OSHA Bloodborne Pathogen Training

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OSHA Bloodborne Pathogen Training
This module is for any associate who needs
bloodborne pathogen training.
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In this module, you will explore

• Exposure to bloodborne diseases
• Bloodborne diseases found in a hospital setting
• The Bloodborne Exposure Control Plan
• Standard Precautions
• Hepatitis B vaccination
• Personal Protective Equipment (PPE)
• Hazardous Communications
• Work Practice and Engineering Controls

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In the workplace

• Exposure to bloodborne pathogens in the workplace
  is a concern to health care workers and
  employers.
• The Occupational Safety and Health Administration
  (OSHA) has a standard to address this concern.
• The Bloodborne Pathogens Rule requires both
  employers and workers to prevent the spread of
  bloodborne diseases.

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What Does OSHA Require?

• OSHA requires employers to develop a Bloodborne
  Pathogen Exposure Control Plan.
• This plan outlines protective practices to
  decrease the risk for hospital employees who
  might be exposed to bloodborne diseases.

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Bloodborne Pathogen Exposure Control Plan

• The plan includes
• Exposure determination
• Procedures for protecting workers
• Standard Precautions
• Hepatitis B Vaccinations
• Personal Protective Equipment
• Hazard Communications
• Work Practice and Engineering Controls
• Post-exposure follow-up to a bloodborne disease.
• The Bloodborne Pathogen Exposure Control Plan is
  located on the Intranet in St. Elizabeth Policy
  and Procedures in the Infection Control Manual.

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Protecting Yourself Its Your Responsibility

• You are responsible for understanding the risk of
  exposure to blood or other potentially infectious
  materials (OPIM) at your workplace.
• Direct questions to your supervisor, Infection
  Control, Employee Health, or the Safety Director.

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What Is A Bloodborne Pathogen?

• Bloodborne pathogens are germs which may be
  present in blood that are capable of causing
  disease.
• Bloodborne pathogens are an important
  consideration in dealing with blood and other
  potentially infectious materials (OPIM).

Other Potentially Infectious Materials (OPIM)
Blood and other materials that can carry
pathogens that cause serious diseases. Materials
include human body fluids, unfixed tissue or
organs, and HIV/HBV-containing cell or tissue
cultures.
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How Are People Exposed To Bloodborne Pathogens?

• You can be exposed to a bloodborne pathogen by
  performing a task or being in an area where you
  might come in contact with blood or other
  potentially infectious materials.
• In a hospital, most exposures to bloodborne
  diseases are through direct exposure to used
  sharps or splashes of blood/body fluids to facial
  mucous membranes.

Direct Exposure which occurs when one touches
or otherwise comes in direct contact with blood
or other potentially infectious materials. An
example is a stick from a needle previously used
on an infected person. Sharps Any object that
can cut, puncture, or penetrate the skin.
Examples are needles, scalpels, broken glass,
knives and blades.
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How Are People Exposed To Bloodborne Pathogens?

• Some exposures have been from blood or OPIM
  splashing
• Onto broken or scraped skin
• Into unprotected eyes, nose or mouth.
• Be careful with anything wet that comes from the
  human body.
• Protective eyewear and masks or face masks with
  visors are available consult your supervisor
  for your specific needs

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What To Do If You Have A Blood/Body Fluid
Exposure

• First flush/wash the affected areas with soap and
  water.
• Promptly call Employee Health, 301-2153 (M-F 700
  am - 900 pm) After hours - phone number (859)
  391-9468.
• Complete an Employee Incident Report and take
• to the lab for testing.
• Report to the ED for HIV exposure or wound care.

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Post-Exposure Evaluation

• The Post-Exposure Evaluation process is directed
  by Employee Health and follow the exposed
  employee for the appropriate time.

Post-Exposure Evaluation An evaluation which
tests the source and the employee after an
exposure has occurred. Counseling and treatment
are offered by Employee Health.
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Does Everyone Exposed To A Bloodborne Pathogen
Become Infected?

• Whether or not you become infected following an
  exposure depends on a number of factors
  including
• The number and strength of the germs from the
  source.
• Your resistance to disease-the ability of your
  body (host) to reject the germs
• The type of exposure-the way that the germs were
  spread-some ways are more efficient than others

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Bloodborne Diseases of Concern
Sharps injury from used needles or other sharps
are the primary means of transmission of these
diseases to healthcare providers.

• Three bloodborne diseases of concern to
  healthcare workers are
• HIV
• Hepatitis B
• Hepatitis C

Hepatitis B HBV A virus that causes
inflammation of the liver and is transmitted by
infected blood. Hepatitis C HCV A virus that
causes inflammation of the liver and is
transmitted by infected blood.
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What Is HIV/AIDS?

• HIV is the Human Immunodeficiency Virus that
  causes AIDS.
• AIDS (Acquired Immune Deficiency Syndrome) is a
  viral infection of the immune system.
• This infection robs a person of the ability to
  fight off other disease-causing germs.

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How Is HIV Contracted?

• HIV may be contracted by
• Unprotected sexual contact with an infected
  person
• Blood transfusion (rare)
• IV drug users who share needles with an infected
  person
• An unborn baby from the infected mother by spread
  in utero, during delivery, or through
  breast-feeding.
• Exposure from a contaminated sharp.

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How Is HIV Not Contracted?

• HIV cannot be contracted by
• Touching telephones, door knobs, toilet seats, or
  mosquito or other insect bites.
• Shaking hands, hugging, being coughed or sneezed
  on.
• Eating food prepared by an HIV positive
  individual.
• You cannot get HIV from donating blood.
• The risk of contracting HIV from a blood
  transfusion is extremely low.
• The blood supply is carefully tested.

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What Happens If You Are Exposed To HIV?

• If you are exposed to HIV through a contaminated
  needle stick or other sharps injury, your risk of
  contracting the disease is about 0.3.
• The risk is less for blood splashes into mucous
  membranes or on broken or scraped skin.

Mucous membranes A lining of the body that
secretes a protective lubricant for all body
passages that come in contact with air. Examples
include the lining of the eyes, nose and mouth.
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What Is Hepatitis B?

• Hepatitis B is a virus that affects the liver.
• Many infected people do not have symptoms.
• An infected person without symptoms is still
  contagious.

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Common Symptoms of Hepatitis B and C

• Yellow skin color (Jaundice)
• Dark urine
• Lightened stool color
• Nausea
• Vomiting
• A general feeling of illness

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How Is Hepatitis B Contracted?

• Hepatitis B can be contracted by
• Unprotected sexual contact with an infected
  person
• IV drug users who share needles with an infected
  person
• Exposure through a contaminated needle stick or
  sharp
• An unborn baby from its infected mother
• Infection can also occur through breastfeeding

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What Happens If You Are Exposed To Hepatitis B?

• Most persons who acquire Hepatitis B infection
  have a full recovery.
• 10 of people who contract the virus develop a
  chronic infection.
• Chronic hepatitis B puts a person at a higher
  risk for
• Cirrhosis of the liver
• Liver cancer.
• A vaccine is available for protection from
  Hepatitis B infection

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What Happens If You Are Exposed To Hepatitis B?

• If you are exposed to Hepatitis B through a
  sharps injury, your risk of contracting the
  disease is about 5-30 if you have not had a
  series of three vaccinations.
• The risk of acquiring the disease is less for
  blood splashes into mucous membranes or on broken
  or abraded skin.
• Your risk drops to almost zero percent if you
  have had a successful series of vaccinations.

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What is Hepatitis C?

• Hepatitis C is a disease that causes similar
  symptoms as Hepatitis B
• 70 of persons with Hepatitis C have no symptoms.
• The virus may remain dormant 10-20 years before
  patients experience fatigue, loss of appetite,
  and abdominal pain.
• Persons who have the infection are contagious
  even if they have no symptoms.

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How is Hepatitis C Contracted?

• If you are exposed to Hepatitis C through a
  needle stick or other sharps injury, your risk of
  contracting the disease is about 3 10.
• Blood transfusions were formerly a major means of
  transmission of Hepatitis C, but that is no
  longer the case.
• Screening tests were put into place in the early
  1990s.
• The chance of acquiring HCV by sexual
  transmission is less than or equal to 6.
• Unlike Hepatitis B, there is no vaccine to
  prevent the disease.

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What Happens If You Develop Hepatitis C?

• The Hepatitis C virus causes chronic disease in
  about 85 of the people who contract it.
• Hepatitis C is a major cause of cirrhosis of the
  liver and liver cancer.
• While there is no cure for Hepatitis C, the
  symptoms may be treated with antiviral drugs.
• Treatment usually leads to long-term improvement.
• Complications of hepatitis account for the
  majority of liver transplants in the United
  States.

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Worker Vaccinations

• Employee Health will direct you regarding
  available vaccines
• As required by OSHA law, Hepatitis B vaccine is
  available to all hospital employees whos job may
  expose them to blood or other potentially
  infectious materials.
• Offered at no charge
• Series of 3 injections
• You may choose to accept or decline the vaccine
• OSHA law does not require offering the vaccine to
  persons who work in other areas (e.g. payroll,
  etc) where there is no reasonable risk of
  exposure.

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Standard Precautions

• Provides the most consistent protection from
  bloodborne disease.
• All blood and body fluids are considered
  potentially infectious, regardless of the
  diagnosis.
• Situations requiring precautions include contact
  with mucous membranes, moist areas of the body,
  broken skin, anything wet coming from the body,
  and any medical devices that drain fluids from
  the body.
• Requires the consistent use of hand hygiene and
  appropriate personal protective equipment (PPE)
  when coming into contact with blood or body
  fluids.

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Hand Hygiene

• The simplest way to prevent spread of infection
• Wash with soap and water when hands are visibly
  dirty or contaminated with body substances, or
  after removal of gloves.
• Wet hands, apply soap, rub hands together
  vigorously for at least 15 seconds, covering all
  surfaces, rinse, dry with disposable towel, using
  towel to turn off faucet, dispose of towel.
• If hands are not visibly soiled, may use a
  alcohol antiseptic hand rub for routinely
  decontaminating hands.
• Apply adequate amount of product to palm of one
  hand and rub hands together, covering all
  surfaces until hands are dry, about 10 seconds.
• Staff who perform direct patient care, prepare
  food or sterile items are required to wear only
  natural fingernails with/without nail polish.

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Personal Protective Equipment (PPE)

• This specialized clothing and equipment provides
  protection against contact with blood or other
  potentially infectious materials.
• Provided at no cost, and is available via carts,
  supply cabinets or room cabinetry as determined
  by department.
• Includes
• Gloves, fluid resistant gowns, aprons
• Eyewear, masks, face shields
• Resuscitation equipment
• Scrub clothing is not PPE
• Remove PPE before leaving the clinical work area

PPE Personal Protective Equipment. Specialized
clothing and equipment meant to provide
protection against contact with bloodborne
pathogens or other potentially infectious
materials.
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Personal Protective Equipment

• PPE should be appropriate to the task performed
• Wear a mask and eye protection or mask with visor
  when you might get splashed in the face with
  blood or body fluids.
• Use a CPR mask when performing CPR.
• Wear a fluid resistant gown when your clothing
  might be soiled with blood or other body fluids.
• Use gloves anytime you may have contact with
  blood or other body fluids

CPR Cardio-Pulmonary Resuscitation
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Soiled Personal Clothing

• If personal clothing is soiled with blood, body
  fluids or OPIM, the clothing will be laundered by
  the medical center if the associate desires.
  Soiled clothing should be removed and placed in
  a plastic bag.
• Edgewood staff contacts SPD
• Florence and Ft. Thomas staff
• contacts EVS

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Safe Injection Practices

• Perform hand hygiene before handling or accessing
  IV products or systems, preparing or
  administering medications, or handling blood
  glucose monitoring devices.

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Rub and allow to dry

• Use friction and perform a thorough alcohol prep
  of any IV port, valve, vial or ampule
• Allow the alcohol to dry completely before
  accessing with sterile technique

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Medication Mistakes

• Do not administer a medication from the same
  syringe to more than one patient, even if the
  needle is changed
• Do not leave a needle or spike in a multi-dose
  vial store the vial in clean conditions
• Discard vials used during a procedure or
  emergency immediately
• Do not store needles, cannulas, syringes, or
  solutions outside of the sterile package, or in
  pockets or clothing

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Standard of Care

• Draw the medication into syringes immediately
  prior to administration
• IV solution administration should begin within
  one hour of spiking the IV bag or bottle

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Blood Glucose Monitoring Devices

• Clean and disinfect all glucometers between
  patient use
• Gloves should be worn when needed to prevent
  contact with blood and body fluids
• All lancets and finger stick capillary sampling
  devices are single patient use items and must be
  disposed of immediately after use in the sharps
  container

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Work Practice and Engineering Controls

• In addition to PPE, use of Work Practice and
  Engineering Controls must also be used to reduce
  or eliminate exposure to bloodborne pathogens.

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Work Practice Controls

• Work Practice Controls - practices that reduce
  the risk of exposure to blood or body fluids
  while on the job.
• Includes use of safety products, wearing of PPE,
  correct handling of soiled equipment, linens and
  hazardous waste, correct handling and transport
  of specimens.

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Engineering Controls

• Engineering Controls - equipment and items that
  are designed to reduce or eliminate the risk of
  exposure to blood or body fluids.
• Includes items such as sharps safety products,
  leak proof specimen containers, laboratory
  equipment, safety shields, and handwashing sinks.

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Sharps Safety

• Use the supplies of Sharps Safety products.
• Dont take chances with your health and well
  being.
• Take the time to learn and use safety
  productstheyre supplied for your safety!
• Report concerns where sharps safety products are
  needed to your manager, the Safety Director or
  Infection Control.

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How To Dispose Of Sharps

• A sharps container is a rigid, puncture resistant
  container labeled as biohazard
• and is designed to store sharps before
  disposal.
• Dispose of sharps in provided sharps containers.
• Never attempt to remove needles from sharps
  containers

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Cleanup of Spills

• Minimize your risk of exposure by
• Containing
• Removing
• Disinfecting
• all blood or body fluid spills as quickly
  and effectively as possible.
• Use the approved hospital disinfectants
• Appropriate PPE must be worn
• during cleanup of spills

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Know And Practice Your Bloodborne Exposure
Control Plan

• Know the risks in your work area.
• Use Standard Precautions.
• Take advantage of Personal Protective Equipment.
• Receive the hepatitis B vaccination series when
  it is offered.
• Properly dispose of infectious waste.
• Contact Employee Health immediately if you are
  exposed to blood or other potentially infectious
  materials.
• For more information about bloodborne pathogens,
  see the Bloodborne Exposure Control Plan or
  contact the Infection Control Department.

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In Conclusion

• We hope this Computer Based Learning course has
  been both informative and helpful.
• Feel free to review this course until you are
  confident about your knowledge of the material
  presented.
• Once you are comfortable with the material, you
  may proceed to the test in order to receive
  credit for course completion.