Bloodborne Pathogens - knoxhealthscience / FrontPage
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Transcript Bloodborne Pathogens - knoxhealthscience / FrontPage
Bloodborne Pathogens Standard
Requirements
TOSHA believes the information in this presentation
to be accurate and delivers this presentation as a
community service. As such, it is an academic
presentation which cannot apply to every specific
fact or situation; nor is it a substitute for any
provisions of 29 CFR Part 1910 and/or Part 1926
of the Occupational Safety and Health Standards
as adopted by the Tennessee Department of Labor
and Workforce Development or of the
Occupational Safety and Health Rules of the
Tennessee Department of Labor and Workforce
Development.
Bloodborne Pathogens
Pathogenic micro-
organisms present
in human blood that
can lead to diseases
Human immunodeficiency virus (HIV)
Hepatitis B (HBV)
Hepatitis C (HCV)
Other Bloodborne Pathogens
Syphilis
Malaria
Brucellosis
Babesiosis
Leptospirosis
Arborviral Infections
Relapsing Fever
Creutzfeld-Jacobs Disease--Mad-cow
Viral Hemorrahgic Fever--Ebola
Potentially Infectious Materials –All
Can Transmit Hepatitis B, C, and HIV
Blood
Semen
Vaginal secretions
Cerebrospinal fluid
Pleural fluid
Pericardial fluid
Peritoneal fluid
Amniotic fluid
Saliva in dental proc.
Any visibly
contaminated body
fluid
Any body fluid where
differentiation is
difficult
Any unfixed tissue or
organ
Aqueous and vitreous
humors in the eyes
Other Body Fluids
These body fluids do NOT have enough virus in
them to transmit disease UNLESS they are
contaminated with blood
–
–
–
–
–
–
Urine
Feces
Tears
Sweat
Vomitus
Spit
Modes of Transmission
Stick or Cut
Splash to mucous membranes of the eyes,
nose, mouth
Non-intact skin exposure
Universal Precautions
Must be observed
All blood and body fluids are treated as if
known to be infected with HIV, HBV, HCV,
etc.
Do not come into contact with another
person's blood or body fluids
Exposure Control Plan
Employer's plan describing how compliance with
the standard is achieved
Describes what employees are covered
Describes tasks that are covered
Describes post-exposure follow-up procedures
Must be reviewed and updated annually
Must be accessible to employees
– Every employee should know the procedure to
follow to obtain a copy
Exposure Control Plan
Safer Medical Devices
– The Exposure Control Plan must be updated every
12 months to reflect evaluation, consideration, and
selection of appropriate devices
– Document in the plan the devises evaluated and
those currently used
– Front line employees must be involved in the
selection of devices
Handwashing
The single most important aspect of
infection control
Wash hands when contaminated with blood
or body fluids and after removing personal
protective equipment
Use antiseptic hand cleaner clean
paper/cloth towels or antiseptic towelettes
when "in the field"
Wash hands with soap and water asap
Needles/Sharp Objects
Use sharps with sharps injury prevention or needleless
systems for all procedures involving sharps
Place in puncture resistant, labeled, leak-proof containers for
transport, storage, and/or disposal
Keep the container closed
Do not bend, break, recap, or remove needles
Do not pick up contaminated broken glass directly with the
hands
Do not reach by hand into containers where contaminated
sharps are placed
Do not overall sharps containers
Eating/Drinking
Do not eat or drink in
areas where there is
exposure to blood or
body fluids
Do not store food in
refrigerators, freezers,
cabinets, on shelves or
countertops where
blood or other body
fluids are present
Personal Protective Equipment
(PPE)
Wear PPE to prevent blood or body fluids
from getting on your clothes, skin,
underclothes, etc.
Must be provided at no cost to the employee
Employer must enforce the use
Must be removed prior to leaving the work
area and placed in designated area
PPE
Parental exposure
– stick or cut
gloves
Mucous membrane
– splash
glasses/ goggles
Non-intact skin
– spill or splash
pocket masks
gowns
masks
shoe covers
Decontamination
Clean and decontaminate all equipment and
environmental and working surfaces after
contact with blood and/or body fluids
Decontaminate with appropriate disinfectant
– EPA registered tuberculocidal disinfectant
– EPA registered disinfectant with label stating it
is effective against HIV and HBV
– Household bleach, diluted 1:10-1:100, made
fresh daily
Contaminated Laundry
Remove contaminated clothing when it
becomes contaminated
Place immediately in bag or container that
is labeled
Prevent leakage
Regulated Waste
Sharps containers
– Needles
– Blades
– Broken glass
Red bags
– Liquid or semi-liquid blood or
OPIM
– Items caked with dried blood
or OPIM
– Items that could release blood
or OPIM
– Pathological waste
– Microbiological waste
Hepatitis B Vaccination
the HBV vaccination must be offered after
the employee has received training and
within 10 working days of job assignment
– At no cost
– Provided by PLHCP
– According to US Public Health Service most
current recommendations
• “Immunization of Health Care Workers:
Recommendations of ACIP and HICPAC,” MMWR,
Vol. 46, No. RR-18
HBV Vaccination
Employees who do not take the shots must sign a
declination statement
Highly recommended
Few contraindications
Three-shot series—titer 1-2 months after last shot
No booster currently recommended
Each person must have a health care professional's
written opinion
– A copy must be provided to the employee within 15
days of completion of the evaluation
An employee can decline now, take the shots later
Written Opinion
Each person must have a health care
professional's written opinion for hepatitis B
vaccination
– A copy must be provided to the employee
within 15 days of completion of the evaluation
Post-Exposure Follow-up
After exposure incident
– Stick or cut
– Splash
– Non-intact skin exposure
At no cost
Begin ASAP after exposure incident
Report exposure incident to your supervisor
or designated personnel immediately
Post-Exposure Follow-up
Investigation of the incident
ID source individual, obtain consent, and
test their blood to determine HBV, HCV,
and HIV infectivity ASAP
Results of source individual's test given to
exposed person
Obtain and test exposed person's blood for
HBV, HCV, and HIV serological status
Post-Exposure Follow-up
Post-exposure prophylaxis as indicated by CDC
– “Updated U.S. Public Health Service Guidelines for
the Management of Occupational Exposures to
HBV, HCV, and HIV and Recommendations for
Postexposure Prophylaxis” June 29, 2001, Vol 50,
No. RR-11
– “Updated U.S. Public Health Service Guidelines for
the Management of Occupational Exposures to HIV
and Recommendations for Postexposure
Prophylaxis,” September 30, 2005, Vol 54, RR-09
Counseling and Evaluation of reported illnesses
Written Opinion
The employee must be provided a copy of
the Health Care Professional's Written
Opinion for Post-Exposure Follow-up
within 15 days of completion of the
evaluation
Labels
Containers with
contaminated items
Can substitute red
Training
For all employees listed in the Exposure
Determination
At no cost to employees
During working hours
At the time of initial assignment
Annually--within 1 year of last training date
Must be opportunity for interactive questions and
answers
Train employees on adopted safer needle devices
before implementation
Training
Five Easy Questions
– What is universal precautions?
– What do you do when there is a blood spill?
• Personal protection
• Clean-up and disposal procedures
• Disinfection (hazard communication applies)
– What do you do with contaminated sharps and
laundry?
– Have you been offered the HBV vaccination free
of charge?
– Where is the Exposure Control Plan?
Additional Training
Copy of the BBP standard, 29 CFR 1910.1030, must be
accessible to you
Explanation of methods of recognizing tasks that may
involve exposure to blood and/or body fluids
Information on types, use, location, removal, handling,
decontamination, and disposal of ppe
Basis of selection of ppe
Actions to take and persons to contact in a bloodborne
emergency that you do not know how to handle
Procedure to follow if exposure incident occurs
Opportunity for interactive Q & A
Records
Medical records
– Name and social security number
– HBV vaccination status
– Results of exposure incident follow-up
– Health care professional's written opinions
– Info provided to health care professional
– Confidential
Records
Training
– Dates
– Contents
– Names and qualifications of trainers
– Names and titles of persons attending
Records
Sharps Injury Log
– Per the Tennessee Sharps Injury
Prevention law
– Keep a log of all sharps injuries with
• Type and brand of device involved in the
incident
• Department or work area where the incident
occurred
• Explanation of how the incident occurred
Resources
www.osha.gov
www.tennessee.gov/labor-wfd/tosha
www.cdc.gov
www.cdc.gov/niosh
Memphis Office
Jackson Office
Nashville Office
Knoxville Office
Kingsport Office
Chattanooga
Consultative Services
901-543-7259
701-423-5641
615-741-2793
1-800-249-8510
865-594-6180
423-224-2042
423-634-6424
1-800-325-9901