Bloodborne Pathogen Standard for VDH Employees

1. Bloodborne Pathogen Standard for VDH Employees

2. Bloodborne Pathogen Standard • The Bloodborne Pathogen (BBP) Standard was written by the Occupational Safety and Health Administration (OSHA) • 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

3. Who does it cover? “You are covered under the standard if it is reasonably anticipated that you could be exposed to bloodborne pathogens as a result of performing your job duties.” OSHA

4. Bloodborne Pathogens Anyone, regardless of age, race, or socioeconomic status, can carry a bloodborne disease.Often, without knowing it.

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

6. Bloodborne Pathogens Bloodborne pathogens are spread by contact with blood and other body substances such as: • Semen and vaginal fluids • Cerebrospinal fluid (spinal cord) • Synovial (joint) and pleural fluid (lung) • Peritoneal (stomach), pericardial (heart) and amniotic fluid (uterus) • Saliva (dental procedures)

7. Transmission Bloodborne diseases are spread by: • Direct contact with blood or body fluids (e.g., needle stick, splash to face) • Indirect contact with blood or body fluids (e.g., touching dried blood or body fluids on surfaces)

8. Hepatitis B • A serious liver disease • 1.25 million people chronically infected • 30% of people infected don’t have symptoms • Most cases resolve, 10% can be chronic • Healthcare workers (HCW) are at increased risk

9. Hepatitis B • Symptoms include loss of appetite, fatigue, jaundice, abdominal pain and nausea • Treatment available to control virus • Can be prevented by vaccination

10. Hepatitis C • A serious liver disease • 4.1 million infected • 3.2 million chronically infected • Chronic infection: 55-85% of cases • 80% of people do not have symptoms • 70% of cases develop liver failure

11. Hepatitis C • Increased risk for liver cancer • Many people do not have symptoms for 20 years after first infected • Anti-virals available to treat some forms • No vaccine available

12. HIV • Disease that causes the immune system to lose its ability to fight infection • 900,000 infected • Chronic infection • Clinical symptoms vary; initial infection may cause flu-like illness

13. HIV • Some people progress to Acquired Immunodeficiency Syndrome (AIDS) • Anti-virals available to treat illness • No vaccine

14. Exposure Control Plan • A document that describes how VDH addresses components of the BPP Standard. It includes: • Who is covered under the standard • Ways to reduce your risk of exposure • Procedures to follow if there is an occupational exposure • Located on the VDH internal Web Site: http://vdhweb/epi/icguide_index_06.asp

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

16. Engineering Controls Sharp safety rules: • Use needles with safety devices • Never recap, break or bend needles • Never reuse disposable sharps • Dispose of all needles in a regulated, color-coded, labeled sharps container • Sharps containers should be changed when 2/3 full.

17. 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

18. Work Practice Controls Hand Hygiene • Hand Hygiene includes both hand washing and hand decontamination. • Hand washing involves the use of soap, water, friction, and drying. • Hand decontamination involves removing surface organisms by a waterless hand sanitizer.

19. Work Practice Controls Hand Hygiene • Artificial nails should not be worn; natural nails should be no longer than ¼ inch • Hand hygiene is appropriate: • Between patients • Every time you remove your gloves • When entering and leaving a treatment room Whenever hands are in contact with blood or other body fluids wash them immediately

20. 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

21. Standard Precautions • A set of precautions that are designed to protect you from exposure to disease • All patients, ALL body fluids, ALWAYS • Includes: • Hand washing • Personal protective equipment (PPE) • Work practice controls • Post exposure prophylaxis (PEP) • Needle safety • Handling of linen and regulated medical waste

22. Personal Protective Equipment Protective wear that serves as a barrier between you and the infection: • Gloves • Gowns • Masks • Goggles/Faceshields • Resuscitation Devices

23. Protective Equipment • Varies with task • Maintained, replaced and disposed of by VDH • Fit properly • Supplied at no cost to employee • Free of flaws • VDH 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

24. 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

25. Hepatitis B Vaccine • Single most significant factor in preventing hepatitis B infection in HCW • 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

26. 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.

27. Occupational Exposure: Post-Exposure Counseling & 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

28. 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

29. Summary • The Bloodborne Pathogen Standard applies to anyone who has exposure to blood/body fluids while performing job duties. • VDH provides 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.

30. 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 VDH and for using the safety measures available to you to reduce your risk of exposure to bloodborne diseases.