Presentation on theme: "BLOODBORNE PATHOGEN PLAN TB EXPOSURE CONTROL PLAN ISOLATION"— Presentation transcript:
1 BLOODBORNE PATHOGEN PLAN TB EXPOSURE CONTROL PLAN ISOLATION THE EXPOSURE CONTORL PLAN IS COMPRISED OF 3 AREASTHE BLOODBORNE PATHOGEN PLANTHE TB EXPOSURE CONTROL PLANAND OUR ISOLATON PROCEDURES
2 can be found on every department at PSMH or via the An Exposure Control Plan Manualcan be found on every department at PSMHor via theDovenet policy & procedures infection controlEXPOSURE CONTROL MANNUALS ARE LOCATED on Dovenet under policy and procedures Infection Control!OSHA SAYS IT WILL BE AVAILBLE TO EVERYONE.
3 BLOODBORNE PATHOGEN PLAN THE FIRST ONE WE WILL DISCUSS IS THE BLOODBORNE PATHOGEN PLAN
4 WHAT ARE BLOODBORNE PATHOGENS? viruses and bacteria that require bloodor body fluids to liveWHAT ARE BLOODBORNE PATHOGENS?THEY ARE VIRSUES AND BACTERIA THAT REQUIRE BLOOD OR BODY FLUIDS TO LIVE.
5 PSMH Bloodborne Pathogen Plan WHAT BACTERIA AND VIRUSES AREWE TALKING ABOUT?HIV, HEPATITIS C, SYPHILIS, DELTA HEPATITIS,B HEPATITIS, AND MALARIAWE are MAINLY CONCERNED withHIV, HEPATITIS B AND C.VIRSIS AND BACTERIA THAT REQUIRE BLOOD/BODY FLUIDS TO LIVE AREHIV, HEPATITIS B AND C, SYPHILIS, EBOLA, HEMMORAGIC FEVER, AND SEVERALOTHERSTHE ONES WE SEE MOST COMMONLY AND WORRY ABVOUT THE MOSTARE HIV, HEPATITIS B & C. NO ONE WALKS AROUNG WITH A MAJIC “H”THEIR FOREHEAD THAT WARNS US TO BE CAREFUL.
6 These bacteria & viruses can live in these BLOOD & BODY FLUIDS P BLOOD AND BLOOD PRODUCTSP CEREBRAL SPINAL FLUIDP PLEURAL FLUIDP PERICARDIAL FLUIDP PERITONEAL FLUIDP SEMEN, VAGINAL FLUIDP AMNIOTIC FLUIDP SYNOVIAL FLUIDWHICH BLOOD AND BODY FLUIDS CAN THESE BACTERIA AND VIRSUS LIVE IN?
7 How are Bloodborne Pathogen spread? When infected fluids enter the body through:Cuts, scrapes or other breaks in the skinNeedle-stick injuriesSplashes into the mouth, nose or eyesOral, vaginal or anal sexUsing infected drug needlesPregnant women who are infected with these pathogens may pass them to their babies.
8 HOW DO YOU KNOW IF SOMEONE HAS ONE OF THESE VIRSUS? YOU DON’T!SIGNES AND SYMPTOMS OF HEPATITIS B & HEPATITIS C: (Flu like)Loss of Appetite, Tired feelingLow grade temperatureVague abdominal pain and discomfortDiarrhea or vomitingYellow skin or eyesPatients with Hepatitis B or C may or may not have symptoms and will not be diagnosed unless they become jaundiced (yellow) – BUT THEY ARE STILL CONTAGIOUS!
9 Signs & Symptoms of HIV: Flu-like symptoms in the beginningMay have more frequent bouts of flu, coldsEventually develop AIDS and will be diagnosedFever, diarrhea and fatigue (tired feeling)It can take up to 10 years or longer beforea person is sick enough to be diagnosedwith HIV. In the mean time they arecontagious!
10 WHAT CAN WE DO TO PROTECT HEALTHCARE WORKERS? STANDARD PRECAUTIONS/UNIVERSAL PRECAUTIONS WERE DEVELOPED BY OSHA AND CDC.HOW CAN WE PROTECT HEALTHCARE WORKERS WHO COME IN CONTACT WITH PATIENTS EVERYDAY AND ARE AT RISK TO COME IN CONATACT WITH THESE BLOOD/BODY FLUIDS?OSHA AND CDC GOT TOGETHER AND DEVELOPED STANDARD TO PROTECT HCW.
11 PSMH Bloodborne Pathogen Plan STANDARD/UNIVERSAL PRECAUTIONS:A SYSTEM THAT OUTLINES SAFEGUARDS OR BARRIERS DESIGNED TO PROTECT HEALTHCARE WORKERSPersonal Protective EquipmentEngineering controlHousekeepingWork Practice Controls
12 PSMH Bloodborne Pathogen Plan STANDARD/UNIVERSAL PRECAUTIONS REQUIREPERSONAL PROTECTIVE EQUIPMENTFOR EACH AND EVERY PATIENTIf there is a possibility that you are going to touch or come in contact with anyone's blood, body fluids or mucous membranes:YOU WILL WEAR GLOVESIf there is a possibility of blood or body fluids splashing or coming in contact with your eyes nose or mouthYOU WILL WEAR A MASK & GOGGLES OR A SHIELDED MASKSTANDARD UNIVERSALPRECAUTIONS SAY: IF THERE IS APOSSIBILITY THAT YOU WILL COME N CONTACT WITH SOMEONE ELSES’ BLOOD OR BODY FLUIDS YOU WILL PROTECT YOURSELFIF THERE IS A CHANCE YOU MIGHT TOUCH SOME ELSES BLOOD/BODY FLUIDS OR MUCOUS MEMBRANES YOU WILL WEAR GLOVES.IF THERE IS ACHANCE YOU MIGHT BE SPLASHED BY BLOOD/BODY FLUIDS YOUR WILLWEAR A MASK AND GOGGLES OR A SHIELDED MASK.
13 PSMH Bloodborne Pathogen Plan STANDARD/UNIVERSAL PRECAUTIONS REQUIREPERSONAL PROTECTIVE EQUIPMENTFOR EACH AND EVERY PATIENTIf there is a possibility that you might have your clothing soiled with someone's blood or body fluidsYOU WILL WEAR A GOWNPersonal Protective Equipment (PPE) is located in each and every patient room (except in the Psychiatric Unit, 2E) in a beige BSI Box on the wall (gloves, gowns, masks, shielded masks, goggles and AMBU BAGS)When you use this equipment – REPLACE IT IMMEDIATELY!IF THERE IS A CHANCE THAT YOUR CLOTHING MIGHT COME IN CONTACT WITH BLOOD OR BODY FLUIDS YOU WILL WEAR A GOWN.YOU ARE THE ONLY PERSON WHO CAN PROTCT YOU!YOU HAVE TO PUT THE PROTECTIVE EQUIPMENT ON!YOU HAVE TO THINK ABOUT WHAT YOU ARE GOING TO DO AND PROTECT YOURSELF-IN ANY SITUTATION YOU ARE THE MOST IMPORTANT PERSON THERE.!!! AND THE ONLY ONE WHO CAN PROTECT YOU.
14 PSMH Bloodborne Pathogen Plan STANARD/UNIVERSAL PRECAUTONS REQUIREENGINEERING CONTROLSBiohazard Labels and containersSafety NeedlesNeedless IV SystemsSharps containersSafety scalpelsSafety equipment is only as good as thepeople who use it!When safety equipment is provided use itactivate the safety mechanisms as soon asyou are done with the procedure.
15 PSMH Bloodborne Pathogen Plan STANDARD/UNIVERSAL PRECAUTONS REQUIREHOUSEKEEPING:Proper disposal of SHARPS and broken glassNever reach into trashDispose of sharps containers when 2/3 fullClean up Blood/Body Fluids using the proper equipment and according to policy
16 PSMH Bloodborne Pathogen Plan STANDARD/UNIVERSAL PRECAUTONS REQUIREWORK PRACTICE CONTROLS:NEVER bend, break, or RECAP a NeedleMinimize splashing of fluids during collection or disposalDon’t eat or drink in work areasWash your hands or skin after contact with body fluids or objects that might be contaminated
17 PSMH Bloodborne Pathogen Plan HEPATITIS B VACCINE:Hepatitis B is the only Bloodborne Pathogen we can protect against!IF YOU HAVE NOT BEEN VACCINATED FOR HEPATISIS B WE WILL GIVE THE VACCINE FREE OF CHARGE!See the Employee Health Nurse – Brenda Dearth
18 PSMH Bloodborne Pathogen Plan HEPATITS B VACCINECONSISTS OF 3 INJECTIONS1- now1- one month later1- five months after the secondA TITER DRAWN BY THE LABORATORY 2 MONTHS AFTER COMPLETION OF THE SERIES.If you are not immune after the vaccination series you will be offered a repeat vaccine series – if you are not immune after the second vaccination series you will not become immune. IF you are exposed to Hepatitis B you can be given Immune Globulin that will give you temporary immunity for 3 to 6 months
19 PSMH Bloodborne Pathogen Plan WHAT IS AN EXPOSURE?It’s any time blood or body fluids come in contact with a worker’s eyes, nose, mouth or skin through a needlestick, splash, or other type of exposure
20 PSMH Bloodborne Pathogen Plan WHAT SHOULD YOU DO IF YOU HAVE AN EXPOSURE?FIRST:WASH THE AFFECTED AREA THROUGHLY WITH WARM WATER AND SOAP AT ONCE!FOR MOUTH OR EYE EXPOSURE THROUGHLY RINSE OUT YOUR MOUTH WITH WATER OR MOUTHWASH: FLUSH EYES WITH WARM WATER OR A SALINE SOLUTIONS.
21 PSMH Bloodborne Pathogen Plan SECOND:NOTIFY YOUR IMMEDIATE SUPERVISORTHEY WILL CALL THE HOUSE OPERATIONS MANAGER (HOM)THE HOM WILL TEST THE SOURCE FOR HIV, HEPATITS B AND HEPATITIS C.NOTIFY YOU OF THE HIV TEST RESULTS WITH IN ONE HOUR.THE HOM WILL FILL OUT A EXPOSURE FORM AND AN EMPLOYEE INJURY FORM
22 PSMH Bloodborne Pathogen Plan IF THE PATIENT IS KNOWN TO BE HIV POSITIVE OR TESTS HIV POSITIVE.You will be sent to the ED or the Occupational Health Office for follow-up IMMEDIATELY. And the Infectious Disease Physician will consult with you about your exposure.If it is a significant exposure and you need medication to help prevent you from turning positive to HIV it will be provided to you immediately.IN ORDER TO PROVIDE YOU WITH THE BESTTREATMENT AVAILABLE IT IS VERYIMPORTANT THAT ALL EXPOSURES AREREPORTED IMMEDIATLEY.
23 PSMH Bloodborne Pathogen Plan THIRD:CONTACT THE EMPLOYEE HEALTH NURSE FOR FOLLOW-UPThe Employee Health Nurse will do base line testing on you – this is for your benefit. She will do a HIV, Hepatitis Profile and a Hepatitis B Titer if you have been vaccinated.If your Hepatitis B titer is below 10 she will offer to revaccinate you. If you do not become immune after the second vaccinationThe Employee Health Nurse will provide follow-up on the source testing – HIV, Hepatitis B and Hepatitis C.The Employee Health Nurse will provide you with a written consultation, and follow-up testing as required.
24 ANY TIME YOU HAVE ANY QUESTONS PLEASE CONTACT THE INFECTION CONTROL COORDINATORPaula Pourchot RNINFECTION CONTROL DEPARTMENTPHONEPAGER(Available 24 hours a day on pager or through theHOM. Pager number also available on answering machine)
26 PSMH TB Exposure Control Plan WHAT IS TB?Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis.The bacteria usually attack the lungs. But, TB bacteria can attack any part of the body such as the kidney, spine, and brain.If not treated properly, TB disease can be fatal.TB disease was once the leading cause of death in the United States.
27 PSMH TB Exposure Control Plan HOW IS TB SPEAD?TB is spread when a person with active TB, who is infectious (sick with TB) coughs, laughs, talks or sings and expels the small bacteria (particle) into the air and someone near by breaths it into their lungsThis bacteria (particle) is so small it can stay in the air for up to 90 minutes.
28 PSMH TB Exposure Control Plan Patients are screened when they enter the hospital for TB by asking them if they have any signs of Infectious TB.Cough lasting longer than 2-3 weeksLow grade temperatureNight SweatsCough up bloodUnexplained weight lossLoss of appetiteFeel weak
29 PSMH TB Exposure Control Plan When these signs and symptoms are present the patients chest x-ray is checked and their doctor is called and ask if the patient could possible have TB. If the Doctor feels this patient may have TB or there is a cavitations in their lungs they are transferred to a “Negative Pressure Isolation and placed in “AIRBORNE ISOLATION”
30 PSMH TB Exposure Control Plan Airborne Isolation requires a room with special ventilation:The air in the room exit the room through a special filter or directly outside. It is not recirculated.The Door is kept shut at all times (except when entering or leaving the room.)Health care workers, visitors and Doctors who enter the room MUST wear an N95 Particulate Filter Respirator Mask.Healthcare workers MUST be fit tested and passed the fit test in order to wear the mask.Visitors must be taught how to put the mask on and fit checked by staff before entering the room.
31 PSMH TB Exposure Control Plan TB SCREENING:PPD (Mantoux Testing) is done on hire and anytime a healthcare worker or volunteer is exposed to MTB.Anyone who tests positive for the first time is sent to the Kankakee County Health Department for evaluation and possible treatmentTreatment is provided Free by the Kankakee County Health Department.
32 PSMH Bloodborne Pathogen Plan A POSITIVE TB TEST (PPD, Mantoux Test) means:You have come in contact with the TB germYou are not infectious unless you have signs/symptoms of TBYou cannot give TB to anyone at this stage.
33 PSMH TB Exposure Control Plan If you come in contact with someone who is infectious in the hospital what happens?When a patient is placed in Airborne Isolationthe doctor will order 3 AFB Sputum TestsIf the test comes back positive for AFB the patient will be placed on treatmentThe specimen is then cultured and if the results are positive for TB you will be contacted and a PPD test will be done approximately 3 months after your exposure
34 PSMH TB Exposure Control Plan PSMH is considered at LOW Risk for contact with Mycobacterium TB:Therefore we do not do annual TB testingStaff/Volunteers will be tested if they areexposed to a patient with active infectious TB.
35 PROVENA ST. MARY’S HOSPITAL ISOLATION GUIDELINES
36 PSMH Isolation Guidelines How do I know if a patient requires ISOLATION?The first policy under ISOLATION in the Exposure Control Manual is called “ISOLATION GUIDELINES”This policy lists all the conditions and bacteria requiring IsolationThe type of Isolation requiredThe duration of IsolationThis policy is also in the Infection Control Policy manual on line.
37 PSMH Isolation Guidelines There are Three different types ofIsolation are used at PSMHAIRBORNEDROPLETCONTACT
38 PSMH Isolation Guidelines Airborne IsolationAirborne Isolation is used for TB, Chickenpox (Varicella) and Disseminated HerpesIf or When we see Smallpox, SARS, or Avian Flu it will be used for these also.
39 PSMH Isolation Guidelines Airborne IsolationFor TB – requires EVERYONE entering the room to wear an N95 Particulate Filter Mask, HealthCare Workers must be fit tested and have passed the fit test.Visitors must be fit checked to wear the mask.
40 PSMH Isolation Guidelines Airborne IsolationFor Chicken Pox (Varicella) and Disseminated Herpes (Shingles in more than one nerve) or Shingles in an immune -compromised patient)If you are immune to chicken pox you may enterthe room without a N95 Particulate FilterRespirator Mask.If you are not immune have someone who isimmune go in the room or wear an N95 ParticulateFilter Respirator Mask for which you have been fittested and passed
41 PSMH Isolation Guidelines Droplet Isolation:Used for respiratory infections:Pertusses (Whooping Cough)InfluenzaPneumonic plagueDiptheriaMycoplasma PneumoniaMumpsRubellaHaemophilus influenza type b (pneumonia and sepsisBacterial Meningitis
42 PSMH Isolation Guidelines Airborne Isolation:Requires a private room equipped with negative air flow. (MICU 346, SICU Rooms 5 & 6, Peds room , Recovery Room and Room 8 in OR.)The DOOR MUST REMAINED CLOSED.Dedicate equipment to the patient (thermometer, B/P Cuff, etc.) use disposable equipment whenever possibleAny equipment used for the patient and taken out of the room must be thoroughly disinfected before it is used again.
43 PSMH Isolation Guidelines Droplet IsolationRequires that a surgical mask be worn by EVERYONE who enters the room.This is in addition to Standard Precautions
44 PSMH Isolation Guidelines Contact IsolationIs used forDiarrhea infectionSalmonella, Shigella,Hepatitis A, Roto virusClostridium difficile Undiagnosed diarrheaRespiratory InfectionsRSV (Respiratory Synovial Virus)Enterovial infections in infants/childrenSkin InfectionsImpetigo Zoster (chicken Pox, Shingles)Scabies
46 PSMH Isolation Guidelines Hand Hygiene when caring for a patient with Clostridium difficile requiring Contact Isolation DO NOT USE WATERLESS ALCOHOL HAND SANITIZER! DO USE SOAP AND WATER!
47 PSMH Isolation Guidelines Clostridium difficile is called a spore forming bacteria – it develops a hard coat to prevent alcohol or disinfectants to enter it – so it is very difficult to kill. The only way to make sure it is not on your hands when you leave a patient who has this bacteria is to wash your hands with soap and water.
48 Contact Isolation for Clostridium difficile: PLACE A SIGN ON THE ALCOHOL DISPENSER IN THE PATIENTS ROOM THAT SAYS:“PLEASE USE SOAP AND WATER FOR HAND HYGIENE. DO NOT USE ALCOHOL GEL!!!”
49 PSMH Isolation Guidelines Contact Isolation:Requires Gown, and gloves be wornbyEVERYONE upon entering the roomEVERY TIME they enter the room!Healthcare workersVisitors, family membersDoctorsVolunteers are not to enter any Isolation RoomIsolation Education must be documented for all patients and visitors.
50 HAND HYGIENE IS THE SINGLE MOST IMPORTANT THING YOU CAN DO TO PROTECT YOUR PATIENTS, YOURSELF AND YOUR FAMILY! YOU CANNOT REMEMBER WHERE YOUR HANDS WERE FIVE MINUTES AGO AND YOU DO NOT KNOW WHERE THEY WILL BE FIVE MINUTES FROM NOW!!!!
51 HAND HYGIENE Perform Hand Hygiene: Before patient contact as you walk into the patients’ roomBefore doing invasive tasks (Starting IV s)Before taking care of newborn, touching all wounds, touching non intact skin or mucous membranes, starting your shift,Before doing vital signsBefore dispensing oral or IV medications and nutritional substances
52 HAND HYGIENE Perform Hand Hygiene: After contact with wounds, mucous membranes, blood and body fluids, secretions and excretions and other potentially infectious materialAfter contact with equipment, inanimate objects, or surfaces that are likely to be contaminated (over bed table, phone, chart, TV, Call light, IV, Door handle, etc.)After leaving an isolation roomAfter removing gloves and other Personal Protective EquipmentAfter giving patient’s Medications or feeding themAs you leave the patient’s roomAfter your shift before leaving work
53 All equipment must be cleaned after use between patients. Germicidal Wipes- need to have wet contact time of 2 minutes on the surface, then be allowed to air dry to kill the bacteria and virusesVirasept - Broad Spectrum Disinfectantcomes in a spray bottle- need to have wet contact time of 10 minutes on the surface, then be allowed to air dry to kill the bacteria and viruses** must be used for all patients with diarrhea
54 use a germicidal wipe to: Clean equipment after patient use (lift equipment, glucometer)Clean room (bedside tables etc.)Clean Stethoscopes, blood pressure cuffs and data scopesClean medication pass area prior to preparing medicationClean pill crushersClean crash cartClean counters, keyboards, mouseClean telephone, pens and highlighters at nurses stationClean patient kitchen, counter, microwave, refrigeratorClean isolation binders
55 For questions please contact: Paula Pourchot RNInfection Control PreventionistPhonePager