Volunteer Services: Bloodborne Pathogens

Bloodborne Pathogens How to Protect Yourself 2024

August 24, © 2023 UnityPoint Health Proprietary and Confidential

Objectives At the end of this course, the learner should be able to: • Recognize tasks that may involve exposure to blood or other infectious materials • Select safety equipment to use in the clinical area to prevent exposure to bloodborne pathogens (BBP) • Discuss reporting an exposure to BBP

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What are Bloodborne Pathogens?

Bloodborne pathogens (BBP) are infectious viruses in •

Human blood

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Body fluids (but not sweat)

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Other potentially infectious material

Bloodborne pathogens cause disease

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How can exposure to BBP happen?

• Needle stick or cut • Contact with mucous membranes or nonintact skin (e.g. skin that is chapped, scraped, or has dermatitis) • Splash of blood or fluid to eyes or mucous membranes • Human bites

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What is the risk from exposure?

The risk is based on the: •

Bloodborne pathogen

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Depth of the wound

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Viral load of the patient who is the source

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Amount of blood/body fluid

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Type of exposure

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What exposures have more or less risk?

• Deep needle sticks and sharps injuries have a higher risk of BBP • Hollow-bore needles have the highest risk • Splashes to mucous membranes have a lower risk for BBP

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What common diseases can occur from BBP? The three most common bloodborne disease risks for health care workers (HCW) are from •

Human Immunodeficiency Virus (HIV)

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Hepatitis B Virus (HBV)

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Hepatitis C Virus (HCV)

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HIV HIV is a viral infection of the immune system. The person is unable to fight off other disease.

•

•

HIV can be spread by: • Sexual contact with an infected partner •

Sharing needles

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Infected mother to her baby

HIV is NOT spread by: • Telephones, door knobs, toilet seats, or mosquito bites •

Shaking hands, a hug, being coughed or sneezed on

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Eating food prepared by an HIV-positive person

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Donating blood

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HIV (continued) • The risk of getting HIV from a blood transfusion is very low. Blood supplies are tested.

• If exposed to HIV through a needle stick, sharps injury, or a splash, the risk of getting the disease is 0.09-0.3% • The risk is much less when preventative medicines are taken as soon as possible after the exposure • Signs of HIV may be many years after the infection • A person can infect others even though they do not look or feel sick

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Hepatitis B Hepatitis B is a virus that affects the liver. Many people who are infected with the virus do not have signs.

• Signs of Hepatitis B include: • Yellow skin color • Dark urine • Lightened stool color • Nausea • Vomiting • Feeling of illness

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Hepatitis B (continued) Hepatitis B can be spread by: • Sexual contact with an infected partner • Sharing needles • Infected mother to her baby during birth

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Hepatitis B (continued) The Hepatitis B vaccine is available to all employees who may be exposed to blood or other potentially infectious material (OPIM) •

The vaccine (a series of two or three injections, depending on which brand of vaccine is used) is offered at no charge

• •

The vaccine may be started at any time If exposed to Hepatitis B by a needle stick, sharps injury, or a splash, the risk of getting the disease is anywhere from 1-62%, based on the severity of the exposure •

•

The risk drops to almost 0% if the series of injections has been completed If you are confirmed immune to Hepatitis B, there is no recommendation to be checked again or to be given boosters

•

Search for “Hepatitis B Vaccine” at UPH Policies

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Hepatitis C Hepatitis C is a virus similar to Hepatitis B •

Hepatitis C is the most common BBP transmitted through blood exposure

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70% of Hepatitis C patients have no signs

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Hepatitis C can be spread even when there are no signs

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About 15% of people who become infected with Hepatitis C fight off the infection and do not spread it to others

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Hepatitis C (continued) •

If exposed to Hepatitis C through a needle stick, sharps injury, or a splash, the risk of getting the disease is 0 to 7%

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The virus may be dormant (or not do anything) for 10 to 20 years before causing signs of fatigue, loss of appetite, and abdominal pain

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Screening tests for Hepatitis C started in the early 1990s

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Blood transfusions are no longer a source of Hepatitis C

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There is no vaccine to prevent Hepatitis C, but there is treatment

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What if I am exposed to BBP? •

First, wash needle sticks and cuts with soap and water

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Flush splashes with water

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Irrigate eyes with water, saline, or sterile solution for 15 minutes

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Notify your immediate supervisor and seek evaluation and treatment through:

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Regional Employee Health or

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Emergency Department

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Complete an incident report through RL Datix Reporting

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Report the exposure right away •

Treatment should start within 1 to 2 hours of the exposure

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Prompt treatment reduces the risk of the virus infecting cells

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In high risk exposures, treatment should start before waiting on source patient testing

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Prompt reporting ensures the source patient can be contacted before they leave the hospital

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Blood is tested for Hepatitis B, Hepatitis C, and HIV

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Rapid HIV testing of source patients can help with timely decisions about the use of HIV Post-Exposure Prophylaxis (PEP)

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What is PEP? •

PEP is Post-Exposure Prophylaxis, or prevention after an exposure

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PEP for HIV involves taking medicines as soon as possible within 2 hours, but no more than 72 hours (3 days), after exposure. This reduces the chance of becoming HIV-positive

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The medicines prevent HIV from making copies of the virus and spreading through the body

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Three medicines are usually prescribed and must be taken for 28 days

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How do I prevent BBP exposure?

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Refuse to rush or be distracted

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Ask for help if the patient is fighting, not cooperating or semi-sedated

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Protect your eyes and mucous membranes – consider when splashes/sprays may occur, and wear face and eye protection

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Double glove during surgical procedures

• •

Use the smallest gauge needle that will do the task Use hands-free passing of sharps to others, i.e., place sharps in a neutral zone or dispose of sharp after use rather than handing it to a coworker for disposal

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How do I prevent BBP exposure?

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Know where needles and sharp objects are placed

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Never handle devices by the sharp end, even if covered by a safety device

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Activate safety on needle or sharp immediately after use

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Dispose of needle or sharp immediately – do not lay it down for disposal later

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Prevent BBP exposures Labeling and Disposal •

Containers that may have infectious materials or biohazard wastes are labeled with the universal biohazard symbol and the word “Biohazard”

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Used sharps need to be put in the biohazard boxes in patient care areas and medicine rooms

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Counter sharps containers must be secured in needle box stabilizers

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Prevent BBP exposures Personal Protective Equipment (PPE)

PPE includes: gloves, liquid-resistant gowns, goggles/face shields, masks •

PPE is provided for all employees

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It is your responsibility to use the PPE for the clinical situation Wear gloves for exposure to blood, body fluids, contaminated items, mucous

•

membranes, and non-intact skin •

Wear gowns when clothing/scrubs may be soiled

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Wear eye protection … see the next slide

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Prevent BBP exposures •

Wear eye protection when blood is very likely to be involved, such as: • • • • • • • • • • •

Starting and discontinuing an IV Drawing blood and ABGs Turning/caring for patient who has a ventilator During intubation Irrigation of any type Stoma/Fistula care Emptying urine bag, urinal, JP drain, and bed pan Handling and disposing of blood and body fluids Dressing change Glucometer testing Lumbar Puncture

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• • • • • •

Surgery Baby delivery Trauma Endoscopy procedure Medical emergency Patients who are known to spit

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Prevent BBP exposures • Eye glasses do not give enough protection • Wear masks and eye protection during procedures and patient care when there can be splashes or sprays of blood, body fluids, secretions, and excretions • Before leaving the patient care area, remove PPE and place it in the trash

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What’s wrong with this picture?

This picture shows safer use of PPE was needed.

Based on the blood splatter, 1. a face shield should have been used 2. gloves should be used to handle these items

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Prevent BBP exposures Safety Devices

Practice activation of safety devices before use on a patient •

Activate the safety device immediately after use •

Ensure safety device is fully engaged – hear the click and see the needle is covered

•

Never recap a used needle unless properly trained to use a mechanical device or a one-handed technique

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Prevent BBP exposures Safety Devices continued

Practice activation of safety devices before use on a patient •

Keep hands away from needle tip at all times, both before and after activation of the safety device

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Do not try to override or defeat the safety lock

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Report defective safety devices or problems with activation to your manager

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Use safety devices and protect yourself Remember: Safety devices are not perfect. Do not rely only on the safety feature to protect you. Never hold a syringe at the needle end.

The best person to prevent needlestick and sharps injuries is you!

•

Dirty broken glass is cleaned up using tongs, broom, pieces of cardboard, or what you have in your work area… Not your hands

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How do I learn more and where do I find our Bloodborne Pathogen Exposure Control Plan?

Please contact the UnityPoint Health – Des Moines Volunteer Services Team:

Blank Children’s Hospital and Iowa Methodist Medical Center

Office Location: Powell 2, Room 218 Phone: (515) 241-6414 Email: dm_volunteers@unitypoint.org © 2023 UnityPoint Health Proprietary and Confidential

Iowa Lutheran Hospital

Methodist West Hospital

Hospital Location: First Floor, Mid Wing Phone: (515) 263-5227 Email: dm_volunteers@unitypoint.org

Office Location: Ground Floor, Room 1188 Phone: (515) 343-1088 Email: dm_volunteers@unitypoint.org

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Attestation of Completion Thank you for completing this training module.

You must now electronically sign the completion form to acknowledge that you have: • •

Read the Bloodborne Pathogens Training document in full.

Understand how to obtain a copy of UnityPoint Health’s Bloodborne Pathogen Exposure Control Plan.

The electronic/online form is accessible through a separate link that was provided to you by UnityPoint Health – Des Moines Volunteer Services. If you do not have the link to the completion form, please contact your Volunteer Coordinator for this information.

August 24©, 2023 UnityPoint Health Proprietary and Confidential

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