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Prevention of Blood-Borne Virus Infections. Learning Objectives 1.List causes of bloodborne pathogen infections 2.Outline risk reduction measures for.

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Presentation on theme: "Prevention of Blood-Borne Virus Infections. Learning Objectives 1.List causes of bloodborne pathogen infections 2.Outline risk reduction measures for."— Presentation transcript:

1 Prevention of Blood-Borne Virus Infections

2 Learning Objectives 1.List causes of bloodborne pathogen infections 2.Outline risk reduction measures for healthcare workers 3.Identify methods for reducing risk of bloodborne infections in patients 2 December 1, 2013

3 Time involved 40 minutes December 1,

4 Blood-borne Viruses Main blood-borne viruses transmitted in health care settings: Human immunodeficiency virus Hepatitis C virus Hepatitis B virus 4 December 1, 2013

5 Hepatitis B virus (HBV) Found in all body secretions and excretions Only blood (and serum-derived fluids), saliva, semen, and vaginal fluids infectious May survive on environmental surfaces for more than a week Indirect exposure to HBV can occur Risk of transmission of HBV is reduced by immunisation 5 December 1, 2013

6 Hepatitis C virus (HCV) Primary cause of parenterally transmitted hepatitis Transmitted via blood No immunisation available 6 December 1, 2013

7 Human immunodeficiency virus (HIV) Transmitted via sexual contact, injection drug use, and from mother to neonate Percutaneous exposure a more effective means of transmission than mucous membrane exposure 7 December 1, 2013

8 HCW Exposure Healthcare workers may be exposed to blood- borne infections from: Lacerations Punctures Non-intact skin exposures to the blood or body fluids of infected patients Surgical or invasive medical/dental procedures 8 December 1, 2013

9 Blood/Body Fluid Exposure among Healthcare Workers 9 Puncture wound Mucous membrane contact Skin contact December 1, 2013

10 Patient Exposure Patients may be exposed to blood-borne infections from: Improperly sterilised equipment Unsterile injection fluids Contaminated infusions Transplantation Blood of infected HCWs during invasive procedures 10 December 1, 2013

11 Healthcare Worker Risk Reduction - 1 Always use disposable gloves whenever exposure to blood or body fluids likely NEVER re-sheath needles Containers for sharps disposal should be available within arm’s length When sharp items being used 11 December 1, 2013

12 Healthcare Worker Risk Reduction - 2 Containers sealed with a tamper proof lid Safely discard when three quarters full Standard Precautions must be adopted Immunise high-risk HCWs Always use available safety devices 12 December 1, 2013

13 Safety Devices: examples 13 Safety hypodermic needle Safety scalpel December 1, 2013

14 Safer Needle Devices - 1 Needleless Connector Systems Needleless connectors for IV delivery systems 14 December 1, 2013

15 Safer Needle Devices - 2 Self-Sheathing Safety Feature Sliding needle shields attached to disposable syringes and vacuum tube holders 15 Before use After use December 1, 2013

16 Safer Needle Devices - 3 Retractable Technology Needles or sharps retract into a syringe, vacuum tube holder or back into the device 16 December 1, 2013

17 Safer Needle Devices - 4 Self Blunting Technology Self-blunting phlebotomy and winged-steel “butterfly” needles 17 Blunt-Tipped Blood Drawing Needle Winged Steel Needles December 1, 2013

18 Safer Needle Devices - 5 Add-on Safety Features Hinged or sliding shields attached to phlebotomy needles, winged steel needles and blood gas needles 18 Add-on sliding shield December 1, 2013

19 One Handed Technique 19 December 1, 2013

20 Sharps Containers - examples 20 December 1, 2013

21 Sharps Containers 21 December 1, 2013

22 Personal Protective Equipment December 1,

23 Reducing Unnecessary Injections Educate HCWs, patients, and the public about injection risk by: Developing teaching materials about injection risk and importance of reducing injection frequency Enlisting influential institutions to campaign against unnecessary injections churches, mosques, universities, hospitals, and government agencies When available, teach how to use safety devices and proper disposal of all single use devices Eliminate use of unsterile needles, syringes, and solutions for injections 23 December 1, 2013

24 Monitoring Surveillance for occupational blood exposures Can provide useful data to focus local prevention efforts Routine accident reports may not provide adequate information Focused studies may be required 24 December 1, 2013

25 Strategies to Eliminate Injuries 25 Eliminate or reduce the use of needles and other sharps 1 Use devices with safety features to isolate sharps 2 Use safe practices to minimize risk for hazards 3 December 1, 2013

26 Recommendations for Healthcare Facilities - 1 Surveillance Training personnel Personnel immunisation Always wash or disinfect hands and surroundings between patients Provide appropriate personal protective equipment Always use gloves when contact with body fluids and blood Enforce safe practices through monitoring and supervision Establish a bloodborne pathogen management policy 26 December 1, 2013

27 Implement management policies Exposure reporting, PEP access, etc. Establish laboratory capacity for bloodborne virus testing Use appropriate PEP regimens Provide access to counseling for exposed personnel Monitor adverse events and seroconversion Monitor exposure management programs Time between exposure and evaluation, testing source persons, completion of follow-up 27 December 1, 2013 Recommendations for Healthcare Facilities - 2

28 Multi-Component Prevention Approaches Experts agree that safety devices and work practices alone will not prevent all sharps injuries Significant declines in sharps injuries also require:  Education  Reduce invasive procedures (as much as possible)  A secure work environment  Adequate staff-to-patient ratio 28 December 1, 2013

29 Patient Risk Reduction Prevent contact transmission Needles and syringes single use Single use vials of medications, not multiple use vials To reduce contamination during use Equipment cleaned and sterilised between patients Single use disposable items used to avoid need for sterilisation/disinfection Single use items must never be reused Blood and blood products used for transfusion screened for blood-borne viruses prior to infusion 29 December 1, 2013

30 Summary BBV transmission is a recognised risk to healthcare workers and patients Transmission of BBVs may occur by contact transmission, injection, infusion, transplantation, unsterile equipment, or other accidental injury/penetration Risk can be reduced by preventing contact transmission eliminating hazards providing and using engineering controls avoiding unsafe practices using personal protective equipment immunisation, and post-exposure prophylaxis 30 December 1, 2013

31 References World Health Organisation (2010), Geneva, Best practices for injections and related procedures toolkit 9252_eng.pdf 9252_eng.pdf Injection Safety, World Health Organisation, Geneva, Dolan SA, Felizardo G, Barnes S, Cox TR, Patrick M, Ward KS, Arias KM. APIC position paper: safe injection, infusion, and medication vial practices in health care. Amer J Infect Control 2010; 38(3): December 1,

32 Quiz 1.Replace sharps containers when ¾ full. T/F 2.Use the following practices to decrease exposure to BBVs except a.Standard precautions b.Immunisation c.Sharps containers d.Resheathing needles 3.Decrease patient risk of exposure to BBVs by a.Use of single dose vials b.Screening blood c.Cleaning equipment d.All of the above 32 December 1, 2013

33 International Federation of Infection Control IFIC’s mission is to facilitate international networking in order to improve the prevention and control of healthcare associated infections worldwide. It is an umbrella organisation of societies and associations of healthcare professionals in infection control and related fields across the globe. The goal of IFIC is to minimise the risk of infection within healthcare settings through development of a network of infection control organisations for communication, consensus building, education and sharing expertise. For more information go to December 1,

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