Medical Asepsis and OSHA Standards Why are germs important? What is a germ? How are germs spread? Should we all be doing the same thing, in terms of cleaning?

Medical Asepsis Asepsis = free of microorganisms Microorganisms Tiny organisms….microscopic Animals or plants Types of microorganisms Bacteria – single cell organisms Virus – not living, smallest of organisms Fungi – parasitic plants Parasites – live off of a host Amoebas and paramecium. – multi-celled organisms Pathogens – disease causing microbes

Growth requirement for microorganisms. Nutrition – food and chemicals Oxygen – some need it some don’t Aerobes live in oxygen Anaerobes live without oxygen Temperature – optimum growth Light or darkness Moisture pH – acidity or alkaline (basic)

How microorganisms are spread Need a germ (what’s another word) Need a host carrier Need a way to get that germ from one person to another. Examples? Need someone to give it to and a way into that person.

Infection cycle

Protective mechanisms of the body The skin – barrier protection. Mucous membranes – skin on parts of the body that “turn in” Mucus and cilia – mucus traps and cilia brushes it out of the body Mechanical – cough, sneeze and tears. pH – sweat, urine, stomach and secretions

Medical asepsis Hand hygiene Hand washing Hand washing Routine Hand washing Antiseptic or surgical hand washing Alcohol based “Quick wash” Not soiled Gloves – not a substitute for hand washing! Flora – microorganisms Resident – normal Transient–not normally there Hand washing Most important! Warm to hot water Soap/detergent Friction Time (how long?) When to wash your hands? Start and end of day Before & after each pt. Before & after eating. See pg 54 in text. Wash, gloves.

Questions about microorganisms and medical asepsis? What is the best way to prevent the spread of disease? What things do you need to spread disease?

OSHA Standards Occupational Safety and Health Administration Establish rules for a safe working environment All health care workers must follow these rules. Bloodborne pathogens Viruses Hepatitis B HIV – Human Immunodeficiency Virus AIDS – Acquired Immune deficiency Syndrome

Means of transmission by contact Direct contact Involves directly touching a susceptible host Examples Taking vital signs Handshake Sexual contact etc Indirect contact Does NOT involve direct contact Examples Airborne particles Droplets Residual pathogens

Stages of infection Incubation period Prodromal period From initial infection until signs of first symptoms. Prodromal period Vague, early symptoms Period of illness disease is at it’s peak Declined period decline of symptoms Period of convalescence body returns to pre-disease state

Stages of infection

How to prevent exposure Control in the workplace All body fluids are contaminated Observe warning labels Bandage cuts before work Wash your hands! If mucous contact, rinse the area Needle safety. Sharps container. Never re-cap! No eating, drinking, etc. Hand to mouth gestures. 3 refrigerators Make sure equipment is working properly before use If and accident happens, get help immediately! Personal protective equipment Types of equimpent Gloves, gown, faceshield Blocks bloodborne pathogens Provided by employer Alternatives to those who are allergic to certain things Wear gloves properly Eye, face protection. If blood or body fluid penetrates fabric, it must be removed immediately

Universal Precautions All body fluids are considered to be contaminated. Hepatitis B Hepatitis C HIV ETC

Hepatitis B Virus A bloodborne virus that causes liver disease -it is mean inflammation Can be transmitted from patient to health care worker Very strong virus outside of the body. How do we protect ourselves?

Hepatitis B Vaccination Must be offered by your employer within 10 working days of start of employment. Hepatitis B vaccination 3 shot series 1st, then 2nd 1month later, final one 6 months later. Reasons why someone would not get a Hep B shot Previously immunized Antibody testing (titers) Contraindications

Hep B Vaccine Refusal Refusal of the Hepatitis B Vaccine I, _________________________________, understand that due to my clinical exposure to blood or other potentially infectious material I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been notified of the availability of the hepatitis B vaccine and realize that it is a requirement of the Athletic Training Education Program to receive this vaccine. However, I decline the hepatitis Bvaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious and potentially fatal disease. If in the future I want to be vaccinated with hepatitis B vaccine, I can choose to do so. Employee Signature____________________________________________ Social Security Number __________________________ Date _________

Regulated Medical Waste Where to dispose of medical waste and disposable medical equipment? Regular trash container Not saturated with body fluids. Band-aid Biohazard Sharps container Anything sharp. Used or not. “drug paraphernalia” Biohazard “red bag” container Saturated in blood Sanitary sewer Large volumes of biohazard liquids

Housekeeping Specific procedures must be followed Clean and decontaminate equipment and surfaces after all procedures. Example in lab. Detergent. What else can be used? Do not pick up glass, even with gloves! Handle all laundry as if it is soiled Biohazard (sharps) containers Dirty? Clean it. Full? Replace it.

Review What is OSHA? What are way disease can be spread? What are the stages of infection? What is Universal Precautions? What is Hepatitis B? How do we get rid of contaminated medical waste?