BLOOD BORNE PATHOGENS

AND PREVENTION OF INFECTION

OBJECTIVES1. 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

BLOODBORNE PATHOGENS

HIVHBVHCVOthers

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RISKS TO HEALTH CARE WORKERS

HIV – smallHCV – 900 annually

HBV – 9,000 annually

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

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INFECTIOUS FLUIDS(CONTINUED)

Fluid around the lungs

Fluid around joints

Tissue removed from the body

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OTHER BODY FLUIDSPotentially Infectious Tears Saliva Sputum/nasal

secretions Emesis Urine Feces

Not Infectious Sweat

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TRANSMISSION Sexual contact

Sharing needles

Transfusions

Mom baby

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TRANSMISSION IN THE WORKPLACE Puncture wounds

Contact with non-intact skin

Mucous membranes

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PREVENTION OF INFECTION

Universal Precautions – OSHA

Standard Precautions - CDC

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HAND DECONTAMINATION

After touching blood, body fluids, secretions, excretions, contaminated items

After gloves removed

Between patient contacts

Waterless antiseptic agents

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CONSIDERED AN EXPOSURE

When:Blood, blood products, cerebral spinal fluid,

semen, vaginal secretions or synovial fluid has had contact with NON-INTACT skin or mucous membranes.

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CONSIDERED AN EXPOSURE

WhenYou have been stuck by a contaminated

needle or sharp object

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NOT AN EXPOSURE 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

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PERSONAL PROTECTIVE EQUIPMENT (PPE) Provided by

employer

Application, removal, disposal

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

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GLOVES Correct size

Change if contaminated

Remove inside out

Utility gloves

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MASKS, SHIELDS, EYEWEAR Used when splashing expected Replace when wet Wash hands before removing Handle by side pieces Protective resuscitation equipment

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PROTECTIVE CLOTHING

Used when splashing expected

Remove if soiled

Remove from inside and roll

Nondisposable laundered by employer

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WORK PRACTICE CONTROLS

Sharps Lab materials Decontamination Laundry Waste

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SAFER MEDICAL DEVICES

Sharps with engineered sharp injury protectors

Needleless systems

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IF NEEDLE MUST BE USED… Immediately discard in sharps containers

Do not bend or break

Do not recap

Do not fill container past designated fill line

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DOCUMENTATION OF NEEDLESTICK INJURIES The type and brand of device involved The department or area where the

exposure occurred An explanation of how the exposure

occurred

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OTHER WORK PRACTICE CONTROLS 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 suction24

SPILLS Put on gloves

Wipe up with towel

Dispose of contaminated towel

Apply bleach solution

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LINENS Wear gloves Place in impervious container if linen is

to be transported Label appropriately

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WASTE Label as biohazard

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POST-EXPOSURE Wash area Notify supervisor Consult physician ASAP Report incident Obtain medical counseling Keep records confidential

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C-DIFF 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 affected29

PREVENTION

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.

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MRSA Staphylococcus aureus (MRSA) is a

bacterium responsible for several difficult-to-treat infections in humans.

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.

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PREVENTION

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

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PREVENTION

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

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POLICIES/PROCEDURES

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

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

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