I n f ection Co n t r ol & Blood Borne Pathogens Updated: 2018

1. InfectionControl & Blood Borne Pathogens Updated: 2018

2. Overview • Infection Control and you • Transmission of Disease • Hand Hygiene • Precautions • Biohazard Waste • BloodBornePathogens • Hepatitis • HIV/AIDS • Tuberculosis • Overviewofdisease • MRSA • Influenza • CourseSummary • Quiz

3. Abbreviations • ICD- InfectionControl Designee • SARS-SevereAcuteRespiratorySyndrome • TB-Tuberculosis • HepA-HepatitisA • HepB-HepatitisB • HepC-HepatitisC • AIDS-Acquiredimmunodeficiencysyndrome • HIV-HumanimmunodeficiencyVirus • PPE-PersonalProtectiveEquipment • CDC- CentersforDiseaseControl and Prevention • WHO-WorldHealthOrganization • OSHA-OccupationalSafetyandHealth Administration

4. InfectionControlandYou • Whyisthisimportant ? • To understandyour riskand yourcustomersrisk • To protect staffand customersfrominfectious diseases • Tokeepyour familysafefrominfectiousdiseases • To have knowledge to • educateyour customers • Whodo Italkto? • InfectionControlDesignee • Environmental Control • Please call the operator and ask to be connected to the specific person.

5. Transmission of Diseases • Thechainof infection Susceptible HostorReceiver Sourceofinfectious agents Methodoftransmission

6. Chain ofInfection • Source • Infectiousagents aretransmittedprimarilyfrom humanbeings. • Host • Thehostisa place wherethegermgrows. • blood,sputum,wounds,andotherbodilyfluids • Methods • Infectionscould be causedbybacteria,viruses,fungi andparasites. • Someareprimarilytransmittedbydirector indirect contact

7. MethodofTransmission • Contact • Direct • Germsaretransmittedfrom oneperson toanother. • Indirect • Germsaretransferred througha intermediate objectorperson. • Droplet • Respiratorydropletsfromsneezing, orcoughing. • CommonCold, Flu,SARS • Smallparticlesthat canbebreathed • inbyanotherperson. • Thesecanlivelongerintheair than adroplet. • TB,Measles, ChickenPox • Bloodborne • Germsthat liveinthe bloodstream • orotherbodilyfluids. • Mucousmembranesallowgermstospreadthroughcontactwithsecretions. • HIV,HepB, HepC • Airborne

8. Hand Hygiene

9. Hand Hygiene • HandHygieneis thesinglemostimportant practicethatcanreduce thetransmissionof disease. • HandHygienealsoincludestheuseof handsanitizer.

10. Whenshouldyouwashyourhands? • Alcoholrub or washbefore andafterevery • contactwitha customer. • Beforepreparingoreatingfood • Beforepreparing medication • Aftersneezing orcoughing inyourhands • After contactwith objectsthatmaybe • contaminated • Afteranyaccidentalexposureto bodilyfluids, • mucous membranes orskinwithcutsand sores

11. Proper Handwashing Use soap andwater Rubvigorouslyfor at least 20sec.Pay special attentionto backof hands,wrists,in betweenfingers andundernails Rinse well,leave waterrunning Dryhandswithsingletoweland usesame towel toshut off water toprevent recontamination

12. AlcoholRub • Whenshould it beused? • Inbetweencustomercontact • Before andafterremoving gloves • Aftercoughing orsneezing • If handsarevisiblysoiled, wash with soapandwater. • Howtouseitproperly • Applyproduct topalm of one hand • Rubtogetherandalloverhands andwristsuntil dry • After10 usesin a rowof sanitizeruse washhandswith soapandwater.

13. Precautions • StandardPrecautions • Standardprecautioninclude a groupof infectioncontrol practicesthatshouldbeappliedtoallclients, suspected or confirmedof beinginfectious. • HandHygiene • PersonalProtective Equipment • “Cover yourCough” • TransmissionBasedPrecautions • ContactPrecautions • Droplet Precautions • Airborne Precautions

14. PersonalProtective Equipment • PPErefersto anyvarietyof barriersand respirators used alone orincombinationthat can protectyour mucous membranes, skin, airway andclothingfrom contact with infectiousagents. • Your choiceof PPEdependson your interaction withyour customerandriskof transmission.

15. PPE-Gloves • Weargloveswhentouchingblood,bodily • fluids,excretions,andcontaminateditems.

16. PPE-GownsandMasks • A disposablegowncanbeusedtoprotectyour skinandclothingduringproceduresandclosecontactactivitieswithcustomersthatare likelyto generatesplashes of blood,bodily fluid secretionsorexcretions. • A maskwithaneyeshieldwill protect • mucous membranes of theeyes,noseandmouth.

17. “Cover your Cough” • Respiratoryhygiene isapartof standard • Precautions. • Washhandsorusealcoholbasedrubaftercoughing, sneezingorcomingincontactwithcontaminatedsurfaces.

18. TransmissionBasedPrecautions • Contact • Thisiswhenadiseaseisspreadthroughcontact • MRSA,Scabies,Chicken • Pox,HerpesandLice • What should Ido? • Usegloveswhen appropriate • Practicestricthand • washing • Disinfectarea asmuchaspossible • Askyourcustomertostay • homeiftheyareinfectious • Ifyouareenteringtheirhome,useofgloveswould beappropriateandagainstricthand washing

19. TransmissionBasedPrecautions • Droplet • Dropletscanbeinfected withgermsthatcancomefromasneeze,coughortalking • Pneumonia,influenza, Meningitis,mumps • Dropletsrequiresclose • contact(3ft orless) • Donotremainsuspendedintheair andtravel shortdistances • What should Ido? • Ifyouhavecustomerwith anyoneoftheseinfectiousdiseases,theyMUSTstayhomeuntiltheyarenolongercontagious. • Inordertoprotectthe • othercustomersandstaff • If youmustseethemin theirhome,this wouldrequireglovesandmask withminimalcontact aspossible

20. TransmissionBasedPrecautions • Airborne • TB,ChickenPox,Measles, Shingles • Arefoundindropletnuclei • Arespreadbycoughing, • sneezing,talkingorbreathing • Theycantravellongdistancesbecausetheyaresmaller • Remainintheairalongtime andareabletotravelthroughventilationsystems • Whatshould I do? • If youhavecustomerwithanyoneofthesediseases, they MUSTstayhomeuntiltheyarenolongercontagious. • In ordertoprotecttheother • customersand staff • Ifyoumust seethemin theirhome,thiswouldrequiregloves and maskwithminimalcontact aspossible • If yourcustomeris positivefor oneoftheseinfectiousdiseases andyouhavebeenexposedcontacttheICDimmediately. • PostexposureformandInfection controlreportingformmayneedtobecompleted

21. Biohazardwaste • Whatis biohazard • waste? • –Itiswastematerialthat containsblood or bodily fluid thatmaycontainorsuspected of having enoughgermstoexpose anindividual. • Biohazardwaste • includes: • Sharps,blades,pipettes, • brokenglass, • Bodilyfluidsormaterial mixedwith bodily fluids • Ifa materialissoaked with bodilyfluids,it belongsinbiohazard waste

22. Biohazardwaste • Itemsthatdonot belongin • redbags: • Vomit:canbe intrash,double baggedor flushed downtoilet. • Bandagesor Kleenexeswith blood:trash ortoilet,unless “dripping”inblood. • Diapers, urinalsorperipads • belongintrash. • Ask your program manager where to find red bags and where to dispose of them.

23. Biohazard waste • Sharpscontainers • Mustbeclosed • Punctureresistant • Clearlylabeledwith • biohazardsymbol • Maintainedupright • Replacedroutinely • Neveroverfilled • Portablesharps • containers • Used minimally • Replacedoftenas • possible • Punctureresistant • Clearlylabeled

24. NeedleStick • Risk • Healthcareworkersareat riskforexposuretobloodbornepathogensthrough needlesticksorothercutsfrom sharpinstruments. • Prevention • No recapping needles • Disposingofusedneedles inthepropersharps bin • Using medicaldeviceswith • safetyfeatures

25. NeedleStick-WhatdoI do? • Washyourhands and puncture siteimmediately! • ContacttheInfection Control Designee(ICD) or Human Resources immediatelyduring working hours. • Afterworkinghours,reporttodesignatedemergencyroom. • Reportingshouldbedone withinthe first 1-2hours. • Post exposure formand incident reportwillbecompletedand submittedwithinthefirst 24hrs. • TheICDand medical director will determinethe employeesimmunestatus anddetermine what followup isneeded. • Workrestrictions • Prophylacticmedical treatment • Medical director will benotified

26. BloodBornePathogens • Your atrisk • Healthcareprofessionals areatoccupationalrisk for bloodborne pathogens. • HIV/AIDS • HepB andHep C • Bloodbornepathogens arediseaseproducing microorganismsthatarespreadbycontactviabloodorotherbodilyfluids. • Exposuremayoccur throughneedlestickor cutsfromsharp instruments

27. BloodBornePathogens • Exposure • Theoverall riskforoccupationalexposuredependsonthe number ofinfectedindividualsin the populationsserved. • Mostexposuredoes not resultininfection • Theriskalsocontains othervariables • Prevention • Dispose ofusedneedles appropriately. • Useappropriate PPE • whencalledfor.

28. BloodBornePathogens • WhatshouldI do? • Immediatelywash needlesticksandcuts withsoapandwater. • Flushsplashes tonose, skin andmouthwith water. • Irrigateeyes withclean water,salineorsterile solution. • AfterExposure • ContactICDimmediately • If afterhoursreportto • emergencyroom • Postexposureform will becompleted • It willbe determined by the ICDwhatrestrictions willbesetinplace • Appropriate medical • treatmentwill be offered

29. Hepatitis • Hepatitisis the inflammationoftheliver. • Virusescause most • hepatitis • HepA • HepB • HepC • HepB andHepC arethetwomostserious kinds ofhepatitis.

30. HepA and HepC • HepatitisAdiseaseis primarilyspread throughfoodorwatercontaminatedbystool fromaninfectedperson. • Thereisavaccinefor HepA • https://medlineplus.gov/hepatitisa.html • HepatitisCisusuallyspreadthroughcontact withinfectedblood. • Itcan alsobespread throughsexwithan infectedpersonandfrommotherandbaby throughchildbirth. • TherearenovaccinesforHepC.

31. HepatitisB • HepatitisB is spreadbycontactwithaninfected • person’sblood,semen, or otherbodilyfluid. • Aninfectedwomancangive HepBtoherbabyat • birth. • There isa vaccineforHepB, itisathreeseriesvaccine. • OSHArequiresthattheHepB vaccinebeoffered forhealthcareworkerswhoareatriskforbeing exposed. • –Thevaccineissafeforwomanwhoarebreastfeeding orpregnant

32. Hepatitis B • Whatismyrisk? • IfyouhavereceivedtheHepBvaccineyouare virtuallynorisk forinfection. • Theannual numberof occupationalinfectionshas decreased95%sincetheHepBvaccinewasavailablein1982. • Post exposuretreatment • ThereistreatmentavailableforHepBexposureand should begin within24hoursand nolaterthan7days. • Pregnantwomenwho areexposedshould alsoreceivethevaccinetopreventinfectionthatcouldcauseseverechronicillnesstothenewborn.

33. Symptoms • ThesymptomsofHepatitis • are • Jaundice • Fatigue • AbdominalPain • Lossof Appetite • Nausea • Diarrhea • Fever • HepA • Youmay feellike youhave the flu andusually getsbetteron itsownaftera coupleweeks • HepB • Youmayfeellike youhave the fluorhave nosymptoms at all. Ifit doesnot get betteron itsownitcanlastalifetime andcalledchronicHepB • HepC • Youmaynot experience symptoms foryears. This usuallylastsa lifetimeand canleadtoscarringon the liverorlivercancer

34. HIV/AIDS • HIVkillsspecificwhitebloodcellswhicharean importantpartofourimmunesystem. • WithouttreatmentHIV destroysthebody’sdefensesagainst diseases. • Nowwithtreatment peoplewithHIVlivelonger. • AIDSwasfirstreported intheU.S.in1981andsincehasbecomeaworldepidemic. • AIDSisamedical conditioncausedbyHIVusuallyaftermanyyears. • Peoplediagnosedwith AIDSaremoresusceptibleto opportunisticinfections.

35. HIV/AIDS • HIVcan be transmitted when blood,semen,vaginal fluid or breast milkfrom an infected personentersthebody ofan uninfected person. • – A mothercanalso passit alongto their unbornchild, the riskislessifthey are on medication. • Transmissionoften occurs duringunprotected sexorduringIV drug use with sharedneedles. • What ismy risk? • HIV canalso be spread throughcontactwithinfected blood. • Therisktohealthcare • workersissmall. • Thiscanbea resultofa needle stick, orbloodgettingintothe mucousmembranesor open cut • YoucannotcontractHIV from • Donatingblood,mosquitoes bites,toiletseats,shaking handsorhugging,sharing eatingordrinkingutensils,or beinginthesameareaas someoneinfectedwithHIV

36. HIV/AIDS • Symptoms • Someone mayexperiencesymptoms2weeks to3months after exposure.Others havenosymptoms. • Manysymptomsarethesameasotherinfections, but overtime havea variety of symptoms. • Themostcommon • symptomsare • Lack of energy • Weightloss • Frequentfeversand nightsweats • Persistentorfrequent • yeastinfections • Persistent skinrashes • Shorttermmemoryloss

37. HIV/AIDS • Riskof exposure • –TheaverageriskofHIV infectionafteraneedle stickis1in300. • Thereisnovaccine againstHIVat thistime. • Postexposure • Therearepostexposureprophylaxisthat arerecommendedfor certainoccupational exposures. • Themedication are not always usedbecausethey cancauseseriousside effects. • Treatmentshouldstart • as soonaspossible.

38. TB • TBisa disease caused by bacteriacalled mycobacteriumtuberculosis.The bacteria usuallyattacks the lungs, butitcanalsoattack the kidneys, spine andbrain. • If nottreatedproperlythe diseasecan be fatal. • All staff will be tested for TB upon hire. Staff with customer contact must have an annual TB skin test.

39. TB • Howis itspread? • Itistransmittedintheairfrom personto person • Airborneprecaution • Thebacteriaareput in the airwhenaperson withActiveTB coughs or sneezes,thenpeople nearbymaybreaththeairand become infected • Notall peopleinfected • haveactiveTB • LatentTBis whenan individual has been infectedwithTB,but doesnot becomesick • PeoplewithLatent TB cannot spreadthedisease

40. TB • Whatare symptomsof • ActiveTB • Badcoughthatlast3weeksormore • Paininthechest • Coughingupbloodor sputum • Weaknessand/orfatigue • Weightloss • Noappetite • Chills • Fever • Nightsweats • Thereare medications that cantreatActiveTB – Multidrug-resistantTBisTBthatisresistanttoat leasttwomedicationsthat occurswhenthe medicationsarestoppedtoo early

41. MRSA • MRSAismethicillin-resistant staphyloccusaureus.Thistypeofbacteriacauses“staph”infectionsthatareresistant totreatmentwiththeuseofantibiotics. • MRSAisbecomingmoreprevalent inthehealthcaresetting. • MRSAinthehealthcaresettingcommonlycausesseriousandpotentiallylifethreateninginfections,suchasbloodstream infections,surgical siteinfectionsandpneumonia. • MRSAcanalsoinfectthecommunityatlargeusuallyasskininfectionsthatpresentaspimplesorboilswhichcanbeswollen, painfulandhavepus. • Themostcommoncarriers arepeoplethathaveMRSAwithnosymptoms. • Themainmodeoftransmission isthroughhumanhands.

42. MRSA • How do I protectmyself? • WASHYOURHANDS! • What ifmy customerhas MRSA • Washyourhands! • Youcanalsouse hand sanitizer • Youcanusedisinfectantwipesforanysurfaces • Ifyourcustomerhasanopencutorboil,askthemtocoveritin publictoprotectyouandtherestof thecommunity

43. Influenza • Influenza,also commonlycalledthe“flu”isa • respiratory illnesscausedby influenza viruses. • Itcancausemildtosevereillnessandat timescan • leadtodeath. • Inthe northern hemisphere, winteristhetimeof the flu, generallyfromNovembertoMarchwith the peak monthbeingFebruary. • Thefluiscontagiousandis spreadfrompersonto person through respiratorydropletswhensomeonecoughsorsneezes.

44. Influenza • Mosthealthyadults maybeabletoinfectothersbeginning1daybeforesymptoms developandupto5daysafterbecomingsick. • Childrenmaypassthe virusonlongerthan7days. • Symptoms: • Fever • Headaches • Fatigue • Sorethroat • Runnynose • Muscle aches • Stomachsymptoms • This usuallyismore • commoninchildren

45. Influenza • Whoshouldreceivethe • Fluvaccine? • Anyonewitha chronic medical condition such asheart disease,COPD, diabetes,etc. • Healthcare workersare at highriskforbeing infectedwith theflu. • Anyonecanget the flu, butismoreseverewith theelderlyandveryyoung. • Individualswithchronic medicalconditionscouldhaveserious complicationsfrominfluenzaasopposedto ahealthyperson.

46. Influenza • H1N1(swine)Flu • Thepandemicarosein Aprilof2009and soonaffectedtheworld • ThereisnovaccineforH1N1 • Therehavebeenmanydeaths,buthasprimarilybeenamilderflu • TheH1N1havethesame • symptomsasinfluenza • Whyshouldwebevaccinated? • Weserveahighriskpopulationthatcould be infectedwiththeflu • Manyofourcustomers alsohavediagnosisof chronicmedicalconditions • Thefluvaccinewouldhelp protectyouandyour customersfrombeinginfected

47. Influenza • You can protectyourselffrom thefluby doing • a coupledifferent things: • “Coveryourcough” • Sneezeandcoughina Kleenexorintothesleeveofyour shirt. • Ifyoufeelyoumayhavesymptomsoftheflu…stay • homeandcall yourdoctor. • Thebestthingtopreventthefluandmanyother • infectiousdiseases………….

49. What ifI am infectious? • Ifyouhaveaninfectiousdiseasepleasecontactyour • doctorfortreatmentandworkrestrictions. • Youwillneedtofillout anInfectionControlReporting Formifyouaremore than4days outsickconsecutivelyor onantibiotics. • A copyof thework return slip will beneededandattached toacopy ofthe Infection ControlReportingformandsent toHumanResources. • Ifyouhave anyquestionspleasecontacttheInfection • ControlDesignee.

50. Summary • It is importantto understandinfectioncontroltobe safe foryou,yourcustomers • andyour family. • The chainof infectionhasthreecomponents: • – Source,method andhost • Methodsof transmissioninclude:contact,droplet, airborne,andbloodborne. • Handhygienebeginswithwashingyourhands andusingalcoholrub. • Standardprecautionsincludea groupofpracticesthatshouldbeappliedtoall clients. • PPEcanbeused whenappropriatedependingonyourcontact withtheclient. • “Cover yourCough”is a methodthat canbeusedby everyone,especiallyduring • fluseason. • Threestages of transmissionbasedprecautionsare:contact,dropletandairborne. Ifinfectedwitha dropletor airborneinfectionleastpossible contactwith customers isrecommendedandcustomers shouldstayhome. • Biohazardwasteis anymaterial thatis bloodorbodilyfluidsoaked and • Sharps.