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 health care worker’s role in evaluation of workplace practices and devices. 6. Describe post-exposure care. 2

HIV HBV HCV Others 3

HIV – small HCV – 900 annually HBV – 9,000 annually 4

 Blood  Body fluids that contain blood  Semen  Vaginal secretions  Fluid from around an unborn baby  Spinal fluid  Fluid around the heart 5

 Fluid around the lungs  Fluid around joints  Tissue removed from the body 6

Potentially Infectious  Tears  Saliva  Sputum/nasal secretions  Emesis  Urine  Feces Not Infectious  Sweat 7

 Sexual contact  Sharing needles  Transfusions  Mom  baby 8

 Puncture wounds  Contact with non-intact skin  Mucous membranes 9

Universal Precautions – OSHA Standard Precautions - CDC 10

 After touching blood, body fluids, secretions, excretions, contaminated items  After gloves removed  Between patient contacts  Waterless antiseptic agents 11

 When:  Blood, blood products, cerebral spinal fluid, semen, vaginal secretions or synovial fluid has had contact with NON-INTACT skin or mucous membranes. 12

 When  You have been stuck by a contaminated needle or sharp object 13

 The following is NOT an exposure (unless visible blood noted in the following)  Feces, saliva, vomitus, sputum, sweat, urine, nasal secretions, tears, blood on INTACT skin 14

 Provided by employer  Application, removal, disposal 15

 Handling blood/body fluids  Performing invasive procedure  Touching non-intact skin 16

 Correct size  Change if contaminated  Remove inside out  Utility gloves 17

 Used when splashing expected  Replace when wet  Wash hands before removing  Handle by side pieces  Protective resuscitation equipment 18

 Used when splashing expected  Remove if soiled  Remove from inside and roll  Nondisposable laundered by employer 19

 Sharps  Lab materials  Decontamination  Laundry  Waste 20

 Sharps with engineered sharp injury protectors  Needleless systems 21

 Immediately discard in sharps containers  Do not bend or break  Do not recap  Do not fill container past designated fill line 22

 The type and brand of device involved  The department or area where the exposure occurred  An explanation of how the exposure occurred 23

 Transport specimens in leak proof containers labeled biological hazard  Place warning labels on containers with hazardous materials  Do not eat, drink, smoke, apply cosmetics, or handle contact lenses where exposure likely  Never use pipettes with mouth suction 24

 Put on gloves  Wipe up with towel  Dispose of contaminated towel  Apply bleach solution 25

 Wear gloves  Place in impervious container if linen is to be transported  Label appropriately 26

 Label as biohazard 27

 Wash area  Notify supervisor  Consult physician ASAP  Report incident  Obtain medical counseling  Keep records confidential 28

 CLostridium difficile (klos-TRID-e-uhm dif-uh- SEEL), often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Most commonly affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotic medications.  May require isolation of persons affected 29

 Hand washing: Health care workers should practice good hand hygiene before and after treating each person in their care.  In the event of a C. difficile outbreak, using soap and warm water is a better choice for hand hygiene, as alcohol-based hand sanitizers may not effectively destroy C. difficile spores. Teach visitors to practice good hand washing as well. 30

 Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult- to-treat infections in humans. bacteriuminfections  To prevent the spread of staph or MRSA in the workplace, employers should encourage proper hand washing and sanitizing of environmental surfaces and contaminated equipment with EPA registered disinfectives. 31

 Although alcohol-based rubs remain somewhat effective, a more effective strategy is to wash hands with running water and an anti-microbial cleanser with persistent killing action.  Proper disposal of isolation gowns is also necessary  MRSA can survive on surfaces and fabrics, including privacy curtains or garments worn by care providers 32

 Hospital staff and visitors wear disposable gloves and gowns while in the room  In any setting, all surfaces should be carefully disinfected with a product that contains chlorine bleach  People who are hospitalized with C. difficile should have a private room or share a room with someone who has the same illness 33

 Be familiar with your facilities policies and procedures regarding issues of safety and infection control. Ask whenever you are uncertain or have a question regarding these issues.  Be Safe  Practice Safety in the workplace 34

 Bloodborne pathogen risks  Modes of transmission  Personal protective equipment  Work practice controls  Evaluation of practices/devices  Post-exposure care 35