Bloodborne Pathogens. HCQU Northwest. Introduction. Infectious Materials. Occupational Exposure

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1 HCQU Northwest Bloodborne Pathogens December 2013, ½ hour Objectives 1) Define blood-borne pathogen and identify the two most common blood-borne pathogens. 2) Identify which fluids are considered infectious and which are not. Introduction Blood-borne pathogens are diseaseproducing microorganisms that are transmitted through blood or body fluids. These include, but are not limited to, Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV). Both of these can be spread through sexual contact, blood transfusions, and sharing needles. While the Human Immunodeficiency Virus does not live for a long time outside of the body, the Hepatitis B Virus can live at least seven days in dried blood! 3) Know what action to take in the event of occupational exposure to blood or infectious body fluids. 4) Identify ways to reduce the spread of germs and viruses, including hand washing. Infectious Materials In the human body, several fluids have been known to carry pathogenic microorganisms. They are: saliva in dental procedures, vaginal secretions, semen, pleural fluid, peritoneal fluid, synovial fluid, amniotic fluid, cerebrospinal fluid, and blood. In addition, tissues and organs can carry blood-borne pathogenic microorganisms. The reason that saliva is considered infectious in dental procedures is because of the high likelihood of bleeding in the mouth during such procedures. Occupational Exposure Employees at risk for occupational exposure to infectious materials include direct care staff (nurses, emergency medical technicians, phlebotomists, nurses aides, resident assistants, group home direct support staff), housekeeping, laundry, and custodial personnel. Occupational exposure is defined as reasonably anticipated skin, eye, mucous membrane, or parenteral (entering the body through a route other than the digestive system) contact with blood or other infectious materials that may result from the performance of the employee s duties. In other words, if you provide direct care to people or maintain their clothing or their living environment, you could be exposed to blood-borne pathogens.

2 Bloodborne Pathogens Page 2 HCQU Northwest Universal Precautions Universal or standard precautions involve the use of mask, or a gown. The type of protective barriers protective barriers in order to reduce the risk of direct should be appropriate for the procedures being contamination with blood-borne pathogens. Examples of protective barriers include: gloves, gowns, better to err on the side of caution when working performed and the type of exposure anticipated. It is masks, and protective eyewear. These items are around potentially infectious materials. Always wash known as Personal Protective Equipment (PPE), and your hands before and after using PPE. should be worn in situations in which exposure to Universal precautions apply to the aforementioned blood or bodily fluids is likely. All PPE fluids (blood, vaginal secretions, semen, should be removed prior to leaving the It is better to err on pleural fluid, peritoneal fluid, synovial fluid, work area and should be placed in an appropriately designed container for the side of caution amniotic fluid, cerebrospinal fluid, and saliva in dental procedures), which may storage, washing, decontaminations, or when working contain pathogens. They do not apply to disposal. Always follow your company s around potentially feces, urine, nasal secretions, sputum, policies and procedures regarding specific vomitus, sweat, tears, and saliva (except in instructions. Any PPE that is torn or infectious materials a dental setting). However, since it is punctured should be removed and replaced. If gloves are thin or flimsy, then double glove. possible for any or all of these to contain blood at any given time, there is a potential risk, so it Make sure any open sores or cuts on your hands are would be prudent to wear PPE anyway. Again, it is covered with a Band-Aid or dressing before donning better to err on the side of caution. It is essential to gloves. If you have a latex allergy, vinyl gloves can have a barrier between you and the potentially be used. Especially when you are doing direct care infectious material. This point cannot be emphasized and will be touching someone s skin, gloves should enough! be worn. Once used, gloves should be discarded; they should never be reused! If you have a refrigerator or another area where infectious materials are stored (hospitals, clinics, and If there is a chance that you could be splattered with nursing homes which hold lab specimens), then no bodily fluids or the individual you care for is vomiting, food or drink should be stored in or near these coughing, or sneezing, you may need to wear other designated areas. personal protective equipment, such as eyewear, a Contamination If your clothing becomes soiled by or penetrated with blood or bodily fluids, you should immediately wash your skin with soap and water and remove the clothing. It is wise to keep an extra change of clothes in your car if there is a high likelihood that you may encounter soiling of your clothes. Soiled clothing that is worn by residents or patients should be placed in designated laundry containers and may need to be double-bagged until it is laundered. Consult your facility s policies regarding this matter. Any item of clothing or surface area which has come into contact with infectious or potentially infectious bodily fluids is considered contaminated. Recall that HBV can live at least seven days in dried blood.

3 HCQU Northwest Bloodborne Pathogens Page 3 Decontamination Every employer whose employees are at risk for exposure to blood or other potentially infectious materials must develop a written schedule for cleaning each area where exposures occur. Methods of decontamination must be specified, determined by the type of surface to be cleaned, the soil present, and the tasks or procedures that occur in that area. Bleach is the most effective material for decontaminating areas and a 1:10 parts bleach to water ratio is often recommended. Prior to cleaning up a blood spill, put on PPE, then cover the spill with paper towels or rags, pour the solution over the towels or rags, and leave it for at least 10 minutes before continuing the cleaning process. There should be a plan in place for disposal of the contaminated materials. Consult your facility s protocol for specific instruction on cleaning contaminated areas. You should always wash your hands following the clean-up. Sharps Sharps are medical instruments such as needles or scalpels that can cause a puncture wound or that have the potential to otherwise penetrate the skin. There are puncture-resistant, labeled, color-coded containers which are manufactured specifically for the purpose of storing discarded sharps, and your facility should have them available if you use such instruments. Hospital studies show that as many as one-third of all sharps-related injuries have been reported to be related to the disposal process. It is important to take great care in disposing of sharps. If you use needles or lancets on a patient, make sure that you have a sharps container close at hand to avoid carrying the object any distance, and dispose of them immediately. Do no recap a used needle. If you see that your sharps container is two-thirds full, then it needs to be replaced with a new one. Your facility should routinely replace sharps containers so that they do not become over-filled. Forcing needles into a container more than two-thirds full increases the risk of a needle stick. The container should be closed immediately before removal or replacement in order to prevent spillage or protrusion of the contents during handling, storage, transport, or shipping. There are syringes on the market today that have retractable needles or protective shields; these are much safer than the older designs. Sharps containers in use must be kept in an upright position to avoid the protrusion of needles through the opening and/or needles coming back out of the container. Hospital studies show that as many as one-third of all sharps-related injuries have been reported to be related to the disposal process.

4 Bloodborne Pathogens Page 4 Exposure Despite our best efforts to prevent needle sticks or other exposure to blood/bodily fluids, accidents can still occur. If you incur exposure, immediately wash the area thoroughly with soap and water. Mucous membranes or eyes should be rinsed with running water for 15 minutes following exposure. Report the incident immediately to your supervisor. Your employer will provide you with a confidential medical evaluation and follow-up, including documentation of the route(s) of exposure, the circumstances surrounding the exposure, and the identification of the source individual. HCQU Northwest You (the employee) will be asked to give consent to have your blood drawn, and then your blood will be drawn for lab testing immediately and at regular intervals to monitor for infection (usually at six months and again and one year postexposure, but your facility s policy may differ). The source individual s blood should be tested as soon as feasible after consent is obtained; if consent cannot be obtained, the employer will establish that legally required consent cannot be obtained. Information regarding your test results and those of the source individual is kept confidential. Post-exposure prophylaxis may include Hepatitis B vaccine and/or immune globulin, and/or antiretroviral medications to combat HIV. If you have already had the Hepatitis B vaccine, a blood titer will be drawn to see if it is still effective. Post-exposure counseling and evaluation of reported illnesses should be provided also. Ask your employee health representative about your facility s policy regarding post-exposure prophylaxis. Hand Washing Our hands are often the means by which diseases are spread. We pick up germs from other sources, then touch our eyes, noses, and mouths, thus introducing pathogens to ourselves. Then we cough, sneeze, and shake hands with other people and spread the pathogens to them. Did you know that 33% of people fail to wash their hands after they use the bathroom?? Washing your hands is the single most effective way to reduce the spread of pathogenic microorganisms (including those responsible for meningitis, the flu, Hepatitis A, and the common cold). It takes seconds to thoroughly wash all surfaces of the hands; you can count silently to yourself or sing Happy Birthday twice in order to make sure you have taken long enough. Using soap and running water is best. Turn the faucet on, adjust the temperature to warm (too hot may cause a burn) and allow the surfaces of the hands to become wet, then apply soap until you have an adequate amount of lather. Begin rubbing your hands together vigorously, starting at the wrists, then proceeding to the thumbs, palms, backs of the hands, between and along the fingers, and scrub the fingernails and thumbnails against the palms of the hands. Rinse thoroughly, allowing the water to run from your wrists down over the hands and fingers. Dry your hands using a paper towel. Do not use your bare hands to shut the faucet off (it is contaminated). Instead, use the paper towel. Use the paper towel to open the bathroom door (door handles are loaded with germs) and then discard it. When should you wash your hands? Before and after preparing food, before you eat, after you use the bathroom, before and after wearing personal protective equipment, before and after caring for any individual, after contact with pets or animal waste, after handling garbage, and whenever your hands are visibly dirty. When in doubt, wash your hands! If you do not have immediate access to soap and water, an alcohol-based hand sanitizer can be quite effective. Make sure that you squeeze at least a quarter-sized amount in the palm of your hand and rub al the surfaces of your hands together. In one study, hospital staff members became more compliant about hand washing after easily accessible alcohol-based hand sanitizer dispensers were installed throughout the facility, and the number of hospital-acquired infections dropped by half. It should be noted that the entire annual cost for the hand sanitizer dispensers equaled the cost of just one hospital-acquired infection, so the investment was well worth it.

5 HCQU Northwest MilestonePA.org Summary It is much easier to make the effort to prevent the transmission of pathogenic microorganisms than it is to treat a person who has already been infected. Maintaining an awareness of universal or standard precautions, how and when to wash hands, and what to do in the event of exposure can reduce risks and help everyone remain infection-free. BLOODBORNE PATHOGENS TEST Name: Agency: Title: Date: Please provide contact information ( address, fax number, or mailing address) where you would like your certificate to be sent: You must submit your completed test, with at least a score of 80%, to receive 1/2 hour of training credit for this course. To submit via fax, please fax the test and evaluation to To submit via , please send an to Please put Bloodborne Pathogens Test in the subject line, and the numbers 1 5, along with your answers, in the body of the . To submit via mail, send the test and evaluation pages to Milestone HCQU NW, 247 Hospital Drive, Warren PA Hand washing is the single most effective way to reduce the spread of infection. True False 2. Sharps containers, when containing sharps, must be kept in an upright position. True False 3. The Hepatitis B Virus (HBV) can survive for several days in dried blood. True False 4. If glove material is thin or flimsy, it is best to double-glove. True False 5. HBV and HIV cannot be spread through sexual contact. True False

6 HCQU Northwest MilestonePA.org Evaluation of Training Training Title: Bloodborne Pathogens Please check the box that best describes your role: Date: Direct Support Professional Provider Administrator/Supervisor Program Specialist Provider Clinical Staff Consumer/Self-Advocate Support Coordinator Family Member Support Coordinator Supervisor PCH Staff/Administrator FLP/LSP County MH/MR/IDD Other (please list): Please circle your PRIMARY reason for completing this home-study training: It s mandatory interested in subject matter need training hours convenience Please circle the best response to each question. 5 = Strongly Agree 4 = Agree 3 = Undecided 2 = Disagree 1 = Strongly Disagree 1. As a result of this training, I have increased my knowledge I learned something I can use in my own situation This training provided needed information The training material was helpful and effective Overall, I am satisfied with this training I am glad I completed this training Suggestions for improvement: Additional information I feel should have been included in this training: I would like to see these topics/conditions developed into home-study trainings:

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