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January 23, 2015

Biohazard Safety and Prevention. January 23, 2015. *All Figures in presentation are open license for public use*. Occupational Safety and Health Administration (OSHA). OSHA Requires Random Checks on:. Decontamination of Units Sharps Containers Placement and Use Work Station Cleanliness

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January 23, 2015

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  1. Biohazard Safety and Prevention January 23, 2015 *All Figures in presentation are open license for public use*

  2. Occupational Safety and Health Administration (OSHA)

  3. OSHA Requires Random Checks on: Decontamination of Units Sharps Containers Placement and Use Work Station Cleanliness Refrigerators and Contents Proper use of PPE on a call Safe practices on a call All Performed by Designated Officer and/or surprise visits

  4. Infectious Disease Illness resulting from the invasion of the body by bacteria, virus, fungi or parasite. The term infectious only means - caused by a pathogen Concern is focused on communicable diseases; diseases that can readily spread between people under the right conditions

  5. Infectious Diseases Viruses Unable to grow or reproduce outside the living host Bacteria Organisms that need certain conditions for growth, reproduction and maintenance of life, but can transform into dormant spores which can survive very hostile conditions for long periods of time. Fungi Organisms (Fungi) that lack chlorophyll, leaves, true stems, and roots, reproduce by spores. The group includes molds, mildews, rusts, yeasts, and mushrooms

  6. THE BODYS NATURAL DEFENSES • Natural Flora on or in: • Skin • Sinuses • Conjunctiva • GI Tract • Immune System • Tears • Blood • Lungs • Lymph • Acid • GI Tract

  7. Modes of Spreading Direct contact Physical contact with secretions that harbor infective organisms Indirect Contact Organism resides outside the reservoir and is transferred to another host

  8. Blood borne Pathogens Microorganisms in the blood or other body fluids that can be transmitted through contact with contaminated blood and body fluids and cause illness.

  9. TYPES OF BBPs WE ARE CONCERNED WITH HIV Hepatitis A Hepatitis B Hepatitis C Tuberculosis Syphilis

  10. Bloodborne Pathogen Transmission Bloodborne pathogens are transmitted through contact with infected human blood and other body fluids such as: • Semen • Vaginal secretions • Cerebrospinal fluid • Synovial fluid • Pleural fluid • Peritoneal fluid • Amniotic fluid

  11. Other diseases to be concerned with • HIV • HBV • HCV • Rabies • Vaccinia virus • Measles • TB • Chickenpox • Avian influenza • Diphtheria • Meningitis • Mumps • Plague • Rubella • SARS-CoV • Smallpox • Viral hemorrhagic fevers

  12. Personal Protection Equipment and Practices

  13. Personal Health • Health Maintenance • Immunization history • Childhood disease history • Work Restriction Guidelines

  14. CDC/OSHA Health care workers with non-intact skin should have the area covered with a dressing, if the area is too large to cover, then the individual should not perform patient care activities that pose a risk

  15. Gloves • Need based on task • Use only when necessary • Heavy duty for cleaning activities

  16. Glove Use • Practical and feasible- • Gloves must be used when there is reasonable anticipation of contact with Blood/OPIM, non-intact skin, mucous membranes • OSHA, Nov. 5, 1999

  17. Protective Eyewear • Use when possible splash/splatter may occur • If prescription glasses, use clip-on side shields • Comply with ANSI Z87.1-1968, OSHA 29 CFR 1910.133

  18. Masks • Surgical Style • Respirators - only if risk assessment shows the need (N’95)

  19. Cover Gowns • Paper or cotton • Coveralls/ jump suits

  20. Respiratory Assist Devices • Bag/Mask • Pocket Mask

  21. Respirators • N-95 Mask • Powered Air Purifying Respirator (PARR) http://www.us.all.biz/n95-respirators-by-3m-g57279 http://www.selectsafetysales.com/c-216-papr.aspx

  22. Hand washing The routine use of antibacterial hand wash solution for routine hand washing is not recommended • APIC Core Curriculum/CDC

  23. Definition of Terms • Antibacterial • destroying or hindering the growth of bacteria • Antimicrobial • preventing or destroying the development of microbes • kills viruses

  24. CDC Hand Hygiene Guidelines • Alcohol based foam or gel • No artificial nails for care of high risk patients

  25. Clean Workplace Cleaning your workspace prevents a safe place for microorganisms to thrive

  26. Cleaning A Blood Spill • Treat as though the blood is contaminated with a potentially hazardous bloodborne pathogen • Bleach/Water at 1:100 dilution • Lysol Concentrate • Mix fresh daily

  27. How To Clean a Blood Spill Cover area Pour disinfectant Put on utility gloves Clean spill Place in biohazard bag Wash off gloves/hang to dry Wash hands

  28. Decontamination • Designated Area • Solution • Schedule

  29. 4 Levels of Decontamination • Cleaning • Disinfection • High-level disinfection • Sterilization

  30. Cleaning Contaminated Clothing • Bag for laundry • Cost paid by Agency • No home laundry permitted by OSHA

  31. Cleaning Issues • There is no disease that requires airing of a vehicle or putting a vehicle out of service • Clean and go!

  32. Remember Cleaning with 1:100 bleach/water solution is adequate (1/4 cup bleach to one gallon water) • Good for 24 hours after being mixed

  33. WHAT IS AN EXPOSURE? OSHA defines blood to mean human blood, human blood components, and products made from human blood. Other potentially infectious materials (OPIM) means: (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;.

  34. Defining Exposure - Bloodborne Pathogens A contaminated Needlestick Injury Blood/OPIM in contact with the surface of the eye, inner surface of the nose or mouth

  35. Defining Exposure- Bloodborne Pathogens Blood/OPIM in contact with an open area of the skin Cuts with sharp objects covered with blood/OPIM Human bites (bloody)

  36. Needlestick Injuries • 300,000 needlestick injuries are reported each year • Now all contaminated sharps injuries must be listed on the OSHA 300 log/Sharps Injury Log • Splash/splatter with blood/OPIM must be recorded • OSHA Compliance Directive, 2001/2005

  37. Sharps Injuries 2004 • 50% decrease noted in hospitals • Needle safe devices • 55% decrease in IV catheter injuries • 70% decrease in phlebotomy injuries • EpiNet, 2005

  38. Define - Other Potentially Infectious Materials -OPIM • CSF • Synovial fluid • Pleural fluid • Amniotic fluid • Peritoneal fluid • Any body fluid containing gross visible blood

  39. Body Fluids =No Risk- HIV, HBV, HCV • Tears • Sweat • Saliva • Urine • Vomitus • Stool • Nasal Secretions • Sputum

  40. Clarification - Bites • When there is exposure to blood as the result of a human bite • the source of the blood is determined • the person exposed to the source blood is to be followed up (not the person bitten)

  41. Exposure Confidential Any exposure is confidential This information should be kept between the exposed person and the Designated Officer

  42. Ryan-White Act Act of the U.S. Congress named in honor of Ryan White, an Indianateenager who contracted AIDS through a tainted hemophilia treatment in 1984, and was expelled from school because of the disease. The Original Ryan White CARE Act mandates that EMS personnel can find out whether they were exposed to life threatening diseases while providing care In 2006 this was removed by congress and it is not clear why that decision was made. It is currently being considered again

  43. What do you do if you think you are exposed?

  44. CONTACT THE DESIGNATED OFFICER The Designated Officer will assist you in determining if there was an exposure They will do an exposure report They will start communications with the hospital concerning testing of the patient All information will be kept confidential

  45. Testing Issues: Post Exposure • CDC, May , 1998, CDC June 29, 2001, September 2005 If source patient is negative with rapid testing = no further testing of health-care worker For potential HIV exposure, use of rapid testing will prevent staff from being placed on toxic drugs for even a short period of time

  46. MEDICAL WASTE

  47. ‘Sharp’ Definition • Any object that can reasonably be anticipated to penetrate the skin or other parts of the body such as needle devices, scalpels, lancets, etc. Other items that are not sharp, but could become sharp if broken, are included such as glass objects and capillary tubes.

  48. Sharps Injuries & Devices • Syringes • Suture needle • Butterfly needle • Scalpel • IV cathstylet • Vacutainer • 26% • 16% • 9% • 8% • 5% • 4% • EpiNet, U. VA.

  49. Sharps Containers Deposit into sharps container Container at site of use Full at 3/4 mark

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