Bloodborne Pathogens by KQp8n3l0


									Bloodborne Pathogens Standard
TOSHA believes the information in this presentation
 to be accurate and delivers this presentation as a
 community service. As such, it is an academic
 presentation which cannot apply to every specific
 fact or situation; nor is it a substitute for any
 provisions of 29 CFR Part 1910 and/or Part 1926
 of the Occupational Safety and Health Standards
 as adopted by the Tennessee Department of Labor
 and Workforce Development or of the
 Occupational Safety and Health Rules of the
 Tennessee Department of Labor and Workforce
Bloodborne Pathogens
 Pathogenic micro-
  organisms present
  in human blood that
  can lead to diseases
 Human immuno-
  deficiency virus (HIV)
 Hepatitis B (HBV)
 Hepatitis C (HCV)
Other Bloodborne Pathogens
 Syphilis
 Malaria
 Brucellosis
 Babesiosis
 Leptospirosis
 Arborviral Infections
 Relapsing Fever
 Creutzfeld-Jacobs Disease--Mad-cow
 Viral Hemorrahgic Fever--Ebola
Potentially Infectious Materials –All
Can Transmit Hepatitis B, C, and HIV

Blood                      Any visibly
                             contaminated body
 Semen
 Vaginal secretions
                            Any body fluid where
 Cerebrospinal fluid        differentiation is
 Pleural fluid              difficult
 Pericardial fluid         Any unfixed tissue or
 Peritoneal fluid           organ
 Amniotic fluid            Aqueous and vitreous
 Saliva in dental proc.     humors in the eyes
Other Body Fluids
 These body fluids do NOT have enough virus in
  them to transmit disease UNLESS they are
  contaminated with blood
  –   Urine
  –   Feces
  –   Tears
  –   Sweat
  –   Vomitus
  –   Spit
Modes of Transmission
 Stick or Cut
 Splash to mucous membranes of the eyes,
  nose, mouth
 Non-intact skin exposure
Universal Precautions
 Must be observed
 All blood and body fluids are treated as if
  known to be infected with HIV, HBV,
  HCV, etc.
 Do not come into contact with another
  person's blood or body fluids
Exposure Control Plan
 Employer's plan describing how compliance with
  the standard is achieved
 Describes what employees are covered
 Describes tasks that are covered
 Describes post-exposure follow-up procedures
 Must be reviewed and updated annually
 Must be accessible to employees
   – Every employee should know the procedure to
     follow to obtain a copy
   Exposure Control Plan
 Safer Medical Devices
   – The Exposure Control Plan must be updated every
     12 months to reflect evaluation, consideration, and
     selection of appropriate devices
   – Document in the plan the devises evaluated and
     those currently used
   – Front line employees must be involved in the
     selection of devices
 The single most important aspect of
  infection control
 Wash hands when contaminated with blood
  or body fluids and after removing personal
  protective equipment
 Use antiseptic hand cleaner clean
  paper/cloth towels or antiseptic towelettes
  when "in the field"
 Wash hands with soap and water asap
 Needles/Sharp Objects
 Use sharps with sharps injury prevention or needleless
    systems for all procedures involving sharps
   Place in puncture resistant, labeled, leak-proof containers for
    transport, storage, and/or disposal
   Keep the container closed
   Do not bend, break, recap, or remove needles
   Do not pick up contaminated broken glass directly with the
   Do not reach by hand into containers where contaminated
    sharps are placed
   Do not overall sharps containers
 Do not eat or drink in
  areas where there is
  exposure to blood or
  body fluids
 Do not store food in
  refrigerators, freezers,
  cabinets, on shelves or
  countertops where
  blood or other body
  fluids are present
Personal Protective Equipment
 Wear PPE to prevent blood or body fluids
  from getting on your clothes, skin,
  underclothes, etc.
 Must be provided at no cost to the employee
 Employer must enforce the use
 Must be removed prior to leaving the work
  area and placed in designated area
 Parental exposure    gloves
   – stick or cut      gowns
 Mucous membrane      glasses/ goggles
  – splash             masks
 Non-intact skin      pocket masks
  – spill or splash
                       shoe covers
 Clean and decontaminate all equipment and
  environmental and working surfaces after
  contact with blood and/or body fluids
 Decontaminate with appropriate disinfectant
  – EPA registered tuberculocidal disinfectant
  – EPA registered disinfectant with label stating it
    is effective against HIV and HBV
  – Household bleach, diluted 1:10-1:100, made
    fresh daily
Contaminated Laundry
 Remove contaminated clothing when it
  becomes contaminated
 Place immediately in bag or container that
  is labeled
 Prevent leakage
Regulated Waste
 Sharps containers
   – Needles
   – Blades
   – Broken glass
 Red bags
   – Liquid or semi-liquid blood or
   – Items caked with dried blood
     or OPIM
   – Items that could release blood
     or OPIM
   – Pathological waste
   – Microbiological waste
Hepatitis B Vaccination
 the HBV vaccination must be offered after
 the employee has received training and
 within 10 working days of job assignment
  – At no cost
  – Provided by PLHCP
  – According to US Public Health Service most
    current recommendations
     • “Immunization of Health Care Workers:
       Recommendations of ACIP and HICPAC,”
       MMWR, Vol. 46, No. RR-18
 HBV Vaccination
 Employees who do not take the shots must sign a
  declination statement
 Highly recommended
 Few contraindications
 Three-shot series—titer 1-2 months after last shot
 No booster currently recommended
 Each person must have a health care professional's
  written opinion
   – A copy must be provided to the employee within 15
     days of completion of the evaluation
 An employee can decline now, take the shots later
Written Opinion
 Each person must have a health care
  professional's written opinion for hepatitis B
  – A copy must be provided to the employee
    within 15 days of completion of the evaluation
Post-Exposure Follow-up
 After exposure incident
  – Stick or cut
  – Splash
  – Non-intact skin exposure
 At no cost
 Begin ASAP after exposure incident
 Report exposure incident to your supervisor
  or designated personnel immediately
Post-Exposure Follow-up
 Investigation of the incident
 ID source individual, obtain consent, and
  test their blood to determine HBV, HCV,
  and HIV infectivity ASAP
 Results of source individual's test given to
  exposed person
 Obtain and test exposed person's blood for
  HBV, HCV, and HIV serological status
    Post-Exposure Follow-up
 Post-exposure prophylaxis as indicated by CDC
   – “Updated U.S. Public Health Service Guidelines for
     the Management of Occupational Exposures to
     HBV, HCV, and HIV and Recommendations for
     Postexposure Prophylaxis” June 29, 2001, Vol 50,
     No. RR-11
   – “Updated U.S. Public Health Service Guidelines for
     the Management of Occupational Exposures to HIV
     and Recommendations for Postexposure
     Prophylaxis,” September 30, 2005, Vol 54, RR-09
 Counseling and Evaluation of reported illnesses
Written Opinion
 The employee must be provided a copy of
 the Health Care Professional's Written
 Opinion for Post-Exposure Follow-up
 within 15 days of completion of the
          Containers with
           contaminated items
          Can substitute red
 For all employees listed in the Exposure
 At no cost to employees
 During working hours
 At the time of initial assignment
 Annually--within 1 year of last training date
 Must be opportunity for interactive questions and
 Train employees on adopted safer needle devices
  before implementation
 Five Easy Questions
   – What is universal precautions?
   – What do you do when there is a blood spill?
      • Personal protection
      • Clean-up and disposal procedures
      • Disinfection (hazard communication applies)
   – What do you do with contaminated sharps and
   – Have you been offered the HBV vaccination free
     of charge?
   – Where is the Exposure Control Plan?
 Additional Training
 Copy of the BBP standard, 29 CFR 1910.1030, must be
    accessible to you
   Explanation of methods of recognizing tasks that may
    involve exposure to blood and/or body fluids
   Information on types, use, location, removal, handling,
    decontamination, and disposal of ppe
   Basis of selection of ppe
   Actions to take and persons to contact in a bloodborne
    emergency that you do not know how to handle
   Procedure to follow if exposure incident occurs
   Opportunity for interactive Q & A
 Medical records
  – Name and social security number
  – HBV vaccination status
  – Results of exposure incident follow-up
  – Health care professional's written opinions
  – Info provided to health care professional
  – Confidential
 – Dates
 – Contents
 – Names and qualifications of trainers
 – Names and titles of persons attending
Sharps Injury Log
 – Per the Tennessee Sharps Injury
   Prevention law
 – Keep a log of all sharps injuries with
     • Type and brand of device involved in the
     • Department or work area where the incident
     • Explanation of how the incident occurred
 Memphis Office                 901-543-7259
 Jackson Office                 701-423-5641
 Nashville Office               615-741-2793
 Knoxville Office               865-594-6180
 Kingsport Office               423-224-2042
 Chattanooga                    423-634-6424
 Consultative Services          1-800-325-9901

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