BLOODBORNE PATHOGEN TRAINING

Transcription

1 BLOODBORNE PATHOGEN TRAINING Background Information for the In-service Trainer Trainer Introduction: All employees who potentially could be exposed to blood or other infectious materials while performing their duties on the job must comprehend the dangers of bloodborne pathogens. OSHA's Bloodborne Pathogens Standard requires such training as well as additional training on various types of exposure risks, safe use of equipment and practices which minimize risks and provide information regarding what to do in the case of exposure. Applicable Regulations: OSHA's Bloodborne Pathogens Standard, Centers for Disease Control and Prevention (CDC) Guideline for Isolation Precautions in Hospitals, the Needlestick Safety and Prevention Act. Objectives of In-Service: Upon completion of this training, the participants should have the following skills / knowledge: Recognize the risks of exposure to bloodborne pathogens Familiarity with the employer s Exposure Control Plan Develop an understanding of equipment and practice, which can help prevent exposure to bloodborne pathogens This knowledge will enable the participant(s) to identify situations with exposure risks and take the appropriate actions to prevent exposure Introduction Healthcare workers must protect their own health, as well as the health of their patients. The exposure to bloodborne pathogens is one risk that affects people in a wide range of healthcare related jobs. A relatively low number of individuals actually contract bloodborne illnesses while on the job. However, HIV/AIDS and Hepatitis B are the most common illnesses contracted. Infected blood and other potentially infectious body fluids transmit these diseases. While the risk is small, it is serious for people involved in patient care, emergency response and housekeeping functions. One may also need protection if handling patient linens or waste (including sharps) or performing laboratory related duties, which involve blood or body fluids. OSHA has developed a detailed regulation called the Bloodborne Pathogens Standard to provide awareness to healthcare employees of these protections. In order to protect healthcare workers from bloodborne pathogen exposure, it states that employers must: Develop a written Exposure Control Plan Provide employees with protective clothing and other barriers to exposure (PPE Personal Protective Equipment)

2 Develop housekeeping procedures, which keep the facility clean and sanitary without exposing employees to risk Mandate that employees follow universal precautions (treating ALL blood, blood products and body fluids as if they are infected) Provide special, labeled biohazard specific containers for sharps, soiled linens and any other items which may be contaminated with blood or other body fluids, which may be potentially infected Offer Hepatitis B vaccinations to all employees at risk, at no cost Provide immediate medical evaluation and follow up to any/all employees who are exposed to bloodborne pathogens Maintain accurate and confidential medical records Provide training for all employees regarding preventative controls and practices Employees have responsibilities as well. To avoid exposure to bloodborne pathogens, they must make use of all the training, procedures and precautions, which have been provided by their employer, at all times. These precautions are necessary because blood and other body fluids can transmit two serious viruses: HIV and hepatitis B. HIV, the virus that causes AIDS, attacks the body's immune system, which inhibits the ability to fight disease. Symptoms may not develop for years after infection. Eventually, most people lose weight and suffer from skin rashes, fatigue and fever. Eventually, people with AIDS generally die from opportunist infections such as pneumonia or unusual cancers, which their immune system can no longer fight. While AIDS treatment has made tremendous strides during the past several years, there remains no cure. The other major bloodborne virus is Hepatitis B (HBV). It is much more common than HIV, and can also be fatal. Hepatitis B infects the liver and can lead to liver cancer, cirrhosis, or chronic liver disease. Some infected individuals never develop symptoms related to Hepatitis B, but there is no way of knowing. Carriers (symptom free/ infected individuals) are capable of transmitting the disease as well. Fortunately, there is a vaccination for Hepatitis B. OSHA requires employers to offer it at no cost to anyone at risk of exposure. You are not required to have to have this vaccination series, but it is recommended in order to protect yourself. If you decline to be vaccinated, you will be required to sign a form stating that you have done so. If you change your mind, you can be vaccinated at a later time, and at no cost. You may encounter an individual at work with HIV or Hepatitis B. If you do, you are not as risk unless you contact their blood or other potentially infectious body fluids. Touching an infected person or using their equipment, showers, toilets or drinking fountains does not transmit the viruses. Coughs and sneezes do not transmit the viruses. Avoid direct contact between broken or irritated skin and infected body fluids to prevent exposure. Hepatitis B can also be transmitted through dried, caked blood and contaminated fluids. Sexual contact and sharing drug needles with an infected person pose the greatest risks. In the healthcare field, most exposures relate to injuries from sharps or infected hypodermic needles.

3 Do not take chances. Make the most of OSHA's recommended protections to remain healthy. Use personal protective equipment and follow all precautions in the written exposure control plan. Make universal (or standard) precautions a habit. Always treat all blood and other potentially infectious body fluids as if they are infected! Bloodborne Pathogens Training Background: Healthcare workers are at risk and may be exposed to illness while performing their jobs. It is extremely important to avoid exposure to blood and other potentially infectious body fluids or substances, which can transmit bloodborne pathogens. These micro- organisms can cause such diseases as HIV/AIDS, and HBV and HCV, the more common viruses that cause Hepatitis B and C. OSHA's Bloodborne Pathogen Standard was created to help protect employees from these pathogens in the workplace. Pre In-Service Test - True or False Exposure to blood is the only means by which bloodborne pathogens can be spread False! Synovial, pleural and cerebrospinal fluids, semen and vaginal secretions can also carry these pathogens True or False Needlesticks are the major means of bloodborne pathogens exposure True! It is imperative to follow safety rules with sharps to avoid needlesticks True or False Healthcare employees may be entitled to receive Hepatitis B vaccinations free of charge from their employers True! Employers must offer the vaccinations to all employees who could be exposed to Hepatitis B while performing their duties. Bloodborne Pathogens Policy: Briefly review the facility s policy regarding preventing exposure to bloodborne pathogens, including: Where to locate and review the written exposure control plan Which job titles, tasks and procedures pose exposure risks to bloodborne pathogens Does your facility follow standard or universal precautions The importance of using the proper equipment and following the proper procedures to reduce the risk of exposure

4 Major Points: Exposure To Bloodborne Pathogens Can Cause Serious Diseases Pathogens such as HIV, HBV, HCV and other diseases may be carried via blood and other potentially infectious materials Hepatitis (HBV, HCV) carriers may be asymptomatic and unaware that they have it Hepatitis can cause serious or fatal liver disease AIDS is usually fatal, despite major advances in the field Exposure to bloodborne pathogens can result from direct contact with blood or other infectious materials. These materials include semen, vaginal secretions and amniotic, cerebrospinal, pericardial, peritoneal, pleural, and synovial fluids Infected sharps are a major source of job related exposure Touching an infected person or touching items which have come in contact with an infected person is not an exposure risk Numerous healthcare jobs/duties pose exposure risks. Patient care, patient transport, blood collection / testing, janitorial / housekeeping, and laundry employees are examples of jobs / duties where there is a risk of exposure OSHA Requires Employers To Identify And Prevent Hazards Employers must help protect employees with: A written Exposure Control Plan which identifies jobs and tasks with bloodborne pathogen exposure risk and practices which prevent exposure Written schedules for cleaning and decontamination Personal protective equipment and other equipment, which reduce the risk of exposure Biohazard warning signs and labels on containers, which could house contaminated materials Offer hepatitis B vaccinations, free of charge, to all employees likely to be exposed to the virus Training which enables the affected employees to understand the hazards of bloodborne pathogens and ways to prevent exposure Practice Universal Precautions to Prevent Exposure Blood and other potentially infectious materials are to be treated as if they are infected In any situation with exposure risk (from patient care to waste handling) this precaution should be followed Follow standard precautions if required by your facility All bodily fluids, with the exception of sweat, should be treated as potentially infectious The use of standard precautions helps protect against bloodborne pathogens and most communicable diseases

5 The Needlestick Safety and Prevention Act Requires Healthcare Facilities to use Engineering Controls to Prevent Exposure Prevent needlesticks by selecting needleless devices or equipment which: Have a barrier between the needle and hands after use Permits or requires hands remaining behind the needle at all times Are an integral part of the equipment/device rather than being an accessory Provides protection before the equipment/device is disassembled and after disposal Identify and use sharps less likely to cause needlesticks and bloodborne pathogen exposure such as: Blunt suture needles Needles which retract into a vacuum tube holder or syringe Capillary tubes wrapped in puncture resistant film or made of plastic to avoid breakage Sliding needle shields which are attached to vacuum tubeholders, disposable syringes or other needles Take precautions with sharps to prevent exposure Never shear or break contaminated needles Never recap, bend or remove contaminated sharps. Use a mechanical device or forceps if medically required to do so Deposit all used sharps in appropriately identified puncture resistant leak-proof biohazard container Use caution when handling containers, which are red and/or have fluorescent orange - red labels with "Biohazard" word and symbol When holding sharps in water filled sinks, use strainer baskets. Remove them with forceps, not hands Identify and prevent splashes and other exposure risks with the use of equipment such as splashguards, glove boxes, mechanical respiratory devices, etc. The Bloodborne Pathogens Standard requires employers to maintain a sharps injury log to record needlestick injuries Employers are required to solicit input from nonmanagerial employees responsible for direct patient care about work practices and effective engineering.

6 Use PPE to Protect Against Exposure Employers must provide appropriate sizes of PPE and at no cost to employees Wear Gloves when performing vascular access procedures or during tasks where hands may come in contact with blood or other contaminated materials Most gloves are latex, but alternatives should be available for those with an allergy to latex Change gloves once contaminated and after each patient or procedure When the potential exists for splashing, spattering, spraying blood or other potentially infectious materials, appropriate PPE should be provided: Face and eye protection Protective fluid resistant or fluid proof long sleeved clothing Shoe and/or cap covers for high risk situations/procedures (e.g., autopsies) Promptly remove contaminated PPE without letting it touch your skin Contaminated PPE should not be worn in clean areas, to handle phones etc. Contaminated PPE should be placed in assigned locations for disposal or cleaning Follow Universal Precautions Wash hands with warm water and soap as quickly as possible after each contact with blood or potentially infectious substances Flush mucous membranes or eyes with water as quickly as possible after exposure Wash hands vigorously after the removal of gloves or other PPE Faucets and dry hands should be handled with separate clean paper towels Do not eat, smoke, drink, apply lip balm or cosmetics, or handle contact lenses in zones where exposure risks to bloodborne pathogens could occur Do not store food, drinks or other objects in refrigerators, cabinets or on countertops etc., where blood or other potentially infectious substances are present Follow decontamination and cleaning schedules for surfaces, equipment and reusable containers Immediately clean after contamination Protective covering should be used on equipment that is difficult to decontaminate Minimize the handling of contaminated laundry Contaminated laundry should be placed in leak-proof bags Never pick up contaminated glass by hand Transported contaminated sharps, waste, or other items in assigned closed, leak-proof containers Containers that may break or leak should be placed in secondary containers Do not open, empty or clean contaminated containers by hand

7 Utilize Medical Protection Programs Receive Hepatitis B vaccinations if offered Immediately report any possible exposure incidents Obtain a confidential, voluntary medical evaluation and follow-up You can learn the results of a voluntary blood test and the blood test results of the source of exposure (if the source is known and agrees to be tested). You have the right to scrutinize and copy your records, which include Hepatitis B vaccinations and exposure-incident results Summary Exposure to blood and other potentially infectious substances pose a risk of exposure to bloodborne pathogens such as HIV and hepatitis Take full advantage of training, Exposure Control Plan information, hepatitis B vaccinations and protective equipment and practices that help prevent exposure to bloodborne pathogens while on the job Practice universal and/or standard precautions, which treat all blood and other potentially infectious substances as if they are infected Select sharps, which are designed to prevent needlesticks and follow safety rules for their use and disposal Select and use gloves and other PPE, which prevent direct contact with blood and other potentially infectious substances Wash hands regularly and vigorously and follows other protective hygiene practices Follow decontamination and cleaning practices, including using proper PPE Promptly report any exposure incidents, and take advantage of confidential medical evaluation

8 Bloodborne Pathogen Knowledge Challenge Answer each of the following questions True or False - Circle the correct answer. 1. Bloodborne pathogens like HIV and Hepatitis B are only transmitted by direct contact with blood. 2. OSHA's Bloodborne Pathogens Standard applies only to employees providing direct patient care. 3. Contaminated sharps are a common cause of bloodborne pathogens exposure incidents in the healthcare field. 4. The handling of all blood and other potentially infectious body fluids as if they are infected is the meaning of universal precautions. 5. Safer needle devices may include a barrier between the hands and needle after use. 6. Gloves are the only required PPE to prevent exposure to bloodborne pathogens. 7. OSHA mandates that that contaminated sharps be sheared, capped or broken before disposal. 8. Food and beverages may be kept in the same refrigerator as blood samples. 9. Contaminated sharps are transported in closed, labeled, leak-proof, puncture proof containers, which are usually red. 10. Employees exposed to potentially infectious substances or blood are entitled to confidential medical evaluation and blood testing. Name (printed) Signature Date

9 Answer Key: 1. False 2. False 3. True 4. True 5. True 6. False 7. False 8. False 9. True 10. True