Bloodborne Pathogens Training

1. Bloodborne Pathogens Training Aurora University 2010

2. Bloodborne Pathogens Training • Overview of BBP Standard • (BBP = Bloodborne Pathogen) • Types of pathogens • Exposure Control Plan

3. OSHA BBP Standard • See the OSHA website www.osha.gov, • 29 CFR 1910.1030 • Aurora University is committed to providing a safe and healthful work environment. In pursuit of this goal, the BBP Exposure Control Plan is provided to eliminate or minimize employee occupational exposure to blood or other potentially infectious materials (OPIM).

4. Bloodborne Pathogens The three pathogens that are of greatest concern are: • Human immunodeficiency virus (HIV) • Hepatitis B virus (HBV) • Hepatitis C virus (HCV)

5. Bloodborne Pathogens • HIV • virus that causes AIDS • incubation period 1 to 3 months • person is infectious from onset of infection throughout life • all persons are susceptible • risk of transmission: • needle stick: 0.3% • splash/spray to mucous membranes: 0.09% • non-intact skin: less than mucous membrane exposure

6. Bloodborne Pathogens • HBV - virus that causes hepatitis B • incubation period 45 to 180 days • person is infectious if test for antigen • (HBsAG) is positive • unvaccinated persons are susceptible • vaccination is recommended for persons with occupational exposure • Risk of transmission • needle stick: 22-31% if source is HBeAG + • needle stick: 1-6% if source is HBeAG - • direct or indirect contact with non-intact skin or mucous membranes is an important source of occupational exposure

7. Bloodborne Pathogens • HCV - virus that causes hepatitis C • incubation period 6 to 9 weeks • most persons are infectious for life • all are susceptible • Risk of transmission • needle stick: 1.8% • mucous membranes: rare • non-intact skin: very rare

8. Bloodborne Pathogens • An individual can acquire BBP from • blood • body fluids containing visible blood • other potentially infectious material (OPIM) • includes… semen, vaginal secretions, cerebral spinal fluid (CSF), synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and all bodily fluids where it is difficult to differentiate between bodily fluids.

9. Bloodborne Pathogens • Occupational exposure occurs through: • percutaneous injury (needle stick or cut) • contact with mucous membranes • contact with non-intact skin when there is blood, body fluids with visible blood, OPIM present

10. Bloodborne Pathogens Feces, nasal secretions, sputum, sweat, tears, urine, and vomitus are not considered infected with bloodborne pathogens unless they contain visible blood.

11. Aurora UniversityBloodborne Pathogen Exposure Control Plan • Policy HR - 212 • Universal precautions • Hand hygiene • Personal Protective Equipment (PPE) • Engineering and work practice controls • HBV vaccination • Post-exposure management • Training

12. Aurora UniversityBloodborne Pathogen Exposure Control Plan • Online at http://www.aurora.edu/hr/policy-manual/212-bbp.html • Copy provided at new employee orientation • reviewed, updated annually

13. Aurora UniversityBloodborne Pathogen Exposure Control Plan AU employees determined to be at risk for occupational exposure to blood or OPIM: • Wellness Center Staff • Campus Safety • Athletics and Physical Education • Health Science Lab Faculty and Assistants • Nursing Lab Faculty and Clinical Faculty • Recreation Administration • Residence Life Professional Staff • Lifeguards

14. Engineering & Work Practice Controls: • Universal Precautions • Part of OSHA BBP standard • Used on ALL individuals • Used for ALL contact with: • blood, body fluids, OPIM • mucous membranes • non-intact skin • To protect against bloodborne pathogens • Standard Precautions • Part of the CDC guidelines on infection control • Use on ALL individuals • Used for all contact with blood, OPIM, all bodily fluids considered infections (regardless of visible blood) • Hand hygiene • Use of PPE

15. Hand Hygiene • Wash hands • after touching blood, body fluids, secretions, excretions, contaminated items, regardless if gloves are worn • immediately after removing gloves • before leaving work area • whenever hands are dirty or contaminated

16. Hand Hygiene • Hand washing technique • turn on faucets to comfortable water temperature • wet hands, apply soap, lather • rub with friction for at least 15 seconds, making sure to wash back of hands, fingers, fingertips, in between fingers • rinse with fingertips pointing downward • dry hands with paper towel • discard paper towel and turn off faucets with clean paper towel

17. Hand Hygiene • Waterless alcohol gel • May use if hands are not visibly soiled • Effective against many organisms if product is used as directed • Must be at least 60% alcohol to be effective • NOT a replacement for a soap and water hand washing if hands are soiled.

18. Hand Hygiene • Use of waterless gel • dispense appropriate amount of gel per product directions • dispense into palm of one hand • rub palms, backs of hands, fingers, fingertips, between fingers until dry, about 30 seconds • make sure hands are dry before resuming activities • Wash hands as soon as practical

19. Personal Protective Equipment(PPE) • Gowns, gloves, surgical masks, face shields, goggles, shoe covers, aprons • Used when there is a reasonable anticipation of exposure to blood, body fluids, mucous membranes, non-intact skin • Provides protection for clothing, skin, eyes, mouth, nose

20. PPE • Employer responsibilities • provide in appropriate sizes • make accessible • require use by employees • clean, launder, repair, replace as needed • provide training • Sodexo has supplies available and restocks areas as necessary

21. PPE • Employee responsibilities: • Use PPE appropriately • Dispose of appropriately

22. PPE • Gloves • Wear for phlebotomies, finger sticks, vaccinations • Wear for cleaning OPIM • Wear when administering first aid • Remove between clients, wash hands • Select correct size • Have readily available at work station and in first aid kits

23. PPE Removal 1) Remove gloves by grasping outside of gloved hand with other gloved hand and peel off. Hold removed glove in gloved hand. 2) Slide fingers of ungloved hand under remaining glove, touching inside of glove only. Discard. 3) Remove goggles/face shield next, handling ONLY by head bands, ear pieces, or ties. Discard. 4) Remove gown by pulling away from neck and shoulders, touching inside of gown only. Turn gown inside out. Discard. 5) Remove mask/respirator last, grasp ONLY bottom then top ties/elastics and remove. Discard.

24. PPE Removal Wash your hands!

25. Labels • Infectious waste: red bag with biohazard label • Sharps containers: biohazard label • Blood specimens: biohazard labeled storage bags, storage containers • Refrigerators, coolers where blood or OPIM is stored: biohazard label

26. Engineering Controls • Safety devices on sharps: needles, lancets • must be used if available • evaluated by staff • Shearing, breaking, bending, re-capping of contaminated sharps is prohibited • Clean spills of blood or OPIM with spill kit, wear protective gloves • Clean up broken glass using spill kit or broom and dustpan, never your hands

27. Engineering Controls • Place used sharps in disposal containers immediately after use • Sharps containers • puncture resistant • leak proof • labeled or red in color • stabilized if portable • Sharps containers • Replace sharps containers when 2/3 full • The users of the containers are responsible for replacing when necessary

28. Work Practice Controls • Do not eat, drink, apply make-up, handle contact lenses, or smoke in areas with likely exposure to blood or OPIM • testing areas • areas where specimens located • Do not store food or beverages in refrigerators, freezers, coolers, shelves, cupboards where specimens are located

29. Waste Disposal • Infectious waste includes: • sharps • disposable items that are saturated with blood or OPIM to the point where such material can be squeezed, poured, dripped, or flaked off the items • Infectious waste removal: • Place in red biohazard bags, seal to prevent spillage during handling • Store in designated areas for collection by waste haulers • Contact Sodexo for pickup of red biohazard bags

30. Laundry • Handle contaminated clothing as little as possible • Place dry laundry in bags at point of use • Laundry that is wet from blood or OPIM is placed in leak proof containers labeled with the biohazard symbol • Follow departmental procedure • Wear gloves when handling soiled laundry • Utilize appropriate washer and dryer settings • Utilize appropriate detergent

31. Handling Blood or OPIM Spills • Procedure for cleaning blood or OIPM spills • wear PPE: gown, gloves, goggles • soak up liquid of spill and use scooper/scraper to remove contents of spill • wet cloth with the disinfectant • wipe item/area with wet cloth • spray disinfectant on item/area • wipe with clean cloth, let air dry • Clean first, then disinfect all equipment and environmental surfaces after contact with blood or OPIM • Use EPA registered disinfectant with activity against HIV, HBV, HCV or 1:10 bleach • Follow instructions on disinfectant label • Separate procedure for blood/OIPM spills on Vago Field artificial turf. (See policy)

32. Hepatitis B Vaccination • Any one with potential for occupational exposure to blood or OPIM will be offered the Hepatitis B vaccination series • Recommended unless: • employee has documentation of receipt of series • antibody testing shows immunity • employee has medical contraindications

33. Hepatitis B Vaccination • Available within 10 working days of work start date. • If employee declines, must sign statement of declination. Employee may decide at any later date to start the series. • If employee accepts, must sign acceptance statement and schedule to start series.

34. Hepatitis B Vaccination • Safety • very safe vaccine • US: as of 2000 more than 100 million adults have received vaccine with few side effects • serious reactions are rare • mild symptoms may occur: soreness at injection site, low-grade fever • may be given during pregnancy • Effectiveness • at least 90% of adults are immune after completing the three doses of vaccine • since 1985, 90% reduction of number of health care workers infected with HBV, largely due to vaccine

35. Hepatitis B Vaccination • Vaccine provided at Occupational Health Providers near our Illinois and Wisconsin campuses. Human Resources will schedule location and initial dose date. • Administered by deep intramuscular injection • 3 doses given: 1st two doses 1 month apart, last dose is given 5 months after second dose • Occupational Health will test antibody levels at 1-2 months after last dose to test for immunity • If antibody level shows lack of immunity, individual will be-revaccinated

36. Post Exposure Management 1) Clean the exposure site • percutaneous injuries: wash with soap and water • mucous membranes: rinse copiously with water for several minutes 2) Go to the nearest occupational health clinic for evaluation. • If none in area, report to nearest ER • In Aurora – go to Provena Mercy Occupational Health on Highland Avenue • In Wisconsin, go to Aurora Occupational Health Services on County Road NN in Elkhorn

37. Post Exposure Management 3) Notify supervisor immediately, who will notify Campus Safety and Human Resources 4) Medical evaluation • documentation of route of exposure • document source person if known • source and exposed will be offered testing • results given to exposed person’s provider or Occupational Health if no personal provider • counseling offered

38. Any Questions? • Please ask any of the BBP Trainers, or call Human Resources with your questions Terri Hoehne Director of Human Resources thoehne@aurora.edu 630-844-3866 Office at 422 S. Calumet on the Aurora campus

39. Certificate of CompletionBloodborne Pathogen Training Name (please print)____________________________ Your Signature:________________________________ Date:______________ Supervisor:_________________ Job Title:_______________________________________ Please print and send to Human Resources