Download I.P. Bloodborne Pathogens.Clinical 2016

2016 Clinical Competency
Kansas Spine & Specialty Hospital
1
According to the CDC, bloodborne pathogens are defined as
disease-causing microorganisms that may be present in
human blood or other potentially infectious material (OPIM).
This includes:
• Hepatitis B (HBV)
• Hepatitis C (HCV)
• Human Immunodeficiency Virus (HIV)
2
Healthcare personnel are at particular risk for exposure to
bloodborne pathogens – this is why it is important to be
aware and take simple and effective preventative
measures to reduce the amount of exposure and contact
with infectious diseases.
3
Important factors influence the overall risk for exposures to
bloodborne pathogens with the risk of infection dependent on a
number of variables such as:
• The number of infected individuals in the patient
population
• The type and number of blood contacts
4
It is important to know, most exposures do not result in
infections – the risk of infection varies with the following:
• The pathogen involved
• Exposure to a larger quantity of blood or other infectious fluid
• Prolonged or extensive exposure of non-intact skin or mucous membrane
• Exposures to the blood of a patient in an advanced disease stage with a high
viral load
• A deep percutaneous injury with a hollow-bore, blood filled needle
5
Puncture wounds or cuts
Contact (touch, splash, or spray) with blood or OPIM on:
• Mucous membrane
• Non-intact skin
* cuts, abrasions, burns
* acne, rashes
* paper cuts, hangnails
• Contaminated sharps
6
Significant exposure to any of the following may pose a risk
for bloodborne pathogen transmission:
• Blood
• Vaginal Secretions
• Semen
• Cerebrospinal fluid
• Synovial fluid
• Peritoneal fluid
• Pleural fluid
• Pericardial fluid
• Amniotic fluid
7
Body fluids that DO NOT pose a risk of bloodborne pathogen
transmission UNLESS visibly contaminated with blood
include:
• Urine
• Nonpurulent sputum
• Emesis
• Tears
• Saliva
• Stool
• Nasal discharge
• Sweat
8
• Is a virus that causes infection and inflammation of the liver
• Is transmitted primarily through "blood to blood" contact
• Can lead to serious conditions such as cirrhosis & liver cancer
• Can survive in dried blood for up to seven days
9
• There is no "cure" or specific treatment
• Many people develop antibodies to fight the disease
which may prevent future infection
• Hepatitis B vaccine is an effective tool in prevention
• There is no vaccine for HCV
10






Mild flu-like symptoms
Fatigue
Possible stomach pain
Loss of appetite
Nausea
Jaundice
 Darkened urine
11
• AIDS is caused by a virus called the human
immunodeficiency virus, or HIV
• It may take many years before AIDS develops
• HIV attacks the body's immune system, weakening it so that
it cannot fight other deadly diseases
• AIDS is a fatal disease, and while treatment for it is
improving, there is no known cure
12
Symptoms of HIV infection can vary, but often include:
 Weakness and fever
 Sore throat
 Nausea
 Headaches
 Diarrhea
 White coating on the tongue
 Weight loss
 Swollen lymph glands
13
Protection and use of PPE is the first step to prevention! If
an exposure does occur, the following steps should be taken:
1. Treat the exposure site
2. Report and document
3. Evaluate the exposure
4. Disease specific management
5. Follow-up
14
Immediately following exposure to blood or OPIM:
• Wash needle sticks and cuts with soap and water
• Flush splashes to the nose, mouth, or skin with water
• Irrigate eyes with clean water, saline or sterile irrigants
There is no scientific evidence that shows using antiseptics or squeezing the
wound will reduce the risk of transmission – and using caustic agents such
as bleach is not recommended.
15
Report the exposure:
• Immediately contact your supervisor and the Nursing
Administration RN.
• Complete an online Bloodborne Pathogen Exposure Report.
• Counseling for the exposed individual will be offered
immediately.
16
Evaluate the exposure:
• The employee will be offered testing through a blood
sample, if source is known, and have blood tested for HIV
antibodies and Hepatitis surface antigen
• The exposure will be evaluated based on the type of body
substance involved, the route and severity of exposure
17
Exposure management:
• If the source patient tests positive for HIV, HBV and/or HCV,
the appropriate education and treatment options will be
offered to the healthcare provider affected
• Appropriate education, testing and follow-up care will be
provided
18
Disease specific follow-up:
• Follow-up, counseling and education will be provided to the
affected healthcare worker on an on-going basis as
recommended by the CDC based on disease-specific
guidelines
19
• Healthcare personnel who have received hepatitis B vaccine
and have developed immunity to the virus are at virtually no
risk for infection
• For a susceptible person, the risk from a single needlestick
or cut exposure to HBV-infected blood ranges from 6-30%
and depends on the status of the source individual
• There is no known risk for HBV from exposure to intact skin
20
• The average risk for infection after a needlestick or cut
exposure to HCV-infected blood is approximately 1.8%
• The risk following a blood exposure to mucous membranes
is unknown, but believed to be very small
• There have been rare reports of HCV transmission from
HCV positive blood splash to the eye and non-intact skin
21
• The average risk of HIV infection after a needlestick or cut
exposure to HIV-infected blood is 0.3% - that means 99.7%
of exposures do not lead to infection
• The risk of exposure to mucous membranes is estimated at
0.1% - or 1 in 1,000
• The risk of exposure to non-intact skin is estimated to be
less than 0.1%
22
HBV: The annual number of occupational infections has decreased
95% since the HBV vaccine became available in 1982 from >10,000 in
1983 to <400 in 2001
HCV: Studies have shown that 1% of hospital healthcare personnel
have evidence of HCV infection – there are no exact estimates
HIV: As of December 2001, CDC reported 57 documented cases and
138 possible cases of occupational exposure in the US since reporting
began in 1985
23
Protection is the KEY to Prevention
• Follow infection control guidelines for effective hand washing practices
• Use personal protective equipment according to the CDC guidelines
• Glove up
• Use sharps with caution and dispose of properly
• Plan ahead – use sharps in a safe environment with a nearby sharps
container
• DO NOT RECAP NEEDLES OR SCALPELS!
24
Theresa Gassett-Haynes, RN,
BSN, CIC
Quality and Risk Manager
316-462-5326
[email protected]
25
You may access OSHA with any questions or concerns at:
1-800-321-OSHA (6742)
26
1. Healthcare personnel are at low risk for bloodborne pathogens exposures.
True or False
2. There are simple and effective preventative measures you can take to
reduce the amount of exposure and contact to infectious diseases. True or
False
3. Significant exposure to blood poses no risk for a bloodborne pathogens
exposure. True or False
4. Urine, tears, saliva and sweat are among body fluids that do not pose a risk
of bloodborne pathogen transmission unless visibly contaminated by blood.
True or False
5. Symptoms of hepatitis may include fatigue, jaundice and darkened urine.
True or False
27
6. Symptoms of HIV may include weakness and fever, white coating on the
tongue, and swollen lymph glands. True or False
7. After 24 hours of a needlestick exposure, wash the needlestick with soap
and water. True or False
8. If an exposure occurs, you should report the exposure immediately to your
supervisor and the Infection Prevention Nurse, and complete an online
Bloodborne Pathogen Exposure Report. True or False
9. Exposed employees will be offered counseling and testing, and provided with
follow-up care. True or False
10. Who is our Infection Prevention Nurse at KSSH? ________________
28