Bloodborne Pathogen Training

                                                                                                                                       December 2013

                   Bloodborne  Pathogens  Training

      Directions: Please read over the following material and take the quiz.

     

      *The NHRC Department of Respiratory Disease Research

      requires that all personnel, both onsite and offsite, who

      work with patient specimens or have patient contact,

      receive bloodborne pathogen training. Bloodborne pathogen

      training is a critical component of laboratory safety and must

      be completed upon orientation and followed by subsequent

      annual refresher courses. The following training is in

      compliance with the OSHA Bloodborne Pathogens Standard

      (29 CFR 1910.1030) and will be used as our annual refresher

      course. Upon completion of this training, you will be required to

      take a quiz.

     

     

     

      Introduction:

     

       Needle sticks and other sharps injuries are a major healthcare

      industry concern. In 1991, OSHA created Bloodborne

      Pathogen Standard 29 CFR 1910.1030 which combined

      engineering and work practice controls, training, and other

      factors to minimize transmission of bloodborne pathogens in

      the workplace.

       In November of 2000, the Needlestick Safety and Prevention

      Act was passed by Congress.

       It is estimated that up to 800,000 needle stick infections

      occur yearly

     

      Bloodborne Diseases

       Bloodborne pathogens are pathogenic microorganisms

      (e.g. viruses, bacteria, or parasites) that may be present in

      human blood and can cause disease in humans.

       There are several bloodborne diseases that you could be

      exposed to on the job. The most significant are:

       Human Immunodeficiency Virus (HIV)

       Hepatitis B Virus (HBV)

       Hepatitis C Virus (HCV)

     

      Human Immunodeficiency Virus (HIV)

       HIV attacks the body’s immune system and may cause

      Acquired Immune Deficiency Syndrome (AIDS).

       Currently, there is no vaccine or cure for HIV.

       Needle sticks are a rare cause of occupational HIV

      transmission (.04% of people are infected in the workplace).

      It is still important to be careful when working with needles

      because HIV can lead to AIDS which is fatal.

     

      Human Immunodeficiency Virus (HIV):

      A person with HIV may:

       Carry the virus without developing symptoms for many years.

       Develop AIDS, or AIDS-related symptoms including:

      neurological problems, cancer, and other opportunistic

      infections.

       Suffer from flu-like symptoms, fever, diarrhea, and fatigue as

      well as weakness, sore-throat, white coating on the tongue,

      weight loss, and swollen lymph glands.

     

      Hepatitis B (HBV)

       Hepatitis means “inflammation of the liver.”

       HBV is a major bloodborne hazard that infects approximately

      8,700 healthcare workers a year, resulting in more than

      200 deaths.

       There is a vaccine available to prevent HBV.

       Blood to blood transmission is the most common form of HBV

      infection.

      If someone becomes infected with HBV he/she:

       May not develop symptoms for up to 9 months.

       May suffer from symptoms such as fatigue, stomach pain,

      jaundice, and darkened urine.

       HBV may severely damage the liver, causing cirrhosis and

      sometimes death

     

      Hepatitis C (HCV)

       HCV is the most common bloodborne infection in the US,

      infecting more than 4 million Americans, most of which are

      unaware that they are infected. As many as 2.7 – 10% of

      new HCV cases are occupationally acquired.

       HCV is a potentially fatal bloodborne virus that can lead to

      liver failure or cancer.

       There is no vaccine against HCV.

       Symptoms include: Jaundice, fatigue, darkened urine,

      abdominal pain, and loss of appetite or nausea, although

      many people remain asymptomatic.

     

      Modes of Transmission

      HIV, HBV, and HCV are transmitted through blood or other

      bodily fluid. This includes:

       Semen

       Vaginal secretions

       Saliva

       Cerebrospinal fluid

       Amniotic fluid

       Peritoneal fluid

       Pleural fluid

       Synovial fluid

       Any fluid that is contaminated with blood

     

      Vehicles of Transmission

      Bloodborne pathogens may enter the body and infect a person

      through a variety of means including:

       Hypodermic Needles

       Sexual Contact

       Accidental puncture with contaminated needles, broken glass

      or any other sharp object that can pierce skin.

       Contact between broken or damaged skin and infected bodily

      fluids.

       Indirect transmission such as touching a contaminated object

      to your mouth, eyes, nose, or other mucous membranes.

     

      Universal Precautions

       HIV, HBV, and HCV infect people of all ages, socioeconomic

      classes, race, and background. This means you cannot

      identify every patient who may transmit the infection.

       Universal precautions resolve this uncertainty by requiring

      you to treat all human blood and bodily fluids as if they were

      known to be infected.

     

      Respiratory Pathogens

       It is possible that you may be exposed to respiratory

      pathogens, such as M. tuberculosis (TB) and B. pertussis,

      at this workplace.

       Although we do not culture TB, we do process throat cultures

      which could be infected.

       Once a year, every employee must get a PPD skin test to

      check for the presence of TB.

       The greatest potential for B. pertussis and other respiratory

      pathogen infection is through aerosol generation during the

      manipulation of cultures.

     

      Respiratory Pathogens:

      Reducing the Risk

      Workers may be protected from Respiratory Pathogens by:

       Using careful work practices

       Having good personal hygiene

      (gowns, gloves, hand washing)

       Using engineering controls (hoods)

       Receipt of an annual influenza vaccination

     

      Reducing Your Risk

      There are five major tactics to help reduce your risk of exposure

      and infection:

      1. Work Practices & Personal Hygiene

      2. Personal Protective Equipment

      3. Engineering Controls

      4. Good Housekeeping

      5. Hepatitis B Vaccine

     

      Work Practices

       If you come in contact with infectious materials, wash the

      exposed area immediately in order to lessen the chance of

      becoming infected.

       In laboratory and patient care areas you should wash your

      hands frequently, including when you:

       Remove your gloves

       Come in contact with blood or other bodily fluids

       Change workstations

       Enter a “clean” area

     

      To Avoid Needle Sticks

       Use a needle with Engineered Sharps

      Injury Protection (SESIP) attached to

      the blood tube holder and dispose of

      the entire unit into a sharps container.

       Do not bend, break, and NEVER re-cap needles.

       Do not remove contaminated needles from blood tube

      following a blood draw.

       Place contaminated sharps in an

      appropriate puncture-resistant container.

     

      Code Regulations

      Code 1910.1030 requires you to:

       Keep a confidential sharps injury log.

       Use the most up to date safety needles which are appropriate

      for your workplace.

       Involve employees in choosing the needle safety devices.

       Have a yearly re-examination of your exposure control plan.

     

      Sharps Disposal Containers

      Sharps disposal containers should be:

       Functional – durable, closeable, leak and puncture resistant

       Accessible – close to where work is being done

       Visible – properly labeled and color coded

       Accommodating – conveniently located and easy to reach with

      an opening large enough for both the needle and SESIP

     

      Handling Sharps

       Do not overfill the sharps containers. Fill only to the

      indicated line or ¾ (75%) of the container, whichever comes first.

       Never reach into any container that is used for sharps.

       Place leaking or punctured sharps containers inside a

      secondary container to prevent further leakage.

       Always use a utensil (tongs, dustpan, etc.) to pick up

      contaminated broken glass, needles, or other sharps.

       Assume all used needles and other sharps are contaminated

     

      Personal Hygiene

      Other precautions to protect yourself include:

       Always minimize splashing, spraying, and spattering.

       Do not eat, drink, smoke, apply cosmetics,

      or handle contact lenses where you may

      potentially be exposed to infectious materials.

       Never pipette or use suction by mouth!

       Don’t store food or drinks where blood and

      other infectious materials may be present.

       Avoid petroleum-based lubricants because they can eat away

      at latex gloves. Hand cream is okay, but only after you have

      thoroughly washed your hands.

     

      Personal Protective Equipment

      Personal Protective Equipment (PPE) protects you from contact

      with potentially infectious materials. PPE includes:

       Masks/Eye Protection: always use when

      you perform procedures likely to generate

      splashes of blood or other bodily fluids.

       Gowns/Coats: use for procedures likely to

      generate splashes of blood or other bodily fluids.

       Gloves: always use before touching or if likely

      to come in contact with blood, bodily fluids,

      non-intact skin, mucous membranes, and when

      performing venipuncture.

       PPE should be worn at all times in the operating room except in

      approved “clean areas”.

       PPE should never be worn outside of the area of potential

      exposure.

       Contaminated PPE must be taken care of appropriately

      by either disposing, decontaminating, or laundering it.

     

      Gloves

       Gloves are a very important way of protecting yourself.

       Always use latex or approved non-latex gloves.

       Always check the gloves for holes before putting them on.

       There are also specific rules to be followed for glove removal:

       With both hands gloved, peel one glove off from wrist to fingers

      and hold it in the gloved hand.

       With the exposed hand, peel the second glove from the inside,

      tucking the first glove inside the second.

       Immediately dispose of both gloves in a bio-hazardous materials

      container.

       Wash your hands thoroughly.

     

      Engineering Controls

      Engineering Controls are the primary means of minimizing or

      eliminating employee exposure to BBP and include the use of

      safer medical devices. Some examples are:

       Self-sheathing needles

       Sharps disposal containers

       Bio-hazardous waste bags

       Biological Safety Hoods

       Autoclaves

     

      Good Housekeeping

      Good Housekeeping means using your common sense and

      knowledge to keep your work areas clean and to protect

      yourself and your colleagues. General rules are:

       Clean and decontaminate all equipment and surfaces at

      the end of each shift using an appropriate decontaminant.

       Replace protective coverings on equipment

       Place contaminated sharps into the proper

      leak-proof containers.

       Please read and follow all biohazard labels.

       Always dispose of hazardous materials (including sharps)

      in the proper RED (NOT orange) container or bag.

     

      HBV Vaccination

       If your occupation has the potential for HBV exposure, your

      employer will offer the vaccine at no cost to you.

       The vaccine is administered in three injections: one at

      employment start, one at three month, the final at

      six months. A post vaccination serology test (titer) should

      be scheduled to check antibody levels.

       All three injections must be received for the vaccine to be

      effective.

       Today’s vaccines are safe and are 85-97% effective.

       

      Exposure Incident Procedures

       An exposure incident is a spill, splash, needle stick, ingestion,

      or accident, in which you have direct and unprotected contact

      with human blood, fluids, or tissue.

       In the event of an exposure incident an

      employee should:

       Wash or flush the area immediately.

       Notify the employee’s supervisor.

       Seek further medical treatment as necessary.

       Ensure the incident is reported to your employer.

       REMEMBER: Report an exposure incident as soon as

      possible

     

      Specific Exposure Procedures

       Contaminated skin: scrub and soak the area for

      at least 10 minutes using a providone iodine solution

      (e.g. Betadine) and water.

       Percutaneous injury (needle stick, cut, wound, etc.):

      Vigorously scrub and soak the area for at least

      20 minutes with a Betadine solution and water

      before seeking additional treatment.

       Mucous Membrane: Flush any exposed area for

      at least 15 minutes at an emergency eyewash

      station before seeking additional treatment.

     

      Emergency Procedures

       In case of an emergency, contact Robby or Raelene as soon as possible.

       All treatments of work-related injuries will be paid for by

      your employer.

                               Bloodborne  Pathogen  QUIZ

     

      Circle The Best Response

     

      In what year was the Needlestick Safety and Prevention Act passed by Congress?

      a. 1998

      b. 2000 

      c. 2001

      d. 2003

      e. 2004

     

      Hepatitis refers the inflammation of the:

      a. heart

      b. lungs

      c. liver

      d. kidneys

      e. intestines

                 

      The most significant bloodborne diseases are:

      a. HIV

      b. HBV

      c. HCV

      d. All of the above

     

      HCV is a potentially fatal virus that can lead to:

      a. liver disease

      b. liver disease and cancer

      c. HIV

      d. HBV

     

      In the event of an exposure incident, the employee should

      a. Report the incident as soon as possible

      b. Wash of flush the area immediately

      c. Notify the employee’s supervisor as soon as possible

      d. Seek further medical care as needed

      e. All of the above

     

      What type of PPE are we required to use while dealing with blood:

      a. gloves

      b. masks including eye protections

      c  shoe covers

      d. gowns

      e. a,b,c,

      f. all of the above

     

      A sharps container shall never be filled more than:

      a. 60% full

      b. 75% full

      c.  80% full

      d. It can filled up as long as the safety guard can still be locked in place

     

      What is  a symptom of the HIV virus?

      a. unexpected weigh gain

      b. coughing up blood

      c. white coating on the tongue

      d. muscle tremors

      It is estimated that how many needle sticks occur yearly?

      a. 500,000

      b.800,000

      c. 700,000

      d. 250,000