1. Bloodborne Pathogens and Prevention of Infection Concorde Career College, Portland ST110

2. 2 Objectives 1. Identify common bloodborne pathogens 2. Describe the risk of bloodborne pathogens to health care workers 3. List potentially infectious substances and their modes of transmission 4. Describe how personal protective equipment and work practice controls can be implemented 5. Describe the healthcare worker’s role in evaluation of workplace practices and devices 6. Describe post-exposure care

3. 3 Bloodborne Pathogens HIVHBVHCVOthers

4. Hepatitis Viral Infection of the liver that can lead to cirrhosis and death Viral Infection of the liver that can lead to cirrhosis and death –Hepatitis A Hepatitis AHepatitis A –Hepatitis B (HBV) Hepatitis B (HBV)Hepatitis B (HBV) –Hepatitis C (HCV) Hepatitis C (HCV)Hepatitis C (HCV) –Hepatitis D (delta agent hepatitis) Hepatitis D (delta agent hepatitis)Hepatitis D (delta agent hepatitis) –Hepatitis E (HEV) Hepatitis E (HEV)Hepatitis E (HEV) 4

5. AIDS/HIV Infection Virus that infects and destroys components of the immune system Virus that infects and destroys components of the immune system HIV infection develops into AIDS HIV infection develops into AIDS Pathogen destroys helper T cells Pathogen destroys helper T cells –Review the CDC Information Review the CDC InformationReview the CDC Information 5

6. Progress of Infection Three main stages Three main stages –Initial infection –Incubation period –Full blown AIDS 6

7. Diagnosis of HIV/AIDS Enzyme-Linked Immunosorbent Assay (ELISA) Enzyme-Linked Immunosorbent Assay (ELISA) Western Blot Test or Immunofluorescent Antibody (ISA) Western Blot Test or Immunofluorescent Antibody (ISA) Polymerase Chain Reaction (PCR) Polymerase Chain Reaction (PCR) 7

8. Other Blood-Borne Infections Cytomegalovirus Cytomegalovirus Cytomegalovirus Fifth Disease Fifth Disease Fifth Disease Fifth Disease Human T-Cell Lymphotropic Virus Human T-Cell Lymphotropic Virus Human T-Cell Lymphotropic Virus Human T-Cell Lymphotropic Virus Listeriosis Listeriosis Listeriosis Malaria Malaria Malaria Syphilis Syphilis Syphilis Toxoplasmosis Toxoplasmosis Toxoplasmosis 8

9. 9 Risks to Health Care Workers HIV – small HCV – 900 annually HBV – 9,000 annually

10. Infectious Fluids Blood Blood Body fluids that contain blood Body fluids that contain blood Semen Semen Vaginal secretions Vaginal secretions Fluid from around an unborn baby Fluid from around an unborn baby Spinal fluid Spinal fluid Fluid around the heart Fluid around the heart 10

11. Infectious Fluids (continued) Fluid around the lungs Fluid around the lungs Fluid around joints Fluid around joints Tissue removed from the body Tissue removed from the body 11

12. 12 Other Body Fluids Potentially Infectious Tears Tears Saliva Saliva Sputum/nasal secretions Sputum/nasal secretions Emesis Emesis Urine Urine Feces Feces Not Infectious Sweat Sweat

13. 13 Transmission Sexual contact Sexual contact Sharing needles Sharing needles Transfusions Transfusions Mom  baby Mom  baby

14. Transmission in the Workplace Puncture wounds Puncture wounds Contact with non- intact skin Contact with non- intact skin Mucous membranes Mucous membranes 14 Review Statistics – Risk Table

15. 15 Prevention of Infection Universal Precautions – OSHA Standard Precautions - CDC Review the Requirements

16. Hand Decontamination After touching blood, body fluids, secretions, excretions, contaminated items After touching blood, body fluids, secretions, excretions, contaminated items After gloves removed After gloves removed Between patient contacts Between patient contacts Waterless antiseptic agents Waterless antiseptic agents 16 Review the Procedure

17. 17 Personal Protective Equipment (PPE) Provided by employer Provided by employer Application, removal, disposal Application, removal, disposal

18. 18 Gloves Handling blood/body fluids Handling blood/body fluids Performing invasive procedure Performing invasive procedure Touching non-intact skin Touching non-intact skin

19. Gloves Correct size Correct size Change if contaminated Change if contaminated Remove inside out Remove inside out Utility gloves Utility gloves 19

20. Masks, Shields, Eyewear Used when splashing expected Used when splashing expected Replace when wet Replace when wet Wash hands before removing Wash hands before removing Handle by side pieces Handle by side pieces Protective resuscitation equipment Protective resuscitation equipment 20

21. Protective Clothing Used when splashing expected Used when splashing expected Remove if soiled Remove if soiled Remove from inside and roll Remove from inside and roll Nondisposable laundered by employer Nondisposable laundered by employer 21

22. 22 Work Practice Controls Sharps Sharps Lab materials Lab materials Decontamination Decontamination Laundry Laundry Waste Waste

23. Safer Medical Devices Sharps with engineered sharps injury protections Sharps with engineered sharps injury protections Needleless systems Needleless systems 23

24. If a Needle Must Be Used… Do not bend or break Do not bend or break Immediately discard in sharps containers Immediately discard in sharps containers Do not recap Do not recap 24

25. 25 Documentation of Needlestick Injuries The type and brand of device involved The type and brand of device involved The department or area where the exposure occurred The department or area where the exposure occurred An explanation of how the exposure occurred An explanation of how the exposure occurred

26. 26 Other Work Practice Controls Transport specimens in leakproof containers labeled biological hazard Transport specimens in leakproof containers labeled biological hazard Place warning labels on containers with hazardous materials Place warning labels on containers with hazardous materials Do not eat, drink, smoke, apply cosmetics, or handle contact lenses where exposure likely Do not eat, drink, smoke, apply cosmetics, or handle contact lenses where exposure likely Do not pipette chemicals or potentially infected materials by mouth Do not pipette chemicals or potentially infected materials by mouth

27. Spills Put on gloves Put on gloves Wipe up with towel Wipe up with towel Dispose of contaminated towel Dispose of contaminated towel Apply bleach solution Apply bleach solution 27

28. 28 Linens Wear gloves Wear gloves Place in impervious container if linen is to be transported Place in impervious container if linen is to be transported Label appropriately Label appropriately

29. 29 Waste Label as biohazard Label as biohazard

30. 30 Post-Exposure Wash area Wash area Notify supervisor Notify supervisor Consult physician ASAP Consult physician ASAP Report incident Report incident Obtain medical counseling Obtain medical counseling Keep records confidential Keep records confidential

31. Summary Bloodborne pathogen risks Bloodborne pathogen risks Modes of transmission Modes of transmission Personal protective equipment Personal protective equipment Work practice controls Work practice controls Evaluation of practices/devices Evaluation of practices/devices Post-exposure care Post-exposure care 31