Transcript What is the Exposure Control Plan? Bloodborne Pathogens

Bloodborne Pathogens Training
Adapted by V .M. Warnock RN, BSN from slides by Heidi Toth RN, MSN
Some occupations put workers at risk for occupationally
acquired infection.
Policies and Procedures that minimize your health risks.
OSHA Standard
Infectious Disease Process
Potential Exposure Risks
Exposure Control Plan
Bloodborne Diseases
Exposure Control Strategies
Occupational Safety & Health Administration
(OSHA) Standard
"Bloodborne Pathogen Rule”
Those at risk of occupational exposure to
blood or other potentially infectious
materials must be trained in universal
precautions and other exposure control
strategies.
At risk employees are individuals whose
work responsibilities bring them in
contact with blood and body fluids.
Training is done upon initial
employment and updated annually.
Internet link to regulation:
www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051
What is the Exposure Control Plan?
Freehold Borough
School District
Bloodborne Pathogens
Exposure Control Plan.
Where ?:
Health Office.
All employees have
access to the exposure
control plan.
Exposure
Control Plan
What? Identifies those
occupations at risk
You may consult this
document if you think
you are at risk.
Infectious Disease Process- What are microorganisms??
Classifications:
bacteria, viruses, fungi,
algae, yeasts, and
protozoa.
Too small to be seen by the
unaided human eye.
Found; in the soil
 in the water,
 on plants and animals.
billions on human skin and the nasal &
intestinal tracts.
Infectious Disease Process- What are pathogens?
Most microorganisms live in harmony
with the human body.
Pathogens—can infect
the body and
cause disease.
Infectious diseases range from mild illnesses, such
as a cold, to fatal illnesses, such as AIDS.
CHAIN OF INFECTION
The Infectious Disease Process.
Microorganism & Reservoir
The chain begins ,,,,,,,,,,,
Second link:……….
An environment in which
the pathogen can survive:
* Water
* soil
* inside someone
already infected
with the germ.
Escape & Transmission
…….
Third link.
Escape from the reservoir
If we are the reservoir, the
pathogenic microorganism can
escape when we cough or
sneeze.
Next link ……..
From the reservoir to the
host.
If water is the reservoir, its
mode of transmission could
be our drinking water
supply.
Entry & Susceptibility
NEXT….
Means of entry
into the host.
A pathogen in water would
enter us if we drank the
water it was in.
A pathogen in the air would
enter us if we inhaled it.
Last link …. host's susceptibility
Depends on the germ and the
disease it causes..…
Some hosts are easier to infect
than others.
CHAIN OF INFECTION
For an infectious disease to occur,
each link in the chain must be connected.
If even one link of the chain is missing:
Interrupted process=No infection
.
Here the chain is broken at the point of host susceptibility.
YOU can break the chain of infection by following
standard precautions/universal precautions.
Bloodborne pathogens ……..
are microorganisms that are present
in blood that can cause disease.
How do you get infected?
blood or body fluid
from an infected
individual
Enters another
persons body
2 examples of Bloodborne pathogens:
Hepatitis B (HBV)
Human Immunodeficiency Virus (HIV)
Any body fluid with visible
blood is potentially infectious.
Other body fluids like semen and vaginal
secretions are considered potentially
infectious fluids.
The risk of transmission from these body
fluids in the school setting is considered
extremely low.
POTENTIAL EXPOSURE RISK
Contact alone does not ensure infection!
Pathogens must enter the bloodstream to cause
infection.
In the workplace, an employee may be exposed to
bloodborne pathogens such as Hepatitis B Virus or
HIV when infected blood or body fluid is allowed to
enter the body by means of penetration.
Exposure may occur through:
a needlestick
a cut or break in the skin
contact with mucous membranes such as the eye,
nose, or mouth
HEPATITIS B VIRUS (HBV)
HBV causes inflammation of the liver
and may lead to complications of:
Lifelong infection (>200 million
carriers worldwide
Hospitalization
Cirrhosis (scarring) of the liver
Liver cancer (cause of 80% of cases)
Death
HBV virus can live up to a week on a
dried environmental surface.
For more information about Hepatitis B:
www.liverfoundation.org
HEPATITIS B VACCINATION
is one way to minimize your risk
 Three shots in upper arm over a 6-month period (0, 1, 4-6
months)
 Low incidence of side effects, people should not get the
vaccine if they have had a life threatening allergic
reaction to baker’s yeast or to a previous dose of
hepatitis vaccine
 Routine booster doses are NOT recommended for any
group
 Post vaccination blood testing is recommended for certain
healthcare workers
Hepatitis B shots are required for all school-age children.
For more information about the
vaccine, check this website:
www.cdc.gov/ncidod/diseases
/hepatitis/b/factvax.htm
Freehold Borough School District
offers hepatitis B shots to
employees who are likely to incur
occupational exposure to blood or
other body fluids.
See The Exposure Control Plan for
more details, or speak with the
School Nurse.
If you decide against
vaccination, you need to
sign a declination form.
However, you remain eligible
for vaccination if you desire
it at a later time.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
•Life-threatening virus
•compromises the body's immune system
spread most commonly through sexual
contact
•or by contact with infected blood and
body fluids
Early symptoms may be similar
to those of the flu
(fever, diarrhea, fatigue)
This virus can be carried for several years
without showing symptoms (asymptomatic)
Eventually, Aids will develop..
AIDS destroy the body’s ability to fight
infections, and certain cancers, and
will lead to death.
There is no vaccine to prevent AIDS
For more information about AIDS :
www.aegis.com
Does my job put me at risk for occupational exposure?
Being at risk for occupational exposure at a job means:
The performance of the employee's duties have anticipated
contact with blood or other potentially infectious materials
(OPIM).
·
The blood or infectious materials can enter a body through
· non-intact skin
· mucous membranes (eyes, nose or mouth)
· parenterally (piercing mucous membranes or the skin
barrier through such events as needlestick, human
bites, cuts and abrasions)
STAFF AT RISK FOR OCCUPATIONAL EXPOSURE
Healthcare staff ( Nurse)
preschool disabled staff,
Building & Grounds Services,
coaches,
special education paraprofessionals ,
assistant and building principals, epinephrine delegates –
You may be at risk If you do the following tasks on a regular
basis:
Involved in biting incidents
First aid for injuries
Diapering/toileting
Tooth brushing
Feeding
Body Fluid cleanup
Epinephrine administration
If your job duties include any of the above, you must be
very careful about practicing standard/universal precautions.
EXPOSURE CONTROL STRATEGIES





Universal & or standard precautions
good personal work habits
personal protective equipment (PPE)
decontamination
procedures for accidental exposures
UNIVERSAL PRECAUTIONS


Treating all blood and
body fluids as
potentially infectious for
HIV, HBV and other
bloodborne pathogens
Applies to bloodborne
pathogens while
Standard Precautions…
Standard Precautions
Applies to all body fluids (not just those
affected by bloodborne pathogens).
Affects all employees, includes the following:
 Avoidance of body fluid exposure
 Glove use and handwashing
 Good Samaritan Law- act promptly to the
best of your training and ability and act until
help arrives or exhaustion
Training is done annually by school nurse
EXPOSURE CONTROL STRATEGIES
Interrupt the chain of infection by using the
following preventive measures:
• Wash your hands (remove pathogens before they
can enter the body).
• Use personal protective equipment (PPE)
(prevent contact with infectious materials.)
• Use caution when handling needles and other
sharp objects. Contaminated sharps must be placed in
puncture resistant containers labeled with a biohazard
label. Do not recap!
Sharps containers are in the Health Offices.
Exposure Control Strategies cont…
.
Additional information on needlestick prevention
at:
http://www.cdc.gov/niosh/2000-108.html
•Finally, Receive a Hepatitis B vaccination to
decrease your susceptibility to the disease.
Presently, no vaccine for HIV is available.
HANDWASHING
Washing your hands with soap under running water
for at least 30 seconds of friction rubbing, then dry thoroughly.
Shut off the faucet with the items you were drying with- not with your
clean hands. Remember, you turned it on with dirty hands!
No access to running water?:
Instant gel hand sanitizer,containing alcohol, or towelettes,
Remember: Handwashing is the best way
to avoid the spread of any infection!
Hands unconsciously touch the eyes, nose, and mouth
numerous times throughout the day.
These body areas are potential portals of entry for
infectious organisms.
Handwashing cont…
Because of potential infection, it is extremely important to wash your
hands frequently. Wash hands immediately if you contact
contaminated material. Wash them after:
•handling infectious waste, even if it is properly contained
•removal of gloves
•using the restroom
•wash your hands before going on breaks and before l
leaving work at the end of the day.
Wash your hands frequently.
Encourage your students to do the same.
How can you minimize your risk?

Always wear gloves when giving first aid for wounds.

Allow students to cleanse their own bloody wounds
when possible. Direct them to self care when possible.

Wash hands as soon as possible after removal of
gloves or other personal protective clothing/
equipment or after contact with blood or body fluids.

Wear protective equipment if splattering of body
fluids is anticipated.

Dispose of sharps (hypodermics, needles, lancets,
scalpel blades, etc.) in sharps containers located in the
health office.

Do not eat, drink, apply cosmetics or handle contact
lenses in locations where there is a likelihood that an
occupational exposure could occur.

Call the custodian to clean up contaminated areas
immediately.
The custodian will…
Wear gloves when emptying waste receptacles and carry trash away
from body. Utility gloves may be decontaminated for reuse if their
integrity is not compromised. The decontamination procedure will
consist of soaking in viricidal solution. Discard utility gloves when they
show signs of cracking, peeling, tearing, puncturing or deterioration.
New gloves may be obtained from building and grounds services.
 Decontaminate work surfaces with an appropriate disinfectant
(virucidal for both HIV and Hepatitis B) following directions on
container, immediately after any spill of blood or other potentially
infectious materials and at the end of the work shift when surfaces
have been contaminated since the last cleaning.
Always use mechanical means such as tongs, forceps or a brush and
dust pan to pick up contaminated broken glassware or any type of
sharp instruments; never pick up with hands even if gloves are worn.
Discard contaminated sharps in sharps containers available in health
office.
Always Use
Mechanical
Means to
Clean Up a
Contaminated
Spill
PERSONAL PROTECTIVE EQUIPMENT
Barriers you wear to prevent contact
with infectious materials .
Where are they located?
Non latex gloves are located:
health offices,
custodians’ offices
preschool changing area
bathrooms for toileting disabled children
*every staff member will be provided non latex
gloves upon request, contact your
school nurse
Utility gloves- custodians, grounds &
maintenance personnel
CPR masks – nurse's key ring, emergency kit in
health office and with AED
Barrier gowns- health offices
Face masks/shields- health offices
GLOVE REMOVAL
•With both hands gloved, peel one
glove off from top to bottom 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.
· Dispose of the gloves
promptly.
· Never touch the outside of
the glove with bare skin.
· Every time you remove your
gloves wash your hands with
soap and water as soon as
possible.
WHAT IS AN EXPOSURE ?
An exposure is any contact between one person’s blood or body fluids
with the broken skin or mucous membranes of another person or
through a needle stick, puncture wound, or bite.
If an Exposure Occurs:
1. Wash hands or exposed skin immediately with soap and
water.
2. Flush eyes or other exposed mucous membranes with
running water.
3. Report incident immediately to your supervisor and school
nurse if during regular school hours. If after school hours,
contact Qual Care at 1-800 425-3222 for a referral for an
immediate confidential medical evaluation. Notify the
building nurse the next school day.
For additional information refer to Bloodborne Pathogens
Exposure Control Plan- Post Exposure Evaluation
Important Note for
Employees
If the employee cannot contact
the principal, supervisor or
department manager, he or she
may contact the School Nurse
and Qual Care directly.
WHAT HAPPENS IF YOU ARE EXPOSED?
Remember to report all exposures…..
•to the school nurse
•and supervisor/administrator.
You will be referred to Qual Care at 1-800-425-3222 for an
immediate confidential medical evaluation.
(Refer to Bloodborne Pathogens Exposure Control Plan)
The confidential medical evaluation and follow up may include:
· Obtaining consents for necessary testing
· Necessary immunizations
· Blood testing
All post-exposure evaluation and follow-up
is done through Qual Care.
“The single most important
thing we can do……..
To keep from getting infectious
disease and spreading them to
others is to clean our hands.”
-Dr J Daly, Am. Society of Microbiology


Take 30 sec to lather up
Or reach for the hand sanitizer
2007 Observational Studies on Handwashing
(done on behalf of ASM and the Soap & Detergent Assoc.,
by Harris Interactiv) :
In a Separate phone survey
92% of
adults report washing their hands.
Yet, Observed in four cities and six different
locations:
ONLY 77% of men and women
actually washed their hands.
Cities ranked
cleanest to dirtiest hands:

Chicago on top: with 81% lathering up
@ Museum of Science and Industry/Shedd Aquarium

New York ,second with 79%
@ Penn & Grand Central Station

Atlanta : 75%
@ Turner Field

San Francisco: 73%

@ Ferry Terminal Farmers Market
Gender Differences?
Who’s better at handwashing hygiene?
Women or Men?
Women outwashed men:
86% to 66%
Some other Gross Statistics you didn’t
want to know:
• 50% of middle and high school students
say they wash after toileting
• of these 33% of females and only 8% of males
used soap while washing hands ;
•Only 34% of respondents say they wash their
hands after coughing or sneezing ( up from 32%
in 2005)
Worldwide: Infectious diseases
remain the leading cause of
death!


Many cases of colds, flu, and foodborne
illness are spread by unclean hands each
year
These diseases are responsible for billions
of dollars each year in healthcare
expenditures and productivity losses in
the USA.
Spread the word……
Spread good hygiene!
Wash you hands often.