WELCOME

2010 - 2011 OSHA UPDATE BLOODBORNE PATHOGENS

Nancy Allen, RN, BS, MPH, COHN-S, CCM/R EMPLOYEE HEALTH NURSE CONSULTANT

TOPICS

 OSHA  TERMS  UPDATES  HEPATITIS B  HEPATITIS C  HIV  REPORTING AN EXPOSURE

OBJECTIVES

 To have a basic understanding of blood borne pathogens and the role of OSHA  To understand how to report an exposure  To understand the role of the school nurse in an exposure.

WHY?

1. IT IS AN OSHA FEDERAL REQUIREMENT 2. Through education and understanding,the employee will be protected and the risk of an exposure can be reduced.

WHAT IS OSHA?

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

(Started in 1970)

SCHOOL DISTRICT’S EXPOSURE CONTROL PLAN (ECP) NEEDS TO BE BASED ON: 29 CFR 1910.1030

BLOODBORNE PATHOGENS STANDARD FEDERAL Register December 6, 1991

OSHA STANDARD ADDRESSES : RULES FOR PROTECTING HEALTH AND SAFETY WORKERS FROM OCCUPATIONAL EXPOSURE TO BLOOD AND CERTAIN OTHER BODY FLUIDS POTENTIALLY CONTAINING BLOODBORNE PATHOGENS.

BBP TRAINING IS MANDATORY UPON EMPLOYMENT FOR NEW HIRES AND ANNUALLY FOR ALL EMPLOYEES.

BBP TRAINING INCLUDES:

 NEW HIRE EDUCATION AND TRAINING  ANNUAL EDUCATION AND TRAINING  AVAILABILITY OF PPE (Personal Protective Equipment)  OFFERING OF HEPATITIS B TO AT RISK EMPLOYEES  PROPER REPORTING OF NEEDLESTICKAND BLOOD/BODY FLUID EXPOSURES

EXPOSURE CONTROL PLAN IS WRITTEN TO:

 MINIMIZE EXPOSURE TO BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS (OPIM)  MANAGE EXPOSURES PROPERLY AND MEDICALLY  DESCRIBE ENGINEERING AND WORK PRACTICE CONTROLS WHICH REDUCE RISK.

SCHOOL NURSES AND MEDICAL SAFETY DEVICES

IMPLEMENTATION OF SAFER NEEDLE/SYRINGE DEVICES IN SCHOOL DISTRICTS TO KEEP THE SCHOOL NURSE SAFE FROM BLOODBORNE PATHOGENS

STANDARD PRECAUTIONS

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TREAT ALL BLOOD AND BODY FLUIDS AS IF THEY ARE KNOWN TO BE INFECTIOUS

AT-RISK EMPLOYEES

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THOSE EMPLOYEES WHO, BY NATURE OF TASK, HAVE THE POTENTIAL TO BE EXPOSED TO BLOOD, BODY FLUIDS OR OTHER POTENTIALLY INFECTIOUS MATERIALS

PPE – PERSONAL PROTECTIVE EQUIPMENT

 GLOVES  MASKS  EYE PROTECTION  FACE SHIELDS  RESPIRATORS  GOWNS, APRONS, LAB COAT

WORK PRACTICE CONTROLS

 HAND WASHING  PROPER USE OF SHARPS CONTAINER – ¾ FULL  STORAGE AND SHIPPING OF CONTAMINATED EQUIPMENT  NO EATING, DRINKING, SMOKING, HANDLING CONTACT LENSES AND APPLYING MAKE-UP AT WORK AREAS

ENGINEERING CONTROLS

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RESPIRATOR

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MEDICAL SAFETY DEVICES

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SHARPS CONTAINERS

OPIM – OTHER POTENTIALLY INFECTIOUS MATERIAL

ANY BODY FLUID THAT IS GROSSLY CONTAMINATED WITH BLOOD OR ANY INTERNAL BODY CAVITY FLUID

SMALL WASTE GENERATORS

 Each School District is a small waste generator if they produce < 50 pounds/month. R.61-105, infectious Waste Management Act, Effective June 24, 2005  Some Districts may have agreement with local Health Department  Transport Sharps containers in a box in car trunk  Diapers, sanitary napkins, wound dressings in school setting are not infectious. Use appropriate PPE (OSHA) Regular trash.

LATEX SENSITIVITY IN SCHOOLS

 School nurse should notify School District Staff about Latex Allergies.

 Non-latex products – Band – Aids, BP Equipment, resuscitative equipment  Be aware of products with latex – balloons, rubber bands, Squishie balls, rubber toys, erasers

HEPATITIS C VIRUS

RISK FACTORS

 3-4 MILLION CHRONIC CARRIERS IN USA (CDC)  36,000 NEW INFECTIONS ANNUALLY IN US  50,000-70,000 CASES ESTIMATED IN SOUTH CAROLINA

WHAT IS HEPATITIS B?

 VIRAL INFECTION OF THE LIVER  SYMPTOMS – NONE/MILD/SEVERE  CHRONIC CARRIERS (5%) CAN DEVELOP CHRONIC LIVER DISEASE AND CAN INFECT OTHERS  95% SPONTANEOUS RESOLUTION  INCUBATION PERIOD – AVERAGE 60-90 DAYS, RANGE 45-180 DAYS.

 HEPATITIS B VACCINE – PROVIDES IMMUNITY (3 vaccine series)

WHAT IS HEPATITIS C?

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VIRAL INFECTION OF THE LIVER

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CAN LEAD TO CIRRHOSIS AND CANCER

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LEADING INDICATOR FOR LIVER TRANSPLANT

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FLU-LIKE SYMPTOMS OR NO SYMPTOMS

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INCUBATION PERIOD – AVERAGE 6-7 WEEKS. RANGE 2-26 WEEKS

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NO VACCINE AVAILABLE

WHAT IS HIV/AIDS?

HIV=VIRUS THAT CAUSES AIDS  Human ImmunodeficiencyVirus that Destroys T Cells, which are necessary for Healthy Immune System.

 INCUBATION PERIOD: Conversion to HIV positive within 25 Days to 3 months. Rarely Longer Than 6 months   Can be HIV POSITIVE but not have developed AIDS PEP (Post Exposure Prophylaxis) is available – Initiate as soon as possible!! Interval after which there is no benefit for humans is undefined.

AIDS=ACQUIRED IMMUNODEFICIENCY SYNDROME

 1/2 PEOPLE Who Are HIV positive DEVELOP AIDS WITHIN 10 YEARS  HIV + Certain Chronic Disease/Destroyed T Cells=AIDS

HEPATITIS B, HEPATITIS C & HIV

 Life-threatening BBP  Transmitted through exposure to blood and other infectious body fluids  Anyone with occupational exposure is at risk  Workers must use PPE and engineering controls

OCCUPATIONAL EXPOSURES: HCW (HCP) RESPONSIBIBILTIES

 KNOW BASIC BBP (HBV, HCV, HIV) ISSUES  ATTEND ANNUAL BPP TRAINING  KNOW WHAT IS A BONA FIDE EXPOSURE  REPORT IT!!! PER SCHOOL DISTRICT POLICY  IF YOU DON’T KNOW, ASK!!!

IF YOU THINK YOU HAVE BEEN EXPOSED IMMEDIATELY TAKE CARE OF YOURSELF AND IMMEDIATELY NOTIFY THE APPROPRIATE PERSON IN YOUR SCHOOL DISTRICT

DEPENDING ON THE EXPOSURE SCHOOL NURSE WILL IMMEDIATELY ASSIST THE EXPOSED PERSON

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WASH HANDS

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FLUSH EYES WITH WATER

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REMOVE ANY SOILED CLOTHING

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GET HELP FROM ANOTHER TRAINED FIRST RESPONDER

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DO NOT DELAY IN REPORTING

PAPERWORK WILL BE DONE BY THE DESIGNATED PERSON IN YOUR SCHOOL DISTRICT. THIS MAY VARY FROM DISTRICT TO DISTRICT

EACH SCHOOL DISTRICT IS RESPONSIBLE FOR DEVELOPING A POST EXPOSURE MANAGEMENT PROCEDURE THE SCHOOL NURSE MAY BE CONSULTED IN DEVELOPING THIS

CDC BBP OEM/PEP

Guidelines: Summary 3.

4.

5.

1.

2.

6.

Provide immediate care to the exposure site. Notify supervisor immediately!!!!

Evaluate risk of exposure (type of fluid, type of exposure) Evaluate exposure source for BBP’s Evaluate the exposed person Give PEP (HIV, HBV) for exposures posing risk of infection transmission Perform appropriate follow-up testing and provide counseling

QUESTIONS???

To complete your update, please click link below to take the BBP Test.

Please see your school nurse regarding the test.