Blood Borne Pathogens Standard Precautions & by 6S8whiQ

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									              Blood Borne Pathogens
               Standard Precautions
                        &
                     HIPAA


Created by Jayne Lutz
Edited: 6/2011
               OBJECTIVES
At the end of this presentation the student will be
  able to:
• Discuss the major Blood Borne Pathogens
• Recognize potentially contaminated material
• Identify exposure routes
• Choose protection measures
• Describe what to do in case of exposure
• Discuss the student responsibilities with HIPAA
 Major Blood Borne Pathogens
• HIV

• HEP B

• HEP C
                Hepatitis B
• Immunized per UNCG SON policy
• No routine booster recommended for series
  completed prior to 1999
• Have a titer drawn only if exposed
• If titer low then get a booster
• Repeat titer as directed by provider
• If titer remains low after booster-
  Repeat the entire series x 1
                      HBV
Received Immunization Series for the First time after
  2000:
• Get test for surface antigen 1-2 mo after series
  completed-do not wait longer or you may not get
  accurate results!
• If this is negative repeat series x 1
• Repeat the titer again in 1-2 mo following
  completion of second series
• If negative again, do not repeat series..you are
  most likely protected but did not sero-convert
               Hepatitis C
• No immunization
  available
• Can live in a drop of
  dried blood for up to 30 days.
• At least 4 million
  Americans infected
• Leading cause of liver failure
   in the US
                    Hepatitis C
• Acute & Chronic Hepatitis C:
• Acute develops into a chronic infection in 50-75% of all
  infected persons

• Estimated that HEP C will cause more deaths in the USA
  than AIDS in the next decade

• HCV related deaths will most likely double or triple in the
  next 10-20 years.

• Many with chronic disease are now in the 40-65 age range.
           Hepatitis C (Continued)
Treatment: Between 40-80% successful. Success and length
  of treatment depends on the point when treatment begins
  and the specific strain. More successful if started early in
  the course of the disease.

       •      Interferon alfa-2a & 2b (Pegasys-injection)
               and
       •      Ribavirin (Copegus and Rebetol-oral meds)

           • Liver transplantation is the only treatment for
             decompensated cirrhosis from Hep C
             Hepatitis C:
       The Course of the Disease
• Acute infection= rarely recognized
  Flu-like symptoms or no symptoms
• Evolution from acute phase to cirrhosis
  usually requires decades: average time is
  20-30 years
• When disease discovered, damage to the
  liver has most likely occurred.
      Recommendation for HCV
• If you are a nurse with any exposure history:
  get tested.

• If you have any of these risk factors: get tested.
   – Injection drug use
   – Straw or sniffer use for cocaine
   – Blood transfusion before 1982
   – Use of blood clotting components before 1987
   – Tattoos/piercings with questionable sterile technique
   – Occupational exposure to blood
   – Sexual contact with an infected partner (risk less)
   Hepatitis C: The Good News
• There has been a decline in diagnosed new
  cases in the past five years

• Hepatitis C is rarely spread from the
  mother to the baby at time of delivery
                    HIV
• There is no known cure for HIV although
  there are drugs that suppress the infection
• HIV causes destruction of the immune
  system
• The terminal state is acquired
  immunodeficiency syndrome (AIDS)
• One Million Americans living with
  HIV/AIDS & more than 1/5 are unaware
        HIV-Interesting Facts
• Adolescents show the most rapid increase in
  HIV at present (age 15-24)

• The number of older adults who are
  infected has been rapidly increasing

• NC ranks #10 in the US for the rate of
  persons contracting HIV
                   HIV


• What is your risk?
                   HIV

• Less than 1% seroconversion rate for health
  care professionals if exposed to a known
  HIV positive source.

• Taking *ZVD after exposure reduces
  seroconversion

*Zidovudine
         Standard Precautions
• A set of precautions designed to prevent
  transmission of HIV, HBV, and other blood borne
  pathogens
• Blood and certain body fluids of all patients are
  considered potentially infectious
Potentially Harmful Body Fluids with
  Universal/Standard Precautions

Blood                               Semen

Vaginal Secretions                  Pleural Fluid

Cerebrospinal Fluid                 Synovial Fluid

Synovial Fluid                      Pleural Fluid

Peritoneal Fluid                Pericardial Fluid

                   Amniotic fluid
           Body Fluids to Which
      Universal/Standard Precautions Do
      Not Apply Unless Blood is Visible
•   Feces              • Urine
•   Nasal secretions   • Saliva
•   Sputum             • Breast milk*
•   Sweat               *only in large
•   Tears                quantities (breast
                         milk bank)
•   Vomitus
             Protect Yourself

•   Gloves
•   Gown
•   Apron
•   Masks
•   Hand washing
•   Safety precautions with sharps
•   Eye shields
      Biohazard Areas
NOT ALLOWED IN A BIOHAZARD
  AREA:
• Drink
• Food
• Cosmetics
• Lip balm
• Handling contact lenses
    ROUTES OF EXPOSURE
An exposure occurs when blood (or other
 contaminated material contacts:

• Non-intact skin (lowest risk)
• Mucous membrane(medium risk)
• Is injected(highest risk)
              Course of Action
                if Exposed
• Flush splashes to nose, mouth, or skin with water

• Irrigate eyes with water or saline

• Report to faculty-preceptor

• Seek counseling/care: within 4-6 hour preferred
  but within 72 hours acceptable
  Course of Action if Exposed)
The location of your treatment & follow
 up (if needed) is your choice:
  • Your clinical site~ if they have agreed &
    have the medication you may need
  • Your personal physician
  • Gove Student Health Center=
    • M-F: 8a-8p; Sat. 9-12 ; Sun. 5-8.
    • Phone: 334-5340
     Phone Calls You Need to Make
          if You Are Exposed

The Student Health Center can provide
 counseling, prescriptions for any needed
 treatment and complete the follow up blood
 draws if needed.

 Notify the OSHA Trainer of the School of
 Nursing. 336-334-5238, jayne_lutz@uncg.edu.
   Information Needed By A
Provider Following An Exposure
• Date & time of exposure.
• Details of the incident. If related to a
  sharp device, note the type and brand.
• Details of the exposure: type of fluid or
  material & severity of exposure
• Source Information: HCV+, HIV+ or
  HCV+
    Needed Information, cont.
• Student Information:
  – Hepatitis B vaccination and vaccine-response
    status
  – Other medical conditions
  – Current medications & drug allergies
  – Pregnancy or breast-feeding
   Who Pays for Your Care?
          • You are responsible
• The University does not cover these costs.
                 HIPAA
• Health Insurance Portability and
  Accountability Act

• A Federal Law that sets standards to protest
  a patient’s health information

• Standards protect the use and sharing of
  verbal, written, and electronic patient
  information
     What is Protected Health
       Information-PHI?
• Information that:
  • Identifies the individual
  • Relates to the patient’s health, treatment or
    payment plan
  • Is kept or released
     • Electronically
     • On paper
     • Orally
    Why is Privacy Important?
• Patients have a right to privacy

• Violation of patient’s privacy
  (confidentiality) can affect the personal lives
  and careers of patients

    It is your job to protect patient privacy
   What is Your Role with HIPAA?

• Keep oral, written, printed, & electronic reports
  private and secure
• Keep telephone calls confidential
• Protect computer passwords
• *Remove patient/client names or other identifying
  information before throwing away papers
• Refer to patients/clients by initials as Mr. or Ms.
  J.D, etc in journals/reports.

*The best action is to shred all such papers
  Information that can be Given
   Out Without Prior Consent

• Communicable diseases: Certain diseases
  must be reported to Public Health Agencies.

• Reports to 3rd party payers: To verify
  medical treatment for insurance claims
  including Medicare payments.
      Questions or Concerns?
• Contact your clinical faculty member.
The End!

								
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