training - 2011.ppt
TRANSCRIPT
Session ObjectivesYou will be able to:• Identify bloodborne pathogens (BBPs)• Understand how diseases are transmitted• Determine your risk of exposure• Protect yourself from exposure through
prevention• Respond appropriately if exposed• Understand your right to medical evaluations
Positions Who May Have Occupational Exposure
• Deputies/Detectives• Corrections/Juvenile Detention Officers• Shelter Home Youth Workers• Public Health Nurses• Custodial Workers• Highway Workers• Park Maintenance Workers• Airport Maintenance Workers• Library Branch Workers• Aging Disability Resources Specialists• Site Managers• Nutrition/Transportation Drivers• Designated First Responders• Medical Examiner and Deputy Medical Examiners• Etc.
What Are Bloodborne Pathogens?• Disease-causing microorganisms in human
blood:• Viruses, bacteria, parasites, fungi
• Primary workplace pathogens• Human immunodeficiency virus (HIV)• Hepatitis B virus (HBV)• Hepatitis C virus (HCV)
HIV • Leads to AIDS
• Attacks and depletes the human immune system
• Does NOT survive outside the body
Hepatitis B Virus • 1-1.25 million people
infected
• Chronic liver disease, liver cancer, death
• Vaccine is available
• Can survive outside the body; 1 week in dried blood
Hepatitis C Virus (HCV)• 3.9 million Americans are infected
• 70% suffer chronic liver disease
• 8,000 to 10,000 deaths/year
• Drug treatment effective in only 10% to 40% of persons
• Can survive outside the body
Transmission of Pathogens• Contact with infected
blood
• Body fluids containing infected blood
• Cut by a contaminated sharp objects or needles
Routes of Entry• Mucous membranes
• Eyes• Nose• Mouth
• Non-intact skin• Cuts• Abrasions• Dermatitis• Hangnails
Routes of Exposure• Co-worker suffers a bleeding
injury
• Administering first aid
• Touching a contaminated surface
• Assigned to clean up blood
Routes of Exposure (cont.)
• Contact with contaminated paper products or equipment in restrooms
• Using a tool covered with dried blood
• Cuts from other contaminated sharps (broken glass, razor, etc.)
• Bite which punctures/penetrates the skin
Bloodborne Diseases—Any Questions?Any questions about:
• The definition of bloodborne pathogens?
• Transmission of bloodborne pathogens?
• How you could be exposed?
Protect Yourself• Review your Department ECP• Take universal precautions• Use personal protective equipment• Follow safe work practices• Get the Hepatitis B vaccination• Follow decontamination and disposal
procedures
Universal Precautions• Treat all blood and
bodily fluids as if infected
• Use barrier protection (gloves, masks, aprons, eyewear) to avoid contact with infected bodily fluids
• Immediately clean up and decontaminate surfaces and equipment
From: osha.gov
Protective Barriers• Gloves• Eye protection• Clothing or aprons• Nose and mouth
protection• CPR mask• Impromptu barriers
Safe Work Practices• Remove contaminated PPE and clothing
• Disinfect contaminated equipment/surfaces
• Wash up immediately after exposure
• Dispose of contaminated items
Avoid Puncture Wounds• Use tongs, forceps, or
similar tools to pick up contaminated items, especially to protect against sharp objects
• Never pick-up broken glass or sharps with your hands
Safe Work Practices—Do’s• Remove contaminated PPE and clothing
before leaving the work area• Disinfect contaminated equipment• Wash up immediately after exposure• Seek immediate medical attention• Double-glove to reduce contamination risk• Dispose of contaminated items properly
Safe Work Practices—Don’ts• No eating, drinking, cigarettes, cosmetics or
other personal items in any work areas where there is the possibility of exposure to blood
• Do not place or store food on bathroom shelves, cabinets, countertops, or work surfaces in any work areas where blood or bodily fluids may occur
ECP, Precautions and Safe Practices—Any Questions?
• Are there any questions about the ECP?
• Any questions about universal precautions or PPE?
• Any questions about safe practices?
Decontamination• Wear appropriate
gloves (latex free)
• Bleach solution – ¼ cup bleach per gallon of water
• Immediately dispose of PPE, towels, rags, and other contaminated items
Biohazard Waste Disposal• Liquid or semi-liquid blood or
other potentially infectious materials (OPIM)
• Contaminated items that would release blood or OPIM if compressed
• Contaminated sharp objects
• Items caked with dried blood or OPIM, capable of release during handling
Label Waste Containers• Labels communicate
a hazard
• Universal biohazard symbol
• Red containers may be substituted for labels
Biohazard Disposal—Unregulated Waste• Blood or OPIM absorbed without the release of
liquid when compressed
• Band-aids or tissues
• Gauze, paper towels, and disposable PPE
• Absorb all liquid
• Double bag waste
Exposure Incident• Wash cuts and skin
thoroughly • Rinse nose and mouth• Flush eyes with clean
water or sterile solution• Clean all contaminated
surfaces• Report accidents
involving blood• Go to emergency room
Post-Exposure Evaluation• Report incident to your supervisor• Complete County’s injury/accident report
form• Complete “determination of exposure to
blood/body fluids” form accurately and with as much information as possible
• Document route(s) of exposure and how exposure occurred
Post-Exposure Follow-Up• Physician needs to determine that there was a significant
exposure
• The County allows an employee to seek a second opinion with their personal physician at the County’s expense.
• County provides risk counseling and offers post-exposure protective treatment for disease when medically indicated
• Physician provides written opinion of findings to County (CONFIDENTIAL) and copy to employee within 15 days of the evaluation.
Post-Exposure Follow-Up• Obtain consent from the source individual to have
blood test – County will pay charges
• Exposed employee should also have their blood tested as soon as possible after exposure incident
• Court Order can be obtained from District Attorney’s Office if source person does not consent
Court Ordered HIV Testing of Source Person Applies
• Wisconsin Statute provides a provision to have source person blood tested for the presence of HIV.
• The District Attorney will help determine if the necessary conditions apply to obtain a court-order, such as using universal precautions, proper forms, significant exposure certification, affected person category, consent to test source person, consent attempted and refused, etc.
Court Ordered HIV Testing of Source Person Applies"Affected persons" includes the following categories of workers:
• EMT's, fire fighters, peace officers, correctional officers, State Patrol officers, health care providers, and employees of health care providers, first responders, jailers and keepers of a jail, persons employed at a State juvenile secured correctional facility, staff members of State crime laboratory.
• "Peace officer" is further defined as any person vested by law with a duty to maintain public order or to make arrests for crimes, whether the duty extends to all crimes or is limited to specific crimes.
• "First responder" means a person who, as a condition of employment or as a member of an organization that provides emergency medical care before hospitalization, provides emergency medical care to a sick, disabled or injured individual before the arrival of an ambulance, but who does not provide transportation for a patient.
Court Ordered HIV Testing of Source Person Applies
Significant Exposure Involving Autopsy or Corpse
• In the case of significant exposure involving an autopsy or a corpse, testing may be ordered by a coroner, medical examiner or physician if certain conditions are met and a request for testing and disclosure is made.
Hepatitis B Vaccination• Endorsed by medical communities• Safe when given to infants, children,
and adults• Offered to all potentially exposed employees• Provided at no cost • Vaccination declination
Blood Titre Test• The County provides at no cost
• Shows if the Hepatitis B series was effective
• Highly recommended because immunity does not always occur with the 1st series.
• If results are not effective - - recommend another full series of Hep B Vaccine
Decon, Disposal, and Incidents—Any Questions?
• Any questions about decontamination and disposal of blood or OPIM?
• Any questions about exposure incidents?
• Any questions about the Hepatitis B vaccination?
Key Points to Remember• Bloodborne pathogens can cause fatal disease
• Be aware of exposure at work
• Take universal precautions• Use PPE and safe work practices• Decontaminate yourself and equipment
• Understand and follow exposure incident procedures
• Report incidences of exposure
QuizHIV and Hepatitis B can be
transmitted when infected bodily fluids directly
contact the eyes or non-intact skin.
True or False
Quiz
The risk of exposure toBloodborne Pathogens is only
possible when blood is present in the bodily fluid.
True or False
Quiz
Treating all bodily fluids as though they are infectedis known as
______________________ precautions.
Quiz
Besides the disinfectant/cleanerprovided in first-aid kits, what other
solutions can be used todecontaminate equipment
or surfaces?