BLOODBORNE PATHOGEN TRAINING
OBJECTIVES At the completion of this training, the participant will be able to: 1. Describe the modes of transmission of bloodborne pathogens 2. Describe the symptoms of bloodborne diseases 3. Identify tasks that may involve exposure to bloodborne pathogens 4. Define and describe personal protective equipment 5. Describe an exposure incident and post-exposure follow-up 6. Describe proper technique for hand washing 7. Define Universal/Standard Precautions
BLOODBORNE PATHOGEN TRAINING
PROGRAM OUTLINE
I. OSHA 1910.1030
II. BLOODBORNE PATHOGENS
A. Bloodborne Pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV). (OSHA 1910.1030). They are present in 1. Blood/blood products 2. Semen 3. Cerebrospinal fluids 4. Synovial fluid 5. Pericardial fluid 6. Amniotic fluid 7. Vaginal drainage
B. Bloodborne pathogens are also present in other body fluids that are visibly contaminated with blood including: 1. Urine 2. Stool 3. Emesis 4. Saliva 5. Sputum 6. Wound drainage
C. Bloodborne pathogens can be transmitted by: 1. Contact with blood or body fluids by needlesticks, breaks in skin or splashes into the mouth, nose or eyes 2. Sexual contact 3. Sharing needles 4. Mother to fetus
D. Diseases spread by bloodborne pathogens include: 1. Hepatitis B 2. Hepatitis C 3. Hepatitis D 4. Human Immunodeficiency virus (HIV) that causes Acquired Immune Deficiency Syndrome (AIDS)
E. Epidemiology and Symptoms of bloodborne diseases
III. UNIVERSAL PRECAUTIONS
A. Universal Precautions is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens (OSHA 1910.1030) B. Measures to prevent healthcare workers who can come into contact with blood and body fluids
IV. HANDWASHING
A. Single most important defense against disease B. Procedure 1. Carry own hand-washing supplies 2. Wet hands and apply soap 3. Lather well 4. Vigorously wash all surfaces for at least 10 seconds 5. Rinse 6. Dry hands using a single-use towel 7. Turn off faucet using a clean, dry paper towel
C. Wash hands 1. Before and after patient care 2. After contact with contaminated objects 3. After handling waste material, secretions, drainage, or blood 4. After caring for personal needs 5. Before eating, drinking, handling or serving food
D. CDC recommendations 1. When hands are visibly dirty or contaminated with protein material or are visibly soiled with blood or other body fluids, staff should wash hands with either a nonmicrobial soap and water or antimicrobial soap and water 2. If hands are not visibly soiled, staff may use an alcohol-based hand rub for routinely decontaminating hands in all other clinical situations
V. PERSONAL PROTECTIVE EQUIPMENT
A. Personal Protective Equipment is specialized clothing or equipment worn by an employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard are not considered to be personal protective
equipment. (OSHA 1910.1030)
B. Create barrier between you and the patient
C. Prevent the spread of bloodborne pathogens
D. Gloves
1. Put gloves on before any patient procedure that could result in contact with blood, body fluids that contain blood, or skin that is open or cut
2. Wear gloves for cleaning spills or handling supplies, utensils, or linens soiled with blood or body fluids
3. Change gloves between patient procedures
4. Wash hands between each glove change
5. To put on gloves:
a. Remove rings that could puncture gloves
b. Wash and dry hands
c. Avoid tearing
d. Inspect for tears and holes
6. To remove gloves:
a. Grasp the cuff of the left glove with the right gloved hand and pull, turning the glove inside out to keep contaminated surface on the inside of glove
b. Hold that glove in the right hand
c. With the ungloved left hand, grasp the inner right glove at the top near cuff and peel it off, turning it inside out over the other glove
d. Throw gloves in the trash receptacle
7. Utility gloves
a. Examine for punctures, cracking, peeling or tearing
b. Wash in detergent and water, remove and place to dry
E. Garments – gowns and aprons
1. Should be waterproof and disposable
2. Cover clothing with the garment
3. Remove garment by rolling it into a ball from the outside inward and dispose of in a plastic trash bag
F. Disposable face masks
1. Wear face mask whenever there is a possibility that blood or bloody fluids could be splattered or transmitted through the air
2. Use a mask only once
3. Use a disposable CPR mask to provide mouth-to-mouth or mouth-to-stoma ventilation
4. Discard used mask in plastic trash bag
G. Goggles or safety glasses with side shields
1. Wear goggles when there is potential for blood or other body substances to splatter into eyes
2. Clean goggles with soap and water after use
3. Clean blood-spattered goggles with ethyl alcohol or chlorine compound
VI. EQUIPMENT HANDLING
A. Examine all equipment before using to make sure that it is clean
B. Wipe stethoscope with alcohol or approved disinfectant
C. Spray or wipe blood pressure cuff with an approved chemical germicide according to agency’s policy
D. Wipe the patient’s thermometer and return to the storage container after use
E. For a digital thermometer, use a disposable sheath and wipe with alcohol after removing the sheath
F. Practice universal precautions when handling soiled or used equipment
VII. DECONTAMINATION OF SPILLS
A. Household bleach is an all-purpose disinfectant for blood and body substance spills and decontamination
B. Procedure:
1. Wear utility gloves
2. Dilute household bleach one to ten parts with water
VIII. EXPOSURE TO BLOODBORNE PATHOGENS
A. Components of an exposure control plan:
1. List of high-risk job classifications, tasks and procedures
2. Procedures for evaluating exposure incidents
3. Documented review of the plan
4. Hepatitis B vaccine program for all at-risk employees
5. Policies and procedures on
a. How to report exposure incidents
b. Whom to contact
c. How to handle bloodborne pathogen emergencies
d. Provisions for post-exposure evaluation and follow-up
B. Exposure incident
1. Contact with blood or potentially infectious body fluid that can enter the bloodstream through
a. Chapped or broken skin
b. Open wounds
c. Mucous membranes
d. A needlestick or puncture with a contaminated instrument
2. Can lead to infection with bloodborne pathogen
C. Actions to take for an exposure incident
1. In case of a needlestick, puncture or scratch:
a. Squeeze the area immediately to induce bleeding
b. Cleanse the wound thoroughly with soap and water, Betadine or alcohol
c. Save the sharps or the items involved
2. For skin exposure, immediately wash the affected area with soap and water
3. For exposure to mucous membranes, irrigate the area vigorously with large amounts of water for at least five minutes
4. Report to the supervisor
a. Needlesticks or other cuts or punctures
b. Splashing of blood or other body fluids into mouth, eyes or nose
c. Direct or prolonged contact with a large amount of blood or other potentially infectious fluid
IX. WORK PRACTICES AND ENGINEERING CONTROLS
A. Engineering Controls means controls (e.g., sharps disposal containers, self-sheathing needles, safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazard from the workplace.
B. Work Practice Controls means controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).
X. SIGNS AND LABELS
A. Warning labels shall be affixed to containers of regulated waste, refrigerators and freezers containing blood or other potentially infectious material; and other containers used to store, transport or ship blood or other potentially infectious materials, except as provided in paragraph (g)(1)(i)(E), (F) and (G).
RESOURCES
1. Beacon Health, “Study Guide, Bloodborne Pathogens, Protecting Yourself and Others in Homecare.”
2. Centers for Disease Control and Prevention website - http://www.cdc.gov
3. OSHA 1910.1030 - http://www.osha.gov