OSHA Bloodborne Pathogen Training

1. OSHA Bloodborne Pathogen Training This module is for any associate who needs bloodborne pathogen training.

2. In this module, you will explore: • Exposure to bloodborne diseases • Bloodborne diseases found in a hospital setting • The Bloodborne Exposure Control Plan • Standard Precautions • Hepatitis B vaccination • Personal Protective Equipment (PPE) • Hazardous Communications • Work Practice and Engineering Controls

3. In the workplace … • Exposure to bloodborne pathogens in the workplace is a concern to health care workers and employers. • The Occupational Safety and Health Administration (OSHA) has a standard to address this concern. • The Bloodborne Pathogens Rule requires both employers and workers to prevent the spread of bloodborne diseases.

4. What Does OSHA Require? • OSHA requires employers to develop a Bloodborne Pathogen Exposure Control Plan. • This plan outlinesprotective practices to decrease the risk for hospital employees who might be exposed to bloodborne diseases.

5. Bloodborne Pathogen Exposure Control Plan • The plan includes: • Exposure determination • Procedures for protecting workers • Standard Precautions • Hepatitis B Vaccinations • Personal Protective Equipment • Hazard Communications • Work Practice and Engineering Controls • Post-exposure follow-up to a bloodborne disease. • The Bloodborne Pathogen Exposure Control Plan is located on the Intranet in St. Elizabeth Policy and Procedures in the Infection Control Manual.

6. Protecting Yourself – It’s Your Responsibility • You are responsible for understanding the risk of exposure to blood or other potentially infectious materials (OPIM) at your workplace. • Direct questions to your supervisor, Infection Control, Employee Health, or the Safety Director.

7. What Is A Bloodborne Pathogen? • Bloodborne pathogens are germs which may be present in blood that are capable of causing disease. • Bloodborne pathogens are an important consideration in dealing with blood and other potentially infectious materials (OPIM)*. *Other Potentially Infectious Materials (OPIM) – Blood and other materials that can carry pathogens that cause serious diseases. Materials include human body fluids, unfixed tissue or organs, and HIV/HBV-containing cell or tissue cultures.

8. How Are People Exposed To Bloodborne Pathogens? • You can be exposed to a bloodborne pathogen by performing a task or being in an area where you might come in contact with blood or other potentially infectious materials. • In a hospital, most exposures to bloodborne diseases are through direct exposure to used sharps or splashes of blood/body fluids to facial mucous membranes. Direct – Exposure which occurs when one touches or otherwise comes in direct contact with blood or other potentially infectious materials. An example is a stick from a needle previously used on an infected person. Sharps – Any object that can cut, puncture, or penetrate the skin. Examples are needles, scalpels, broken glass, knives and blades.

9. How Are People Exposed To Bloodborne Pathogens? • Some exposures have been from blood or OPIM splashing: • Onto broken or scraped skin • Into unprotected eyes, nose or mouth. • Be careful with anything wet that comes from the human body. • Protective eyewear and masks or face masks with visors are available – consult your supervisor for your specific needs

10. What To Do If You Have A Blood/Body Fluid Exposure • First flush/wash the affected areas with soap and water. • Promptly call Employee Health, 301-2153(M-F 7:00 am - 9:00 pm) After hours - phone number: (859) 391-9468. • Complete an Employee Incident Report and take • to the lab for testing. • Report to the ED for HIV exposure or wound care.

11. Post-Exposure Evaluation • The Post-Exposure Evaluation process is directed by Employee Health and follow the exposed employee for the appropriate time. Post-Exposure Evaluation – An evaluation which tests the source and the employee after an exposure has occurred. Counseling and treatment are offered by Employee Health.

12. Does Everyone Exposed To A Bloodborne Pathogen Become Infected? • Whether or not you become infected following an exposure depends on a number of factors including: • The number and strength of the germs from the source. • Your resistance to disease-the ability of your body (host) to reject the germs • The type of exposure-the way that the germs were spread-some ways are more efficient than others

13. Bloodborne Diseases of Concern Sharps injury from used needles or other sharps are the primary means of transmission of these diseases to healthcare providers. • Three bloodborne diseases of concern to healthcare workers are: • HIV • Hepatitis B • Hepatitis C Hepatitis B – HBV – A virus that causes inflammation of the liver and is transmitted by infected blood. Hepatitis C – HCV – A virus that causes inflammation of the liver and is transmitted by infected blood.

14. What Is HIV/AIDS? • HIV is the Human Immunodeficiency Virus that causes AIDS. • AIDS (Acquired Immune Deficiency Syndrome) is a viral infection of the immune system. • This infection robs a person of the ability to fight off other disease-causing germs.

15. How Is HIV Contracted? HIV may be contracted by: • Unprotected sexual contact with an infected person • Blood transfusion (rare) • IV drug users who share needles with an infected person • An unborn baby from the infected mother by spread in utero, during delivery, or through breast-feeding. • Exposure from a contaminated sharp.

16. How Is HIV Not Contracted? • HIV cannot be contracted by • Touching telephones, door knobs, toilet seats, or mosquito or other insect bites. • Shaking hands, hugging, being coughed or sneezed on. • Eating food prepared by an HIV positive individual. • You cannot get HIV from donating blood. • The risk of contracting HIV from a blood transfusion is extremely low. • The blood supply is carefully tested.

17. What Happens If You Are Exposed To HIV? • If you are exposed to HIV through a contaminated needle stick or other sharps injury, your risk of contracting the disease is about 0.3%. • The risk is less for blood splashes into mucous membranes or on broken or scraped skin. Mucous membranes – A lining of the body that secretes a protective lubricant for all body passages that come in contact with air. Examples include the lining of the eyes, nose and mouth.

18. What Is Hepatitis B? • Hepatitis B is a virus that affects the liver. • Many infected people do not have symptoms. • An infected person without symptoms is still contagious.

19. Common Symptoms of Hepatitis B and C • Yellow skin color (Jaundice) • Dark urine • Lightened stool color • Nausea • Vomiting • A general feeling of illness

20. How Is Hepatitis B Contracted? • Hepatitis B can be contracted by • Unprotected sexual contact with an infected person • IV drug users who share needles with an infected person • Exposure through a contaminated needle stick or sharp • An unborn baby from its infected mother • Infection can also occur through breastfeeding

21. What Happens If You Are Exposed To Hepatitis B? • Most persons who acquire Hepatitis B infection have a full recovery. • 10% of people who contract the virus develop a chronic infection. • Chronic hepatitis B puts a person at a higher risk for • Cirrhosis of the liver • Liver cancer. • A vaccine is available for protection from Hepatitis B infection

22. What Happens If You Are Exposed To Hepatitis B? • If you are exposed to Hepatitis B through a sharps injury, your risk of contracting the disease is about 5-30% if you have not had a series of three vaccinations. • The risk of acquiring the disease is less for blood splashes into mucous membranes or on broken or abraded skin. • Your risk drops to almost zero percent if you have had a successful series of vaccinations.

23. What is Hepatitis C? • Hepatitis C is a disease that causes similar symptoms as Hepatitis B • 70% of persons with Hepatitis C have no symptoms. • The virus may remain dormant 10-20 years before patients experience fatigue, loss of appetite, and abdominal pain. • Persons who have the infection are contagious even if they have no symptoms.

24. How is Hepatitis C Contracted? • If you are exposed to Hepatitis C through a needle stick or other sharps injury, your risk of contracting the disease is about 3 – 10%. • Blood transfusions were formerly a major means of transmission of Hepatitis C, but that is no longer the case. • Screening tests were put into place in the early 1990s. • The chance of acquiring HCV by sexual transmission is less than or equal to 6%. • Unlike Hepatitis B, there is no vaccine to prevent the disease.

25. What Happens If You Develop Hepatitis C? • The Hepatitis C virus causes chronic disease in about 85% of the people who contract it. • Hepatitis C is a major cause of cirrhosis of the liver and liver cancer. • While there is no cure for Hepatitis C, the symptoms may be treated with antiviral drugs. • Treatment usually leads to long-term improvement. • Complications of hepatitis account for the majority of liver transplants in the United States.

26. Worker Vaccinations • Employee Health will direct you regarding available vaccines • As required by OSHA law, Hepatitis B vaccine is available to all hospital employees who’s job may expose them to blood or other potentially infectious materials. • Offered at no charge • Series of 3 injections • You may choose to accept or decline the vaccine • OSHA law does not require offering the vaccine to persons who work in other areas (e.g. payroll, etc) where there is no reasonable risk of exposure.

27. Standard Precautions • Provides the most consistent protection from bloodborne disease. • All blood and body fluids are considered potentially infectious, regardless of the diagnosis. • Situations requiring precautions include contact with mucous membranes, moist areas of the body, broken skin, anything wet coming from the body, and any medical devices that drain fluids from the body. • Requires the consistent use of hand hygiene and appropriate personal protective equipment (PPE) when coming into contact with blood or body fluids.

28. Hand Hygiene • The simplest way to prevent spread of infection • Wash with soap and water when hands are visibly dirty or contaminated with body substances, or after removal of gloves. • Wet hands, apply soap, rub hands together vigorously for at least 15 seconds, covering all surfaces, rinse, dry with disposable towel, using towel to turn off faucet, dispose of towel. • If hands are not visibly soiled, may use a alcohol antiseptic hand rub for routinely decontaminating hands. • Apply adequate amount of product to palm of one hand and rub hands together, covering all surfaces until hands are dry, about 10 seconds. • Staff who perform direct patient care, prepare food or sterile items are required to wear only natural fingernails with/without nail polish.

29. Personal Protective Equipment (PPE) • This specialized clothing and equipment provides protection against contact with blood or other potentially infectious materials. • Provided at no cost, and is available via carts, supply cabinets or room cabinetry as determined by department. • Includes: • Gloves, fluid resistant gowns, aprons • Eyewear, masks, face shields • Resuscitation equipment • Scrub clothing is not PPE Remove PPE before leaving the clinical work area PPE – Personal Protective Equipment. Specialized clothing and equipment meant to provide protection against contact with bloodborne pathogens or other potentially infectious materials.

30. Personal Protective Equipment • PPE should be appropriate to the task performed • Wear a mask and eye protection or mask with visor when you might get splashed in the face with blood or body fluids. • Use a CPR mask when performing CPR. • Wear a fluid resistant gown when your clothing might be soiled with blood or other body fluids. • Use gloves anytime you may have contact with blood or other body fluids CPR – Cardio-Pulmonary Resuscitation

31. Soiled Personal Clothing If personal clothing is soiled with blood, body fluids or OPIM, the clothing will be laundered by the medical center if the associate desires. Soiled clothing should be removed and placed in a plastic bag. • Edgewood staff contacts SPD • Florence and Ft. Thomas staff contacts EVS

32. Safe Injection Practices • Perform hand hygiene before handling or accessing IV products or systems, preparing or administering medications, or handling blood glucose monitoring devices.

33. Rub and allow to dry • Use friction and perform a thorough alcohol prep of any IV port, valve, vial or ampule • Allow the alcohol to dry completely before accessing with sterile technique

34. Medication Mistakes • Do not administer a medication from the same syringe to more than one patient, even if the needle is changed • Do not leave a needle or spike in a multi-dose vial; store the vial in clean conditions • Discard vials used during a procedure or emergency immediately • Do not store needles, cannulas, syringes, or solutions outside of the sterile package, or in pockets or clothing

35. Standard of Care • Draw the medication into syringes immediately prior to administration • IV solution administration should begin within one hour of spiking the IV bag or bottle

36. Blood Glucose Monitoring Devices • Clean and disinfect all glucometers between patient use • Gloves should be worn when needed to prevent contact with blood and body fluids • All lancets and finger stick capillary sampling devices are single patient use items and must be disposed of immediately after use in the sharps container

37. Work Practice and Engineering Controls In addition to PPE, use of Work Practice and Engineering Controls must also be used to reduce or eliminate exposure to bloodborne pathogens.

38. Work Practice Controls Work Practice Controls - practices that reduce the risk of exposure to blood or body fluids while on the job. Includes: use of safety products, wearing of PPE, correct handling of soiled equipment, linens and hazardous waste, correct handling and transport of specimens.

39. Engineering Controls Engineering Controls - equipment and items that are designed to reduce or eliminate the risk of exposure to blood or body fluids. Includes items such as: sharps safety products, leak proof specimen containers, laboratory equipment, safety shields, and handwashing sinks.

40. Sharps Safety • Use the supplies of Sharps Safety products. • Don’t take chances with your health and well being. • Take the time to learn and use safety products…they’re supplied for your safety! • Report concerns where sharps safety products are needed to your manager, the Safety Director or Infection Control.

41. How To Dispose Of Sharps • A sharps container is a rigid, puncture resistant container labeled as “biohazard” and is designed to store sharps before disposal. • Dispose of sharps in provided sharps containers. • Never attempt to remove needles from sharps containers

42. Cleanup of Spills • Minimize your risk of exposure by • Containing • Removing • Disinfecting all blood or body fluid spills as quickly and effectively as possible. • Use the approved hospital disinfectants Appropriate PPE must be worn during cleanup of spills

43. Know And Practice Your Bloodborne Exposure Control Plan • Know the risks in your work area. • Use Standard Precautions. • Take advantage of Personal Protective Equipment. • Receive the hepatitis B vaccination series when it is offered. • Properly dispose of infectious waste. • Contact Employee Health immediately if you are exposed to blood or other potentially infectious materials. • For more information about bloodborne pathogens, see the Bloodborne Exposure Control Plan or contact the Infection Control Department.

44. We hope this Computer Based Learning course has been both informative and helpful. Feel free to review this course until you are confident about your knowledge of the material presented. Once you are comfortable with the material, you may proceed to the test in order to receive credit for course completion. In Conclusion…