BLOODBORNE PATHOGENS

What are bloodborne pathogens?

     –  Bloodborne pathogens (BBP) are microorganisms present in human blood/body fluids and other potentially infectious materials that can cause disease in humans.

     –  Other potentially infectious materials may include:

          –  Unfixed tissue or organs (not treated with chemicals )

          –  HIV/Hepatitis C/Hepatitis B containing cell or tissue cultures

Exposure to Pathogens

The Occupational Safety and Health Administration (OSHA) regulates exposure to bloodborne pathogens and has developed a Bloodborne Pathogen Exposure Control standard.

Any employee who could reasonably anticipate coming in contact with bloodborne pathogens as part of their job duties are covered by this standard.

Transmission of Pathogens

Bloodborne pathogens can be transmitted through:

     *  Accidental punctures and cuts with contaminated sharp materials (e.g. Needle stick).

     *  Contact between mucous membranes or broken skin and infected body fluids (e.g. Splash).

     *  Sharing of needles

     *  Sexual Contact

Bloodborne Diseases

The three Bloodborne diseases of most concern are:

     –  Human Immunodeficiency Virus (HIV)

     –  Hepatitis B (HBV)

     –  Hepatitis C (HCV)

Other Bloodborne diseases include:

     –  Malaria

     –  Brucellosis

     –  Syphilis

     –  West Nile Virus

Human Immunodeficiency Virus (HIV)

Human Immunodeficiency Virus (HIV) is a virus that infects human T-cells and decreases a person’s ability to fight off other disease causing germs.  It may ultimately lead to the development of Acquired Immune Deficiency Syndrome (AIDS).

Contracting HIV

HIV can be contracted by:

     –  Occupational exposure to the blood or body fluids of a patient infected with

     –  Sexual Contact

     –  Sharing Needles

     –  An unborn baby through its infected mother (though the risk can be lowered with appropriate pre-natal treatment).

Myths About Contracting HIV

You cannot contract HIV from:

     –  Telephones, toilet seats, doorknobs or insect bites

     –  Shaking hands, being sneezed or coughed on

     –  Donating blood

Hepatits B

The Hepatitis B virus is known as a bloodborne virus, because it is transmitted from one person to another via blood or fluids contaminated with blood.

     –  The virus attacks the liver.

     –  It can cause scarring of the liver, liver cancer, liver failure, and death.

     –  Symptoms of infection include jaundice, fatigue, abdominal pain, vomiting.

     –  It can be prevented with the Hepatitis B

Hepatitis C

     –  Hepatitis C is similar to Hepatitis

     –  May remain dormant with no symptoms for 10-20

     –  People may be contagious even if they have no symptoms.

     –  There currently is no vaccine available

     –  Chronic Hepatitis C infection is the leading cause of liver transplant in the US.

Protecting Yourself

You can protect yourself and your co-workers by following standard precautions:

     –  Using Personal Protective Equipment (PPE)

     –  Using safe-needle devices as specified

     –  Dispose of sharps and wastes appropriately

     –  Obtain the Hepatitis B vaccinations

     –  Perform Hand Hygiene

Standard Precautions

     –  Standard Precautions combine the previous Universal Precautions approach of treating all blood and body fluids as infectious with body substance isolation practices.

     –  The precautions are applied to all clients receiving care, regardless of infection status.

Person Protective Equipment (PPE)

Bloodborne pathogen exposure can be prevented with the proper use of specialized equipment and clothing.  Common types of PPE include:

     –  Gloves

     –  Face Shields

     –  Gowns

     –  Masks

     –  Goggles

Personal Protective Equipment is usually available at each client’s home, made available by the client.  PPE must be worn anytime there is potential contact with blood and body fluids.

Safer Medical Devices

There are engineering control devices in place that are designed to reduce the potential for bloodborne pathogen exposures.

     –  These include needle-less systems and safe-needle devices.

Needle-less systems should NEVER be bypassed with needle devices.  If you have concerns with using a needle-less system, contact your supervisor.

Safe-needle devices MUST be used unless:

     –  They are not available for the specified task

     –  They pose a risk to clients or caregivers.

Many accidents occur because employees fail to activate the safety device after using the needle.  The safety device MUST be activated IMMEDIATELY after the needle is used.

     –  The majority of accidents occur because employees fail to follow safe work practices and/or do not activate the safety device in a timely manner after using the needle.

     –  Your safety is everyone’s responsibility, especially yours!

          –  Know correctly how safety mechanisms work on devices before use.

          –  Activate the safety device IMMEDIATELY after the needle is used.

          –  Dispose of sharps correctly in a sharps container, never in a trash can or red biohazard bag.

          –  If you encounter a sharps device that you do not know how to safely use notify your supervisor to obtain safety instructions

     –  If you have concerns with using a safety device and/or needle-less system, contact your Supervisor or office staff.

Proper Disposal

Non-sharps – Materials contaminated with blood or other infectious material must be handled carefully and disposed of in infectious waste containers.

     –  These containers are typically red and are lined with red biohazard bags.

     –  Sharps – Materials (syringes with or without needles attached, scalpels, etc.) must be disposed of in approved sharps

     –  Safety devices must be engaged immediately after use and before putting the sharp into the sharps

     –  When feasible portable sharps containers should be kept as close to the use area as possible

     –  These containers MUST be removed for disposal when they are ¾ full or reach the “full” line, whichever is less.

     –  NEVER reach your hand into a sharps container.

Employees handling filled sharps containers should:

     –  Visually inspect sharps containers before handling

     –  Close the lid before manipulating the container.

     –  Secure filled sharps containers

          –  If its overfilled,

               *  Use forceps to remove protruding devices

               *  Place removed devices in a new container

     –  Inspect waste container

          –  If there is anything sticking out, take corrective actions and notify a supervisor or nurse on visit to address immediately.

Hand Hygiene

     –  The most effective way to prevent the spread of infection is to perform hand hygiene following the World Health Organization’s Five Moments of Hand Hygiene:

          –  Before touching a client

          –  Before clean/aseptic procedures

          –  After body fluid exposure risk

          –  After touching a client

          –  After touching client surroundings

       –  To enhance this practice, waterless hand sanitizers are placed in various accessible locations and may be used for hand hygiene unless hands are visibly soiled

     –  Hand washing with soap and water is required following care of patients with GI illness causing diarrhea such as C-diff or Norovirus.

If You Have An Exposure

     –  Immediately wash hands and other skin surfaces with soap and water.

     –  If the eyes are splashed, irrigate the eyes with large amounts of clean water or sterile saline.

     –  If the mouth or nose is involved, flush with plain water and/or mouthwash if available.

     –  Report the injury to your supervisor and seek medical evaluation / treatment AS SOON AS POSSIBLE.