Training The Standard Issued in 1991 by OSHA applies to all occupational exposure to blood or other potentially infectious materials Revised in 2001 to include the Needle stick Safety and Prevention Act ID: 660628
Download Presentation The PPT/PDF document "Bloodborne Pathogens Initial" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Bloodborne Pathogens Initial
TrainingSlide2
The Standard
Issued in 1991 by
OSHA
.
“…applies to all occupational exposure to blood or
other potentially infectious materials
.”
Revised in 2001 to include the Needle stick Safety and Prevention Act.
Intent is worker protection
Hard copies available
Available onlineSlide3
Requirements of The Standard
Employers are required to:
Establish an Exposure Control Plan and keep it updated
Provide
annual
safety training for employees
Ensure engineering controls are in place
Provide personal protective equipment (PPE)
Ensure employees are offered Hepatitis B vaccination free of chargeSlide4
Exposure Control Plan
Defines which employees are included in the plan
Covers potential exposures and ways to minimize them
Indicates a plan for what to do should an exposure incident occur
Describes incident reporting requirementsSlide5
Employee Responsibilities
Attend mandated BBP training and
annual
retraining
Familiarize yourself with Exposure Control Plan
Utilize work practice controls and PPE properly
Report all exposure incidents and/or injuries to supervisor in a timely mannerSlide6
Supervisor Responsibilities
Identify all “occupational exposed” employees to BHS w/in 10 days of hire
Ensure these employees attend BBP training and any additional training necessary
Make PPE available
Emergency action procedures in place and are followed
Proper disinfection and disposal procedures followedSlide7
Other Potentially Infectious Materials (OPIMs)
Materials that may carry and transmit BBPs
Human blood and blood components
Human cell lines, including embryonic stem cells
Body cavity fluids (spinal, synovial, pleural, pericardial, peritoneal, amniotic)
Breast milk
Semen and vaginal secretions
Saliva in dental procedures
Any fluid that is visibly contaminated with blood
Any unidentified fluids in a lab where human materials are usedSlide8
Known
Bloodborne
Pathogens
HIV
Bloodborne Hepatitis viruses (Hepatitis B, D, C and E)
Human T-lymphotropic virus Type I
Hemorrhagic Fever viruses (Ebola, Marburg, Lassa)
West Nile Virus
Colorado Tick Fever viruses (a number of arboviruses)
Plasmodium species (Malaria)
Treponema species (Syphilis)
Babesia species
Brucella species (Brucellosis)
Leptospira species
Francisella species
Streptobacillus
moniliformis
Spirillum
minus
Borrelia species (Lyme Disease)
Creutzfeldt-Jacob agent (CJD)Slide9
Significant Bloodborne Pathogens
Human Immunodeficiency Virus (HIV)
Destroys host immune system resulting in death
Effective anti-retroviral drugs available, no cure
~37 million living with HIV
Hepatitis B Virus (HBV)
Can destroy or damage host liver, resulting in death
Host can recover from disease, chronically infected
Preventable with vaccination
350 million chronic carriers
780,000 die each year due to complications (cirrhosis, cancer)-WHO
Hepatitis C Virus (HCV)
Can destroy or damage host liver, resulting in death
Chronic infections, costly cure is available
Hepatitis D Virus (HDV)
Requires Hepatitis B co-infection to cause diseaseSlide10
Significant Bloodborne Pathogens
Human Immunodeficiency Virus (HIV)
Transmission risk-1:300 (0.3%)
Hepatitis B Virus (HBV)
Transmission risk-
1:2 (50%)!!!
One drop can have 100 million virus particles present
Hepatitis C Virus (HCV)
Transmission risk-1:50 (1.8%)
These statistics are from direct patient care settings.
86% of occupational exposures that result in seroconversion to HIV are caused by hollow bore needles.Slide11
Common Characteristics of BBPs
Biohazardous Agents
Transmission
Direct Contact
Person to person contact
Indirect
Person to object to person
Parenteral inoculation
Mucous membranesSlide12
Chain of Infection
All components need to be present for successful transmission:
Presence of virulent pathogen
High concentration of pathogen (infectious dose)
Mechanism of transmission of pathogen to host
Portal of entry
Susceptible hostSlide13
Personal Risk Factors
Factors that may suppress or alter immune system
Age
Stress
Nutrition
Pregnancy
Diabetes
Immunodeficiency through disease or drug use including the use of many prescription medications
Chemotherapy Slide14
Protection in Healthy Adults
Natural protection
Intact Skin
Cellular Immunity (leucocytes)
Humoral Immunity (antibodies)
Acquired immunity
Vaccination
Immunoglobulin administration
IllnessSlide15
Symptoms
Symptoms are similar for most diseases
“Flu-like”
Fever
Nausea
Malaise
Night sweats
Some diseases have no initial symptoms
Hepatitis B may be asymptomatic in some individualsSlide16
Hepatitis B Virus Vaccination
Strongly endorsed by medical community
Protection has been proven to last 7-15 years
Became available in 1983, was required by 1991
Healthcare worker infection rates decreased by 95% between ‘83 and ‘95!
CDC and WHO recommend vaccinations from birth-2 months onward
Series of 3 shots
Given over a 6 month period
95-97% effective at conferring immunity
Some individuals will never develop immunity
Also protects against Hepatitis D (without co-infection with B, D cannot cause disease)Slide17
Include your e-mail address for any necessary follow-ups.
For those requesting the Hep B immunization,
this form can be copied to give to your PI upon request.
Hepatitis B vaccineSlide18
myhealth.uconn.edu
(student health portal)
Is not a university requirement
Get your titers checked
Get a booster
Not Sure about your immunization status?Slide19
Exposure Incident Reduction Strategy
Employ standard (universal) precautions in the workplace
Engineering controls
Work practice controls
Use PPE!Slide20
Standard Precautions
Employ standard (universal) precautions in the workplace
Reduce the risk of transmission of BBPs and other pathogens from both
recognized
and
unrecognized
sources.Slide21
Exposure Incident Reduction Strategy
Employ standard (universal) precautions in the workplace
Engineering controls
Work practice controls
Use PPE!Slide22
Engineering Controls
Equipment that comes between you and the hazard
“To err is human”-Alexander Pope
To reduce parenteral exposures
Sharps containers
Dustpan & brush or large forceps
“safe” needlesSlide23
Safer Sharps Devices
To reduce parenteral exposures
An estimated 1,000 sharps injuries happen
EVERY DAY
in the U.S.Slide24
Safe Sharps Practices
If you have never used a sharp, be sure you are trained prior to handling
Incident Prevention
Needles and other sharp instruments should only be used when there is no alternative
Try to use plastic instead of glass whenever possible
Always keep sharps in view
Try to limit use to one open needle or sharp at any given time when possible. Slide25
Engineering Controls
Equipment that comes between you and the hazard
Contains spills, splashes and aerosols
Spill clean up and containment
Biological safety cabinet for aerosol containmentSlide26
Engineering Controls
Equipment that comes between you and the hazard
Additional aerosol and splash protection
Centrifuge safety cups
Pipette devices and
good pipette practice!
Splash shieldSlide27
Engineering Controls
Controls to decontaminate surfaces and equipment
Must
be tuberculocidal
1:10 solution of at least 5.25% strength household bleach
Check concentration!
Bleaches with fragrance and splash less bleaches are
not
considered sanitizers.
EPA number
Iodine/iodophore
Wescodyne is not EPA registered and is not tuberculocidal.
phenol containing products
Alcohol preparations
do not
meet requirements
Not enough contact time
Check labels or contact EHS to ensure you comply!Slide28
Engineering Controls
Check contact time requirementsCDC Guideline for Disinfection and SterilizationExcellent source of information for
effective use of disinfectantsSlide29
Decontamination
Appropriate hand washing
OSHA
requires hand washing with soap and running water for at least 20 seconds after procedures when blood or body fluids are present.
Soap or Hand sanitizer?
Use lots of hand sanitizer to increase contact time.
“Washing hands with soap and water is the best way to reduce the number of microbes…if soap and water are not available, use alcohol-based hand sanitizer…soap and water are more effective than hand sanitizers at removing or inactivating certain kinds of germs.”
www.CDC.gov
Lots of proteinaceous material present? Just use soap.Slide30
Decontamination
Sterilization
Disinfection
Antisepsis
SanitizationSlide31
Exposure Incident Reduction Strategy
Employ standard (universal) precautions in the workplace
Engineering controls
Work practice controls
Use PPE!Slide32
Clutter is dangerous, keep work area tidy
No re-capping needles
No re-using disposable PPENo applying cosmetics (including lip balm) or contact lenses
Keep sharps disposal container close to work area
Disinfect area before and after work
Follow spill clean-up procedure
Footwear
Shoes should cover whole foot
Don’t work late or alone
Know emergency response procedures
Call 911 from campus phone
Work Practice ControlsSlide33
Signs and Labels
Signs must be posted to warn of potential hazard
Post on all entry doors
Post on all equipment that contains, stores or transports biohazardous agentsSlide34
Exposure Incident Reduction Strategy
Employ standard (universal) precautions in the workplace
Engineering controls
Work practice controls
Use PPE!Slide35
Personal Protective Equipment
Protective clothing
To cover street clothes
Worn closed
The correct size for you - not oversized or too tight
Choose the right materialSlide36
Personal Protective Equipment
Face and mucous membrane protection
To serve as a barrier to splashes of potentially infectious materials
Use during spill clean up, first aid and with large volumes of materialsSlide37
Personal Protective Equipment
Gloves appropriate to the task
Non-latex exam gloves for most lab work
Verify integrity before donning gloves
Remove carefully to avoid contaminating hands
Do not reuse disposable gloves
Do not wear gloves outside of the laboratory
Wash hands after removing gloves
Make these measures second natureSlide38
Personal Protective EquipmentSlide39
PPE Rules to Remember
Use proper PPE for the situation
Gloves, goggles, lab coat, surgical masks, etc…
Always check PPE to ensure it free of tears or defects
Remove PPE and wash hands before leaving lab
Wear correctly and wear the right sizeSlide40
“Workers are the first line of defense for themselves, others in the laboratory and the public from exposure to hazardous agents. Protection depends on conscious and proficient use of good microbiological practices and the correct use of safety equipment.” BMBL
Containment cannot
compensate for poor technique.
Safe Work PracticesSlide41
If a Spill Happens:
Wear PPE
Contain spill with absorbent material
Remove sharp objects if necessary
Cover spill with disinfectant (tuberculocidal)
If it is a large spill, undiluted disinfectant may need to be used to achieve effective final concentration
Allow to sit for
at least
15 minutes (reference
decon
. time)
Dispose of materials as necessary in appropriate biohazard waste receptacle
Wipe area again with disinfectant Slide42
If there is an exposure incident:
Needle stick or other percutaneous exposure:
Wash the wound with soap and water
If there is no soap use an alcohol based solution
Do not scrub
-could create more entry points for pathogens
Do not suck on the wound
Apply antiseptic and a clean dressing
Mouth, Nose or Eye exposures
Irrigate with copious amounts of
cold
water for10-15 minutesSlide43
Exposure Incident Procedures
Employee responsibilities
Self treat exposed area
Report the incident
Supervisor responsibilities
Document the incident
Advise employee that medical treatment is availableSlide44
Required Reporting Information
If the incident involves a sharp object of any kind, you must record the:
Type and brand of device involved
Department or area of incident
Description of incidentSlide45
Exposure Incident Procedures
Medical treatment providers for the Storrs Campus
Student Health Services
Students Only
Windham Community Memorial Hospital
Staff and Faculty
Students when Health Services is closed
Walk-in clinic location in Storrs downtownSlide46
Exposure Incident Procedures
Medical treatment provider responsibilities
Discuss all treatments and options
Very specific monitoring and procedures
Disclose possible side effects of treatments or post exposure prophylaxis (PEP)
Keep all information confidential as required by state of Connecticut and Federal privacy laws
Medical evaluation remains confidential
Post exposure follow-up
Return to treatment provider as directed for follow-up evaluationsSlide47
Recordkeeping
Medical records
Hepatitis B vaccine status
Any exposure records and follow-up results for said exposures
Kept confidential and separate from personnel record
Training records:
Training Dates (this is an
annual
training!)