1. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Textbook for Nursing Assistants Chapter 8: Bloodborne and Airborne Pathogens

2. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Bloodborne Pathogens

3. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins A bloodborne pathogen is a disease- producing microbe that is transmitted through – Blood – Other body fluids Bloodborne Pathogens

4. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Body fluids are liquid or semi-liquid substances produced by the body such as –Blood –Urine, feces –Vomitus, saliva –Drainage from a wound –Sweat, tears –Semen, vaginal secretions –Cerebrospinal and amniotic fluid –Breast milk Body Fluids

5. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Ways bloodborne pathogens are transmitted: –Needle sticks (puncture wounds caused by dirty hypodermic needles) –Cuts from contaminated, broken glass (such as that from a broken blood tube) –Direct contact between infected blood and broken skin, mucous membranes, or the eyes –Sexual intercourse –Blood transfusions Transmission of Bloodborne Pathogens

6. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Diseases Caused by Bloodborne Pathogens

7. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The following diseases are caused by bloodborne pathogens: –Hepatitis B, C, and D –Acquired immunodeficiency syndrome (AIDS) –Malaria –Syphilis –Ebola Hepatitis and AIDS pose the most occupational risk to a health care worker. Diseases Caused by Bloodborne Pathogens

8. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins –Inflammation of the liver, the organ that removes toxic substances from the bloodstream –Caused by a viral infection, chemicals, drugs, or drinking alcohol –Some infections are mild, producing no lasting effects on the liver –Others are chronic and affect the liver’s ability to function over time. If the liver failure is severe, the person will die unless he or she receives a liver transplant. Hepatitis

9. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis A virus (HAV) Hepatitis B virus (HBV) Hepatitis C virus (HCV) Hepatitis D virus (HDV) Hepatitis E virus (HEV) Types of Hepatitis Virus

10. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Hepatitis A Virus: Transmission HAV is transmitted via the oral–fecal route This virus lives in the digestive tract of the patient –Contaminated food or water –Unclean hygiene habits –Infected shellfish

11. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Illness caused is acute Complete recovery possible Effective vaccine available; recommended for the general public Handwashing important for preventing the spread of infection Hepatitis A Virus: Recovery/Prevention

12. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins HBV is transmitted through –Transfusion of infected blood or blood products –Across the placenta from mother to infant –Unprotected sexual intercourse Hepatitis B Virus: Transmission

13. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Health care workers are at risk for contracting HBV through –Needlestick injuries –Cuts from contaminated objects –Exposure of broken skin or mucous membranes to contaminated blood or other body fluids Hepatitis B Virus: Transmission

14. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Illness caused is acute Carriers are people who carry the virus but have no symptoms Effective vaccine available – Recommended for general public – Recommended by OSHA for health care workers Hepatitis B Virus: Recovery/Prevention

15. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins HCV is transmitted through –Contaminated blood transfusions –Needlestick exposures Mode of transmission is mainly bloodborne; but in more than 40% of people who are diagnosed with HCV, no obvious route of transmission is found. In many cases, leads to liver failure and liver transplant becomes necessary. Hepatitis C Virus: Transmission –most common cause of chronic hepatitis

16. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Illness caused by HCV infection is chronic and serious –End-stage cirrhosis (a fatal liver disease) –Liver failure –Liver cancer Hepatitis C is the leading cause for liver transplantation in the United States. Currently, no vaccine against HCV is available. Hepatitis C Virus: Recovery/Prevention

17. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Bloodborne pathogen Found only in people who are already infected with HBV Vaccination against HBV protects against HDV Hepatitis D Virus: Transmission

18. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Spreads through the oral–fecal route HEV infection common in countries with poor sanitation controls No vaccination is available for HEV Hepatitis E Virus: Transmission

19. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins HIV is a bloodborne pathogen that: –Is transmitted through body fluid and blood –Causes acquired immunodeficiency syndrome (AIDS) –Affects the body’s immune system People with AIDS do not die from the virus itself. Instead, they die from infections that the body is no longer able to fight To date, there is no cure for AIDS and no vaccine for HIV HIV and AIDS

20. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The human immune system –Recognizes pathogens –Destroys pathogens T cells are special white blood cells (leukocytes) –One type of T cells recognize and kill cells infected by viruses –Other types of T cells produce substances that help other cells in the immune system to defend the body against the pathogens –HIV invades the T cells Cause of Acquired Immunodeficiency Syndrome

21. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Cause of Acquired Immunodeficiency Syndrome –HIV uses the T cells to multiply and copy itself –Eventually, HIV kills the T cell and moves on to repeat the process in other T cells –The body then becomes unable to recognize and fight off infections, leading to the condition known as AIDS

22. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Protection PPE

23. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins HIV and HBV pose an occupational risk to health care workers Health care workers come in contact with substances that carry these viruses Health care workers are not able to easily identify patients or residents who have these diseases The virus can live in a person’s body without causing signs or symptoms For these reasons, in the health care field, every patient or resident must be treated as if he or she may be infected with a bloodborne pathogen—thus, the term standard precautions Standard Precautions

24. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Gloves are worn if the POSSIBILITY exists that the hands could come in contact with blood or other body fluids. Gloves are also worn when touching any surface that could be contaminated with pathogens A waterproof gown is worn if the POSSIBILITY exists that your clothes could become soiled with blood or other body fluids A mask, face shield, and eye goggles are worn if the POSSIBILITY exists that blood or other body fluids could splash or spray Standard Precautions

25. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Standard Precautions Sharps, such as needles and razors, are disposed of properly in OSHA-approved containers Broken glass is never handled; it is swept or vacuumed up for disposal Spills of blood and other body fluids must be cleaned up promptly with an approved cleaning agent

26. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Standard Precautions Personal protective equipment must be worn when cleaning up spills. Hands must be washed when you remove your gloves. Handwashing is the single most important method of preventing the spread of infection!

27. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins OSHA Standards

28. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Employees must receive training on the risks associated with bloodborne pathogens and on the methods they can use to safeguard themselves Employers must make the hepatitis B vaccine available to workers who are at risk, free of charge Employers must provide adequate personal protective equipment (PPE) as required by the employee’s duties OSHA Bloodborne Pathogens Standard

29. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins OSHA Environmental control methods, such as special ventilation systems, procedures for the disposal of liquid waste, and procedures for handling contaminated linen and trash must be in place to protect both the employees and the patients or residents An updated exposure control plan must be in place in case an employee is exposed to blood or other body fluids from a patient or resident

30. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Airborne Pathogens

31. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Airborne pathogens: disease-producing microbes that are transmitted through the air Infection spreads when an infected person coughs or sneezes, and another person breathes the air containing the suspended pathogens Infections that are transmitted in this way include measles, chickenpox, and tuberculosis (TB) Vaccines are available to prevent measles and chickenpox Currently, no vaccine is available for TB, HIV, or HBV Pose an occupational risk to a health care worker Airborne Pathogens

32. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Infection caused by bacteria present in the sputum of an infected person; spread by airborne droplets when the person coughs, sneezes, speaks, or sings People who have close, frequent contact with a person who has TB are most likely to contract the disease Infects the lungs, kidneys, or bones TB is usually diagnosed following a routine skin test (used to screen for the disease) or chest x- ray Tuberculosis (TB)

33. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patients or residents known or suspected to be infected with an airborne pathogen are to be placed in private rooms with special ventilation systems Health care workers – masks when caring for patients or residents with known or suspected tuberculosis (TB) If the health care worker has not been exposed to measles or chickenpox then he or she is at risk for these diseases – mask should be worn when caring for patients or residents with measles or chickenpox Airborne Precautions

34. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins A surgical mask should be placed over the patient’s or resident’s face if he or she must be transported from one location to another Transport of the patient or resident should be kept to a minimum All precautions for preventing transmission of TB should be implemented if the patient or resident is known or suspected to have TB Airborne Precautions

35. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation