You will now begin the Bloodborne Pathogen Refresher Training. The following program will review your occupational risks and the steps that you and your Client must take to reduce your risks of exposure. 1
Employees must report any occupational accident, illness, or hazardous exposure to their Client AND by phone to the office (612-789-0049) Contact the office if you have any questions regarding medical or infection control issues. 2
Bloodborne Pathogen Training PEP Bloodborne Pathogen Exposure Control Program A Written Plan available from Office (612-789-0049) or website at www.pepeople.org Identifying Those at Risk BBP Training Providing information on Hep. A & B Immunizations Preventing Exposures Evaluating & Treating Exposures Properly Disposing of Waste 3
Bloodborne Pathogen Training In addition to blood, other fluids may also present an infection risk. OSHA defines these as Other Potentially Infectious Materials or OPIM. These are listed below. Synovial Fluid Semen Peritoneal Fluid Pericardial Fluid Cerebraspinal Fluid Bloody Body Fluids Pleural Fluid Amniotic Fluid Saliva in Dental Procedures Vaginal Secretions HIV or HBV Cultures Unfixed Tissue 4
Bloodborne Pathogen Training Bloodborne Pathogens are pathogenic microorganisms that are present in human blood and can cause diseases in humans. Commonly we emphasize Hepatitis B, Hepatitis C, and HIV (Human Immunodeficiency Virus) in the health care setting. Exposure to these pathogens may result in serious illness or death! 5
Bloodborne Pathogen Training Employer Responsibilities Include Implementing a written plan. Enforcing good work practices that include disinfecting surfaces, following universal precautions, and proper waste disposal. *Will be managed by Client* Controlling potential exposures. *Will be managed by Client* Training employees initially and through annual updates. Providing Personal Protective Equipment (PPE): sterile gloves, gowns/aprons, eye protection (i.e., goggles, faceshields, side shields) and surgical mask. *Will be provided by Client* Identifying hazards. Managing medical wastes. *Will be managed by Client* 6
Bloodborne Pathogen Training Individual Responsibilities Your Actions are key to good exposure control. These include: Active engagement during training. Complying with and enforcing the PEP Exposure Control Plan. Segregating medical waste properly. Properly selecting, wearing, removing, and disposing of Personal Protective Equipment (PPE). 7
Bloodborne Pathogen Training Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) Bloodborne viruses Can produce chronic infection Transmissible in healthcare settings The vaccine for Hepatitis A and B are available from your County Public Health Department. 8
Bloodborne Pathogen Training Preventing Transmission of Bloodborne Viruses in Healthcare Settings Understand the importance of Hepatitis B vaccination Treat ALL blood and bodily fluid as potentially infectious Use barriers to prevent blood contact Prevent percutaneous injuries Safely dispose of sharps and bloodcontaminated waste materials, including needles, razors, bandages, etc. 9
Hepatitis B 10
Bloodborne Pathogen Training Hepatitis B - Symptoms Only a small portion of acute Hepatitis B infections may be clinically recognized. Symptoms include: Anorexia or loss of appetite Vague abdominal discomfort Nausea and vomiting Sometimes arthralgias and rash Jaundice or yellowing of the skin Fever which may be absent or mild 11
Bloodborne Pathogen Training Hepatitis B Modes of Transmission Modes of transmission: Accidental injury (such as by a sharp object that is contaminated.) Direct exposure (such as transmission through open cuts, skin abrasions, or dermatitis to potentially infectious materials.) Indirect exposure (such as by touching a contaminated object and then your mouth, eyes, nose or open skin.) 12
Bloodborne Pathogen Training Hepatitis B Vaccine Available A safe and effective vaccine against Hepatitis B is available through your County Public Health. You are potentially at risk if you have direct contact with blood and other potentially infectious body fluids. It doesn t matter how frequently you have contact or that you take precautions when you do. The vaccine is generally thought to be 95-97% effective in producing antibodies against hepatitis B. It is usually administered as a series of 3 injections over a 6-month period. However, it sometimes takes up to 5 injections for the vaccine to be effective. No serious adverse reactions to the vaccine have been reported. 13
Hepatitis C 14
Bloodborne Pathogen Training Hepatitis C Virus Most common chronic bloodborne infection in U.S. 3.9 million Americans (1.8%) have current or past infection with HCV 40% of chronic liver disease HCVrelated, leading to 8-10,000 deaths annually HCV-associated end-stage liver disease most common indication for liver transplants in U.S. adults 15
Bloodborne Pathogen Training HCV Transmission in Healthcare Settings Risk factors for occupational transmission not well defined Environmental transmission not believed to be important - HCV rapidly degrades at room temperature Neither presence of antibody nor HCV RNA is a direct measure of infectivity 16
Typical symptoms include jaundice, fatigue, abdominal pain, loss of appetite, intermittent nausea vomiting HCV Transmission in Healthcare Settings 17
Is There a Vaccine or Treatment for Hepatitis C? There is no vaccine for Hepatitis C. There are some drugs licensed for the treatment of individuals with long-term HCV. About 2-3 out of every 10 patients who are treated gets rid of the virus. Treatment with immune globulin is not recommended. HCV Vaccination 18
HIV 19
Blood-borne Pathogen Training HIV Symptoms Within several weeks to several months after infection with the human immunodeficiency virus (HIV), many people develop an acute self-limiting mononucleosis-like illness lasting for a week or two. Infected people may then be free of clinical signs for many months to years before clinical manifestations, Including opportunistic infections and constitutional and neurological symptoms appear. American Public Health Association Acquired Immunodeficiency Virus, Benenson, AS, ed, Control of Communicable Diseases Manual, Washington, 1995. 20
HIV Symptoms Enlarged lymph nodes (swollen glands) in the neck, armpits or groin Raised purple areas on the skin, mouth, eyes, nose or anus Thrush (candida), a white coating of the mouth or throat, caused by a fungus Sudden weight loss that is not explained by dieting or other reasons Fever and/or night sweats Repeated bouts of diarrhea Fatigue that is not explained by other causes A dry cough that does not go away 21
The main diseases people with AIDS develop are: Pneumocystis carinii pneumonia -- a rare type of pneumonia Kaposi's sarcoma -- a rare form of skin cancer Severe cases of other infections including herpes simplex, tuberculosis, candida (thrush) and severe diarrhea 22
Blood-borne Pathogen Training HIV Modes of Transmission Blood Contacts needle sticks and exposure of skin and mucous membranes Sexual Contact exchange of vaginal secretions and semen Mother to Infant transmission can occur throughout the perinatal period during pregnancy, at delivery & through breastfeeding Although other modes of transmission (i.e., mosquitoes and kissing) have been suggested, none have been substantiated as distinctly different as those mentioned above. 23
Blood-borne Pathogen Training HIV No Vaccine Available Research continues toward the development of an AIDS vaccine. There is no vaccine available for the prevention of HIV infection. 24
Exposure Prevention 25
Get HBV vaccination Treat all blood and other potentially infectious materials as if they were contaminated with HIV or HBV. Standard Precautions must be used when handling feces, nasal secretions, sputum, sweat, tears, urine or vomit. Use devices engineered to prevent exposures (Sharps container). Wear sterile, latex gloves when performing duties that expose you to bodily substances. *Wash hands after removing gloves.* Follow proper disposal methods. Prevent Hazardous Exposure 26
Don't eat, drink, smoke, apply cosmetics or lip balm, or insert or remove contact lenses in areas where you could be exposed to blood or other potentially infectious materials. Clean and decontaminate your work area at the end of each work shift. Possible areas of contamination that are non-waste items include countertops, sheets, clothing, etc. Dispose of contaminated sharps in an appropriate sharps container immediately after use. Prevent Hazardous Exposure (Con t) 27
Blood-borne Pathogen Training Proper Disposal Double bagging method with tissues, Band-Aids, bandages, sanitary napkins, and used gloves. Needles and blades placed in Sharps container. Sharps containers must be changed frequently enough so that they never become overfilled. To reduce the potential of injury due to an overfilled container, replace the sharps container when it is ¾ full. 28
Exposure Response 29
Blood-borne Pathogen Training I ve Been Stuck!! Now What?! Promptly wash or flush the affected area, notify your Client, and seek medical treatment immediately! For needle sticks or cuts, squeeze the area under running water (warm if possible) until it bleeds. For skin contact, wash the area with soap and running water for several minutes. For eye contact, flush the eyes with copious amounts of running water. Do not vigorously disrupt the skin. Do not use bleach or other strong chemicals to clean an exposure or other wound site. Harsh chemicals can damage the skin and increase chances of infection through the skin. The CDC currently recommends treatment Within 2 hours of exposure. 30
Blood-borne Pathogen Training Where do I go to be evaluated and treated? Post-exposure treatment should be sought immediately if there is a known exposure with possible transmission of infectious material. Contact your primary care physician, nearest urgent care location or county public health department for immediate assistance. 31
Blood-borne Pathogen Training When should I be evaluated? Promptly! You need to be evaluated as soon as possible after the exposure so that the severity of the injury can be assessed. Serious exposures will require the initiation of drug therapies that are believed to be most effective when given within a few hours of the exposure. Contact your primary care physician, nearest urgent care location or county public health department for immediate assistance. 32
Blood-borne Pathogen Training Must I do anything else? YES! People Enhancing People employees, after appropriate medical evaluation, need to call the office (612-789-0049) and complete a First Report of Injury Form with the Care Manager. 33
Blood-borne Pathogen Training Hand Washing One of the best techniques for infection control is using plenty of soap and water when washing your hands! A critical method of reducing your risk of transmission is proper hand washing, including using antibacterial soap, washing for at least 30 seconds, and pointing your hands facing down when rinsing in the sink. Be sure to wash before and after all Client contacts! 34
Blood-borne Pathogen Training Conclusion: Prevention is key! You are at risk for occupational exposure to Bloodborne Pathogens. The People Enhancing People Exposure Control Plan outlines the steps necessary to reduce infection risk. Copy available from the office or online at www.pepeople.org When accidents occur, prompt medical attention is necessary. The CDC recommends treatment within 2 hours. 35
1. Blood Borne Pathogens are pathogenic microorganisms that are present in human and can cause disease in humans. 2. What are the 3 modes of transmission of Blood-Borne Pathogens? Accidental by a sharp object that is contaminated. Direct of open cuts, skin abrasions, or dermatitis to potentially infectious materials. Indirect by touching a contaminated object and then your mouth, eyes, nose or open skin. List the top three (3) Must do of hand washing: Use anti-bacterial. Wash for at least seconds. Point hands facing when rinsing in the sink. True or False You do not need to wash your hands after providing care if you wear gloves. List two (2) examples of waste items that might be contaminated with infectious material: a. b. ***RETURN THIS PAGE (1 of 3)*** 36
List two (2) examples of non-waste items that might be contaminated with infectious material: a. b. Where can you get information regarding the hepatitis vaccination? List three (3) ways to protect yourself from infectious disease while working as a PCA: Wear latex when performing duties that expose you to bodily substances. Wash before and all client contacts, with proper hand washing techniques. Use proper disposal methods when disposing of items that may be contaminated with substances. If a potential exposure has occurred, I should follow the washing instruction on slide 30 and then notify my and seek immediately. ***RETURN THIS PAGE (2 of 3)*** THANK YOU! 37
You have now completed your Annual Bloodborne Pathogen Refresher training. To receive credit, please sign this Training Certification Form and mail or fax it to the office (fax 651-234-0864) along with your quiz on pages 36 and 37. Name: Signature: Date: ***RETURN THIS PAGE (3 of 3)*** THANK YOU! 38