Protecting Employees from Bloodborne Pathogens

1. Protecting Employees from
Bloodborne Pathogens

2. Course Objectives
After completion of this course, attendees should be able to:
 Discuss the components of Occupational Health and
Safety Administration (OSHA) Bloodborne Pathogen
Standard
 Describe HIV, hepatitis B and hepatitis C
 Review occupational risks for exposure to bloodborne
diseases
 Discuss engineering and work practice controls
 Describe appropriate personal protective equipment
 Define an occupational exposure, discuss the steps to
take if you are exposed

3. By definition, ALFs are non-medical facilities
that provide assistance with activities of
daily living.
By design, ALFs provide unique services to
residents who want to live as independently
as possible for as long as possible.
By day, many of these services carry the risk
of acquiring a serious disease.
Assisted Living Facilities (ALFs)

4. Your Risks
Caring for the needs of your residents may
expose you to bloodborne pathogens when:
 Assisting with bathing and oral care
 Performing dressing changes
 Monitoring blood glucose
 Performing injections
 Managing nose bleeds and abrasions
 Handling diapers, linens, and trash
 Cleaning rooms, common areas, and equipment
 Cleaning blood/body fluid spills

5. The Facts
Anyone, regardless of age,
race, or socioeconomic
status, can carry a
bloodborne disease.
Often, without knowing it.

6. Bloodborne Pathogens Standard
(BBP)
 Written by the Occupational Safety and
Health Administration (OSHA)
– Title 29 of the Code of Federal Regulations
(29 CFR 1910.1030)
 Purpose: To protect you and reduce
your risks for occupational exposure to
disease
 Describes policies and practices that
employers must establish to protect
employees who have contact with
blood/body fluids in their job

7. Bloodborne Pathogens Standard
(BBP)
The Bloodborne Pathogens Standard describes important
strategies that can reduce the risk of infection on the job.
These include:
 Exposure Control Plan
 Engineering Controls
 Work Practice Controls
 Standard Precautions/Personal Protective Equipment
 Housekeeping
 Hepatitis B Vaccine
 Occupational Exposure Follow-up

8. Bloodborne Pathogens
Bloodborne pathogens are diseases that are
carried in the blood and can be transmitted by
contact with infected blood. The most common
include:
 Hepatitis B
 Hepatitis C
 HIV

9. Hepatitis B
 Serious liver disease
 Most cases resolve, 10% of adult cases can
be chronic
 800,000 - 1.4 million chronically infected
 43,000 new cases in 2007
 30% of people infected don’t have symptoms
 Treatment available to keep the virus under
control

10. Hepatitis B
 Symptoms include loss of
appetite, fatigue, jaundice,
abdominal pain, and nausea
 Healthcare workers (HCW) are
at increased risk
 Can be prevented by vaccination
 Treatment available to keep the
virus under control

11. Hepatitis C
 Serious liver disease
 17,000 new infections in 2007 (estimated)
 Many people do not have symptoms for 20
years after first infected
 3.2 million chronically infected
 Chronic infection: 75-85% of cases

12. Hepatitis C
 Increased risk for liver cancer
 60-70% of cases develop chronic liver
disease
 Treatment available to keep the virus
under control
 No vaccine available

13. HIV
 Disease that causes the immune system
to lose its ability to fight infection
 1.1 million infected (1 in 5 undiagnosed)
 Chronic infection
 Some people progress to Acquired
Immunodeficiency Syndrome (AIDS)
 Clinical symptoms vary; initial infection
may cause flu-like illness
 Antiviral medications available to treat
illness
 No vaccine available

14. Transmission
Bloodborne pathogens are spread by contact
with blood and other potential infectious
materials such as:
 Semen and vaginal fluids
 Cerebrospinal fluid (spinal cord)
 Synovial (joint) and pleural fluid (lung)
 Peritoneal (abdominal), pericardial
(heart), and amniotic fluid (uterus)
 Saliva (dental procedures)

15. Bloodborne pathogens can enter the body in
a variety of ways, including:
 Needles
 Broken glass (broken blood tubes)
 Non-intact skin exposure through cuts, skin
abrasions, and mucous membranes of mouth,
eyes and nose
 Touching your mouth, eyes, nose or open skin
after touching surfaces or equipment
contaminated with blood or contaminated body
fluids
Transmission

16. Transmission Risk
Risk of infection depends on:
 The pathogen involved
 The type/route of exposure
 The amount of virus in the infected blood/body fluid at the
time of exposure
 The amount of infected blood/body fluid involved in the
exposure
 Specific immune response of the individual who was
exposed
 Presence and timeliness of post-exposure treatment

17. Transmission Risk
Risk of infection following an occupational
needlestick or cut from a known positive
source:
HBV: 6% - 31%
HCV: 1.8%
HIV: 0.3%

18. Exposure Control Plan
The Plan is a document that describes how
your employer will address the components
of the Bloodborne Pathogens Standard. It
includes:
 Who is covered under the standard
 Ways to reduce the risk of exposure
 Procedures to follow if there is an
occupational exposure.

19. Engineering Controls
Systems or mechanical devices that
minimize hazards in the workplace.
Examples:
 Self-sheathing or retractable needles
 Sharps disposal containers

20. Engineering Controls
Sharps safety rules
 Use needles with safety devices
 Never recap, break or bend
needles
 Never leave needles unattended
 Never reuse disposable sharps
 Dispose of all needles in a
regulated, color-coded, labeled
sharps container
 Sharps containers should be
changed when ½ - ¾ full.

21. “One-Hand” or “Scoop” Technique
Step 1: Place the cap on a flat surface,
then remove your hand from the cap
Step 2: With one hand, hold the syringe
and use the needle to “scoop up” the cap
Step 3: When the cap covers the needle
completely, use the other hand to secure the
cap on the needle hub. Be careful to handle
the cap at the bottom only (near the hub).

22. Work Practice Controls
Practices in the workplace
that protect you from disease
and prevent transmission to
your residents and coworkers.
These include:
 Hand hygiene
 Personal hygiene
 Personal protective
equipment

23. Work Practice Controls:
Hand Hygiene
 Hand hygiene includes both
hand washing and the use of
alcohol-based hand gels.
 Hand washing involves the use
of soap, water, friction, and
drying.
 Alcohol-based hand gels
decontaminate hands by
removing organisms on the
skin.

24. Work Practice Controls
Hand Hygiene
 Hand hygiene is appropriate:
– Between residents
– Every time you remove your gloves
– Before and after entering a resident’s room
– Whenever hands are in contact with blood or
other body fluids, WASH THEM
IMMEDIATELY
 Artificial nails should not be worn; natural
nails should be no longer than ¼ inch

25. Work Practice Controls:
Personal Hygiene
Self-protective practices that protect you from
disease:
 Do not leave food and drinks in refrigerators,
freezers or on counter tops where blood or
potentially infectious materials can be present,
e.g., nurses station
 Do not use petroleum-based lubricants with latex
gloves
 Do not eat, drink, apply cosmetics, or handle lip
balm in an area where you might be exposed to
blood or body fluids

26. Standard Precautions

27. Personal Protective Equipment
Protective wear that serves
as a barrier between you
and blood/body fluids:
 Gloves
 Gowns
 Masks
 Goggles/Face shields
 Resuscitation devices

28. Protective Equipment
 Varies with task
 Maintained, replaced, and disposed of by
facility
 Fit properly
 Supplied at no cost to employee
 Free of flaws
 Facility must offer training on use
 Must be cleaned carefully and as soon as
possible to prevent contamination
 Utility gloves can be reused if not damaged

29. Housekeeping
 Facility cleaning schedule
 Procedure for cleaning up
blood spills
 Use standard precautions
when handling all linen
(including sheets, clothes)
 Regulated medical waste
policy/procedure

30. Hepatitis B Vaccine
 Single most significant factor in preventing
hepatitis B infection in healthcare workers
 Must be offered to all employees who have
exposure to blood or body fluids on the job
 Safe, effective
 Series of three shots
 Long-term immunity

31. Occupational Exposure:
Immediate Response
If you should get stuck by a needle or if
you have direct skin or mucous membrane
contact with blood or other body fluids, you
will be provided with counseling and
follow-up care.
Exposures should be reported immediately
(within two hours) so that appropriate care
can be initiated.

32. Occupational Exposure:
Post-Exposure Counseling and Follow-up
 Don’t panic
 Wash the area with soap and water
 Flush eyes or mucous membranes
with water
 Report the incident immediately to
your supervisor and record date and
time of incident

33. Occupational Exposures
 You will be offered counseling by trained
medical staff to determine your risk of
acquiring a bloodborne disease
 If there is a risk, appropriate testing and
follow-up of the patient and employee will
be initiated
 Keep all follow-up appointments

34. Education
 Training in the BBP Standard is required
upon hire and annually thereafter
 Training must be conducted by a person who
is knowledgeable in the subject
 Training must be offered at a convenient
location and on company time
 Training records must be kept at least 3 years

35. Recordkeeping
 Medical records must be maintained for the
length of employment plus 30 years
 Sharps injury log must be maintained for 5
years from the date of exposure
– Type and brand of device involved
– Department or area of incident
– Description of incident

36. Summary
 The Bloodborne Pathogen Standard applies to
anyone who has exposure to blood/body fluids
while performing job duties.
 Your employer must provide engineering and
workplace controls to help prevent
occupational exposure, including personal
protective equipment and safe needle devices.
 The hepatitis B vaccine must be offered to
anyone who has exposure to blood and body
fluids while performing their regular job duties.

37. Summary
 Occupational exposures should be reported
immediately to your supervisor because
follow-up testing should be initiated as soon
as possible.
 You are responsible for following the
policies and procedures written by your
employer and for using the safety measures
available to you to reduce your risk of
exposure to bloodborne diseases.

38. Self Test (True or False)
1. The Bloodborne Pathogens Standard
covers anyone who has the potential for
contact with blood while working.
2. HIV, HBV, and HCV may cause no
obvious symptoms.
3. Standard Precautions should be used
with ALL residents.

39. 4. Used needles and syringes should always
be placed in a regulated sharps container.
5. Every employee is responsible for
following the BBP Standard when
performing job duties that require contact
with blood and body fluids.
6. Training in the BBP Standard is only
required upon hire.
Self Test (True or False)

40. Resources
 Centers for Disease Control and Prevention
– http://www.cdc.gov/HAI/organisms/organisms.html
 Occupational Safety and Health Administration
– http://www.osha.gov/SLTC/bloodbornepathogens/index.html
 Virginia Department of Health
– Contact your local health department (http://www.vdh.virginia.gov/lhd/)
– Office of Epidemiology, Division of Surveillance and Investigation
(804) 864-8141
 Department of Environmental Quality
– http://www.deq.state.va.us/