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  1. MEDICAL PROFESSIONALS Blood borne and Airborne Pathogens Patty Maloney MSN/ED,RN

  2. Pathogens • Pathogen-any agent that causes disease, commonly encountered in the occupational setting. • eg-viruses, bacteria, fungi, parasitic worms

  3. Vireses

  4. Bloodborne Pathogens • Bloodborne pathogens are disease causing microorganisms carried in the blood. • eg-hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) • These pathogens may be transmitted through unprotected contact with contaminated blood or body fluids.

  5. Bloodborne Transmission

  6. Airborne Pathogens Airborne Pathogens-are disease-causing agents that spread infection through mechanisms such as droplets or dust. eg- coughing, sneezing

  7. Airborne Transmission

  8. Chain of Transmission Elements present for a pathogen to cause illness or disease. The chain includes: • Source-an infected patient or animal. • Portal of exit-mouth, nose, cut, needle puncture. • Route of transmission-contact, air/droplet, food, vector. • Portal of entry-mouth, nose, cut needle puncture. • Susceptible host

  9. Chain of Infection

  10. OPIM’s Exposure-refers to occupational disease transmission. OPIM’s-(Other potentially infected materials) Exposure indicates that blood or OPIM’s have entered a host portal of entry.

  11. OSHA Certain occupations involve the risk of contact with blood or OPIM’s. In order to reduce or eliminate the risk of exposure to airborne or bloodborne pathogens regulations have been implemented. U.S. Department of Labor’s Occupational and Safety and Health Administration (OSHA) has implemented standards.

  12. OSHA Standards Goal-is to train and educate employees regarding various pathogens and how to minimize or eliminate exposures to pathogens by using: • Standard precautions • Personal protective equipment (PPE) • Administrative controls • Work practice controls • Engineering controls

  13. OSHA

  14. Who needs OSHA Training? Any employee who has occupational exposure to blood or OPIM’s. The standards also address employees with the potential for exposure. Employees must receive OSHA training on orientation and annually to update any changes.

  15. Routes of Transmission Five main routes of transmission: • Contact • droplet • Air • Food • Vector The key to infection prevention revolves around interrupting the contact, droplet, and airborne transmission routes.

  16. Routes of Transmission Contact • Most common • Can be classified into direct and indirect contact • Direct contact-Person to person, eg. not wearing gloves when caring for bleeding wound. • Indirect-exposed from contaminated object (fomites), eg. bed linens

  17. Droplet Transmission • Occurs when droplets contaminated with infectious pathogens are expelled during coughing, sneezing, talking, suctioning.

  18. Airborne Transmission Occurs when microdroplets carrying a pathogen are generated by an infected person coughing, sneezing, or talking. Airborne pathogens are passed through the air and infect another host via the respiratory tract but they do not always cause respiratory illnesses. Eg. Chicken pox can be transmitted through the air. Most common is TB.

  19. Vector Transmission • Vector transmission occurs when animals or insects transmit pathogens such as rabies, malaria , or West Nile virus to human hosts.

  20. Hierarchy of Controls OSHA & CDC believe that preventing pathogen exposures requires a comprehensive program of strategies: • Administrative controls • Engineering controls • Work practice controls

  21. Administrative Controls Policies and programs that manage and support the infection program. Eg. Providing vaccinations, promoting infection prevention, and control training programs. Managerial and employee cooperation and adherence to the guidelines determine the effectiveness of the polocies.

  22. Engineering Controls Includes any effort to design safety into the tools and workspace organization. Eg. Handwashing facilities, eye stations, sharps containers, self-sheathing needles or syringes and needle-less symptoms. Engineering controls include any object that comes between you and the potential infectious material.

  23. Contaminated Sharps • OSHA defines contaminated sharps as any contaminated object that can penetrate the skin including but not limited to needles, scalpels, broken capillary tubes, exposed ends of dental wires. • Contaminated needles or other contaminated sharps must NOT be bent, recapped or removed unless no alternative is feasable.

  24. Reusable Sharps Must be clearly labeled in a puncture-resistant, leak-proof container immediately after use until they can be reprocessed. Items will be sterilized and decontaminated.

  25. Acceptable Sharps Containers Sharps containers Sharps containers • The Food and Drug Administration (FDA) regulates sharps containers as Class II medical devices. • OSHA’s Bloodborn Pathogens Standard establishes minimum design performance elements for containers.