BLOODBORNE PATHOGENSBloodborne Diseases

HIV

HBV

HCV

Objective• Understand the difference between HBV, HCV, and HIV• Learn effective ways to decrease risks• Understand the Exposure Control Plan• Able to identify engineering controls• Understand work practice controls• Sharps safety guidelines• Personal protective equipment• Good housekeeping practices

Hepatitis B• Causes serious liver disease• Half of those infected have no symptoms• Symptoms include: jaundice, abdominal pain, loss of

appetite, occasional nausea and diarrhea• 10% become chronically infected• Each year – 5,000 die from chronic liver cancer• Hepatitis B vaccine is recognized as an effective defense

against Hepatitis B.

Hepatitis C• Causes serious liver disease• Causes symptoms similar to hepatitis B• 85% of people infected with HCV have chronic infections• People with chronic infections have no symptoms for up to

30 years – but the liver is slowly being damaged• No vaccine is available to treat Hepatitis C• Newly approved antiviral drugs have been effective

HIV – Human Immunodeficiency Virus

• Attacks the immune system

• Infected person becomes symptomatic when the immune system loses its ability to fight infections.

• HIV can lead to Acquired Immune deficiency - AIDS

• According to the CDC – 900,000 are infected

• The number of people who develop AIDS has decreased

Transmission • Usually spread by contact with blood

• Spread by contact with other potentially infectious materials (OPIM)

• Other body fluids or tissue containing visible blood• Semen and vaginal secretions• cerebrospinal, synovial , pleural, peritoneal, pericardial and amniotic

fluids. • Saliva in dental procedures• Non-intact skin, organs from both living and dead humans• Cell tissue, organ cultures, biological matter from lab experiments

Means of Transmission• Accidental injury by a contaminated sharp object

• Needles, scalpels, broken glass, exposed dental wires

• Open cuts or abrasions on the skin

• Indirect transmission

• Needle stick injuries cause 80% of the exposures

• Contaminated surfaces = HBV

Exposure Control Plan

• Written plan to minimize occupational exposures

• Identifies the job classifications that have exposure risks

• Identifies job classifications that have some risk of exposure

• Lists the tasks and procedures performed by those workers

• Changes made to eliminate or decrease risk of exposures

• Procedures to follow if an exposure occurs

Engineering Controls

Devices that isolate or remove bloodborne pathogens hazards

• Sharps disposal containers• Self-sheathing needles• Safer medical devices

• Sharps with engineered sharps-injury protection• Needless systems

Engineering Controls

The effectiveness of the controls depend on you!

A sharps container provides no protection if you do not use it properly. Capping a needle

by hand before using does not provide effective prevention controls.

Work Practice Controls

• Handwashing

• Decreases the chance of infection• Decreases the risk of transmission• Wash you hands

• Every time you remove or change your gloves• When you come into contact with blood or body fluids• Between caring for patients• Use antiseptic hand cleaner when running water is not

available. • Wash your hands as soon as possible if antiseptic cleaner is used

Handwashing• According to WHO (World Health Organization)

• Adequate handwashing with soap and water• takes 40-60 seconds

• The average time adopted by healthcare• workers is <10 seconds.

• Adequate Alcohol based hand rubbing technique – 20-30 seconds.

Personal Hygiene

• When performing procedures that involve blood• Minimize splashing or spraying of the material• Do not eat, drink, smoke, apply make-up, or contact

lenses• Avoid petroleum based lubricants • Never mouth pipette or suction blood or potentially

infectious material.• Don’t store food or drinks anywhere that blood products

or infectious materials may be present.

Personal Protective Equipment (PPE)

• Equipment that protects from contact with potentially infectious material.

• Equipment must not allow infectious material to touch clothes, skin, or mucous membranes.

• Use the appropriate PPE for the task being performed

• Protective equipment is provided at no cost

Examples of PPE• Hazard – potential exposure to eyes, nose, and/or mouth• Mask and eye protection or face shield

• Hazard – potential clothing or skin exposure• Gown, gloves, apron, or other protective clothing

• Hazard – Encounter large amounts of blood • Gloves, gown, surgical cap, and shoe covers

• Providing peri-care to a patient• gloves

General Rules for using PPE• Obtain proper training prior to using

• Use the appropriate protective equipment for the task

• Inspect the PPE for any defects

• Make sure the PPE fits properly – including gloves

• Remove soiled PPE as soon as possible

• Before leaving the work area – remove all PPE

• Place PPE in the designated area for disposal or decontamination.

Resuscitation Devices

• Avoid unprotected mouth-to-mouth resuscitation

• Carry pocket masks as part of your PPE kit

• Use mechanical emergency respiratory devices if available in an emergency.

Gloves – Proper Use • Primary barrier between hands and infectious material

• Use when • Anticipate contact with body fluids, excretions, or mucous

membranes, open areas on a patients skin.

• Change gloves after:• Contact with blood or body fluids• Completing a task with one patient before moving to another

patient• Contacting a potentially contaminated site before moving to a

clean site

Gloves – Removal

• Follow safe removal procedures:• With both hands gloved, peel one glove off from the top to bottom

• Hold the removed glove in the gloved hand

• With ungloved hand, peel the second glove from the inside

• Tuck the first glove inside the second glove

• Dispose of the gloves while bundled

• Wash hands properly

Proper Hand Washing Technique

Infection Control Plan

• Surveillance

• Identification

• Prevention

• Control

• Reporting

Hepatitis B Vaccine• According to OSHA – the HBV vaccination must be

offered after workers have received the required bloodborne pathogen training.

• Hepatitis B vaccine is a recognized as an effective defense against HBV infection.

• Exposure incidents must be reported immediately

• Post-exposure evaluations and follow-up are made available.

Housekeeping• Everyone is responsible for good housekeeping

• Clean and decontaminate at the end of each shift

• Clean all equipment and work areas when contaminated

• Replace protective coverings on equipment

• Place infectious waste in proper containers

• Place contaminated laundry in labeled, leak-proof bags

Everyone is responsible to prevent

exposure to bloodborne pathogens and infectious material

References• OSHA FactSheet. hepatitis B vaccination protection. Occupational Safety and Health

Administration; 2011. www.osha.gov [accessed 18, December 2012.]

• OSHA FactSheet. OSHA bloodborne pathogens standard. Occupational Safety and Health Administration; 2011. www.osha.gov [accessed 18, December 2012.]

• Occupational Safety and Health Administration. 2011. Bloodborne pathogens and needlestick prevention. www.osha.gov/SLTC/bloodbornepathogens/index. [accessed 18, December 2012]