Bloodborne - PowerPoint Presentation

Slide1

Bloodborne Pathogens

LectureSlide2

Bloodborne Pathogens

Viruses, bacteria and other microorganisms that:

Are carried in the bloodstream or transmitted by Other Potentially Infectious Materials (OPIM)

Cause disease

There are over 20 different bloodborne pathogensSlide3

Bloodborne Pathogens

Of most concern are

Human Immunodeficiency Virus (HIV)

Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)Slide4

Additional Bloodborne Pathogens

Human T-lymphotrophic virus Type 1

Malaria

Syphilis

Babesiosis

Brucellosis

Leptospirosis

Arboviral infections

Relapsing fever

Creutzfeldt-Jakob disease

Viral hemorrhagic feverSlide5

Other Potentially Infectious Materials (OPIM) Include:

Plasma

Amniotic fluid

Spinal fluid

Semen

Vaginal Secretions

Peritoneal fluid

Breast Milk

Unfixed tissue or organs

Fluids surrounding the brain, spine, heart and joints

Other fluids containing visible blood (such as saliva in dental procedures)Slide6

How Do Bloodborne Pathogens

Enter the Body?

Break in skin integrity

Needle sticks

Cuts, scrapes and

breaks in skin

Mucous Membranes

Splashes to eyes, nose and mouth

Life style issues (IV drug use)Slide7

OSHA’S BLOODBORNE PATHOGENS STANDARD

The purpose of OSHA’S

Bloodborne

Pathogens Standard is to

reduce occupational exposure

to Hepatitis B, Hepatitis C, HIV and other

bloodborne

pathogens that employees may encounter in their work place.Slide8

WHO is Covered by the Standard?

All employees

who could be “reasonably anticipated” to face contact with blood or other potentially infectious materials as the result of job duties Slide9

Exposure Control Plan

OSHA Requirement

OSHA – the Occupational Health and Safety Administration requires employers to develop an

Exposure Control Plan.

This plan provides protection for all health care workers who might be exposed to bloodborne diseases.

The plan outlines the steps employers must take to provide protection against bloodborne pathogens.Slide10

HIV

virus that causes AIDS

person

is infectious from

onset

of infection throughout life

all persons are susceptible

Symptoms (Acute stage) include fever, rapid weight loss, night sweats, pneumoniaSlide11

HIV

risk of transmission

needlestick: 0.3%

splash/spray to mucous membranes: 0.09%

non-intact skin: less than mucous membrane exposure

Slide12

Risk Factors for Acquiring HIV Infection in Health Care

Sustaining a

deep

injury

Sustaining an injury with a device which is visibly contaminated with blood

Being injured with a needle which had been placed directly into the source patient’s artery or vein

Source patient is in terminal stages of AIDSSlide13

HBV

virus that causes hepatitis B

person

is infectious if test for antigen (

HBsAG

) is positive

unvaccinated persons are susceptible

Symptoms, if present, include fever, muscle ache, fatigue, jaundiceSlide14

HBV

risk of transmission

needlestick: 22-31%

direct or indirect contact with non-intact skin or mucous membranes is an important source of occupational exposure

Slide15

HCV

virus that causes hepatitis C

incubation

period 6 to 9 weeks

most persons are infectious for life

leads to chronic liver disease, liver cancer

all are susceptible

Symptoms, if present, include fever, muscle ache, fatigue, jaundiceSlide16

HCV

risk of transmission

needlestick: 1.8%

mucous membranes: rare

non-intact skin: very rareSlide17

Chain of Infection

Agent

↓

Reservoir

↓

Portal of exit

↓

Mode of transmission

↓

Portal of entry

↓

Susceptible hostSlide18

Standard Precautions

used on ALL individuals

used for ALL contact with:

blood, all body fluids (except sweat)

mucous membranes

non-intact skin

If it’s wet and it comes from the human body—treat as infectious! Slide19

Hand Hygiene

Alcohol hand gel is preferred method in health care

settings

more effective against organisms

convenient

takes less time than soap and water wash

gentler to skin than soap, water, paper towels

may use if hands are not visibly soiledSlide20

Hand Hygiene

Use of alcohol gel

press pump down completely to dispense appropriate amount

dispense into palm of one hand

rub palms, backs of hands, fingers, fingertips, nails, in between fingers until dry,

about 30 seconds

make sure hands are dry before resuming activities Slide21

Hand Hygiene

Hand washing technique

turn on faucets to comfortable water temperature

wet hands, apply soap

rub with friction for

at least 15 seconds

, making sure to wash back of hands, fingers, fingertips, nails, in between fingers

rinse with fingertips pointing downward

dry hands with paper towel

discard paper towel and turn off faucets with clean paper towelSlide22

Hand Hygiene

When to wash hands:

Before and after patient contact

When ever you remove gloves

Before and after use of the bathroom

Prior to and after meal breaks

After coughing, sneezingSlide23

Respiratory hygiene/cough etiquette

Cough or sneeze into tissue or curve of elbow

Toss tissue

Decontaminate hands

Wear mask if infected with respiratory illnessSlide24

Engineering Controls

Safety Devices

Sharps ContainersSlide25

Safety Devices

Where a safety device exists, you

must

use it

Primary defense against

bloodborne

pathogens

Do not tamper or alter

Do not activate safety device by hand, use hard surface to activate

Dispose

in sharps containerReport device failure to infection control epidemiologistSlide26

Work Practice Controls

Do not eat, drink, apply make-up, handle contact lenses, or smoke in areas with likely exposure to blood or OPIM

specimen collection rooms

testing areas

areas where specimens located

Do not store food or beverages in refrigerators, freezers, coolers, shelves, cupboards where specimens are located

Slide27

Work Practice Controls

Do not place hands into used sharps containers

Use a brush or tongs to place broken glass or other sharp items into a dust pan for disposal

Shearing, breaking, bending, re-capping of contaminated sharps is prohibitedSlide28

Labels

Infectious waste: red bag with biohazard label

Sharps containers: biohazard label

blood specimens: biohazard label on storage bag, storage containers

refrigerators, coolers where blood or OPIM is stored: biohazard labelSlide29

Biohazard Warning Labels

Warning labels required on

Containers of regulated waste

Refrigerators and freezers containing blood or other potentially infectious material

Containers used to store, transport, ship blood or other potentially infectious material

Red bags or containers may be substituted for labelsSlide30

Specimens

label with appropriate information

wrap in material to prevent breakage

place in plastic biohazard bag

place paperwork in outside pouch of bag

do not place specimens back into clean collection kitsSlide31

What to do When an Exposure Incident Occurs

1) Clean the site.

percutaneous injuries: wash with soap and water

mucous membranes: rinse copiously with water

2) Report to your supervisor immediately.

3) Seek medical attention

4) Report to infection control

5) Complete an incident report and exposure incident report

See complete instructions in your packet

Slide32

Transmission Based Precautions

Contact

Droplet

Airborne

Used in addition to standard precautionsSlide33

Contact precautions

For infections transmitted by direct or indirect contact with an infected person or contaminated environment

Wear gown, gloves for all contact with patient or potentially contaminated environmentSlide34

Contact precautions

Examples

Norovirus

Other GI illnesses when infected person is incontinent

Draining wounds

Drug-resistant organisms

Vancomycin resistant enterococcus

Methicillin resistant staph aureusSlide35

Droplet precautions

For infections transmitted by close respiratory or mucous membrane contact with respiratory secretions

Spatial separation of

> 3 feet

Use of surgical mask when within three feet of infected personSlide36

Droplet precautions

Examples

Influenza

Pertussis

Adenovirus

Rhinovirus

Group A StreptococcusSlide37

Airborne precautions

For infections carried over long distances (up to 25 feet) when suspended in the air

In hospitals, airborne isolation with negative pressure are used

Use of N-95 respirators is used when sharing air with infected personSlide38

Airborne precautions

N-95 respirators

Must have respiratory protection plan

Medical evaluations

Fit testing

Only those who are fit-tested may enter space of the infected personSlide39

Airborne precautions

Examples

Tuberculosis

Measles

Chickenpox

Smallpox

Non-immune persons should not be in contact with infected personsSlide40

Transmission Based Precautions

Examples of diseases spread by multiple means:

SARS—airborne and contact plus eye protection

Adenovirus—droplet and contactSlide41

Drug-Resistant Pathogens

Streptococcus pneumoniae

Tuberculosis (MDR-TB)

MRSA – Methacylin resistant Staphlococcus Aureus

VRE – Vancomycin Resistant EndococcusSlide42

MRSA stands

for meticillin-resistant Staphylococcus aureus.

MRSA

is a common skin bacterium that is resistant to a range of

antibiotics

including meticillin, which is a type of penicillin antibiotic.

'Meticillin-resistant' means the bacteria are unaffected by meticillin, a type of antibiotic that used to be able to kill them.Slide43

MRSA

infections are most common in people who are already

in

hospital

.

This is because

:they often have an entry point for the bacteria to get into their body, such as a surgical wound or a catheter they tend to

be older, sicker and weaker

than the general population, which makes them more vulnerable to infection

they are surrounded by a large number of other patients and staff, so the bacteria can spread easily (through direct contact with other patients or staff, or via contaminated surfacesSlide44

MRSA infection is commonly accompanied with the following

MRSA symptoms

:

carbuncles (infections larger than an abscess usually with several openings to the skin),

abscesses (pus clusters under the skin),

sty (an infection of eyelid glands),

boils (pus-filled infections of hair follicles),

cellulitis (an infection of the skin or the fat and tissues that lie beneath the skin usually starting as small red bumps on the skin),

impetigo (a skin infection with pus-filled blisters).Slide45
Slide46

VRSA:

Vancomycin

resistant staphylococcus (

staf

-

i

-lo-KOK-us)

aureus (VRSA) infection is a condition caused by bacteria (germs). This infection occurs when bacteria, called Staphylococcus aureus or Staph

, becomes resistant (not killed) to the antibiotic medicine

vancomycin

. The Staph bacteria are commonly found on the skin and in the nose.Slide47

What increases my risk of getting a VRSA infection?

Antibiotics:

Taking

strong antibiotics the wrong

way may cause the bacteria to develop resistance to the antibiotics. These may include prolonged or frequent use of

vancomycin

antibiotics.

Hospital stay

:

Having surgery, or being in the ICU. Staying in the hospital too long or sharing a room with a VRSA infected patient increases your risk.Slide48

Lines, tubes, or metal implants

:

Medical tubes may have been placed into your body, such as IV lines, dialysis or a feeding tube. VRSA also likes to

live on and around metal implants.

Having a

urine catheter or other special tubes

may also promote a VRSA infection.

Poor hygiene:

Poor hygiene practices may include not washing the hands after caring or visiting a person with VRSA infection.Slide49

Weak immune system

:

The immune system is the part of your body that fights infection. Having diabetes (high blood sugar) or kidney disease may weaken your immune system. Having surgeries or procedures in the past, such as an organ transplant, may also affect your body defenses.

What are the signs and symptoms of a VRSA infection?

Skin and soft tissue infections may include redness, pain, swelling, and a warm feeling when touched

fever, chills, or body weakness and pain

Cough, chest pain, trouble breathing, and a fast heartbeat

If you have meningitis, you may have frequent sleepiness, headaches, or a stiff neck

rash, vision changes, nausea (upset stomach), or vomiting (throwing up).Slide50

VRSASlide51

Clostridium

Difficile

or C-Diff:

is a microorganism that is one of the many bacterial organisms normally found in the

gastrointestinal (GI) tract.

they aid in digestion and absorption of food and nutrients

C. diff is present as normal GI flora in about three percent of all healthy adults and about 10 to 30 percent of hospitalized or chronically ill patients

.Slide52

If C-diff is a normal GI flora, why does it make people sick?

However, under certain circumstances, C-diff can grow out of control in the GI tract.

This

overgrowth

of C-diff produces toxins within the GI tract that result in severe infectious diarrhea and inflammation of the large intestine (colitis).Slide53

Why Does C-diff Overgrow?

In the GI tract, there can be “good” bacteria and “bad” bacteria.

Good bacteria

assists in digestion and the absorption of nutrients but also helps control the growth of “

bad” bacteria

Antibiotic use

Anti-ulcer medications

Long hospital stays

Immune system suppressionSlide54

How Does C. diff Spread?

C

. diff is present in the stool of infected people

transferred by direct contact to toilets, bed rails, towel racks, etc.

Chlorine bleach at a concentration of 1:10

is the only agent that effectively kills C. diff spores on environmental surfacesSlide55

What are the Symptoms of C. diff Infection?

There are three primary symptoms of C. diff infection:

watery diarrhea that may contain blood or pus

fever

abdominal pain, cramping or tendernessSlide56

Scabies

is a common skin infection that causes small itchy bumps and blisters due to

tiny mites

that burrow into the top layer of human skin to lay their eggs.

is contagious, and is usually transmitted by skin-to-skin contact or through sexual contact with someone else who is infected with itSlide57

Signs and Symptoms

The

most common symptom

of scabies is

severe itching

, which may be worse at night or after a hot bath.

A scabies infection begins as

small, itchy bumps, blisters, or pus-filled bumps that break when you scratch them. Itchy skin may become thick, scaly, scabbed, and crisscrossed with scratch marks.

The areas of the body most commonly affected by scabies are the

hands and feet

(especially the webs of skin between the fingers and toes).Slide58
Slide59

Thank You For Listening!