OSHA'S Bloodborne Pathogens Standards

Is there a vaccine available to protect against HBV?

Yes there is a vaccine to protect against HBV. Is a series of three injections. The preferred schedule administration of the vaccine should be 0, 1, and 2 months or 0, 1, and 6 months.

Always use Universal Precautions when dealing with:

Blood or body fluids

The HBV Vaccination is contraindicated or not given to anyone?

The ONLY person who CAN NOT take the HBV vaccination is someone who is hypersensitive or allergic to yeast. So if the person isn't allergic to yeast anybody can take it.

What 5 things should be included in the documentation of the administration of the HBV vaccine ?

The date of each vaccination. Manufacturer and lot number. Site of injection. Who administered the vaccine. Any adverse reactions noted.

4 factors to consider when selecting PPE

Type of fluid or tissue involved. Potential exposure volume of infectious material. Probable route of exposure. Overall working conditions

Removal, decontamination, and disposal of PPE

Always remove PPE so that the exposed ( outside/dirty ) side is turned to the inside and placed in the appropriate biohazard container for proper disposal. Hands should always be washed after removing PPE.

Pathogen

An organism that causes disease

Any unfixed human tissue or organ

Any tissue ,organ, or body part removed from the body

Pocket Mouth to Mouth Resuscitation Masks and Mechanical Respiratory Devices

Are used by Emergency Responders and Healthcare workers to reduce the chance of transferring disease

Hand Sanitizers

Are usually alcohol based and can be used to decontaminate the hands if soap and water is not available. But these aren't effective against obvious body fluid contamination. There use should be followed as soon as possible by washing with an antiseptic cleanser and water.

Work practice controls to use when dealing with sharps

Avoid using sharps if possible (use another method/technique if possible rather than using a sharp), Never bend, break, or recap a needle, if you must recap a needle use the "Scoop" method, Never use hands to pick up broken glass, use tongs or sweep up broken glass, Disposable sharps must be stored and disposed of in a puncture resistant, leakproof, closeable container (Sharps container)that is labeled with the biohazard symbol or colored coded red. Sharps containers should be located as close as possible to the area of use. Never overfill a Sharps container, dispose of Sharps container before they are full, Sharps containers must be closed and locked before transporting full Sharps containers , If there is a danger of leakage or outside contamination, the primary container should be placed into a secondary container that is labeled, sealable, and impervious to leakage.

Procedures that must be followed by handwashing

Before and after patient contact, Before and after putting on PPE ( personal protective equipment), when visibly contaminated with blood or body fluids, after handling blood or body fluids, Before leaving patient care area, after using the restroom and periodically throughout the day. If there is any doubt if you should wash your hands, always wash them, better safe than sorry !

Hand Washing Procedure

1) wet hands and arms with warm water at least 100 degrees 2) apply soap to build a lather 3) scrub hands and wrists vigorously for at least 30 seconds ( front, back, and sides of hands, in between fingers, under fingernails) 4) rinse hands and arms with warm running water 5) dry hands and arms with a single use paper towel or hand dryer. 6). Turn off faucet with a dry paper towel

Example of the most effective and economical disinfectant:

10% bleach ( 1 part bleach to 10 parts water prepared weekly)

Disinfectant

A chemical agent that eradicates organisms from environmental or work surfaces and instruments

Antiseptic

A chemical agent that eradicates organisms from the skin

The most common route of exposure to bloodborne pathogens:

Accidents involving sharps.

Body fluids that can transmit HIV or HBV are:

Blood, Semen, Vaginal Secretions, Cerebrospinal Fluid ,Synovial Fluid, Pleural Fluid, Pericardial Fluid, Peritoneal Fluid, Amniotic Fluid, Saliva (if mixed with blood or body fluids), and any unfixed human tissue or organ.

CSF

Cerebrospinal fluid is the fluid surrounding the brain and spinal cord

3 most common FDA- approved antiseptics:

Chlorhexidine Gluconate (CHG), Alcohol, and Iodophors (Betadine)

Biohazard Label

Denotes the presence of potentially hazardous infectious material

Bloodborne Pathogens

Disease-causing microorganisms carried in the body by blood or body fluids, such as hepatitis and HIV.

When disposing used PPE:

Dispose all used PPE in the proper biohazard container.

How would you properly dispose of blood specimen vials ?

Dispose in a Biohazard labeled Sharps Container.

Universal Precautions Don't's:

Don't shear break, or bend contaminated needles or other sharps. Don't keep food or drinks in work areas with exposure potential. Don't eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in work areas with exposure potential. Don't pipette or suction potentially infectious materials with your mouth.

10 S/S of HBV

Fatigue, Anorexia/weight loss, Low grade fever, Aching muscles or joints, Stomach pain, Nausea, Diarrhea, Jaundice(yellowish discoloration) of skin and sclera (whites of the eyes), Dark colored urine, & Light colored stool

What are the 5 less frequently occurring adverse reactions to the HBV vaccine ?

Fever, headache, malaise( feeling blah), nausea, and vomiting.

Peritoneal Fluid

Fluid aspirated from the abdominal cavity

Saliva ( If mixed with blood or body fluids )

Fluid in the mouth that lubricates the mouth.

Amniotic Fluid

Fluid within the amniotic sac that surrounds and protects the fetus

Two of the most common bloodborne pathogens are:

HIV ( Human Immunodeficiency Virus) and HBV (Hepatitis B Virus)

By what route is the HBV vaccination administered ?

IM ( intramuscular)

Universal Precautions Do's :

If exposed to potentially infectious materials, immediately wash the exposed area with soap and water and notify your supervisor. Always wash your hands after removing PPE. Use antiseptic cleaners if washing facilities aren't available and then wash with soap and water ASAP. Minimize splashing, spraying., or spattering of droplets of blood or other potentially infectious materials. Place contaminated sharps ( needles, razor blades, scapels, or glass) in an assigned, labeled, puncture resistant, leak proof container ( Sharps Container).

Personal Protective Equipment (PPE)

Is a barrier worn to protect the skin, clothing,and mucous membranes from infectious material.

HIV

Is a retrovirus that attacks and destroys the human immune system, leaving the body defenseless to fight against disease. Human Immunodeficiency Virus, is the virus that causes AIDS. At present, there is no vaccine to prevent HIV.

HBV

Is a virus that Infects the liver, can be mild or chronic, can cause serious or fatal problems such as cirrhosis, liver cancer, or chronic liver disease or liver failure. There is series of vaccines available to prevent Hepatitis B Virus is more common than HIV and is a greater risk on the job.

Contaminated Laundry

Laundry which has been soiled with blood or other potentially infectious materials or may contain sharps. This laundry must be handles with gloved hands, avoid letting the contaminated laundry items to touch you or your clothing, must be placed in a biohazard leak proof bag. Try to handle this laundry as little as possible and bag the contaminated laundry where it's used and away from patient areas. Keep contaminated laundry separate from other laundry items

Pleural Fluid

Liquid that surrounds the lungs

Later symptoms of AIDS:

May develop unusual types of cancer or infections including pneumonia that the body can no longer fight off

Sharps

Needles, scalpels, razor blades, and any other sharp, potentially dangerous object used in a health care facility. Can include broken glass.

Scoop Method

Technique for threading the needle of a syringe into the cap without touching the cap itself.

Some people who carry the HIV virus have:

No symptoms. and others won't develop AIDS for years after they are infected. There is no cure and there is no vaccine as of yet.

OSHA (Occupational Safety and Health Administration)

Occupational Safety and Health Administration

Goggles/ Eye Glasses

PPE that protects the eyes from splash or spatter of infectious material

Respiraory or Ventilation Devices

PPE used for emergency resuscitation (CPR) for patients to prevent the transfer of infection to the respiratory system./ Example : Pocket masks

Masks

PPE used to protect mouth and nose from harmful germs

Gowns

PPE used to protect skin and clothes from harmful germs

Gloves

PPE used to protect skin on hands from harmful germs

Face Shield

PPE: A solid, clear plastic barrier that covers the eyes the nose and mouth to protect against splash and spatter of infectious materials

19 Tasks that may involve exposure to Bloodborne Pathogens (HIV/HBV) include:

Personal care of the patient(bathing, shaving, or oral care). Wound care or debridement, Suctioning, Catheter changes, Enema/impaction removal, IM/sub-q injections, Vascular access procedures( venipunctures, finger sticks), Respiratory treatments (breathing treatments), CPR, Douches, Insertion of vaginal/rectal suppositories, Oral/rectal temperatures, Whirlpool, Emergency first aid procedures, Transporting/processing laboratory specimens ( ex blood or stool specimens), Dental procedures, Surgical procedures, and Post mortem/morgue care ( care of the body when a person dies).

When transporting blood specimens to the laboratory:

Put blood containers in a leakproof biohazard container bag

What should you do if you are directly exposed to blood or body fluids on the job ?

Report it to your supervisor IMMEDIATELY. You will be offered a confidential medical evaluation and blood test. A Medical Professional will tell you the results of your evaluation and tests, plus any conditions that require more evaluation or treatment.l Your employer may ask for the source of the exposure in order to have his or her blood tested as well.

Forensic, Laboratory, and Mortuary Workers:

Should always use Universal Precautions when performing their jobs to help reduce the transmission of bloodborne pathogens.

Pericardial Fluid

Small amount of lubricating fluid in heart.

What are the 3 most common adverse (negative/bad) reactions to the HBV vaccine?

Soreness at the injection site, erythema (redness), and swelling

Items that must display the biohazard label

Specimens, Contaminated laundry, Contaminated equipment, Extracted (pulled) teeth, Sharps containers, Containers for regulated waste, refrigerators, freezers, phlebotomy trays ( trays set up with items used to draw blood on patients), or other containers used to store, transport, or ship blood or other potentially infectious materials.

Always inspect your PPE before you put them on for any:

Tears, holes, dampness or visibly contaminated. DO NOT USE if any of these are present

Synovial Fluid

The small amount of liquid within a joint used as lubrication.

Universal Precautions

Treat all blood and body fluids as if they are infected. Treat everybody as if they were infected.

9 Signs & Symptoms (S/S) of HIV

Unexplained, persistent fatigue (tiredness), Unexplained fever, night sweats, or shaking, chills lasting several weeks or longer, Unexplained/sudden weight loss of over 10 pounds, Diarrhea for a period of several weeks, Lymphedema ( swelling of lymph glands/nodes) , Anorexia, Persistent dry cough, & Leukoplakia ( white patches in the mouth).

How should you pick up and dispose of broken glass ?

Use tongs, brush and a dust pan, or forceps to pick up possibly contaminated broken glass and dispose of it in a Sharps Container.

HIV and HBV are transmitted by:

Vaginal oral, and anal intercourse, Sharing needles , Needle stick injuries from infected hypodermic needles acupuncture, ear or body piercing, or tattooing with infected needles or equipment,or sharps , Sharing of personal care items such as razors, nail clippers, toothbrushes, Neonatal (newborn) infection during birth, skin, eye, mucous membrane, or parenteral contact with blood or other infectious waste, Breast milk from(HIV/HBV) infected mother, or direct contact with broken or chaffed skin and infected body fluids. May also be transmitted through caked, dried blood and contaminated surfaces.