bloodborne pathogens · 2019. 8. 3. · steve barnett, mba. vp, emergency care. health & safety...

Bloodborne Pathogens

in the Workplace

I N S T R U C T O R G U I D E

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ISBN 978-1-945991-00-4 4383

Bloodborne Pathogens in the WorkplaceInstructor Guide, Version 8.0

Purpose of this GuideThis MEDIC First Aid Bloodborne Pathogens in the Workplace Version 8.0 Instructor Guide is solely intended to give information on the presentation and administration of MEDIC First Aid Bloodborne Pathogens certified training classes. The information in this book is furnished for that purpose and is subject to change without notice.

Notice of RightsNo part of this MEDIC First Aid Bloodborne Pathogens in the Workplace Version 8.0 Instructor Guide may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without written permission from MEDIC FIRST AID International, Inc.

TrademarksMEDIC First Aid and the MEDIC First Aid logo are registered trademarks of MEDIC FIRST AID International, Inc.

MEDIC FIRST AID International, Inc.1450 Westec DriveEugene, OR 97402

800-447-3177 541-344-7099

E-mail: [email protected] our website at hsi.com/medicfirstaid

Copyright © 2017 MEDIC FIRST AID International, Inc. All rights reserved. Printed in the United States of America.

First Edition—2017

ISBN 978-1-945991-00-4 ART2204

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PLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE USING THESE MEDIC FIRST AID MATE-RIALS. BY PURCHASING, DOWNLOADING OR OTHERWISE USING OR ACCESSING THESE MATERIALS, YOU ACKNOWLEDGE AND HEREBY AGREE TO BE LEGALLY BOUND BY BOTH THESE TERMS AND CONDITIONS AND THE MOST RECENT HSI TRAINING CENTER ADMINISTRATIVE MANUAL (TCAM) AVAILABLE AT HTTP://WWW.HSI.COM/QUALITYASSURANCE

Unless otherwise indicated in writing by MEDIC First Aid, MEDIC First Aid grants you (“recipient”) the limited right to download, print, photocopy and use the electronic materials, subject to the following restrictions:

■■ The recipient is prohibited from selling electronic or printed versions of the materials.

■■ The recipient is prohibited from altering, adapting, revising, or modifying the materials.

■■ The recipient is prohibited from creating any derivative works incorporating, in part or in whole, the content of the materials.

■■ The recipient is prohibited from downloading the materials and re-posting them to any website without written permission from MEDIC First Aid.

■■ Any rights not expressly granted herein are reserved by MEDIC First Aid.

DISCLAIMERHSI has used reasonable effort to provide up-to-date, accurate information that conforms to generally accepted treatment recommendations at the time of publication. These recommendations supersede recommendations made in previous MEDIC First Aid® programs. Science and technology are constantly creating new knowledge and practice. Like any printed material, this publication may become out of date over time. Guidelines for safety and treatment recommendations cannot be given that will apply in all cases/scenarios as the circumstances of each incident often vary widely. Signs and symptoms may be incomplete and can vary from person to person. Do not use the information in this program as a substitute for professional evaluation, diagnosis, and treatment from an appropriately qualified physician or other licensed healthcare provider. Local or organizational physician-directed practice protocols may supersede treatment recommendations in this program. Alert emergency medical services (EMS) or activate your emergency action plan immediately if you are not sure an emergency exists or when any person is unresponsive, badly hurt, looks or acts very ill, or quickly gets worse.

MEDIC First Aid and the MEDIC First Aid logo are registered trademarks of MEDIC FIRST AID International, Inc. MEDIC First Aid® is a member of the HSI family of brands.

MEDIC FIRST AID International, Inc. 1450 Westec Drive Eugene, OR 97402

800-447-3177 541-344-7099

E-mail: [email protected]

Visit our website at http://www.hsi.com

Copyright © 2016 MEDIC FIRST AID International, Inc. ALL RIGHTS RESERVED. Printed in the United States of America.

First Edition—2016

— SUBJECT TO CHANGE WITHOUT NOTICE —

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Acknowledgments

Staff/Technical Consultants/Expert Reviewers

Medical DirectorGregory R. Ciottone, MD, FACEP

Production TeamTeresa Bonk, Alex Cascaddan, Carolyn Claman, David Keefer, Donna Medina, Dana Midles, Carol Perez-Vitier, Scott Wallace, Jason Williams

Technical ConsultantsCorey Abraham, MEdSr. Account Representative Health & Safety Institute

Craig S. Aman, MBA, MICPLeadership Team, MD Solutions International Captain/Paramedic Seattle Fire Department Seattle, WA

Steve Barnett, MBAVP, Emergency Care Health & Safety Institute

Brandon Condon BA, RN, EMT-B (Ret.)Owner Safety Training Professionals, LLC Milwaukee, WI

Dave FinleyDirector of Instructional Systems TrainSmart, Inc Chicago, IL

Christopher J. Le Baudour, MS Ed, NREMT Adjunct Faculty EMS Training Program Santa Rosa Junior College Santa Rosa, CA

Jeffrey Lindsey, PhD, PM, EFOCoordinator/Lecturer University of Florida St. Petersburg, FL

Howard Main, NREMTP, CCEMTPOwner Health Education Services Salinas, CA

W. Daniel Rosenthal RN, BS, CCHCPresident Workplace Nurses, LLC Gretna, LA

William Rowe, FF/EMT-P (Ret.)VP Business Development, 24/7 Health & Safety Institute

Ralph Shenefelt, FF/EMT-P (Ret.)SVP, Regulatory & Quality Assurance Health & Safety Institute

Zigmund Sawzak, ParamedicDirector of EMS Instruction CPR LifeLine Portland, OR


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iv Bloodborne Pathogens in the Workplace MEDIC First Aid

Program Advisory GroupJim Clover, MED, AT, PTA, CESCoordinator of Sport Medicine Riverside Medical Clinic Owner Clover Enterprises Inc. Riverside, CA

Kim Dennison, RN, BSN, COHC, COHN-S, ACLSOwner Absolute Learning Success, LLC Perry, MI

Bradford A. (Brad) Dykens, EMT-PPublic Affairs Officer/ Public Information Officer City of Seminole Fire Rescue President Rescuer Education Services St. Petersburg, FL

Jeanne Hanson, EMT-B (Ret.)OSHA Outreach Trainer Director of Training Mountain Medic CPR Everett, WA

Wade Himmerlick, EMT IAOwner First Aid For Life Barstow, CA

Pam Isom, BS Biological Sciences-CardiovascularPresident/CEOICE Safety Solutions Fremont, CA

Benjamin B. Karp, MAPresident/Owner Georgia CPR, LLC Avondale Estates, GA

Tanya LeDonneEMT, Firefighter (Ret.) Owner Lifeline Training Center Chico, CA

John Mateus, EMT-I, MSN, RN, NREMT-POwner Less Stress Instructional Services Roselle, NJ

Kira Miller, BA, EMT-B (Ret.)Owner CPR Training Solutions Santa Clara, CA

Jason RoyseEMT-Paramedic (Ret.)/Military Medic President Northwest Health and Safety, Inc. Vancouver, WA

Neal ShabashovEMT/First Responder (Ret.) Owner Life Support Services Fremont, CA

Marcy Thobaben, NREMT-BOwner Blue Grass Health and Safety Wilmore, KY

Jill WhiteFounder Starfish Aquatics Institute (SAI) Savannah, GA

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Part 1: Program Design and Instructional Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Program Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Class Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Class Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Training Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Initial Classroom Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Initial Blended Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Instructional Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

OSHA Bloodborne Pathogens Training Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Part 2: Class Requirements and Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Class Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Learning Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Equipment and Materials List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Class Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Part 3: Initial Training, Classroom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Initial Class Outline and Time Frame . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13


OSHA Bloodborne Pathogens Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Specific Bloodborne Pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)

Human Immunodeficiency Virus (HIV)

Hepatitis B Immunization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Your Company’s Exposure Control Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Job Classifications

Communicating a Hazard in the Workplace

Reducing the Risk of Exposure

Managing an Exposure

Transmitting Bloodborne Pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Methods to Control the Risks of Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Standard Precautions

Personal Protective Equipment (PPE)

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tsWhen an Exposure Occurs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Post-Exposure Follow-Up

Post-Exposure Prophylaxis (PEP)

Housekeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Regulated Waste

Contaminated Laundry

Decontaminating Surfaces

Class Wrap-UpReal-Time Question and Answer Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Documentation and Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Part 4: Initial Training, Blended . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Blended Class Outline and Time Frame

Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61Summary of Program Documents Found Online in Otis

Class Roster with Instructions

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lsProgram Design

Program OverviewThe MEDIC First Aid Bloodborne Pathogens in the Work-place training program is intended for individuals who are trained as a CPR and/or first aid provider, or have an identified job classification in which there are tasks or procedures that increase the risk of exposure to blood-borne pathogens. There are no class prerequisites.

The goal of this training program is to provide knowledge to employees with an identified risk on how to avoid ex-posure to blood and other potentially infectious materi-als, and what steps will be taken if an exposure occurs. For 35 years, MEDIC First Aid Training Programs have used a scenario-based, vid eo-directed, instructional ap-proach that combines seeing, hearing, speaking, feeling, and doing to engage students, embrace different learn-ing styles, and make teaching and learning easier and more enjoyable.

Program StructureMEDIC First Aid Bloodborne Pathogens in the Work-place contains only core training content.

Core Training ContentThe core training content is the minimum knowledge content that is required for certification in MEDIC First Aid Bloodborne Pathogens in the Workplace.

Third-Party Training ContentAdditional training materials that are not produced by HSI may also be used to enhance MEDIC First Aid Bloodborne Pathogens in the Workplace at the dis-cretion of the training center director. These additional materials may not be used in lieu of MEDIC First Aid Bloodborne Pathogens in the Workplace materials and may not be used to shorten or otherwise alter the core training content required for certification.

Important:INSTRUCTORS MUST BE FAMILIAR WITH AND COMPLY WITH ALL APPLICABLE LOCAL, STATE, PROVINCIAL, FEDERAL LAWS AND ADMINISTRATIVE RULES AS THEY PERTAIN TO THE APPROVAL, DELIVERY, AND ADMINISTRATION OF THIS TRAINING. HSI MAINTAINS A DATABASE OF ALL REGULATORY APPROVALS IN OTIS.

Class TypesThere is only one class type for MEDIC First Aid Blood-borne Pathogens. Regardless if the student is new, or has taken Bloodborne Pathogens in the past, each class is taught as if it is an initial class training.

Renewal ClassRenewal training is accomplished by repeating an initial training class.

ChallengeThere is no challenge option available for this course.

Class MethodsThere are 2 main methods to teaching and certifying stu-dents in MEDIC First Aid Bloodborne Pathogens in the Workplace: instructor-led classroom training and blend-ed learning.

Classroom TrainingThis is an instructor-led, in-person, classroom-based approach where the core knowledge content is provided using scenario-based video segments followed by the opportunity for interactive questions and answers with the instructor. There is no restriction on the number of students in a training class.

Blended LearningThis is a mixed-mode approach using both online and in-person learning; core knowledge content is provided in video segments and interactive student exercises on-line, followed by a required real-time interactive question and answer session with an instructor.

Training Content

Initial Classroom ClassThe content of the initial class is divided into lessons. Each lesson provides an approximate length, states specific knowledge objectives (What Students Should Learn), provides an encouraging reason for learning (Why This Topic Matters), lists required equipment, and describes the necessary instructor activities. The outline and time frame for the Initial Instructor-Led Class are provided in Part 3.

Each lesson uses some combination of teaching tools such as video, print, and discussion. Lessons build on each other, reinforcing core knowledge. Required ac-tivities of the initial class include showing the video, emphasizing key points, and checking for students’ understanding.

The initial class proceeds lesson by lesson until its con-clusion. MEDIC First Aid Bloodborne Pathogens in the Workplace certification cards are issued to those stu-dents who have earned them.

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lstion of the online portion is required to attend the re-al-time portion of the class for interactive questions and answers with an instructor.

Important:COMPLETION OF THE ONLINE PORTION ALONE DOES NOT RESULT IN CERTIFICATION. THE ONLINE PORTION IS USEFUL FOR KNOWLEDGE ACQUISITION, ONLINE TRAINING ALONE DOES NOT MEET THE BLOODBORNE PATHOGENS TRAINING REQUIREMENTS OF THE US DEPARTMENT OF LABOR, OCCUPATIONAL SAFETY & HEALTH ADMINISTRATION (OSHA) STANDARDS. ONLINE TRAINING MUST BE ACCOMPANIED WITH A REAL-TIME INTERACTIVE QUESTION AND ANSWER SESSION WITH THE INSTRUCTOR.

Real-Time Question and Answer SessionStudents must be provided an opportunity for inter-active questions and answers with a person knowl-edgeable in the program content and the site-specific methods used to reduce exposure in order to meet the knowledge objectives.

The opportunity for interactive questions and answers can be achieved either face-to-face in a classroom set-ting or via online video conferencing. Sessions can be conducted for groups or for individuals.

For more information: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=25992

Certification RequirementsThe certification requirements for the Initial Blended Class are the same as for an Initial Instructor-Led Class-room Class.

Instructional ToolsThis MEDIC First Aid Bloodborne Pathogens in the Workplace Instructor Guide (integrated with pages from the Bloodborne Pathogens in the Workplace Student Book), video segments, and online training provide the materials necessary for a properly qualified and autho-rized instructor to conduct the Classroom and Blended classes. Lesson plans are located in Parts 3 and 4.

Instructor/Training Center Portal in OtisThe instructor/training center portal in Otis provides ac-cess to the most current support documents, including exams, errata sheets, and more. Please see Otis for the most up-to-date information. Login to Otis at otis.hsi.com/login. If you need assistance logging into Otis, call 877-440-6049 to speak with technical support.

Certification RequirementsInstructors must be current and properly authorized as an MEDIC First Aid Bloodborne Pathogens in the Work-place instructor to issue Bloodborne Pathogens in the Workplace certification cards.

The certification requirement for an initial class requires students to demonstrate cognitive knowledge through interaction with the instructor in a classroom setting or by successful completion of the interactive online course. It also requires participating in a real-time inter-active question and answer session with the instructor. A Written Exam is not required for certification unless required by a regulatory agency.

Important:WHEN NOT REQUIRED, THE WRITTEN EXAM MAY BE USED AS A PRE-, POST-, OR IN-CLASS ACTIVE LEARNING TOOL. THE INDIVIDUAL’S SCORE ON AN OPTIONAL EXAM MAY NOT BE USED TO WITHHOLD A PROPERLY EARNED CERTIFICATION CARD. WHEN A WRITTEN EXAM IS NOT USED OR REQUIRED, INSTRUCTORS CAN MEASURE COGNITIVE UNDERSTANDING BY INFORMAL OBSERVATION AND QUESTIONING USING THE KNOWLEDGE CHECK FEATURE.

Initial Blended Class

About Blended LearningBlended learning combines the convenience of online learning with a real-time, interactive question and answer session with an authorized instructor. The platform used for the online portion of the Initial Blended Class is Otis. This web-based learning system allows for a variety of sensory interactions to provide users with a low-stress, easy-to-use, and convenient way to learn the required information. The management of blended training, including scheduling online and face-to-face sessions, is also done through Otis. Students are notified by email of enrollment in the online class. Student progress can be monitored online. For information on system require-ments and how to register students for the online portion of the class contact your training center director or email [email protected].

Online PortionThe online portion of a blended training class covers the essential cognitive content for the class using pro-gram video segments and interactive exercises. When a student successfully completes the online portion of the class, a Recognition of Completion certificate will be made available to the student for printing and the com-pletion will be recorded within Otis. Successful comple-


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lsStudent BookThe MEDIC First Aid Bloodborne Pathogens in the Work-place Student Book is an up-to-date resource that cov-ers the core knowledge content required for certification. Each participant should have a current print or digital Student Book readily available during and after the class.

Program VideoThe MEDIC First Aid Bloodborne Pathogens in the Work-place program video is a scenario-based visual learning tool. Video segments cover all core training content. The video is available on digital video disc (DVD), online as a component of the blended class, and as an Otis-pow-ered desktop or mobile application.

Skill GuidesThere are no skill guides for the Bloodborne Pathogens in the Workplace program.

Scenario SheetsThere are no scenario sheets for the Bloodborne Patho-gens in the Workplace program.

Performance Evaluation SheetsThere are no performance evaluations for the Blood-borne Pathogens in the Workplace program.

Written ExamUnless required by a regulatory agency, it is not required for students to take and pass the Written Exam. How-ever, the Written Exam documents are provided as an instructional tool and can be used to check student learning and effective retention of knowledge objectives.

Two Written Exam versions, an answer sheet, and answer keys are included in the program documents in Otis.

OSHA Bloodborne Pathogens Training ComplianceThe MEDIC First Aid Bloodborne Pathogens in the Work-place training program has been designed to meet the needs of different individuals, including those who need to meet the requirements established by the Occupa-tional Safety and Health Administration’s (OSHA) Blood-borne Pathogens Standard 29 CFR 1910.1030.

The following information provides more details on how the MEDIC First Aid Bloodborne Pathogens in the Work-place training program can be used to help employers comply with the OSHA Standard.

Covered Employees As determined by the employer, employees whose job classification creates an occupational risk of exposure to blood or other potentially infectious materials must comply with the requirements of the OSHA Bloodborne Pathogens Standard.

Meeting ComplianceThe MEDIC First Aid Bloodborne Pathogens in the Work-place training program is only a part of a larger com-prehensive site-specific training plan required to comply with the OSHA Bloodborne Pathogens Standard.

In the Bloodborne Pathogens Standard, OSHA speci-fies the minimum training elements to be covered when training to meet regulation. These elements are cov-ered in general terms within the MEDIC First Aid Blood-borne Pathogens in the Workplace training program. It is important to understand that compliance training also needs to include the site-specific methods employers use to meet the standard. For example, after learning what personal protective equipment (PPE) is, what are the specific types of PPE provided by the employer and how are they made available?

To help, instructor activities are included in most les-sons of the MEDIC First Aid Bloodborne Pathogens in the Workplace training program to allow for coverage of any site-specific details as outlined in an organization’s exposure control plan. Space is provided on Student Handbook pages to write notes on site-specific infor-mation. Discussion opportunities are included in each segment of the program.

Real-Time Question and Answer Session Part of the OSHA Bloodborne Pathogens Standard specifies that students must have an opportunity for an interactive question and answer session with a person knowledgeable in general content and site-specific infor-mation, conducting the training. OSHA has determined that this session be in real-time, either in the classroom or by video-conferencing. It can be done in groups or individually.

This real-time session is required for certification in the MEDIC First Aid Bloodborne Pathogens in the Work-place training program.

Certification PeriodTo meet the OSHA Bloodborne Standard, annual train-ing is required for those employees determined by their employer to be at risk for exposure to blood or other potentially infectious materials.

The MEDIC First Aid Bloodborne Pathogens in the Work-place training program provides a certification card that can be issued for up to 12 months.

Instructor BackgroundBased on the OSHA compliance directive entitled CPL 2-2.44D Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens: “The person con-ducting the training is required to be knowledgeable in

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lsthe subject matter covered by the elements contained in the training program as it relates to the workplace that the training will address. In addition to demonstrat-ing expertise in the area of the occupational hazard of bloodborne pathogens, the trainer must be familiar with the manner in which the elements in the training program relate to the particular workplace.

The Compliance Officer should verify the competency of the trainer based on the completion of specialized courses, degree programs, or work experience, if he/she determines that deficiencies exist in training. Pos-sible trainers include a variety of healthcare profes-sionals such as infection control practitioners, nurse practitioners, registered nurses, occupational health professionals, physician’s assistants, and emergency medical technicians.

Non-healthcare professionals such as, but not limited to, industrial hygienists, epidemiologists, or profession-al trainers, may conduct the training, provided they are knowledgeable in the subject matter covered by the el-ements contained in the training program as it relates to the workplace.

One way, but not the only way, knowledge can be demonstrated is the fact that the person received spe-cialized training. In some workplaces, such as dental or physicians’ offices, the individual employer may conduct the training, provided he or she is familiar with blood-borne pathogen exposure control and the subject matter required by paragraphs (g)(2)(ix)(A) through (N). (Of the OSHA Bloodborne Standard 29 CFR 1910.1030).”

Important LinksOSHA Bloodborne Pathogens Standard 29 CFR 1910.1030

https://www.osha.gov/pls/oshaweb/owadisp.show_ document?p_table=STANDARDS&p_id=10051

OSHA CPL 2-2.44D Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens

https://www.osha.gov/pls/oshaweb/owadisp.show_ document?p_table=DIRECTIVES&p_id=2570


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nClass Requirements

Important:COMPLETE STANDARDS AND GUIDELINES FOR QUALITY ASSURANCE INCLUDING PROGRAM STANDARDS, CERTIFICATION STANDARDS, AND THE TERMS AND CONDITIONS FOR INSTRUCTOR AND INSTRUCTOR TRAINER AUTHORIZATION ARE LOCATED IN THE MOST RECENT VERSION OF THE HSI TRAINING CENTER ADMINISTRATION MANUAL (TCAM) AVAILABLE AT http://www.hsi.com/qualityassurance.

ALL INSTRUCTORS HAVE AGREED TO COMPLY WITH THESE STANDARDS BY SUBMITTING A SIGNED APPLICATION FOR INSTRUCTOR AUTHORIZATION.

Before ClassA few days before the class, confirm the date, location, and number of students. Ensure you have the following materials (see Equipment List for detailed information):

■■ Bloodborne Pathogens in the Workplace Instructor Guide

■■ Bloodborne Pathogens in the Workplace Student Books

■■ Audio visual equipment and cables

■■ Class paperwork

Review this Instructor Guide, paying particular atten-tion to the outline and time frame for the class you are teaching (Classroom or Blended). Review the video and key points for each lesson. Review all of the includ-ed Instructor Notes to see if you need to adjust your approach to training. Familiarize yourself with the Student Book.

Learning EnvironmentThe ideal learning environment is comfortable, efficient, and distraction-free with sufficient space, seating, re-sources, and equipment. Instructors should take rea-sonable efforts to ensure a physically safe, comfortable and appropriate learning environment. The room should be well lit, well ventilated, and comfortable in tempera-ture. Avoid cramped classroom setups where possible. Instructors must often create a makeshift classroom out of a noisy shop floor, poorly lit cafeteria, or cramped conference room. Such challenges should be anticipat-ed and the learning environment be made as favorable as possible.

Classroom SpaceThe room should be large enough to accommodate com-fortable seating for all of the students in your class. Care should be taken to make sure all students can clearly see and hear the video, any instructor comments, and student discussion.

Classroom SafetyMake sure there are no obvious hazards in the class-room, such as extension cords that can be tripped over. Discourage students from smoking, eating, or engaging in disruptive or inappropriate behavior. Have an emer-gency response plan in case of serious injury or illness, including evacuation routes from the classroom. Be aware of and share with students the location of the nearest bathrooms, exit, phone, first aid kit, AED, fire alarm pull station, and fire extinguisher.

Student Illness and Other EmergenciesAdvise students to not attend class if they have an ill-ness such as influenza or a fever. Training centers should provide reasonable accommodation to students to make up class time. If a student has a medical emergency, in-structors should provide the appropriate first aid care and activation of EMS.

Equipment and Materials ListSome equipment and materials are required for teach-ing, while other materials are optional (like the Written Exam). Some materials and equipment are recommend-ed but not required. Use the lists below to prepare the right materials and equipment for the training you are delivering.

Core ContentRequired■■ Television with DVD player, or computer with speakers, large monitor, or projection screen

■■ Bloodborne Pathogens in the Workplace Student Books, 1 for each student (print or digital)

■■ Bloodborne Pathogens in the Workplace program video, DVD or Otis-powered desktop, mobile application, 1 for each class

■■ Bloodborne Pathogens in the Workplace certifi-cation cards, 1 for each student who fulfills the requirements (print or digital)

■■ Class roster, 1 for each class (print or digital)

May Be Required (Regulatory Agency)■■ Written exams A and B, 1 version for each stu-dent (print)

■■ Written exams answer sheets, 1 for each student (print)

■■ Written exams answer keys, A and B, 1 for each instructor/assistant (print)

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nWritten ExamA Written Exam is not required for certification unless required by a regulatory agency.

Evaluation of the core knowledge objectives in Blood-borne Pathogens in the Workplace is normally accomp-lished by informal observation and questioning through-out a training class.

When a Written Exam is required, adequate time must be added to the class to complete the exam. Two ver-sions of the Written Exam, along with instructions for their use are included online in Otis. An exam answer sheet is also available to help minimize the amount of paper used. Exam answer keys are provided for both exam versions to aid in exam correction.

Each student must obtain a passing score of 70% or better. If a student does not pass the first Written Exam, he or she must take the alternative version. If a student does not pass the alternative version, he or she must retake the class.

MEDIC First Aid is implementing open-book exams with the G2015 training programs. Open-book exams em-phasize critical thinking and problem solving over recall of memorized facts and decrease test anxiety. Open-book exams mean that students may use reference ma-terials to take exams when they are required. Reference materials include any notes taken during the class as well as the print or digital MEDIC First Aid Student Book.

Although students may use reference materials while taking the exam, they should not be allowed to openly discuss the exam with other students or the instructor. Their answers should be their own. Instructors may read aloud the exam to the students as necessary without providing the answers.

Consider the following tips to prevent cheating if stu-dents take the Written Exam.

1. Before distributing the exams, remind students those who are caught cheating will not receive certification cards.

2. Request a photo ID if you suspect someone may be taking the test in place of a student. Taking an exam for someone else constitutes cheating.

3. Inform students there is to be no talking during the exam. If a student has a question during the exam, ask that student to raise a hand and you will go to him or her.

4. For extra precaution, use both versions of the exam, alternating them between students to make copying from another student more difficult.

5. Walk around the room throughout the exam. Do not do other work while monitoring the exam.

Recommended■■ Pens or pencils, 1 for each student when Written Exam is administered

■■ Name tags or tent cards, 1 for each student

■■ Spare projector bulb (as needed)

■■ Extension cord (as needed)

■■ Whiteboard with dry erase pens and eraser, if available

■■ Large black markers for student name tags or tent cards

■■ Large envelope for class paperwork, including Written Exam answer sheets when required

Conducting a Class1. Arrive early. Give yourself plenty of time to get

organized.

2. Circulate a sign-in sheet or the Class Roster. Be sure all students sign-in.

During Class1. Start on time. Briefly cover class expectations:

class goal, certification requirements, classroom safety, facilities, mobile phone use, and breaks.

2. Stay on track. Keep lessons within their time lim-its. End discussions when they are not produc-tive or lead off class.

3. At the beginning of each lesson, briefly commu-nicate the knowledge objectives, and explain why this topic matters.

4. Show the video and emphasize the key points as needed. Ask for and briefly answer any questions.

5. Upon class completion, issue Bloodborne Patho-gens in the Workplace certification cards to those individuals who earned them.

6. Offer and collect students’ Rate Your Program evaluations.

After ClassComplete and sign the Class Roster.

Administration

Skill EvaluationThere are no required skills to be evaluated for the MED-IC First Aid Bloodborne Pathogens in the Workplace training program.


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nRate Your Program Course EvaluationEncouraging class participants to provide feedback and then using that feedback to improve instruction is an es-sential aspect of any quality educational effort. HSI re-quires that students be given the opportunity to evaluate any MEDIC First Aid class using the Rate Your Program course evaluation form.

When used, course evaluations must be promptly deliv-ered to the training center responsible for the class.

Additionally, class participants may provide Rate Your Program feedback directly to HSI http://www.hsi.com/rateyourprogram. All information obtained by HSI through this process is reviewed and shared with the training center, instructor, or instructor trainer as appropriate.

Criteria for CertificationWhen the instructor determines a student has demon-strated an adequate understanding of the cognitive content and participated in a real-time question and an-swer session with an instructor, the instructor may is-sue a certification card (print or digital). For the blended option, successful completion of the interactive online course demonstrates an adequate understanding of the cognitive content.

Certification means verification that on the indicat-ed class completion date the student demonstrated achievement of the required knowledge objectives to the satisfaction of a currently authorized MEDIC First Aid in-structor or instructor trainer.

Certification does not guarantee future performance or imply licensure or credentialing. Certification is docu-mented by the legitimate issuance of a correctly com-pleted Bloodborne Pathogens in the Workplace certifi-cation card.

Important:SEE THE MOST RECENT VERSION OF THE HSI TRAINING CENTER ADMINISTRATION MANUAL (TCAM) FOR COMPLETE PROGRAM STANDARDS REGARDING CERTIFICATION. THE TCAM IS AVAILABLE AT http://www.hsi.com/qualityassurance.

Class DocumentationAll of the class documentation forms used in the Blood-borne Pathogens in the Workplace training program are available for download in the documents section of Otis. A complete list of those forms can be found in the Ap-pendix of this Instructor Guide.

There may be periodic revisions or updates to the class documentation forms. Refer to Otis for the most current version.

Class RosterThe Class Roster is the principal record of training. The roster verifies student completion of the class. It also documents the results of the Written Exam if used during training. A complete, accurate, and legible Class Ros-ter signed by the authorized instructor or submitted on-line through Otis is required for every training class. The Class Roster must be promptly delivered to the train-ing center responsible for the class or submitted online through Otis. The training center is required to keep clear, legible and orderly class records (paper or digital) for no less than 3 years.

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Lesson Lesson Title Knowledge ObjectivesApproximate Length (min)

Introduction Describe the purpose of the program, health and safety precautions, and conduct a warm-up exercise.* 3

BlooDBorne Pathogens 1 OSHA Bloodborne Pathogens

StandardLocate a copy of the OSHA Bloodborne Pathogens Standard and explain the basic content within it. 1910.1030(g)(2)(vii)(B)

5

2 Specific Bloodborne Pathogens

Describe the general facts and symptoms of bloodborne diseases. 1910.1030(g)(2)(vii)(B)

8

3 Hepatitis B Immunization Describe the efficacy, safety, and method of administration of the hepatitis B vaccine; describe the benefits of being vaccinated and your right to the vaccine free of charge when there is occupational exposure risk. 1910.1030(g)(2)(vii)(I)

5

4 Your Company’s Exposure Control Plan

Describe the employer’s exposure control plan and how to obtain a written copy of it. 1910.1030(g)(2)(vii)(D)

Identify tasks and activities that may involve exposure to blood and other potentially infectious materials. 1910.1030(g)(2)(vii)(E)

Describe the required signs and labels and/or color-coding used to communicate the presence of potentially infectious materials. 1910.1030(g)(2)(vii)(M)

7

5 Transmitting Bloodborne Pathogens

Describe the common routes of transmission for bloodborne pathogens. 1910.1030(g)(2)(vii)(C)

4

6 Methods to Control the Risks of Exposure

Describe the use and limitations of methods that will prevent or reduce exposure to blood and other potentially infectious materials, including engineering controls, work practices, and personal protective equipment. 1910.1030(g)(2)(vii)(F)

Describe the proper types, proper use, location, removal, handling, decontamination, and disposal of personal protective equipment. 1910.1030(g)(2)(vii)(G)

Describe how to select personal protective equipment. 1910.1030(g)(2)(vii)(H)

7

7 When an Exposure Occurs List the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials. 1910.1030(g)(2)(vii)(J)

Describe the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available. 1910.1030(g)(2)(vii)(K)

Describe the required post-exposure evaluation and follow-up after an exposure incident. 1910.1030(g)(2)(vii)(L)

10

8 Housekeeping Describe what regulated waste is and how to manage it safely through the use of safe containers and decontamination. 1910.1030(d)(4)

7

Real-Time Question and Answer Session An opportunity for interactive questions and answers with the person conducting the workplace training session is required when conducting training. 1910.1030(g)(2)(vii)(N)

5+

evaluationWritten Exam Optional, unless required.a 20–30

conclusionDocumentation and Certification Verify class documentation and issue certification cards to students

who earned them.5+

Total Timeb about 1 hour

* The person conducting the training shall be knowledgeable in the subject matter covered by the elements contained in the training pro-gram as it relates to the workplace that the training will address. 1910.1030(g)(2)(viii)

a When a Written Exam is not required by a regulatory agency, it is optional. The optional exam may be used before, during, or after class as an active learning tool; however, the participant’s score on an optional exam may not be used to withhold a properly earned certification card. See Written Exam on page 9.

b Projected times for lessons take into account video run times, brief introductions, basic site-specific information, and answers to ques-tions. Depending on the organization and the job classifications within it, the time to cover site-specific information required for com-pliance with the OSHA Bloodborne Pathogens Standard can vary widely. Lesson times are influenced by class preparation, available equipment, the amount of detailed site-specific information, and instructor efficiency. These could increase the time to meet training compliance.

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IntroductionClass Type: Initial

Class Method: Classroom

Length: 3 minutes

Why This Topic MattersThe class introduction is important, whether the students and instructor know each other or are meeting for the first time. The introduction helps everyone to relax and to feel less inhibited and comfortable. The introduction sets the tone for the entire class.

Equipment ■■ Sign-in sheet or Class Roster, name tags or tent cards (optional), large black markers (optional)

Instructor Activities

1 Greet Students■■ Arrive early . Give yourself plenty of time to get set up and organized■✓ Greet students as they arrive and introduce yourself . Have them sign in on the roster .

■✓ Be friendly, considerate, respectful, and professional .

■✓ Have students complete a name tag or tent card and select a seat .

2 Begin Class■■ Start on time .■✓ Consider using an appropriate icebreaker as a warm-up exercise . Great ideas for these activities can be found on the internet by searching with the key word icebreaker .■✓ Establish a connection with the students . Ask about previous training . Connect the students’ experiences and knowl-edge to this class .

■■ Briefly cover class goal, agenda, certification requirements, facility and classroom safety .

■✓ Class goal: provide knowledge to employees with an identified risk of occupational exposure on how to avoid exposure to blood and other potentially infectious materials and what steps will be taken if an exposure occurs .

■✓ Describe the agenda, including breaks .

■✓ Outline the minimum requirements for certification .

■✓ Review facility safety features . Know and share the locations of the following:

1 . Bathrooms, fire/emergency exits, fire alarm pull stations, best emergency evacuation route

2 . First aid kits, emergency oxygen, and AEDs

■✓ Distribute the MEDIC First Aid Bloodborne Pathogens in the Workplace Student Book .

3 Close■■ Ask for and answer any questions before moving on to the next lesson .


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14 Bloodborne Pathogens in the Workplace MEDIC First Aid

OSHA Bloodborne Pathogens Standard Class Type: Initial


Length: 5 minutes

Why This Topic MattersThe OSHA Bloodborne Pathogens Standard requires employers to protect employees who are at risk from oc-cupational exposure to infectious bloodborne diseases.

What Students Should LearnAfter completing this lesson, the student should be able to state or identify the following:

■■ Where to locate a copy of the OSHA Bloodborne Pathogens Standard and explain the basic content within it

Equipment ■■ Television with DVD player or computer/tablet with speakers, large monitor, or projection screen (will be used throughout class), copy of the OSHA Bloodborne Pathogens Standard (optional, available at www.osha.gov)


1 Show Video — (required, approx. duration 2:00)■■ Emphasize key points as needed .■✓ OSHA Bloodborne Pathogens Standard

■– Some employees face significant health risk as a result of exposure to blood or other potentially infectious materials (OPIM) .

■– In 1991, the Occupational Safety and Health Administration (OSHA) issued the Bloodborne Pathogens Standard, 29 CFR 1910 .1030, which applies to all employees who can reasonably come in contact with human blood and OPIM in the course of their job activities .

■– The purpose of the standard is to protect employees by minimizing or eliminating exposure to disease-carrying microorganisms, or pathogens, that can be found in human blood and other body fluids .

■– Every year, all employees with the potential of occupational exposure must receive training on bloodborne pathogens and exposure control methods .

■■ Ask for and briefly answer any questions .

■■ Refer students to pages 1–2 of the Student Book .

■■ Use the Knowledge Check activity to evaluate and increase retention .

2 Review Site-Specific Information■■ Inform students about who to talk to about bloodborne pathogens for their organization . ■■ Notes can be written in their student books or handout .

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•Knowledge CheckWhat is the purpose of the OSHA Bloodborne PathogensStandard?

The purpose of the standard is to protect employees by minimizing or eliminating occupational exposure to disease-carrying microorganisms, or pathogens, which can be found in human blood and other body fluids.

NEXT LESSON:Specific Bloodborne Pathogens


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Specific Bloodborne PathogensClass Type: Initial


Length: 8 minutes

Why This Topic MattersUnderstanding the most common bloodborne diseases can help inform employees about the risks of serious infections through occupational exposure to bloodborne diseases.


■■ The general facts and symptoms of bloodborne diseases


1 Show Video — (required, approx. duration 6:00)■■ Emphasize key points as needed .■✓ Specific Bloodborne Pathogens

■– The most concerning bloodborne pathogens are the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV), the virus that causes AIDS .

■– Not all of these bloodborne pathogens are contagious to the same degree, nor have the same symptoms . Some people can be infected and contagious but show no symptoms . All can be caused by bloodborne pathogens transmission, but only a few have any available treatment .

■✓ Hepatitis B Virus (HBV)

■– The hepatitis B virus (HBV) can cause hepatitis, an infection that causes inflammation of the liver .

■– Life-threatening complications of hepatitis B include cirrhosis of the liver, liver cancer, and liver failure .

■– Symptoms of someone infected with hepatitis B can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellow color in the skin or eyes) .

■– Not all people infected with HBV show symptoms . But even without symptoms, HBV-infected individuals can still be infectious to others .

■– The hepatitis B virus can be infectious on surfaces for up to 7 days in the presence of dried blood .

■– There are no medications available to treat an acute HBV infection . Limited medications are available for chronic infections .

■– A vaccination to prevent HBV infection is available . It has relatively few adverse side effects and is well tolerated by most of the population .

■✓ Hepatitis C Virus (HCV)

■– The hepatitis C virus (HCV) can cause severe liver damage in a manner similar to HBV .

■– Most people with an acute HCV infection do not display symptoms . When they do occur, they include the same symptoms that can occur with HBV .

■– Just like with HBV, HCV-infected individuals are still infectious to others even if they show no symptoms .

■– HCV can be infectious on surfaces for up to 3 weeks in the presence of dried blood .

■– Currently, there is no immunization available for HCV, but treatment is available for an acute infection that may reduce the risk of the disease becoming chronic .

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■✓ Human Immunodeficiency Virus (HIV)

■– The human immunodeficiency virus (HIV) is the virus responsible for causing acquired immunodeficiency syndrome (AIDS) .

■– The virus attacks and suppresses the immune system specifically targeting the cells crucial for fighting infection from invading organisms . This allows other diseases and infections to progress in the body without resistance .

■– Similar to HBV and HCV, many of those infected with HIV will not show any symptoms of infection but are still potentially infectious to others . It could take many years before an HIV-infected person shows symptoms of disease .

■– Early symptoms could include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers .

■– HIV is very fragile and can only survive for a few hours outside of the human body .

■– There is no immunization or known cure for HIV . Effective new drug therapies can keep HIV-infected persons healthy longer, and have dramatically reduced the death rate .

■✓ Risk of Infection

■– Of the 3 major bloodborne pathogens, HBV is the most contagious, with up to a 1-in-3 chance of getting infected from being exposed if you are not vaccinated . HCV has the next greatest risk of transmission, with up to a 1-in-50 chance of getting infected . Comparatively, HIV is much less contagious than either hepatitis virus, with the highest risk of occupational transmission at about 1 in 300 .





•Knowledge CheckWhich of the bloodborne pathogens covered has the greatest risk of transmission from an exposure?

Hepatitis B (HBV) is the bloodborne pathogen covered here that has the greatest risk of transmission from an exposure.

NEXT LESSON:Hepatitis B Immunization


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Hepatitis B ImmunizationClass Type: Initial


Length: 5 minutes

Why This Topic MattersThe hepatitis B vaccine is very effective in protecting against the hepatitis B virus.


■■ The efficacy, safety, and method of administration of the hepatitis B vaccine; the benefits of being vaccinat-ed; that the vaccination is free of charge

Equipment ■■ HBV vaccination declination form (optional)


1 Show Video — (required, approx. duration 2:30)■■ Emphasize key points as needed .■✓ Hepatitis B Immunization

■– The hepatitis B vaccine is very effective in protecting against the hepatitis B virus .

■– Your employer must offer the hepatitis B vaccine for free to any employees with risk of occupational exposure to blood or body fluids, prior to undertaking any tasks that could result in an exposure . The vaccine is safe with very few adverse reactions .

■– Your employer does not have to offer you the vaccination series if you have previously received the complete series or have tested as immune to HBV .

■– You can decline the vaccination for hepatitis B after being informed of the risks and benefits .

■– If you initially decline the hepatitis B vaccine, you can ask for it from the company at any time, at no cost to you .




2 Review Site-Specific Information■■ Inform students about their organization’s method for providing HBV vaccination .■■ Notes can be written in their student books or handout .


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•Knowledge CheckTrue or false? An employee may not change his or her mind about receiving the hepatitis B immunization after initially declining the vaccine.

False. If an employee initially declines the hepatitis B vaccine, he or she can ask for it from the company at any time, at no cost.

NEXT LESSON:Your Company’s Exposure Control Plan

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Your Company’s Exposure Control PlanClass Type: Initial


Length: 7 minutes

Why This Topic MattersThe goal of an exposure control plan is to eliminate or minimize risks from employee exposure to bloodborne pathogens.


■■ The employer’s exposure control plan and how to obtain a written copy of it

■■ Tasks and activities that may involve exposure to blood and other potentially infectious materials

■■ Required signs and labels and/or color-coding used to communicate the presence of potentially infectious materials

Equipment ■■ Organization’s exposure control plan (optional)


1 Show Video — (required, approx. duration 3:00)■■ Emphasize key points as needed .■✓ Exposure Control Plan

■– Your company’s exposure control plan outlines the site-specific strategies necessary to eliminate or minimize employee exposure to blood and other body fluids .

■✓ Job Classifications with Risk of Exposure

■– The plan includes the identification of job classifications that have risk of exposure to blood and other potentially infectious materials .

■– It is important to know if your job classification puts you at risk for occupational exposure .

■– Job classifications with a likely chance of occupational exposure include first aid providers, housekeeping staff, lab workers, firefighters, EMTs and paramedics, law enforcement agents, medical and dental personnel, and tattoo and body modification artists .

■✓ Communicating a Hazard in the Workplace

■– The exposure control plan explains how your employer has decided to make you aware of potentially infectious materials in your workplace .

■– A biohazard label or sign should be attached to each object or container of contaminated materials by string, wire, adhesive, or another method that prevents loss or unintentional removal of the label or sign .

■– Signs should have a fluorescent orange or orange-red background with a black “biohazard” symbol in the foreground . Labels must contain the biohazard symbol and must have the word “biohazard” written on them .

■– When red bags or containers with the biohazard symbol on them are used, a sign or label is not necessary .

■– Properly indicating contaminated materials using labels and signs will greatly reduce the risk of accidental exposure to the contaminated materials .


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■✓ Reducing the Risk of Exposure

■– The exposure control plan at your workplace will contain site-specific methods used to reduce the risk of occupational exposure:

a . Engineering and work practice controls

b . Personal protective equipment (PPE)

c . Housekeeping procedures

d . Containment and labeling of potentially infectious materials

■– The plan lists the site-specific means by which the facility will reduce employee risk . These methods include appropriate training, the communication of hazards, hepatitis B vaccinations for any employee who has occupational risk of exposure, methods for post-exposure evaluation and follow-up, and proper recordkeeping .

■✓ Managing an Exposure

■– The plan describes the procedure for the investigation and evaluation of circumstances surrounding exposure incidents in order to quickly provide effective follow-up care to exposed employees .

■– This investigation will help you and your employer learn from what happened and establish measures to prevent it from happening again .

■– The exposure control plan must be a written document accessible to all employees . It is reviewed and updated at least annually or when alterations in procedures create the possibility of new occupational exposure .




2 Review Site-Specific Information■■ Inform students about how to get a copy of their organization’s exposure control plan .■■ Inform students on the general details of their organization’s exposure control plan .

■■ Notes can be written in their student books or handout .


•Knowledge CheckWhat are 4 general things you can expect to find in your company’s exposure control plan?

You should find which employees are covered by the OSHA standard, how to communicate the presence of contaminated material, how to minimize the risk of exposure, and how to handle an exposure if one occurs.

NEXT LESSON:Transmitting Bloodborne Pathogens

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Transmitting Bloodborne PathogensClass Type: Initial


Length: 4 minutes

Why This Topic MattersKnowing the ways bloodborne pathogens are transmitted helps employees better understand how to reduce the risk of exposure to them.


■■ The common routes of transmission for bloodborne pathogens


1 Show Video — (required, approx. duration 2:00)■■ Emphasize key points as needed .■✓ Transmission

■– The primary ways exposure to bloodborne pathogens occur in an occupational setting are the following:

a . through non-intact skin, such as a cut or abrasion

b . through the mucous membranes of the eyes, nose, or mouth

c . through a puncture wound from a sharp, contaminated object, such as a syringe or broken glass

■– Direct contact with blood or other potentially infectious materials can cause an exposure incident .

■– Indirect contact with an intermediate object such as a work surface or door knob that has been contaminated with body fluids can also cause an exposure incident .

■– Body fluids that have a risk of transmitting bloodborne pathogens in an occupational setting include blood and cerebrospinal fluid .

■– In the absence of visible blood, some body fluids have no documented risk of transmission . However, during an emergency, you may not be able to tell which fluids you are handling or whether injury has mixed them with blood . It is best to simply consider all body fluids as potentially infectious .





•Knowledge CheckWhat are the primary ways exposure to bloodborne pathogens occur in an occupational setting?

The primary ways exposure to bloodborne pathogens occur in an occupational setting is through non-intact skin, the mucous membranes of the eyes, nose, or mouth; or through a puncture wound from a sharp, contaminated object, such as a syringe or broken glass.

NEXT LESSON:Methods to Control the Risks of Exposure

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Methods to Control the Risks of ExposureClass Type: Initial


Length: 7 minutes

Why This Topic MattersConsidering all body fluids to be potentially infectious and always using personal protective equipment to pro-vide barrier protection will reduce an employee’s occupational exposure to blood and other potentially infec-tious materials.


■■ The use and limitations of methods that will prevent or reduce exposure to blood and other potentially infectious materials, including engineering controls, work practices, and personal protective equipment

■■ The proper types, proper use, location, removal, handling, decontamination, and disposal of personal pro-tective equipment

■■ How to select personal protective equipment


1 Show Video — (required, approx. duration 2:00)■■ Emphasize key points as needed .■✓ Methods to Control Exposure

■– Work practice controls and engineering controls help prevent the transmission of bloodborne diseases in the workplace and allow you to perform job tasks with a minimal risk of exposure .

■– Work practice controls focus on the manner in which tasks are performed . For example, using personal protective equipment, such as disposable gloves when performing first aid, is considered a work practice control .

■– Engineering controls reduce exposure in the workplace by either removing or isolating the hazard, such as providing an appropriate disposal container for needles . Your employer is required to examine and maintain or replace engineering controls on a regular basis .

■✓ Standard Precautions

■– Standard precautions means treating all body fluid as potentially infectious, even that of someone you know well .

■✓ Personal Protective Equipment (PPE)

■– PPE is specialized clothing or equipment that isolates your body from contact with potentially infectious materials .

■– Effective PPE must not permit potentially infectious materials to pass through or reach your skin, eyes, mouth, or clothes under normal conditions of use .

■– Your employer will make PPE available to you in the appropriate size and at no cost .

■– Non-latex alternatives will also be made available to employees who have allergic sensitivity to latex .

■– Employers must also properly clean, launder, repair, replace, or dispose of contaminated PPE as needed .

■– Always wear disposable gloves when there is a possibility of hand contact with blood or other body fluids .

■– Replace gloves as soon as possible when torn, punctured, contaminated, or if their ability to function as a barrier is compromised .

■– Perform all actions involving blood or other potentially infectious materials in such a way as to minimize splattering, splashing, and spraying .





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Instructor Note:According to the U.S. Department of Health & Human Services, Centers for Disease Control and Prevention (CDC), “Standard Precautions are designed to protect health care personnel and to prevent them from spreading infections to patients. They are based on the premise that all blood, body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes might contain transmissible infectious agents. Standard Precautions include 1) hand hygiene, 2) use of personal protective equipment (PPE), 3) respiratory hygiene and cough etiquette, 4) safe injection practices, and 5) safe handling of potentially contaminated equipment or surfaces in the patient environment.”1

According to the U.S. Department of Labor, Occupational Safety & Health Administration (OSHA), universal precautions is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens. The OSHA Bloodborne Pathogen Standard 29 CFR 1910.1030(d)(1) requires employees to observe Universal Precautions to prevent contact with blood or other potentially infectious materials (OPIM). Universal precautions include use of gloves, masks, gowns, as well as engineering and work practice controls to limit exposure if blood or OPIM exposure is anticipated.

For compliance with OSHA Standards, the use of either Universal Precautions or Standard Precautions are acceptable.2

1 Olson CK, Iwamoto M, Perkins KM, et al. Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:290–292. DOI: http://dx.doi.org/10.15585/mmwr.mm6511e3.

2 OSHA Healthcare Wide Hazards, (Lack of) Universal Precautions. Available: https://www.osha.gov/

SLTC/etools/hospital/hazards/univprec/univ.html

2 Review Site-Specific Information■■ Inform students about the engineering controls used at their organization .■■ Inform students about the work practice controls used at their organization .

■■ Inform students about the PPE used at their organization .

■■ Notes can be written in their student books or handout .


•Knowledge CheckWhat is the infection-control approach wherein all blood and body fluids are treated as potentially infectious?

Standard precautions is the infection-control approach wherein all blood and body fluids are treated as potentially infectious.

NEXT LESSON:When an Exposure Occurs

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When an Exposure OccursClass Type: Initial


Length: 10 minutes

Why This Topic MattersIf an exposure occurs, it is critical that the exposed employee accomplishes immediate self-care and reports the incident as soon as possible in order to reduce the chance of infection.


■■ The appropriate actions to take and persons to contact in an emergency involving blood and other poten-tially infectious materials

■■ The procedure to take if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available

■■ The required post-exposure evaluation and follow-up after an exposure incident


1 Show Video — (required, approx. duration 5:30)■■ Emphasize key points as needed .■✓ When an Exposure Occurs

■– If an exposure occurs, immediately care for it .

a . When a potentially contaminated sharp object creates an open wound, wash and irrigate the wound with soap and large amounts of running water .

b . If you suspect an exposure from potentially contaminated materials to the eyes, nose, or mouth, flush the affect-ed areas with large amounts of running water .

c . If potentially contaminated material gets on to non-intact skin, wash it off as soon as possible with soap and water .

■– If you provided care, wash your hands immediately whenever blood or other potentially infectious materials was present, even if you were wearing gloves .

■– If soap and running water are not available, alcohol-based foam or gel hand sanitizers can be used .

■– Your employer must provide readily accessible handwashing facilities or antiseptic hand cleanser or wipes if handwashing facilities are not available .

■– Place contaminated protective equipment in appropriately designated areas or containers for cleaning or disposal .

■✓ Post-Exposure Follow-Up

■– If an occupational exposure does occur, it is important for you to follow the employer’s written procedures for handling the exposure .

■– After any immediate care, report an exposure incident without delay . This allows for timely testing of the source individual, and, if necessary, the person who was exposed .

■– Anyone affected by an exposure will be directed to a healthcare professional for medical evaluation and testing as soon as possible after receiving the source individual’s test results .

■– The result of your testing is confidential and is reported only to you and your healthcare provider .

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gens■✓ Post-Exposure Prophylaxis (PEP)

■– If an employee has been exposed to HIV-infected blood, most medical facilities offer short-term therapy called post-exposure prophylaxis (PEP) . PEP can reduce the risk of getting HIV by as much as 80% .




2 Review Site-Specific Information■■ Inform students about their organization’s procedure for following up on a suspected exposure .■■ Notes can be written in their student books or handout .


•Knowledge CheckWhat is the first thing to do if an exposure to blood or other potentially infectious materials occur?

The first thing to do if an exposure to blood or other potentially infectious materials occurs is to immediately care for it. When there is non-intact skin, or a potentially contaminated sharp object creates an open wound, wash and irrigate the wound with soap and large amounts of running water.

For an exposure to the eyes, nose, or mouth, flush the affected areas with large amounts of running water.

NEXT LESSON:Housekeeping


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HousekeepingClass Type: Initial


Length: 7 minutes

Why This Topic MattersThe appropriate handling of contaminated waste can reduce the chance of accidental or indirect exposure.


■■ What regulated waste is and how to manage it safely through the use of safe containers and decontamina-tion.


1 Show Video — (required, approx. duration 4:00)■■ Emphasize key points as needed .■✓ Housekeeping

■– Proper containment and labeling of potentially infectious materials ensures that these items are handled appropriately .

■✓ Regulated Waste

■– The term “regulated waste” refers to specific categories of waste that require special handling, including blood and other potentially infected materials .

■– Regulated waste that warrants special handling includes the following:

a . Liquid or semi-liquid blood or other potentially infectious materials

b . Contaminated items that would release potentially infectious materials in a liquid or semi-liquid state

c . Items caked with potentially infectious materials that are capable of releasing these materials during handling

d . Contaminated sharp objects

■– Infectious waste should be placed in specially designed containers constructed to contain the contents . The containers need to be leak-proof, labeled or color coded, and closed prior to removal to prevent spills .

■– If a container is leaking, place it in a secondary container that is appropriate for handling liquids or semi-liquids .

■– Pick up potentially contaminated broken glassware using mechanical means only, such as tongs, forceps, or brush and dustpan . Never use your hands, even if you are wearing gloves .

■– Contaminated items should not be stored or processed in a way that requires anyone to reach into containers where the contents cannot be seen or safely handled .

■✓ Contaminated Laundry

■– Contaminated laundry is laundry soiled with potentially infectious materials or that may contain contaminated sharp objects, such as needles . Contaminated laundry should be handled as little as possible . Wear gloves when handling contaminated laundry, and place it in labeled, leak-proof bags or containers before transporting it .

■– Do not take contaminated protective clothing home for laundering .


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■✓ Decontaminating Surfaces

■– Keep potentially infectious materials from lingering on surfaces . All equipment and work surfaces that could be contaminated should be cleaned and decontaminated routinely using an appropriate disinfectant while wearing PPE .

■– All pails, bins, and similar reusable receptacles should be decontaminated on a regular basis and as soon as possible after visible contamination is noticed .

■– Cleanup and decontamination of contaminated objects and surfaces are very important in helping reduce future exposures from indirect contact .




2 Review Site-Specific Information■■ Inform students about the housekeeping procedures used by their organization . ■■ Notes can be written in their student books or hand