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ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page i Blood-borne Pathogens – Comprehensive Course This program is designed for individuals who may be exposed to blood and body fluids during the performance of their work and who wish to gain a more thorough understanding of blood-borne pathogens. The primary objectives for the Blood-borne Pathogens course are: to provide participants with the information required to recognize the hazards associated with occupational exposure to blood and body fluids become familiar with the steps to prevent exposure to blood and body fluids as well as the steps that should be taken following exposure to blood and body fluids Course Content: The Blood-borne Pathogens Course consists of 9 modules. The outline for the course material is as follows: Module 1: Introduction to Blood-borne Pathogens Module 2: The Immune System Module 3: Defence – The Immune System at Work Module 4: Anatomy, Physiology and Pathophysiology of the Liver Module 5: Hepatitis B Virus (HBV) Module 6: Hepatitis C Virus (HCV) Module 7: Human Immunodeficiency Virus (HIV) Module 8: Prevention of Blood-borne Pathogen Exposure Module 9: Blood and Body Fluid Exposure Follow-up Evaluation Process At the end of each module, there is a quiz that each course participant must challenge and successfully complete with a passing grade before continuing to the next content module. Module quizzes are review and evaluation tools that assist in preparing the course participant for the formal timed examinations following completion of Modules 4, 7 and 9, followed by a final exam. These exams consist of the following: Tests (3) (Modules 1-4, Modules 5-7, and Modules 8-9) Final Exam (Modules 1-9) ** Pass mark for each examination is 80% ** ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page ii Upon completion of the Blood-borne Pathogens Course the participant will be able to: Describe the hazards associated with exposure to blood and body fluids. Describe the most common blood-borne pathogens. Describe methods and protocols to prevent exposure to blood-borne pathogens. Describe the appropriate steps that should be taken following exposure to blood and body fluids. Objectives: Module 1: Introduction to Blood-borne Pathogens Define the term pathogen. Define the term blood-borne. Be familiar with the main groups of pathogens. Define the three most common occupationally acquired blood-borne pathogens. Define and differentiate the terms exposure and infection. Describe what constitutes significant exposure. Define occupational exposure. Describe the routes by which BBP can enter the body. Define percutaneous. Describe mucous-membranes. Define prophylactic. Define the term hepatitis. Describe the individuals most at risk of acquiring infection involving bloodborne pathogens. Discuss the procedures associated with the highest risk of BBP transmission. Discuss the relevance of injection practices with respect to BBP transmission. Be familiar with the types of body fluids known to transmit or have the potential to transmit blood-borne pathogens. Be familiar with the types of body fluids not associated with blood-borne transmission. Discuss the importance of vaccine with respect to HBV, HCV and HIV. Be familiar with factors that affect risk of transmission and infection following exposure. Describe the procedures most at risk for occupational exposure to bloodborne pathogen. Be familiar with factors that affect the risk of transmission and infection following exposure. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page iii Module 2: The Immune System Be familiar with the organs and tissues included in the immune system. Be familiar with the three major functions of the immune system. Discuss the structure and function of lymph nodes. Be familiar with the different types of white blood cells (WBCs). Demonstrate a general understanding of the different types of WBCs. Describe the functions of macrophages. Demonstrate an understanding of the flow of lymph fluid. Define antigen and antibody. Differentiate the terms ‘self’ and ‘non-self’. Differentiate donor and recipient. Name the types of materials and substances that may be recognized as foreign antigens. Define immunity, compatibility, autoimmune disease, immunosuppressants, phagocytes, interstitial fluid and stem cells. Differentiate specificity and non-specificity. Be familiar with the terms cytokine and chemotaxin. Name the four main types of lymphocytes. Demonstrate an understanding of cluster of differentiation antigens. Module 3: Defence – The Immune System at Work Differentiate innate and acquired immunity. Differentiate active, passive and induced immunity. Demonstrate an understanding of antibody production, recognition and presentation. Be familiar with the function of NK cells. Differentiate T-cells and B-cells. Differentiate humoral and cell-mediate immunity. Be familiar with the purpose of complement proteins. Be familiar with MHC proteins. Describe the three types of T-cells. Be familiar with CD proteins found on TC-cells and TH-cells. Describe the function of TH-cells, TC-cells and TS-cells Demonstrate an understanding of memory cells. Be familiar with the cytokines, especially interferon and histamine. Describe the function of the membrane attack complex. Demonstrate an understanding of immune response to viral invasion and bacterial invasion. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page iv Module 4: Anatomy, Physiology and Pathophysiology of the Liver Define and be able to differentiate the terms anatomy, physiology, and Pathophysiology and pathogenesis. Be familiar with the previous names for HAV, HBV and HCV. Describe the function of the liver. Properly label a simple diagram of the biliary tract. Describe the function of the gall bladder. Describe bilirubin and where it originates. Describe bile. Describe the role of bile with respect to fat metabolism. Define metabolism. Define hepatocyte. Differentiate liver lobes, lobules and hepatocytes. Differentiate canaliculi, ductules and ducts. Discuss the role of the liver with respect to metabolism, detoxification, and waste removal. Describe the function of the liver with respect to glucose, fats and proteins. Name the three types of fat synthesized by the liver. Name the three main groups of proteins produced by the liver. Define enzyme. Describe the importance of cholesterol in metabolic processes. Demonstrate understanding of liver function with respect to blood coagulation. Name the two major categories of liver proteins. Differentiate glucose and glycogen. Define co-infection and superinfection. Name the two most common causes of hepatocyte injury. Define the terms acute and chronic. Define hepatitis. Be familiar with the clinical presentation of acute hepatitis. Define carrier state. Be familiar with blood tests commonly used to monitor liver function. Name four causes of liver damage. Be familiar with the risks associated with acquiring HAV, HBV and HCV infection. Be familiar with the mode of transmission for HAV, HBV, HCV, HDV and HEV. Define fulminant liver disease. Define necrosis. Describe the long term complications associated with HBV, HCV, and HIV infection. Describe the complications associated with chronic infection. Define the term cirrhosis. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page v Module 5: Hepatitis B Exposure Describe the routes of transmission associated with HBV infection. Describe the effect of HBV on the liver. Define and differentiate between the terms epidemiology, incidence, and prevalence. Be familiar with the term ‘Dane particle.’ Be familiar with the three major HBV antigens. Describe the incubation period for HBV infection. Define the term carrier. Describe the risk of developing chronic HBV infection. Describe the risk of developing HBV infection following percutaneous injury. Be familiar with the incidence and prevalence of HBV infection. Describe the symptoms and clinical presentation associated with HBV infection. Describe the complications associated with HBV infection. Be familiar with the treatments for acute and chronic hepatitis. Describe the role of prophylactic treatment with respect to prevention of HBV infection following exposure to blood or body fluids. Describe safety measures associated with prevention of HBV exposure. Define the risk of developing HBV infection following exposure. Describe safety measures associated with prevention of HBV infection following exposure. Define fulminant hepatitis and cirrhosis. Be familiar with the laboratory blood tests used to diagnose and monitor HBV infection. Describe the role of immunization with respect to prevention of HBV infection. Discuss the role of re-immunization and booster shots following initial HBV. immunization. Describe the role of immunity testing following HBV exposure. Describe the efficacy of immunization with respect to immune response. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page vi Module 6: Hepatitis C Exposure Describe the routes of transmission for HCV exposure/infection. Describe the effect of HCV on the liver. State the prevalence of HCV infection in the population. Discuss the most common risk factors associated with HCV infection. Describe the role of donated blood or blood products in HCV transmission. Describe the role of hemodialysis in HCV transmission. What is the incubation period for HCV infection. Describe the symptoms and manifestations of acute HCV infection. Describe the complications associated with chronic HCV infection. Define the risk of developing chronic HCV infection following acute infection. Describe the role of prophylactic treatment with respect to prevention of HCV. Define the risk of developing HCV infection following exposure. Describe the role of immunization with respect to prevention of HCV infection. Discuss the difficulties associated with HCV vaccine development. Be familiar with the treatment goal(s) for HCV. Discuss the two most common anti-viral agents used to treat chronic HCV infection, and common side-effects. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page vii Module 7: HIV Exposure Describe the routes of transmission associated with HIV infection. State the prevalence of HIV infection in the population. Describe the incubation period preceding seroconversion in individuals exposed to HIV. Describe the incubation period preceding symptoms of HIV infection. Describe the symptoms and manifestations of acute HIV infection. Describe the complications associated with chronic HIV infection. Define the risk of developing HIV infection following exposure. Describe the role of prophylactic treatment with respect to prevention of HIV infection following exposure to blood or body fluids. Describe safety measures associated with prevention of HIV exposure. Describe safety measures associated with prevention of HIV infection following exposure. Describe the role of immunization with respect to prevention of HIV infection. Define and differentiate HIV infection, Aids-related complex, and acute immunodeficiency syndrome. Be familiar with the treatment for hepatitis C. Describe the role of prophylactic treatment following exposure to HIV. Describe the current role of immunization with respect to prevention of HIV infection. Define and differentiate between HIV screening tests and confirmatory tests. Module 8: Prevention of Blood-borne Pathogen Exposure Describe the government regulations and workplace policies created to reduce occupational exposure to blood-borne pathogens. Define Body Substance Isolation. Define and differentiate the terms Universal Precautions and Standard Precautions. Describe employer responsibilities in prevention of occupational exposure to blood-borne pathogens. Define employee responsibilities in prevention of occupational exposure to blood-borne pathogens. Describe the main issues targeted in the Blood-borne Pathogen Regulations. Describe practical methods to prevent needle-stick and sharps exposures. Describe the role of workplace Exposure Control Plans in preventing exposure to blood-borne pathogens. Describe the components that should be included in a workplace Exposure Control Plan. ARO Training & Consulting Bloodborne Pathogens Bloodborne Pathogens Course Overview Page viii Module 9: Blood and Body Fluid Exposure Follow-up Describe the steps that should be performed following an exposure to blood or body fluids. Describe the role of the workplace Occupational Health department in blood and body fluid exposure follow-up. Describe the laboratory testing that may be appropriate following an occupational exposure to blood or body fluids. Describe the relative risk of infection following exposure to blood or body fluids from an individual who is positive for HBV, HCV, or HIV. Describe the factors and considerations that influence blood-borne pathogen infection following exposure to blood and body fluids from an individual who is positive for HBV, HCV, or HIV.