La Salle University School of Nursing & Health Sciences Occupational & Safety Health Administration (OSHA) Orientation for Faculty

Welcome to La Salle! The following slide show focuses on the following objectives: Discusses role of microorganisms and pathogens in chain of infection Describes bloodborne, airborne, droplet, contact, vehicle and vector transmission of pathogens Explains protective interventions for decreasing risk of infection

Please Note: Faculty With proof of attendance at an OSHA orientation during this past year you do not need to review this presentation Just take the post-test and submit it to the Dean’s secretary

Bloodborne Pathogens & Other Infectious Agents

Microorganisms are Everywhere Most do not cause disease and are important for everyday life Some cause infection and disease (Pathogens)

Who Can Get Infection? Host = you, the patient, patient’s family, other healthcare workers, or visitors Anyone can be at-risk for developing infection after exposure if the circumstances are night.

Microorganisms Are Spread in These Ways

Airborne Transmission Person with infection coughs, sneezes organism into air Organism remains suspended in air Susceptible person breathes in organism and may become infected Example: TB, Measles, chickenpox

Droplet Transmission Droplets containing microorganisms contact mucous membranes of susceptible host Example: Influenza, meningococcal meningitis, rubella, mumps

Contact Transmission Transferring organisms to another person or surface Touching surfaces that are contaminated with pathogens Example: Chickenpox, C. difficile diarrhea, lice, scabies, HIV, Hepatitis B, Hepatitis C

Vehicle Transmission Organism passed on in food or water Example: Hepatitis A, Salmonella, Shigella, Giardia, E. coli 0127

Vector Transmission Etiologic agent must pass through animal or insect Example: Lyme disease, Rabies, West Nile Virus, Malaria

Stopping Infection Transmission We can stop infection from spreading to others by interrupting the way the microorganisms get from place to place.

Things You Can Do Prevent the spread of infection by: Washing your hands Using Standard Precautions Personal Protective Equipment Safety devices Safe work practices

Best Practice “Handwashing is the single most effective method to prevent the spread of infection.” Centers for Disease Control & Prevention

Handwashing Running water – comfortable temperature Soap – friction to all surfaces for seconds Backs of hands, between fingers, under nails Rinse well Dry thoroughly Use paper towel to turn off faucet (touching faucet recontaminates you)

Standard Precautions Protect you from both known and unknown sources of infection Should be used for everyone regardless of diagnosis or infectious state

Be Aware! Germs may enter through cuts, punctures, broken skin, eyes-nose-throat and mucous membranes

Standard Precautions WEAR GLOVES when touching blood, body fluids, excretions, broken (non-intact) skin, contaminated items WASH HANDS before and after any patient contact, after gloves removed, before invasive or sterile procedures

Standard Precautions Use personal protective equipment (PPE = gowns, masks, eyewear, gloves, etc.) to prevent exposure from splash of blood or body fluids to face or body

Infectious Waste Use gloves to discard items soiled with blood or body fluids, IV tubing, urinary catheters & nasogastric tubes into the infectious waste containers Wash hands after removing gloves

Prevent Sharps Injuries Be careful with sharps Activate safety mechanisms Don’t recap needles Get help with uncooperative patients Dispose immediately after use into designated sharps container

How to Clean a Blood Spill Put on gloves (if spill is large, wear gown) Use paper towels to absorb the blood, discard into red bag Clean area with soap & water Disinfect area with product such as Hepacide Discard all materials, including gloves into red bag Wash hands For larger spills, call Environmental Services

Soiled Linen Handle all linen as though it has blood or body fluids on it Place in linen bag Wash hands after handling soiled linen

Isolation Sometimes additional precautions are necessary for certain infections Airborne infections such as TB, measles, or chickenpox need special air handling Check your facility’s Infection Control Manual for specific infections that need extra precautions (isolation)

TB Skin Test - PPD You should have a PPD every year to check for TB A negative PPD usually means you are not infected with TB A positive skin test for TB (PPD) means you may have been exposed to tuberculosis and should be evaluated for active TB

OSHA Bloodborne Pathogen Rule Intent: To reduce or eliminate employee’s occupational exposure to bloodborne pathogens Any healthcare facility should have: Written exposure control plan Engineering controls (e.g., sharps boxes, etc) Safe work practices and safety devices Hepatitis B vaccine available Education and post-exposure follow-up

Occupational Exposure to Bloodborne Pathogens Occupational Exposure can occur following contact with blood or body fluids in these ways: Percutaneous – any new break in the skin caused by contaminated needle or other sharp object Mucous membrane contact – any splash or splatter of blood and/or body fluids to the eys, ears, nose, mouth, etc. Non-intact (broken) skin contact – any contact o blood and/or body fluid with an existing break in the skin

Bloodborne Pathogens These pathogens are found in the blood and certain body fluids of people who have these infections Hepatitis B Hepatitis C Hepatitis D Human Immunodeficiency Virus (HIV)

Transmission of Hepatitis Hepatitis B, C, and D are spread by contact with blood or body fluids containing Hepatitis B virus, or Hepatitis C virus, or Hepatitis D virus Prevention includes Always using Standard Precautions Getting your hepatitis B vaccine to prevent hepatitis B

Hepatitis B Vaccine Hepatitis B Vaccine protects you from getting Hepatitis B Hepatitis B vaccine is available from primary care providers Most health care facilities provide it for full-time employees

How is HIV Transmitted? Occupational exposure – blood or mucous membrane contact with infected blood or body fluids Sexual contact with HIV-infected person: anal, genital, oral, and other Blood to blood: injecting drug use, transfusion of blood or blood products Perinatally from HIV-infected mother to infant before, during or after birth

Infection Control for Home & Work Wash hands Before and after contact with patients and/or equipment After contamination and toileting before eating and touching face After removing gloves Between “dirty” and “clean” procedures

Infection Control for the Healthcare Worker Always practice safety Use Standard Precautions routinely Consider all patients potentially infected Add other isolation precautions as needed Plan ahead, anticipate potential problems, get help Follow procedures, don’t short-cut Use safety devices that are available

Infection Control for the Healthcare Worker Safe practices Practice sharps safety: don’t recap; activate safety devices and dispose of sharp items immediately after use into designated container Use engineering controls Wear personal protective equipment (gloves, gowns, goggles, or masks) to protect against splash of blood or body fluids to face or clothing

Infection Control for Everyone Be kind to your immune system Get enough rest Eat balanced diet Reduce or manage stress in your life Keep immunizations up-to-date, including getting Hepatitis B vaccine and annual influenza vaccine

Post-Exposure Follow-up If you have a blood or body fluid exposure: Wash/flush with water or saline Report the exposure immediately to your supervisor; complete an incident report Go for immediate medical evaluation and follow-up via Occupational Health (go to Emergency Department if exposure occurs off-shift); Faculty on affiliation may be expected to follow up with their own primary care provider

Post-Exposure Follow-up If you are exposed to a communicable disease, such as chickenpox, TB, or measles: Report the exposure to your supervisor and complete an incident report Review your immune status (have you had this infection or been immunized for it?) Go for medical evaluation

Do Not Come to the Facility If you have a fever If you are getting sick with a cold, influenza, or other communicable disease (example, measles, chickenpox) If you have Conjunctivitis (until on antibiotics and eye drainage stops) If you have Diarrhea and fever (until diarrhea stops) If you aren’t sure whether you should work, talk with your supervisor or director

Summary You are in control of your own protection Use hand washing consistently Use personal protective equipment Think!!