Bloodborne Pathogens Training Adapted by V .M. Warnock RN, BSN from slides by Heidi Toth RN, MSN

Infectious Disease Process- What are microorganisms?? Classifications: bacteria, viruses, fungi, algae, yeasts, and protozoa. Too small to be seen by the unaided human eye. Found;                    in the soil in the water, on plants and animals. billions on human skin and the nasal & intestinal tracts. Microorganisms include the following classifications: bacteria, viruses, fungi, algae, yeasts, and protozoa. These organisms are too small to be seen by the unaided human eye. They are found in the soil, in the water, and on plants and animals. In fact, billions are found in humans on the skin and in both the nasal and intestinal tracts.

Infectious Disease Process- What are pathogens? Most microorganisms live in harmony with the human body. Pathogens—can infect the body and cause disease. Infectious diseases range from mild illnesses, such as a cold, to fatal illnesses, such as AIDS. Although most microorganisms live in harmony with the human body, some—called pathogens—can infect the body and cause disease. Infectious diseases range from mild illnesses, such as a cold, to fatal illnesses, such as AIDS.

CHAIN OF INFECTION The Infectious Disease Process. The infectious disease process is defined as the interaction between the pathogenic microorganism, the environment, and the host. The process may be thought of as a circular chain with six links. The following story illustrates the chain. The Infectious Disease Process.

Microorganism & Reservoir The chain begins ,,,,,,,,,,, Second link:………. An environment in which the pathogen can survive: * Water * soil * inside someone already infected with the germ. The chain begins with the existence of a specific pathogenic microorganism.The second link is the reservoir, an environment where the pathogen can survive.

Escape & Transmission Escape from the reservoir ……. Third link. If we are the reservoir, the pathogenic microorganism can escape when we cough or sneeze.                    Next link …….. From the reservoir to the host. If water is the reservoir, its mode of transmission could be our drinking water supply.   The third link is the means of escape from the reservoir.The fourth link is the mode of transmission from the reservoir to the host.  

Entry & Susceptibility NEXT…. Means of entry into the host. A pathogen in water would enter us if we drank the water it was in. A pathogen in the air would enter us if we inhaled it.   Last link …. host's susceptibility Depends on the germ and the disease it causes..… Some hosts are easier to infect than others. The fifth link is the means of entry into the host.

CHAIN OF INFECTION For an infectious disease to occur,                                             For an infectious disease to occur, each link in the chain must be connected.  If even one link of the chain is missing, it interrupts the process, and no infection will occur. Here the chain is broken at the point of host susceptibility For an infectious disease to occur, each link in the chain must be connected.  

If even one link of the chain is missing: Interrupted process=No infection . Here the chain is broken at the point of host susceptibility. YOU can break the chain of infection by following standard precautions/universal precautions. If even one link of the chain is missing, it interrupts the process, and no infection will occur. Here the chain is broken at the point of host susceptibility.

Bloodborne pathogens …….. are microorganisms that are present in blood that can cause disease.                                                                                    How do you get infected? Enters another persons body blood or body fluid from an infected individual 2 examples of Bloodborne pathogens: Hepatitis B (HBV) Human Immunodeficiency Virus (HIV)

Any body fluid with visible blood is potentially infectious. Other body fluids like semen and vaginal secretions are considered potential infectious fluids. The risk of transmission from these body fluids in the school setting is considered extremely low.

POTENTIAL EXPOSURE RISK Contact alone does not ensure infection! Pathogens must enter the bloodstream to cause infection. In the workplace, an employee may be exposed to bloodborne pathogens such as Hepatitis B Virus or HIV when infected blood or body fluid is allowed to enter the body by means of penetration. Exposure may occur through: a needlestick a cut or break in the skin contact with mucous membranes such as the eye, nose, or mouth Bloodborne pathogens are transmitted when an individual comes in contact with an infected person's blood or body fluids. However, contact alone does not mean infection will result. Pathogens must enter the bloodstream to cause infection. In the workplace, an employee may be exposed to Hepatitis B Virus or HIV when infected blood or body fluid is allowed to enter the body by means of penetration. This can occur through: a needlestick a cut or break in the skin contact with mucous membranes such as those of the eye, nose, and mouth

HEPATITIS B VIRUS (HBV) HBV causes inflammation of the liver and may lead to complications of: Lifelong infection (>200 million carriers worldwide Hospitalization Cirrhosis (scarring) of the liver Liver cancer (cause of 80% of cases) Death HBV virus can live up to a week on a dried environmental surface. For more information about Hepatitis B: www.liverfoundation.org Hepatitis B Virus The microorganism known as Hepatitis B Virus (or HBV) causes an inflammation of the liver. This can result in illnesses such as chronic hepatitis, cirrhosis of the liver, and liver cancer. Because the virus is present in the blood or body fluids of a person with the Hepatitis B Virus, it is termed a bloodborne pathogen. Hepatitis B Virus is a serious health concern for any employee whose work responsibilities bring them in contact with blood or body fluids.

HEPATITIS B VACCINATION is one way to minimize your risk Three shots in upper arm over a 6-month period (0, 1, 4-6 months) Low incidence of side effects, people should not get the vaccine if they have had a life threatening allergic reaction to baker’s yeast or to a previous dose of hepatitis vaccine Routine booster doses are NOT recommended for any group Post vaccination blood testing is recommended for certain healthcare workers Hepatitis B shots are required for all school-age children. http://www.cdc.gov/ncidod/diseases/hepatitis/b/factvax.htm

HUMAN IMMUNODEFICIENCY VIRUS (HIV) Life-threatening virus compromises the body's immune system spread most commonly through sexual contact or by contact with infected blood and body fluids Early symptoms may be similar to those of the flu (fever, diarrhea, fatigue) Human Immunodeficiency Virus The Human Immunodeficiency Virus (HIV) is another bloodborne pathogen. This life-threatening virus compromises the body's immune system. Early symptoms may be similar to those of the flu. During later stages of the disease, the body is incapable of warding off other infections which frequently prove fatal. This virus can be carried for several years without showing symptoms (asymptomatic)

Eventually, Aids will develop.. AIDS destroy the body’s ability to fight infections, and certain cancers, and will lead to death. There is no vaccine to prevent AIDS For more information about AIDS : www.aegis.com

UNIVERSAL PRECAUTIONS Treating all blood and body fluids as potentially infectious for HIV, HBV and other bloodborne pathogens Applies to bloodborne pathogens while Standard Precautions…

Standard Precautions Applies to all body fluids (not just those affected by bloodborne pathogens). Affects all employees, includes the following: Avoidance of body fluid exposure Glove use and handwashing Good Samaritan Law- act promptly to the best of your training and ability and act until help arrives or exhaustion Training is done annually by school nurse

EXPOSURE CONTROL STRATEGIES Interrupt the chain of infection by using the following preventive measures: Wash your hands (remove pathogens before they can enter the body). Use personal protective equipment (PPE) (prevent contact with infectious materials.) Use caution when handling needles and other sharp objects. Contaminated sharps must be placed in puncture resistant containers labeled with a biohazard label. Do not recap! Sharps containers are in the Health Offices. Preventive Measures To interrupt the chain of infection for Hepatitis Virus or HIV, use the following preventive measures: Wash your hands to remove infectious organisms before they can enter the body.

Exposure Control Strategies cont… . Additional information on needlestick prevention at: http://www.cdc.gov/niosh/2000-108.html Finally, Receive a Hepatitis B vaccination to decrease your susceptibility to the disease. Presently, no vaccine for HIV is available. http://www.cdc.gov/niosh/2000-108.html Use caution when handling needles and other sharp objects. They can penetrate the skin and create entries for pathogens Finally, receive a Hepatitis B vaccination to decrease your susceptibility to the disease. Presently, no vaccine for HIV is available.

HANDWASHING Remember: Handwashing is the best way Washing your hands with soap under running water for at least 30 seconds of friction rubbing, then dry thoroughly. Shut off the faucet with the items you were drying with- not with your clean hands. Remember, you turned it on with dirty hands! No access to running water?: Instant gel hand sanitizer,containing alcohol, or towelettes, Remember: Handwashing is the best way to avoid the spread of any infection! Hands unconsciously touch the eyes, nose, and mouth numerous times throughout the day. These body areas are potential portals of entry for infectious organisms.

Handwashing cont… Because of potential infection, it is extremely important to wash your hands frequently. Wash hands immediately if you contact contaminated material. Wash them after: handling infectious waste, even if it is properly contained removal of gloves using the restroom wash your hands before going on breaks and before l leaving work at the end of the day. Wash your hands frequently. Encourage your students to do the same. Because of these factors, it is extremely important to wash your hands frequently. Wash hands immediately if you contact contaminated material. Wash them after: handling infectious waste, even if it is properly contained removal of gloves using the restroom And finally, wash your hands before going on breaks and before leaving work at the end of the day.

GLOVE REMOVAL With both hands gloved, peel one glove off from top to bottom and hold it in the gloved hand. · With the exposed hand, peel the second glove from the inside, tucking the first glove inside the second. · Dispose of the gloves promptly. · Never touch the outside of the glove with bare skin. · Every time you remove your gloves wash your hands with soap and water as soon as possible. · With both hands gloved, peel one glove off from top to bottom and hold it in the gloved hand. · With the exposed hand, peel the second glove from the inside, tucking the first glove inside the second. · Dispose of the gloves promptly. · Never touch the outside of the glove with bare skin. · Every time you remove your gloves wash your hands with soap and water as soon as possible.