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. •
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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
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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? •
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? •
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
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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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