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BLOODBORNE PATHOGENS. Presented by Office of Environmental Health and Safety. Goals of training:. Knowledge of regulatory requirements Increase awareness of diseases Provide information regarding: Routes of exposure Risk of transmission Prevention. Regulated requirements.

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bloodborne pathogens

BLOODBORNE PATHOGENS

Presented by

Office of Environmental Health and Safety

goals of training
Goals of training:
  • Knowledge of regulatory requirements
  • Increase awareness of diseases
  • Provide information regarding:
    • Routes of exposure
    • Risk of transmission
    • Prevention
regulated requirements
Regulated requirements
  • OSHA Bloodborne Pathogens standard
    • Designed to protect workers
    • In effect since 1992
    • Goal: Prevent occupational transmission of diseases potentially present in blood and bodily fluids
    • Regulated in Calif. by Title 8
some of the requirements
Some of the requirements:
  • Written plan
  • Use of controls
  • Cleaning and decontamination program
  • Sharps injury prevention plan
  • Training & protective equipment
  • HBV vaccinations
body fluids that can transmit infection
Body fluids that can transmit infection:
  • Blood
  • Semen
  • Vaginal secretions
  • Cerebrospinal fluid
  • Synovial fluid
  • Pleural fluid
  • Pericardial fluid
  • Peritoneal fluid
  • Amniotic fluid
  • Saliva (e.g. dental procedures)
  • Any unfixed human tissue or organ
prevention universal precautions
PREVENTION: Universal precautions
  • Treat all blood and other potentially infectious body fluids as if infected
  • Avoid direct contact with blood and body fluids & contaminated materials
  • Wear PPE appropriate for job
  • Practice good housekeeping and personal hygiene
universal precautions cont
Universal precautions – cont.
  • Follow proper decontamination procedures
  • Dispose of all contaminated materials properly
  • Seek prompt medical attention in the event of exposure
personal protective equipment provides a barrier
Personal Protective EquipmentProvides a barrier

Examples:

  • Latex/PVC gloves
  • Goggles, safety glasses w/side shields
  • Plastic or rubberized gowns/aprons
  • Surgical masks/face shields
  • Pocket mouth-mouth resuscitation masks
special ppe precautions
Special PPE precautions
  • Cover open cuts, rashes, and other broken skin.
  • Check condition before using
  • Remove carefully to avoid contaminating yourself or anything around you
  • Dispose properly
  • Don’t mix contaminated clothing or laundry with other laundry
  • Wash hands thoroughly after removing gloves.
hygiene
Hygiene
  • Wash hands w/ soap and water
  • Don’t keep food or drink in work areas w/ exposure potential
  • Don’t eat, drink, smoke, apply make-up or lip balm, or handle contact lenses
  • Avoid splashing/spattering of potentially infectious materials
  • Don’t suction potentially infectious materials by mouth.
housekeeping
Housekeeping
  • Clean up all spills immediately.
  • Clean and decontaminate all equipment and surfaces after contact w/ blood and other potentially infectious materials.
  • Clean and sanitize pails and other reusable waste containers regularly.
  • Replace protective coverings, immediately upon obvious contamination, or at end of work day.
cleaning vs sanitizing
Cleaning vs. Sanitizing
  • Cleaning:

Removal of infectious agent via mechanical means using a cleaning agent.

  • Sanitizing:

Applying sanitizing agent, carefully following label instructions.

Contaminated surfaces and equipment must be sanitized!

sharps injury prevention
Sharps Injury Prevention
  • Evaluate and provide devices designed to prevent injury
    • Syringes w/ sliding sheath that engages after use
    • Needles that retract after use
    • Shielded or retracting catheters
    • IV delivery systems w/ catheter port/needle in protective covering
  • Provide training on new equipment
  • Keep a sharps injury log – which includes:
    • date and time of incident
    • type of sharp involved
    • description of incident
  • PI/Supervisor must immediately report all sharps incidents to EH&S
proper disposal procedures
Proper Disposal Procedures

Contaminated materials

  • Dispose in red, plastic biohazard bag.
  • Tie off bag tightly.
  • Place bag in labeled, rigid container with close-fitting lid.
  • All bags must be transported in labeled rigid containers with close-fitting lids.
    • Note that this requirement is in effect whenever the waste leaves the point of generation.
disposal cont
Disposal - cont.

Potentially contaminated sharps

  • Dispose in rigid, labeled sharps containers.
  • Never:
    • Break off needles or blades
    • Attempt to retrieve sharps from a sharps container
disposal cont16
Disposal - cont.
  • Bloodborne pathogen waste cannot remain on campus beyond one week.
    • Waste is currently picked up by a licensed contractor every Tuesday.
  • Contact EH&S at 8-7422 if you have bloodborne pathogen waste requiring disposal
hbv vaccination
HBV Vaccination
  • HBV vaccination series will be made available to employees at risk of exposure at no cost.
  • Employee may decline series by completing declination form.
  • If employee declines series, may elect to have series at a later time.
post exposure
Post exposure
  • Wash needlesticks/cuts with soap & water.
  • Flush splashes to nose, mouth, or skin with water.
  • Irrigate eyes with clean water, saline, or sterile irrigants.
  • Report the exposure promptly!
post exposure cont
Post exposure – cont.
  • After exposure incident; employee shall be offered post-exposure evaluation, including at no cost:
    • Medical exam
    • Blood testing
risk of infection from occupational exposure
RISK OF INFECTION from Occupational Exposure

Overall risk depends on:

  • # infected individuals in patient population
  • Type and # of blood/fluid contacts

Risk factors following exposure:

  • Pathogen involved
  • Type of exposure
  • Amount of blood/fluid involved
  • Amount of virus present in blood/fluid at exposure
bloodborne diseases
Bloodborne Diseases
  • HIV/Aids
  • HBV, HCV
risk of infection cont
Risk of infection cont.
  • HIV needlestick/cut: 0.3%
  • HIV mouth/nose/eye: 0.1%
  • HIV skin: 0.1%
  • HBV w/ pre-vaccination: no risk
  • HBV w/o pre-vaccination: 6 ~ 30 % depending on HBV antigen status of source individual
  • HCV: 1.8 %
hiv aids stats cont
HIV/AIDS Stats cont.
  • As of Dec. 2001:

57 documented cases of occupational HIV transmission to healthcare personnel

Primarily from accidental “sticks”

aids advanced hiv
AIDS: Advanced HIV
  • Definition:
    • Fewer than 200 CD4-T cells/mm blood (vs. healthy: 1000+)
    • Clinical conditions, opportunistic infections and cancers generally not affecting health people
diagnosis of hiv
Diagnosis of HIV
  • May take 1 ~ 6 months post infection for presence of sufficient # of antibodies using standard blood tests
  • Acute/recent exposures: screen for presence of HIV genetic mat’l
  • Depending on exposure circumstances, more tests may be necessary

Prompt disclosure of details re: suspected exposure

4 Proper diagnosis procedure

hiv post exposure treatment
HIV: Post exposure treatment
  • Determined on a case-by-case basis Treatment should be started within hours
  • Slows spread of HIV and delays start of opportunistic infections/conditions
  • Post Exposure Prophylaxis treatment

4 80% reduction infection risk

hepatitis hbv hcv
HEPATITIS – HBV, HCV
  • Virus that can cause acute liver infections or chronic liver disease (cirrhosis, liver cancer)
  • Approx. 300,000 cases of acute HBV infection annually.
  • 5 ~ 10% become chronically infected
  • Approx. one million chronic carriers
  • HBV: Highly effective vaccine available
  • No cure for HBV or HCV
hepatitus routes of exposure
HEPATITUS Routes of Exposure
  • HBV, HCV: Entrance of infected blood into the body.
    • Includes bodily fluids that could contain blood in amounts not visible to naked eye.
hbv post exposure treatment
HBV Post Exposure Treatment

May include:

Depends on several factors:

  • Whether source individual is positive for HBV
  • Whether you have been vaccinated
  • Whether the vaccine provided you w/ immunity.

No post exposure treatment for HCV

comparison of hbv hiv
Comparison of HBV/HIV

HBV:

  • More “sturdy”, can survive outside the body up to a week vs. less than a day for HIV
  • Likely to be more concentrated in blood and bodily fluids
  • Much higher risk of transmission.
    • One case of HBV transmission in athletics setting.
summary
Summary…
  • Use Universal Precautions when in contact with bodily fluids.
  • Use PPE and use it properly
  • Sanitize – don’t just “clean”!
  • Protect yourself from HBV infection
    • Complete your vaccination series
    • Get your titer checked