Bloodborne Pathogens OSHA

Bloodborne pathogens are transmitted from one person to another when __________ ____ or bodily fluids get into someone's bloodstream, which can occur different ways.

infectious blood

Accidental puncture by a sharp object contaminated with a pathogen.

injection

Exposures to bloodborne pathogens can occur via infection from:

injections, skin abrasions, mucous membranes, and sexual contact.

Bloodborne pathogens pose very real ____-______ dangers.

life-threatening

Found in the eyes, nose, or mouth.

mucous membranes

What should you do with contaminated broken glass?

must NOT be picked up by hand, but must be cleaned up using mechanical means, such as a brush and dust pan, tongs, or forceps.

Where should Sharps disposal containers be?

must be readily accessible and located as close as feasible to the area where sharps will be used. must be available wherever sharps may be found, such as in laundries.

For healthcare workers, the most common risk of exposure is by ____ stick injury.

needle

What is OSHA's bloodborne standard?

needleless or have built-in protection to guard workers against contact with the contaminated sharp. In addition, employers must ask patient care workers who could be exposed to contaminated sharps injuries for their input in identifying, evaluating and selecting effective work practice and engineering controls, including safer medical devices.

In hospitals, what is the source of the vast majority of sharps injuries?

needles

Contaminated sharps must ___ be sheared or broken.

never

Laboratory tests must be conducted by an accredited laboratory and also must be at ____ cost to you.

no

If there is a chance of leakage from the disposal container, the employer must ensure that it is:

placed in a secondary container that is closable, appropriately labeled or color-coded red, and constructed to contain all contents and prevent leakage during handling, storage, transport, or shipping.

Infected blood or bodily fluids can directly enter a person's body through an accidental puncture by a sharp object contaminated with a pathogen.

"Sharps" include objects, such as needles, scalpels, broken glass, and razor blades.

According to CDC, the average risk of infection after a needlestick or cut exposure to infected blood is approximately ____ for Hepatitis C.

1.8%. Although recent studies show an association between sharps injuries and Hepatitis C infection, the number of healthcare workers who have acquired Hepatitis C occupationally is unknown. However, of the total acute Hepatitis C infections that have occurred annually (ranging from 100,000 in 1991 to 36,000 in 1996), 2 percent to 4 percent have been healthcare workers exposed to blood in the workplace.

Your employer must also provide you with a copy of the evaluating healthcare professional's written opinion within ___ days of completion of the evaluation.

15

What should you do immediately if you're are exposed to infectious materials via an exposure incident?

1: Wash needlesticks and cuts with soap and water 2: Flush splashes to the nose, mouth, or skin with water 3: Irrigate eyes with clean water, saline, or sterile irritants 4: Report the incident to your supervisor 5: Immediately seek medical treatment

How many doses the Hepatitis B vaccination have?

3 doses over a 6-month period (0, 1, and 6 months). . It is recommended that healthcare workers have their Hepatitis B surface antibody level tested 4-6 weeks after completion of the series, to make sure that they have built up protection against Hepatitis B.

Research conducted by the CDC shows that in hospitals, __% or 4 out of every 5 of sharps injuries are due to the use of hypodermic needles or syringes, suture needles, winged-steel or butterfly-type needles, blood collection needles, scalpels, and IV catheter stylets.

80

After the actual use of sharps devices, what is the next leading cause of sharps injuries?

Activities after use and prior to disposal.

Bloodborne Pathogens Standard Employer Requirements for Exposure Control Plan:

An exposure control plan is a written plan to eliminate or minimize occupational exposures. The employer must write a plan that lists the jobs where workers may be exposed, along with a list of the tasks and procedures performed by those workers that result in their exposure.

Reducing Infection Exposure Risks for Avoidance:

Avoid eating, drinking, smoking, or applying cosmetics or contact lenses in an area with a likely source of a bloodborne pathogen.

Containers for contaminated sharps must have certain features. What are these?

Biohazard labeled or color-coded red, leakproof, puncture-resistant, closable, kept up right.

Reducing Infection Exposure Risks for Disposal:

Dispose of all protective equipment in a biohazard bag.

Studies show that in addition to the actual use of sharps devices which is the leading cause of sharps injuries, injuries are also closely associated with certain work practices that can pose an increased risk of bloodborne pathogen exposure. These work practices include:

During Use which accounts for 41% of injuries Disposal-related activities which account for 15% of injuries and, Activities after use and prior to disposal, such as item disassembly which account for 40% of injuries

Bloodborne Pathogens Standard Employer Requirements for Medical and Training Records:

Employers also have an obligation to maintain worker medical and training records. The employer also must maintain a sharps injury log.

Bloodborne Pathogens Standard Employer Requirements for Work Practice Controls:

Employers are required to identify and ensure the use of work practice controls. These are practices that reduce the possibility of exposure by changing the way a task is performed, such as appropriate practices for handling and disposing of contaminated sharps, handling specimens, handling laundry, and cleaning contaminated surfaces and items.

Bloodborne Pathogens Standard Employer Requirements for Universal Precautions:

Employers are required to implement the use of universal precautions (treating all human blood and other potentially infectious material as if known to be infectious for bloodborne pathogens).

Bloodborne Pathogens Standard Employer Requirements for Training:

Employers must ensure that their workers receive regular training that covers all elements of the standard including, but not limited to: information on bloodborne pathogens and diseases, methods used to control occupational exposure, Hepatitis B vaccine, and medical evaluation and post-exposure follow-up procedures. Employers must offer this training at the time of hiring, at least annually thereafter, and when new or modified tasks or procedures affect a worker's occupational exposure.

Bloodborne Pathogens Standard Employer Requirements for Post-exposure Evaluation and Follow-up:

Employers must make available post-exposure evaluation and follow-up to any occupationally exposed worker who experiences an exposure incident.

Bloodborne Pathogens Standard Employer Requirements for Personal Protective Equipment:

Employers must provide personal protective equipment (PPE), such as gloves, gowns, eye protection, and masks. Employers must clean, repair, and replace this equipment as needed. Provision, maintenance, repair and replacement are at no cost to the worker.

Bloodborne Pathogens Standard Employer Requirements for Annual Plan Update:

Employers must use input from frontline workers to update the exposure control plan annually. These updates must reflect changes in tasks, procedures, and positions that affect occupational exposure, and also technological changes that eliminate or reduce occupational exposure.

Bloodborne Pathogens Standard Employer Requirements for Engineering Controls:

Engineering controls are devices that isolate or remove the bloodborne pathogens hazard from the workplace and the standard requires that employers identify and use such engineering controls. They include sharps disposal containers, self-sheathing needles, and safer medical devices, such as sharps with engineered sharps-injury protection and needleless systems.

Sexual contact:

Hepatitis B, HIV, and other diseases can be transmitted through sexual activities, even if the infected person does not show any symptoms.

Hepatitis C Virus

Hepatitis C infection can occur without symptoms or only mild ones. Chronic hepatitis develops in 75 to 80 percent of infected patients, and 70 percent of these individuals get active liver disease. Of those with active liver disease, 10 to 20 percent develop cirrhosis and 1 to 5 percent develop liver cancer.

What are the 3 most common pathogens that workers are at risk for?

Human Immunodeficiency Virus (HIV), Hepatitis B virus, and Hepatitis C virus.

Mucous Membranes:

Infected blood or bodily fluids can enter through contact with the mucous membrane found in the eyes, nose, or mouth.

Skin abrasion:

Infection can occur when open cuts or skin abrasions come in contact with contaminated blood or bodily fluids.

Now that the initial exposure has occurred and you have taken the immediate steps of cleaning the area and reporting the incident to your supervisor, what do you think needs to happen next?

Medical evaluation

. Recapping, bending, or removing needles is permissible only if there is __ feasible alternative or if such actions are required for a specific medical or dental procedure.

NO

The following practices can help ensure the safety of your patients:

Needles and syringes are single-use devices. They should not be used for more than 1 patient or reused to draw up additional medication. Once used, the syringe and needle are both contaminated and must be discarded; Do not administer medications from a single‐dose vial or an IV bag to multiple patients, and never combine leftover contents for later use; In general, limit the use of multidose vials and dedicate them to a single patient, whenever possible; and Finally, please take a moment to pause, with your staff and colleagues, to review injection procedures to ensure that safe practices are understood and followed by all.

Intravenous (IV) tubing or valves can prevent backflow and contamination of injection devices. True or False?

False

Contamination of injection devices is limited to the needle and removing the needle makes the syringe safe for reuse. True or False?

False, both the needle and the syringe are contaminated and must be discarded.

If you don't see blood in the IV tubing or injection equipment, there is no risk of cross‐contamination. True or False?

False, pathogens, including hepatitis B and C viruses, and HIV, can be present in sufficient quantities to produce infection without any visible blood.

Single-dose vials that appear to contain multiple doses may be used for more than 1 patient. True or False?

False, single-dose vials are intended for use in a single patient for a single procedure and should not be used for more than 1 patient, regardless of the vial size.

Reducing Infection Exposure Risks for Sharps:

Handle needles with care. Only properly trained individuals should draw blood or administer injections to prevent excess blood loss and resulting exposure.

Human Immunodeficiency Virus (HIV):

Once a person becomes immunocompromised, he or she can exhibit symptoms of weight loss, persistent low-grade fever, night sweats, and flu-like symptoms. The person is also more vulnerable to pneumonias, intestinal disorders, and fungal infections.

If you are exposed to infected bodily fluid, what should you do after properly washing the area?

Report the incident to get a follow-up evaluation

Chaundrise disposes of the syringe and needle after administering medication to her patient. Is this safe or unsafe?

Safe

Safe Devices Characteristics:

Since employers are required to involve frontline workers in selecting devices with safety features, you should get involved in this selection process. Choose devices that: Come attached with safety features that cannot be removed. Are easy to use and have clear instructions. Do not interfere with patient care. Can be engaged with one hand. Enable hands to remain behind the exposed sharp. Are visibly different when activated.

Hepatitis B Virus:

Symptoms of Hepatitis B include jaundice, fever, nausea, and abdominal pain. Approximately 5 to 10 percent of patients develop chronic infection with Hepatitis B, which carries an estimated 20 percent lifetime risk of dying from cirrhosis and 6 percent risk of dying from liver cancer. The chance of becoming infected with Hepatitis B from a sharps injury is estimated to be between 6 and 30 percent.

Types of Sharp Devices:

The following are types of sharps devices that can be used to protect you. Needle-free IV systems Sheathed, blunting, or retractable needles Blood transfer adapters Non-breakable plastic vacuum and capillary tubes Sharps disposal containers

How are bloodborne pathogens not transmitted?

Touching an infected person Coughing or sneezing Using the same equipment, materials, toilets, water fountains, or showers as an infected person sweat, tears, urine, or feces.

Luis notices that there is a lot of medication left over in the vial he has just used. Two more of his patients use the same medication so he plans to use it for them. Is this safe or unsafe?

Unsafe

Olivia has finished adding medication to her patient's IV. She keeps the syringe for use with the next patient since the valves can prevent backflow and contamination of injection devices. Is this safe or unsafe?

Unsafe

Reducing Infection Exposure Risks for PPE:

Use appropriate PPE when you may be exposed to blood.

Bloodborne Pathogens Standard Employer Requirements for Labels and Signs to Communicate Hazards:

Warning labels must be affixed to containers of regulated waste; containers of contaminated reusable sharps; refrigerators and freezers containing blood or other potentially infectious material; other containers used to store, transport, or ship blood or other potentially infectious material; contaminated equipment that is being shipped or serviced; and bags or containers of contaminated laundry, except as provided in the standard. Facilities may use red bags or red containers instead of labels. In HIV and Hepatitis B research laboratories and production facilities, signs must be posted at all access doors when other potentially infectious material or infected animals are present in the work area or containment module.

Reducing Infection Exposure Risks for Sanitation:

Wash and sanitize hands frequently and keep hands away from eyes, nose, and mouth until they are washed and sanitized.

CDC Safety Tips with Sharps:

Work in well-lit areas. Organize your work area with appropriate sharps disposal containers within reach. Receive training on how to use sharps safety devices. Before handling sharps, assess any hazard and get help if needed. Keep the exposed sharp in view. Be aware of people around you. Stop if you feel rushed or distracted. Focus on your task. Avoid hand-passing sharps and use verbal alerts when moving sharps. Watch for sharps in linen, beds, on the floor, or in waste containers.

Bloodborne Pathogens Standard Employer Requirements for Hepatitis B Vaccination:

Your employer must provide Hepatitis B vaccinations to all workers with occupational exposure. This vaccination must be offered after the worker has received the required bloodborne pathogens training and within 10 days of initial assignment to a job with occupational exposure.

The most common bloodborne pathogens are HIV, Hepatitis B, and Hepatitis C. Exposures to these diseases can occur via

a skin injury, contact with mucous membranes, non-intact skin with blood, tissue, or other bodily fluids.

What is considered contaminated?

a used needle, a syringe, an IV tube, and one or more medication bags

Where should sharps be disposed?

in a designated sharps container.

What are the routes of entry for hepatitis b?

blood and other infectious materials touch the eyes, nose, or mouth. exposure can occur if contaminated blood or other potentially infectious materials come in contact with dermatitis, open sores, or nicks and cuts on the skin.

Who must empty sharp containers?

by professional biohazard removal services. Never empty a sharps container yourself.

What must the post-exposure follow-up include?

counseling about the possible implications of the exposure and your infection status, including the results and interpretation of all tests and how to protect personal contacts, an evaluation of reported illnesses that may be related to the exposure.

Employers must also ensure that contaminated sharps are _____ of in sharps disposal containers _______ or as soon as feasible after use.

disposed, immediately

Which of the following statements are safe sharps device characteristics?

easy to use, clear instructions, visibly different when activated.

The ____ must document consideration and implementation of these devices and that they asked for worker input in the exposure control plan.

employer

The Needlestick Safety and Prevention Act revised the bloodborne pathogens standard requiring employers to evaluate, select, and use what to eliminate or minimize exposure to contaminated sharps?

engineering controls

What must Employers do for reusable sharps that are contaminated?

ensure they are not stored or processed in a manner that requires workers to reach by hand into the containers where these sharps have been placed.

Post-exposure medication for HIV, Hepatitis B, and Hepatitis C, when medically indicated, must be offered to you after an ______ according to the current recommendations of the U.S. Public Health Service.

exposure

Who has an increased occupational risk for Hepatitis C Virus?

healthcare workers

This disease causes serious damage to the liver and can be fatal. Infection can occur without symptoms or only mild ones. Chronic disease develops in 75 to 80 percent of infected patients, and 70 percent of these individuals get active liver disease. Of those with active liver disease, 10 to 20 percent develop cirrhosis and 1 to 5 percent develop liver cancer.

hepatitis c

healthcare providers caring for Ebola patients are at a ___ risk of getting sick because they may come in contact with infected blood or bodily fluids.

high

Hepatitis b is transmitted through potentially infectious materials, including:

human blood.

OSHA's Bloodborne Pathogens Standard, as amended by the 2000 Needlestick Safety and Prevention Act, is a regulation that:

prescribes safeguards to protect workers against health hazards related to bloodborne pathogens.

Before sharps disposal containers are removed or replaced, they must be closed to _________ spilling the contents.

prevent

You, as a worker, have legal protections against health hazards related to bloodborne pathogens. Among other things, these protections require that employers:

provide PPE, use controls to prevent injury, label hazards correctly, and provide Hepatitis B vaccinations, as well as free medical evaluations should an injury involving bloodborne pathogens occur.

What color label should a contaminated sharps container be?

red

Careful handling of contaminated sharps can prevent injury and ______ the risk of infection.

reduce

What does the CDC recommend to all workers for the Hepatitis B Virus?

s that all healthcare workers, emergency personnel, and other individuals who are exposed to blood or bodily fluids on the job, should be vaccinated against Hepatitis B. The vaccine is safe and effective and can protect you for a lifetime.

What are the routes of transmission for Hepatitis B?

skin abrasion, injection, mucous membranes, and sexual contact, in human blood and other potentially infectious materials such as semen, vaginal secretions, and saliva in dental procedures.

How can Ebola spread?

through direct contact with objects like clothes, bedding, needles, syringes, sharps, or medical equipment that have been contaminated with infected bodily fluids.

You can protect yourself from exposure to bloodborne pathogens by

treating all body fluid as infectious, wearing PPE, disposing of PPE correctly, keeping your hands clean, and avoiding eating, drinking, applying cosmetics or contact lenses around potential bloodborne pathogens.

Employers are required to implement the use of what when working with all human blood and other potentially infectious material regardless of whether it is known to be infectious for bloodborne pathogens?

universal precautions

How can you be exposed to bloodborne diseases?

via a skin injury in which you are injured by a sharp object. Second, via contact with mucous membranes or non-intact skin with blood, tissue, or other potentially infectious bodily fluids.

These are practices that reduce the possibility of exposure by changing the way a task is performed, such as appropriate practices for handling and disposing of contaminated sharps, handling specimens, handling laundry, and cleaning contaminated surfaces and items. Which term best describes these practices?

work practice control