HIV/AIDS

Elaine Kauschinger PhD, MS, ARNP, FNP-BC

Assistant Professor of ClinicalLead Faculty, Family Nurse Practitioner Program

University of MiamiSchool of Nursing & Health Studies

Part 4:Prevention & Infection Control

Infection control practices

Standard precautions• Standard precautions are the basic level

of infection control that should be used in the care of all patients all of the time

Hand hygiene Gloves, gowns, masks, face shield, & eye

protection Patient care equipment 1:10 bleach solution for accidental infectious

fluid/blood spills

Post Exposure Prophylaxis

A bloodborne pathogen is a pathogenic microorganismss that are transmitted via human blood and cause disease in humans. They include, but are not limited to, hepatitis B

virus, and human immunodeficiency virus. Although a number of pathogens can be transmitted percutaneously, HIV remains the most common. Mosby's Medical Dictionary, 8th edition, 2009, Elsevier

What is the Occupational Safety and Health Administration (OSHA)? Created in 1970 to ensure a safe and

healthy workplace. In 1991 the Bloodborne Pathogen

standard was created. In 2001 the Needlestick Prevention Act

required employers to select safer devices.

All institutions are required to develop and implement a bloodborne pathogen exposure control plan.

Types of Bloodborne Pathogen Exposures

Needlestick injuries are wounds caused

by needles that accidentally

puncture the skin.Sharps Injury

scalpels

Splash

Cutaneous Exposure

Exposure These situations require consideration of

treatment with HIV antiretroviral therapy:• Post exposure prophylaxis (PEP)

Average risk of HIV transmission following percutaneous exposure to • Infected blood: 0.3%• Mucous membrane exposure: 0.09%• After skin exposure: unknown • Following exposure to fluids or tissues other

than blood: unknown Risk of transmission of hepatitis B virus after a

large bore needle stick is approximately 5% while to hepatitis C virus is 1.8%

Post Exposure Management

Clean exposed area with soap and water

Apply first aid

Supervisor Assistance –follow instructions located in UM Student Handbook (located on-line).

Counseling to determine need for PEP

Initiation of PEP, as needed, within 2 hrs

Post Exposure Management

Post Exposure drug management dependent upon severity of injury:– Percutaneous

– Mucous membrane

– Skin

Resources

National Clinicians’ Post-Exposure Hotline (PEPLine): 888-448-4911

Post-Exposure Prophylaxis Registry for Health Care Workers: 888-737-4448 (888-PEP-4HIV)

CDC (for reporting HIV seroconversion in health care workers who received PEP): 404-638-6425

National Post-Exposure Prophylaxis Hotline: 888-HIV-4911

Florida/Caribbean AIDS Education & Training Center: www.FCAETC.org