bloodborne pathogens standard requirements
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Bloodborne Pathogens Standard Requirements. - PowerPoint PPT PresentationTRANSCRIPT
Bloodborne Pathogens Standard Requirements
TOSHA believes the information in this presentation to be accurate and delivers this presentation as a community service. As such, it is an academic presentation which cannot apply to every specific fact or situation; nor is it a substitute for any provisions of 29 CFR Part 1910 and/or Part 1926 of the Occupational Safety and Health Standards as adopted by the Tennessee Department of Labor and Workforce Development or of the Occupational Safety and Health Rules of the Tennessee Department of Labor and Workforce Development.
Bloodborne Pathogens
Pathogenic micro-organisms present in human blood that can lead to diseases
Human immuno-deficiency virus (HIV)
Hepatitis B (HBV) Hepatitis C (HCV)
Other Bloodborne Pathogens
Syphilis Malaria Brucellosis Babesiosis Leptospirosis Arborviral Infections Relapsing Fever Creutzfeld-Jacobs Disease--Mad-cow Viral Hemorrahgic Fever--Ebola
Potentially Infectious Materials –All Can Transmit Hepatitis B, C, and HIV
Blood Semen Vaginal secretions Cerebrospinal fluid Pleural fluid Pericardial fluid Peritoneal fluid Amniotic fluid Saliva in dental proc.
Any visibly contaminated body fluid
Any body fluid where differentiation is difficult
Any unfixed tissue or organ
Aqueous and vitreous humors in the eyes
Other Body Fluids
These body fluids do NOT have enough virus in them to transmit disease UNLESS they are contaminated with blood– Urine
– Feces
– Tears
– Sweat
– Vomitus
– Spit
Modes of Transmission
Stick or Cut Splash to mucous membranes of the eyes,
nose, mouth Non-intact skin exposure
Universal Precautions
Must be observed All blood and body fluids are treated as if
known to be infected with HIV, HBV, HCV, etc.
Do not come into contact with another person's blood or body fluids
Exposure Control Plan
Employer's plan describing how compliance with the standard is achieved
Describes what employees are covered Describes tasks that are covered Describes post-exposure follow-up procedures Must be reviewed and updated annually Must be accessible to employees
– Every employee should know the procedure to follow to obtain a copy
Exposure Control Plan
Safer Medical Devices– The Exposure Control Plan must be updated every
12 months to reflect evaluation, consideration, and selection of appropriate devices
– Document in the plan the devises evaluated and those currently used
– Front line employees must be involved in the selection of devices
Handwashing The single most important aspect of infection
control Wash hands when contaminated with blood or
body fluids and after removing personal protective equipment
Use antiseptic hand cleaner clean paper/cloth towels or antiseptic towelettes when "in the field"
Wash hands with soap and water asap
Use sharps with sharps injury prevention or needleless systems for all procedures involving sharps
Place in puncture resistant, labeled, leak-proof containers for transport, storage, and/or disposal
Keep the container closed Do not bend, break, recap, or remove needles Do not pick up contaminated broken glass directly with the hands Do not reach by hand into containers where contaminated sharps
are placed Do not overall sharps containers
Needles/Sharp Objects
Eating/Drinking
Do not eat or drink in areas where there is exposure to blood or body fluids
Do not store food in refrigerators, freezers, cabinets, on shelves or countertops where blood or other body fluids are present
Personal Protective Equipment (PPE) Wear PPE to prevent blood or body fluids
from getting on your clothes, skin, underclothes, etc.
Must be provided at no cost to the employee Employer must enforce the use Must be removed prior to leaving the work
area and placed in designated area
PPE
Parental exposure– stick or cut
Mucous membrane– splash
Non-intact skin– spill or splash
gloves gowns glasses/ goggles masks pocket masks shoe covers
Decontamination
Clean and decontaminate all equipment and environmental and working surfaces after contact with blood and/or body fluids
Decontaminate with appropriate disinfectant– EPA registered tuberculocidal disinfectant– EPA registered disinfectant with label stating it is
effective against HIV and HBV– Household bleach, diluted 1:10-1:100, made fresh
daily
Contaminated Laundry
Remove contaminated clothing when it becomes contaminated
Place immediately in bag or container that is labeled
Prevent leakage
Regulated Waste
Sharps containers– Needles– Blades– Broken glass
Red bags– Liquid or semi-liquid blood or
OPIM– Items caked with dried blood
or OPIM– Items that could release blood
or OPIM– Pathological waste– Microbiological waste
Hepatitis B Vaccination the HBV vaccination must be offered after the
employee has received training and within 10 working days of job assignment– At no cost– Provided by PLHCP– According to US Public Health Service most current
recommendations• “Immunization of Health Care Workers:
Recommendations of ACIP and HICPAC,” MMWR, Vol. 46, No. RR-18
HBV Vaccination Employees who do not take the shots must sign a declination
statement Highly recommended Few contraindications Three-shot series—titer 1-2 months after last shot No booster currently recommended Each person must have a health care professional's written
opinion– A copy must be provided to the employee within 15 days of
completion of the evaluation
An employee can decline now, take the shots later
Written Opinion
Each person must have a health care professional's written opinion for hepatitis B vaccination– A copy must be provided to the employee
within 15 days of completion of the evaluation
Post-Exposure Follow-up
After exposure incident– Stick or cut– Splash– Non-intact skin exposure
At no cost Begin ASAP after exposure incident Report exposure incident to your supervisor
or designated personnel immediately
Post-Exposure Follow-up
Investigation of the incident ID source individual, obtain consent, and test
their blood to determine HBV, HCV, and HIV infectivity ASAP
Results of source individual's test given to exposed person
Obtain and test exposed person's blood for HBV, HCV, and HIV serological status
Post-Exposure Follow-up Post-exposure prophylaxis as indicated by CDC
– “Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis” June 29, 2001, Vol 50, No. RR-11
– “Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis,” September 30, 2005, Vol 54, RR-09
Counseling and Evaluation of reported illnesses
Written Opinion
The employee must be provided a copy of the Health Care Professional's Written Opinion for Post-Exposure Follow-up within 15 days of completion of the evaluation
Labels
Containers with contaminated items
Can substitute red
Training
For all employees listed in the Exposure Determination
At no cost to employees During working hours At the time of initial assignment Annually--within 1 year of last training date Must be opportunity for interactive questions and
answers Train employees on adopted safer needle devices
before implementation
Training Five Easy Questions
– What is universal precautions?– What do you do when there is a blood spill?
• Personal protection• Clean-up and disposal procedures• Disinfection (hazard communication applies)
– What do you do with contaminated sharps and laundry?
– Have you been offered the HBV vaccination free of charge?
– Where is the Exposure Control Plan?
Additional Training Copy of the BBP standard, 29 CFR 1910.1030, must be
accessible to you Explanation of methods of recognizing tasks that may involve
exposure to blood and/or body fluids Information on types, use, location, removal, handling,
decontamination, and disposal of ppe Basis of selection of ppe Actions to take and persons to contact in a bloodborne
emergency that you do not know how to handle Procedure to follow if exposure incident occurs Opportunity for interactive Q & A
Records
Medical records– Name and social security number– HBV vaccination status– Results of exposure incident follow-up– Health care professional's written opinions– Info provided to health care professional– Confidential
Records
Training– Dates
– Contents
– Names and qualifications of trainers
– Names and titles of persons attending
Records
Sharps Injury Log– Per the Tennessee Sharps Injury
Prevention law– Keep a log of all sharps injuries with
• Type and brand of device involved in the incident
• Department or work area where the incident occurred
• Explanation of how the incident occurred
Resources www.osha.gov
www.tennessee.gov/labor-wfd/tosha www.cdc.gov www.cdc.gov/niosh Memphis Office 901-543-7259 Jackson Office 701-423-5641 Nashville Office 615-741-2793
1-800-249-8510 Knoxville Office 865-594-6180 Kingsport Office 423-224-2042 Chattanooga 423-634-6424 Consultative Services 1-800-325-9901