1. Anesthesia Medical Alliance Bloodborne Pathogen & OSHA Update.

2. What are bloodborne pathogens? They’re disease causing organisms, including viruses and bacteria, that may be present in human blood, blood components or blood products. Bloodborne pathogens can make you very ill. Some can even kill.

3. Which ones are most common in health-care settings ? The pathogens of greatest concern for most health- care workers are: HIV (human immunodeficiency virus), the virus that causes AIDS – it can take up to 10 years to progress into AIDS HBV (hepatitis B virus), a virus that can cause serious liver damage HCV (hepatitis C virus), another virus that can cause liver disease

4. Are there others I should know about ? Yes. Many other bloodborne diseases pose a threat to people in both health- care and home-care settings. Examples include:  Hepatitis D  Ebola (viral hemorrhagic fever)  Diphtheria  malaria  Syphilis  herpes

5. Other body substances may also spread bloodborne pathogens… These include: blood products (such as plasma) tissue semen vaginal secretions amniotic fluid pericardial synovial fluid Some bloodborne pathogens are deadly.

6. Patients who are ill, injured or otherwise weakened… may be especially vulnerable to infection. Taking steps to prevent transmission of bloodborne pathogens helps keep patients, their families and other visitors out of harm’s way.

7. How are bloodborne pathogens transmitted ? Infections are most likely to occur when contaminated blood or other body substances come in contact with a person’s : broken skin – examples include skin that’s been jabbed with a needle or cut with a sharp object, or skin with an existing cut, rash or burn mucous membranes - splashing or spraying blood can cause infection through the delicate tissues of the eyes, nose and mouth.

8. Bloodborne Pathogen Standard OSHA’s Bloodborne pathogen standard introduced in 1991 Outlines preventative measures to reduce the risk of transmission of bloodborne pathogens Measures include: protective barriers, engineering controls, work practice controls, prompt post exposure evaluation and treatment

9. Bloodborne Pathogen Standard Cont’d Needlestick Safety and Prevention Act passed in 2000 and it amended the OSHA Bloodborne Pathogen Standard to include stronger requirements for safety needles

10. Bloodborne Pathogens and Health Care Providers 600,000-800,000 exposures annually Sharp decline in incidence of HBV infection among HCP since OSHA regulations implemented CDC reports 57 U.S. HCP with documented HIV sero-conversion An additional 139 episodes are considered possible occupational HIV transmission

11. Summary of Actual BBP Risks HIV0.3%PEP HCV3%No vaccine or PEP HBV30%Vaccine

12. Primary Prevention Consistent use of Universal / Standard Precautions Education / retraining staff about occupational risks Modification of procedures & work practices

13. Primary Prevention, cont’d Engineered controls - use of technological advances Immunization

14. Protect Yourself from Bloodborne Pathogens Use required equipment and labels for your job. These may include: Biological safety cabinets - which help protect lab workers from airborne particles. Autoclaves - for sterilizing equipment. Special tools - such as needles designed to help prevent needle-stick injuries.

15. Special containers for potentially contaminated materials. These include: used sharps (needles, broken glass or any object that can pierce the skin) other regulated wastes (gloves contaminated with blood or other body substances, used dressings, etc.) contaminated laundry. Biohazard labels which display the biohazard symbol with the word BIOHAZARD. (Red bags or containers may be used in place of labels.) Protect Yourself from Bloodborne Pathogens

16. Use required personal protective equipment (PPE). Wear gloves if contact with blood, other body substances or contaminated objects is possible. * Never reuse disposable latex or nylon gloves. Wash your hands before putting on and after removing gloves. Examine gloves for tears, cracks and tiny holes before and during use. Replace damaged gloves as soon as possible. Remove gloves so that the glove’s outer surface never touches your skin. 1. Grasp the outside of a glove near the wrist 2. Pull down until the glove comes off inside-out 3. Cup this glove in the palm of your gloved hand. Then, insert 2 fingers of your bare hand inside the cuff of the remaining glove. 4. Pull down so this glove also comes off inside-out -- with the first glove tucked inside.

17. Wear other PPEs as needed: Wear a mask and eye protection, or a full face shield, if fluids could splash or spray into your eyes, nose or mouth. Wear an apron or a gown if fluids could splash or drip onto your clothing. If fluid penetrates the apron or gown, change it as soon as possible. Wear other PPE, such as a cap, a hood and shoe coverings, when exposure to a lot of fluids is possible (such as during surgery, autopsy or embalming). Use a resuscitation device or pocket resuscitation mask when providing rescue breathing. Remove contaminated PPE and other contaminated clothing carefully—while wearing gloves. Remember to wash your hands after removing PPE.

18. Eliminate hazards with proper housekeeping. Don’t touch broken glass - Pick it up with tongs, or use a broom and dustpan. Dispose of sharps in a covered, puncture-resistant, leakproof container that is red or labeled with the biohazard symbol. Place other contaminated wastes (linens, gloves, etc.) in a leakproof container or bag that is red or labeled with the biohazard symbol. (Bag linens where they were used.) If the outside of the container or bag becomes contaminated, place it in a second container or bag. Never reach into trash to retrieve an object. Report full sharps containers and waste containers see that they’re covered, removed and replaced. Clean equipment and work surfaces at the end of your shift, as well as when visibly contaminated. Wear gloves. Use approved disinfectant towelettes.

19. In the Event of BBP Exposure: Immediate first aid to site Soap and water for wound and skin exposures (no back bleeding) Flush with water for mucous membrane exposures Phone Infection Control / Employee Health to report incident Fill out facility incident occurrence report

20. In the Event of BBP Exposure: Draw 3 tubes of blood from source Clearly mark blood tubes “ for needlestick investigation” Take blood to Lab Notify AMAET Human Resources Manager

21. Summary Occupational exposures are crisis situations demanding immediate, decisive action.

22. Tuberculosis Control Plan Annual TB skin test Annual health questionnaire if previously + ● Employer has Exposure Control Plan ● Respirator fit testing is available and is provided by facility

23. OSHA Might Ask……. Does your employer have an Exposure Control Plan? Yes, AMAET has an Exposure Control Plan. Where is it? It can be found in the hospital anesthesia lounge, in the AMAET office, or online at AMAET.com Are you provided with protected sharps / safer sharps products? Yes, our facilities provide us with the necessary safe products. Do you utilize them?

24. OSHA Might Ask……. Does anyone monitor your usage of PPE? Our facilities monitor our PPE usage. How do you get new / replacement PPE? Simply by requesting new PPE at our facility.

25. OSHA Might Ask……. Did you receive training by your employer on the Bloodborne Pathogen Standard? By reviewing this online module and completing the test, you have received training regarding BBP Standards.

26. Important Contact Numbers St. Mary’s:Stephanie Brooks 545-7592 or 631-1748 Gail Beeler545-8642 St. Mary’s ASC:Bridgette Welch 545-3700 Fort Sanders:Norma Sundberg 541-4921 Parkwest:Trish Chaloux 373-1940 TVEC:Kathy Brock or Susan Sams 251-0338 Fort Sanders West:Erma Morgan 531-5048 GIA:Gayle Mahan Parkwest Surgery Center:Mary Horton 531-0494 Physician’s Surgery Center:Sally Dargan 522-2949

27. Hand Hygiene Wash hands!!!!! Wash hands some more!!!!!

28. Finished…Almost Now that you have finished the AMAET Bloodborne Pathogen and OSHA Update, you must click below and take the 10 question test. OSHA Test