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Occupational Exposure to Blood or Other Potentially Infectious Materials by Sharps, Mucous Membrane Splashes, or Broken Skin Under OSHA Regulations (Standards - 29 CFR) Bloodborne pathogens. - 1910.1030. employers must have a plan in place to evaluate and treat health care workers in accordance with the latest postexposure assessment, prophylaxis, and treatment guidelines published by the CDC. See http://63.234.227.130/OshDoc/data_BloodborneFacts/bbfact01.pdf last updated 1/2011 Examples of exposures: Contaminated Laundry, disposable drapes, or underpads which have been soiled with blood or other potentially infectious materials or may contain sharps that cause a skin puncture, or blood which comes in contact with broken skin, or mucous membranes. Contaminated Sharps which are any contaminated objects that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires. Splashes of blood and body fluids in eyes, nose, lips, mouth, or on broken skin of healthcare worker. Under OSHA Standard – 29 CFR Bloodborne pathogens, your employer must be able to provide: • Immediate evaluation and risk assessment for exposure of healthcare workers to Bloodborne Pathogens meaning pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV) http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=10051 • Immediate evaluation and risk assessment for exposure of healthcare worker to other Potentially Infectious Materials meaning (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV. Employers may use a HOTLINE where an exposed employee calls to receive instructions on their shift and location 24 hours a day, 7 days per week. WHAT TREATMENT SHOULD THE NURSE RECEIVE BY LAW? • Confidential testing for HIV, hepatitis B, and hepatitis C. • Access to post-exposure treatment and prophylactic medications within two hours of exposure. • Counseling, education, and follow-up testing for up to one year after exposure. IMMEDIATE RESPONSE TO ANY KIND OF SHARPS INJURY • Wash the wound with soap and water. • Alert your supervisor and initiate the injury reporting system used in your workplace. • Identify the source patient, who should be tested for HIV, hepatitis B, and hepatitis C infections. Your workplace will begin the process to test the patient by seeking consent. • Report to employee health services, the emergency department, or other designated treatment facility. • Get tested immediately and confidentially for HIV, hepatitis B, and hepatitis C infections • Get post-exposure prophylaxis called PEP in accordance with CDC guidelines which can be found below or call the National Clinicians PEP Hotline at 1(888)448-4911 1. Recommendations for management of occupational exposures to blood when it is unknown if the patient has HIV, HBV, and HCV (link updated by ANA 3-9-11) 2001 Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis RR-11 MMWR Recommendations and Reports, Volume 50, (ONS make direct link here) http://www.cdc.gov/mmwr/PDF/rr/rr5011.pfd Number 2. Recommendations for the management of occupational exposures to blood when the patient was tested and was positive for HIV (link updated by ANA 3-9-11) 2005 Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis MMWR Recommendations and Reports, Volume 54, Number RR-9(ONS make direct link here) - http://www.cdc.gov/mmwr/PDF/rr/rr5409.pfd IMMEDIATE RESPONSE TO ANY KIND OF MUCOUS MEMBRANE EXPOSURE AND NONINTACT SKIN If you are stuck by a needle or other sharp or get blood or other potentially infectious materials in your eyes, nose, mouth, or on broken skin, • Immediately flood the exposed area with water • Clean any wound with soap and water or a skin disinfectant if available. • Report this immediately to your employer • Seek immediate medical attention and receive post-exposure prophylaxis called PEP in accordance • with CDC guidelines which can be found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm And/or call the National Clinicians PEP Hotline at 1(888)448-4911 Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm Accessed 3/9/11 Resources: For dozens of free resources about prevention of exposures to bloodborne pathogens and treatment, please see this website at the US Department of Labor: http://63.234.227.130/SLTC/bloodbornepathogens/index.html#standards updated March 9, 2011 ana.coeh r R