appropriate barrier precautions.
  • All Health care workers who perform/assist vaginal, and cesarean deliveries should wear gloves and gowns when handling, the placenta, and the new born, till blood and amniotic fluid has been removed from infants.
  • Amniotic fluid is rich in HIV/HBV virus, in infected mothers.
handling dentistry patients
Handling Dentistry Patients

Blood,Saliva,Gingival fluid from all Dental patients should be considered infective, Dental, workers should wear surgical mask, gloves and eye wear

caring bleeding patients
Caring Bleeding Patients
  • Primary health care workers who handle the patients in Emergencies, and Accidents to be trained in basic principles of Universal Health care precautions.
  • Mouth to Mouth resuscitation is life saving in the Critically injured accident victims. May be neglected because of fear of HIV infection.
  • If the situation warrants, Bleeding from mouth can be wiped out with clean cloth, or Handkerchief, and still one can do resuscitation.
importance of vaccination in hepatitis b infection
Importance of Vaccination in Hepatitis B Infection.
  • We have > 400 Million carriers with Hepatitis B infections.
  • Every HCW is at risk of Contacting infection.
  • Vaccination is safe -Genetically Engineered vaccination remains the great hope for prevention, apart from Major component of Universal precautions.
vaccination for hbv infection
Vaccination for HBV infection
  • All HCW’s must take at least three doses of Vaccine,

At 0 – 1 – 6 months. without discontinuationof the schedule.

  • All Health care workers many not attain equal response.
  • High risk HCW’s should undergo estimation of anti HB s ( antibodies ) to know whether they were well protected.
problem of hbv vaccines in the developing world
Problem of HBV vaccines in the Developing world
  • Who pays for the Vaccine.
  • Many who work in unorganized sector, do not get Institutional support of Vaccine.
  • Life, at risk if Infected with HBV
  • More Awareness to be brought in by Managers of the Hospitals, to promote to vaccinate their Employees.
waste disposal
Waste Disposal
  • Bag and tie after segregation as per codes
  • Place in second bag and tie again (double bag technique)
  • Place all sharps (used needles) in sharps container.
  • Wash hands after removing

gloves.

slide52
Created for benefit of Medical and Paramedical

Health care workers in the

Developing world

Dr.T.V.Rao, MD

E mail : doctortvrao@gmail.com