1 Kansas Spine & Specialty Hospital 2016 Clinical Competency

2 According to the CDC, bloodborne pathogens are defined as disease-causing microorganisms that may be present in human blood or other potentially infectious material (OPIM). This includes: Hepatitis B (HBV) Hepatitis C (HCV) Human Immunodeficiency Virus (HIV)

3 Healthcare personnel are at particular risk for exposure to bloodborne pathogens – this is why it is important to be aware and take simple and effective preventative measures to reduce the amount of exposure and contact with infectious diseases.

4 Important factors influence the overall risk for exposures to bloodborne pathogens with the risk of infection dependent on a number of variables such as: The number of infected individuals in the patient population The type and number of blood contacts

5 It is important to know, most exposures do not result in infections – the risk of infection varies with the following: The pathogen involved Exposure to a larger quantity of blood or other infectious fluid Prolonged or extensive exposure of non-intact skin or mucous membrane Exposures to the blood of a patient in an advanced disease stage with a high viral load A deep percutaneous injury with a hollow-bore, blood filled needle

6 Puncture wounds or cuts Contact (touch, splash, or spray) with blood or OPIM on: Mucous membrane Non-intact skin * cuts, abrasions, burns * acne, rashes * paper cuts, hangnails Contaminated sharps

7 Significant exposure to any of the following may pose a risk for bloodborne pathogen transmission: Blood Vaginal Secretions Semen Cerebrospinal fluid Synovial fluid Pleural fluid Peritoneal fluid Pericardial fluid Amniotic fluid

8 Body fluids that DO NOT pose a risk of bloodborne pathogen transmission UNLESS visibly contaminated with blood include: Urine Nonpurulent sputum Saliva Stool Emesis Nasal discharge Tears Sweat

9 Is a virus that causes infection and inflammation of the liver Is transmitted primarily through "blood to blood" contact Can lead to serious conditions such as cirrhosis & liver cancer Can survive in dried blood for up to seven days

10 There is no "cure" or specific treatment Many people develop antibodies to fight the disease which may prevent future infection Hepatitis B vaccine is an effective tool in prevention There is no vaccine for HCV

11  Mild flu-like symptoms  Fatigue  Possible stomach pain  Loss of appetite  Nausea  Jaundice  Darkened urine

12 AIDS is caused by a virus called the human immunodeficiency virus, or HIV It may take many years before AIDS develops HIV attacks the body's immune system, weakening it so that it cannot fight other deadly diseases AIDS is a fatal disease, and while treatment for it is improving, there is no known cure

13 Symptoms of HIV infection can vary, but often include:  Weakness and fever  Sore throat  Nausea  Headaches  Diarrhea  White coating on the tongue  Weight loss  Swollen lymph glands

14 Protection and use of PPE is the first step to prevention! If an exposure does occur, the following steps should be taken: 1.Treat the exposure site 2.Report and document 3.Evaluate the exposure 4.Disease specific management 5.Follow-up

15 Immediately following exposure to blood or OPIM: Wash needle sticks and cuts with soap and water Flush splashes to the nose, mouth, or skin with water Irrigate eyes with clean water, saline or sterile irrigants There is no scientific evidence that shows using antiseptics or squeezing the wound will reduce the risk of transmission – and using caustic agents such as bleach is not recommended.

16 Report the exposure: Immediately contact your supervisor and the Nursing Administration RN. Complete an online Bloodborne Pathogen Exposure Report. Counseling for the exposed individual will be offered immediately.

17 Evaluate the exposure: The employee will be offered testing through a blood sample, if source is known, and have blood tested for HIV antibodies and Hepatitis surface antigen The exposure will be evaluated based on the type of body substance involved, the route and severity of exposure

18 Exposure management: If the source patient tests positive for HIV, HBV and/or HCV, the appropriate education and treatment options will be offered to the healthcare provider affected Appropriate education, testing and follow-up care will be provided

19 Disease specific follow-up: Follow-up, counseling and education will be provided to the affected healthcare worker on an on-going basis as recommended by the CDC based on disease-specific guidelines

20 Healthcare personnel who have received hepatitis B vaccine and have developed immunity to the virus are at virtually no risk for infection For a susceptible person, the risk from a single needlestick or cut exposure to HBV-infected blood ranges from 6-30% and depends on the status of the source individual There is no known risk for HBV from exposure to intact skin

21 The average risk for infection after a needlestick or cut exposure to HCV-infected blood is approximately 1.8% The risk following a blood exposure to mucous membranes is unknown, but believed to be very small There have been rare reports of HCV transmission from HCV positive blood splash to the eye and non-intact skin

22 The average risk of HIV infection after a needlestick or cut exposure to HIV-infected blood is 0.3% - that means 99.7% of exposures do not lead to infection The risk of exposure to mucous membranes is estimated at 0.1% - or 1 in 1,000 The risk of exposure to non-intact skin is estimated to be less than 0.1%

23 HBV: The annual number of occupational infections has decreased 95% since the HBV vaccine became available in 1982 from >10,000 in 1983 to <400 in 2001 HCV: Studies have shown that 1% of hospital healthcare personnel have evidence of HCV infection – there are no exact estimates HIV: As of December 2001, CDC reported 57 documented cases and 138 possible cases of occupational exposure in the US since reporting began in 1985

24 Protection is the KEY to Prevention Follow infection control guidelines for effective hand washing practices Use personal protective equipment according to the CDC guidelines Glove up Use sharps with caution and dispose of properly Plan ahead – use sharps in a safe environment with a nearby sharps container DO NOT RECAP NEEDLES OR SCALPELS!

25 Theresa Gassett-Haynes, RN, BSN, CIC Quality and Risk Manager

26 You may access OSHA with any questions or concerns at: OSHA (6742)

27 1.Healthcare personnel are at low risk for bloodborne pathogens exposures. True or False 2.There are simple and effective preventative measures you can take to reduce the amount of exposure and contact to infectious diseases. True or False 3.Significant exposure to blood poses no risk for a bloodborne pathogens exposure. True or False 4.Urine, tears, saliva and sweat are among body fluids that do not pose a risk of bloodborne pathogen transmission unless visibly contaminated by blood. True or False 5.Symptoms of hepatitis may include fatigue, jaundice and darkened urine. True or False

28 6. Symptoms of HIV may include weakness and fever, white coating on the tongue, and swollen lymph glands. True or False 7.After 24 hours of a needlestick exposure, wash the needlestick with soap and water. True or False 8. If an exposure occurs, you should report the exposure immediately to your supervisor and the Infection Prevention Nurse, and complete an online Bloodborne Pathogen Exposure Report. True or False 9. Exposed employees will be offered counseling and testing, and provided with follow-up care. True or False 10. Who is our Infection Prevention Nurse at KSSH? ________________