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Bloodborne Pathogens Training CUSD BP/AR 6314 Fall 2014 Sponsored by the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Begin the Training Course Welcome Some slides may have audio narration and others may have embedded video clips Press an arrow button to advance or go back a slide Course Welcome ASCIP, in collaboration with CUSD’s Nursing Services, developed this elearning course specifically for Clovis USD You are responsible for reading and understanding information in this module Course Overview Introduction Bloodborne Pathogens Definitions Transmission & Workplace Safety Exposure Response, Prevention & Control ◦ Exposure Control Plan Course Overview Methods of Compliance o Engineering Controls o Reducing Your Risk Personal Protective Equipment Housekeeping Glove Removal Blood or Other Potentially Infectious Materials (OPIM) Gets on My Skin First Aid Course Overview Communication of Hazards to Employees oWarning & Signs oBiohazardous Waste oContaminated Laundry Hepatitis B Vaccine Series Post Exposure Follow-Up Training Introduction Cal/OSHA Title 8 CCR, Section 5193 requires an employer to educate employees and implement practices to minimize or prevent exposure to bloodborne pathogens Introduction BBP Standards OSHA estimates approximately 8 million healthcare workers and related industries have exposure to BBP The standard applies to all occupational exposure to blood or other potentially infectious materials (OPIM) What is an Occupational Exposure? Any employee who could reasonably anticipate coming into contact with blood or other potentially infected materials while performing assigned job duties Definitions Definitions Bloodborne Pathogens ◦ Is defined as pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus. Blood ~ means human blood, human blood components, and products made from human blood Definitions Continued Other Potentially Infectious Material (OPIM) ~ means the following fluids: semen, vaginal secretions, saliva in dental procedures, any other body fluid that is visibly contaminated with blood such as saliva or vomit, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids such as emergency response Or Definitions Continued Contaminated ~ means the presence or the reasonably anticipated presence of blood or OPIM on a surface/item Contaminated Laundry ~ means laundry which has been soiled with blood or OPIM or may contain SHARPS Definitions Continued SHARPS ~ any object that can be reasonably anticipated to penetrate the skin or any other part of the body, and to result in a exposure incident {needle devices, scalpels, lancets, broken glass, etc.} Engineering Controls ~ means of controls to isolate or remove the bloodborne pathogens hazards from the workplace. Example - SHARPS disposal containers. Definitions Continued Exposure Incident ~ A specific eye, mouth, or other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM that results from the performance of an employee’s job duties HBV ~ Hepatitis B can cause inflammation of the liver (jaundice, fatigue, etc.) HCV ~ Hepatitis C is similar to HBV but there is no current vaccine HIV ~ Human Immunodeficiency Virus Exposure Incidents Definitions Continued Personal Protective Equipment ~ specialized clothing or equipment worn or used by an employee for protection against a hazard (uniforms, pants, shirts, shoes, gloves, goggles, etc.) Universal Precautions ~ an approach to infection control ◦ Treat all human blood & OPIM as if known to be infectious for HBV, HCV, HIV Exposure Incidents Always Follow Universal Precautions Definitions Continued Regulated Waste ~ waste that contains oLiquid or semi-liquid blood or OPIM oContaminated SHARPS Work Practice Controls ~ controls that reduce the likelihood of exposure by defining the manner in which a task is performed (no recapping of needles, always wearing PPE, attend required training, etc.) Transmission & Workplace Safety Transmission & Workplace Safety On the job transmission to HBV, HCV, & HIV occur the same way. You can be exposed to contaminated blood if: oContaminated blood or OPIM containing visible blood contacts any break in your skin (cuts, nicks, abrasions, etc.), or oContaminated fluids come in contact with the mucus membranes of your nose, eyes, or mouth, or Transmission & Workplace Safety o You are cut with a sharp object that’s contaminated with these fluids, or o You touch a contaminated surface, then touch your mucous membranes or broken skin Hepatitis B (HBV) A virus that infects the liver HBV can survive outside the body at room temperature for over 7 days HBV is more easily spread than HIV 90% of adults contracting the disease recover fully and develop immunity Up to 10% of adults contracting the disease become carriers 6% - 30% SHARPS infection rate of unvaccinated person CDC, 2009 Hepatitis C (HCV) One of the most common causes of chronic liver; disease, cirrhosis and cancer Estimated 17,000 new infections annually 1.8% infection rate by SHARPS http://www.cdc.gov/hepatitis/hcv/pdfs/hepcgeneralfactsheet.pdf Transmission of HIV HIV is spread when infected blood, semen, vaginal fluid, or breast milk gets into bloodstream of another person oSexual contact oSharing needles oBreastfeeding oWorkplace exposure to blood and/or OPIM Transmission of HIV The average risk for HIV infection after a SHARPS exposure to HlV-infected blood is 0.3% (about 1 in 300) ◦ Stated another way, 99.7% of needle stick/cut exposures to HIV-contaminated blood do not lead to infection The risk after exposure of the eye, nose, or mouth (splash) is estimated to be, on average, 0.1% (1 in 1,000) There have been no documented cases of HIV transmission due to an exposure involving a small amount of blood on intact skin for a short period of time Exposure Response, Prevention & Control Exposure Determination An employer with employees having an occupational exposure to BBP must prepare an exposure determination oList of all job classifications in which All employees have occupational exposure Some employees have occupational exposures A list of exposure tasks and procedures Job Classification - Category 1 Job Classification Task Procedures Nursing Services Staff, Health Services Assistants, and Children’s Health Services Staff. Performance of health care duties as defined in job descriptions. Student Services Assistants I, Regional Learning Center Staff; Police Officers, and Campus Monitors. Providing first aid for cuts or lacerations. Special Education Teachers, Special Education Aides, Special Education Instructional Aides; Infant and Childcare Teachers, Infant and Childcare Aides, Childcare/Daycare Staff; Occupational Therapists, Kindergartner Teachers, and First Grade Teachers. Specialized health care procedures; feeding students; responding to accidents or injuries to students with blood spills or blood flow; interaction which results in student spitting at, biting or bleeding on an employee; toileting or diaper changing students where blood may be mixed with other bodily fluids; clean up of blood, salvia or vomit. Specialized District Program Staff: Campus Catering. Occupational exposure with Sharps. Job Classification - Category 1 Job Classification Task Procedures Specialized Health/Allied Health Educational Programs Instructors, Staff and in some cases Students: CUSD ROP: Courses in Health Pathways. CUSD Adult Education: Health Careers (LVN, Certified Nurse Assistant), Older Adult Program, Career Technical Programs. Occupational exposure with Sharps; performance of health care duties as defined in the educational programs. Plumbers, Custodial, Grounds, Maintenance Staff, and Bus Drivers. Clean up of blood, saliva or vomit, or handling tools or equipment that may be contaminated with blood, saliva or vomit. Athletic Trainers, Coaches, Lifeguards, Playground Supervisors, and Disaster First Aid Response Staff. Responding to accidents or injuries to students with blood spills or with blood flow; or interaction with students which results in student spitting, biting or bleeding. Job Classification - Category 2 Job Classification Task Procedures All Instructional staff not specified in Job Classification #1 above, Campus Club Staff, School Office Managers, School Administrators, Secretaries, Business Support Employees, and Psychologists. Providing first aid for cuts or lacerations. ECP ~ Potential Hazards Of Your Job Coming into contact with a cut, abrasion, etc. Possible contact with contaminated clothing or first aid material Cleaning up blood or OPIM Contaminated needles, condoms, etc. SHARPS & Needlestick Injuries Methods of Compliance Engineering & Work Practice Controls Personal Protective Equipment PPE’s should be worn in many task you perform When cleaning and disposing of trash you should wear latex gloves Other types of PPE ~ aprons, face shields, eyewear, shoes, masks Always make sure your PPE fits and is not damaged Proper Gloving Procedures Proper Hand-Washing Procedures ECP ~ Procedures to Follow if You Are Exposed Communication of Hazards to Employees Warnings & Signs Red Bag – Hazardous Materials All gloves must be disposed of in a biohazard bag All masks must be disposed if in a biohazard bag Bags are red in color and OSHA approved o All biohazards bags must be sealed and disposed of properly Regulated Medical Waste Sharps containers and red bags are provided for the collection of regulated medical waste Never use your hand or foot to push down biohazard waste materials Contaminated Laundry Contaminated laundry shall be handled as little as possible with a minimum of agitation Contaminated laundry shall be bagged or containerized at the location where it was used and shall not be sorted or rinsed in the location of use Contaminated laundry shall be placed and transported in bags or containers labeled or color-coded Cleaning Up Spills of Bloodborne Pathogens O The job of cleaning up a spill should be limited only to those persons who are properly trained O If an untrained person encounters blood, they should limit access and find someone to help who is trained Cleaning Up Spills of Bloodborne Pathogens O The following clean up procedures are general guidelines O When cleaning up spills of BBP be sure to follow Clovis USD specific procedures PPE O ALWAYS wear gloves and other PPE as needed O Mask and/or face shield O Disposable apron or other body covering O Shoe covers O If you’re using a commercial blood spill kit use PPE as required in the kit’s instructions Surface Disinfectants O Clean contaminated areas with O 10% household bleach and water; or O EPA registered germicide Proper Cleaning Supplies O Disinfectant solution O Spill bucket lined with a biohazard bag O Absorbent material such as D-Earth, kitty litter, absorbent pads or paper towels O Appropriate PPE Proper Cleaning Supplies O Disposable dust pan, broom, brush or tongs O If a spill involved broken glassware, always use mechanical means such as tongs or brush and a dustpan O Broken glassware or other SHARPs must be disposed of in a rigid, puncture resistant and leak proof container Proper Cleaning Procedures O Isolate the area O Do not allow unauthorized persons to enter until the spill has been cleaned up O Prepare disinfectant solution O Line spill bucket with a biohazard bag O Cover the spill with absorbent material Proper Cleaning Procedures O All surfaces to be cleaned must first be cleared of all visible soil and blood before a disinfectant is applied O Carefully remove visible blood with disposable towels by gently placing them over the spill to absorb it O If the blood spill has dried, soak the area, or scrub the area with disposable towels and disinfectant as needed Proper Cleaning Procedures O Place the towels in a bio-hazard bag O After cleaning up visible blood and soil, the area should be decontaminated a second time with an appropriate disinfectant used according to the manufacturer’s directions O If using 1:10 household bleach solution allow disinfectant to soak area for 20 minutes Proper Cleaning Procedures O All clean up materials, including PPE, should properly disposed of O Remove gloves inside out and also place them in the disposal bag O Wash your hands O Contact your supervisor for proper disposal procedures Hepatitis B Vaccine Series Hepatitis B Vaccine Series 1. No cost to the employee Employees in job category 1 & 2 2. Done by a physician 3. Conducted per the recommendations of the US Public Health Service 4. Done by an accredited laboratory 5. If employee declines HBV series, there must be a declination signed on file Hepatitis B Vaccine Series The vaccine is given in a three dose series The vaccine is generally well tolerated Prior to starting the series ◦ Contact your personal medical provider Post Exposure Procedures CUSD Work Comp Reporting Procedures If you have been contaminated by blood or OPIM wash off the exposed area Immediately report the incident or exposure to your supervisor Your supervisor will assist you in receiving medical treatment if necessary Inform the physician of your BBP exposure CUSD Work Comp Reporting Procedures The doctor will work with you to determine which post exposure evaluation and care is right for you Notify your supervisor of your work status Complete all required forms Training Requirements Training Requirements Time of initial job assignment Annually ◦ Job Classifications Categories 1 & 2 Biennial ◦ All other Job Classifications Changes to job or introduction to administrative or work practices CUSD Specific Items: Job Category 1 & 2 You Submit 1 Item Hep B Vaccine Routing Form ◦ Complete this form if you wish to begin the vaccine series Hep B Vaccination Series Verification ◦ Complete this form if you are already vaccinated Must have completed three dose series Hep B Vaccine Declination ◦ Complete this form if you have not received the series and do not want to begin the series Enroll in Hep B Series You’ve Already Had the Series You Don’t Want the Series CUSD Specific Items: Job Category 1 & 2 You Must Return 1 Item If you decline the Hep B Vaccine series but elect to begin the series in the future ◦ Contact the Benefits Office ◦ Remember, you must be in Job Category 1 or 2 Renewing employees must complete and submit one of the three Hep B Vaccine forms CUSD Specific Items: All Employees Be sure you have read CUSD’s written plan Review all appendices Complete and return EE Acknowledgement of Training form CUSD Specific Items: BBP Contacts Program Administrator ◦ Michael Clear, Assistant Superintendent, Business Services Program Manager ◦ Jeanne Prandini, Director of Nursing Services Job Safety Officer ◦ Shareen Crosby, Benefits Return Paperwork Hep B form (only one) Quiz Time Thank You