1. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 1 This product was funded by a grant awarded under the President’s Community-Based Job Training Grants as implemented by the U.S. Department of Labor’s Employment & Training Administration. The information contained in this product was created by a grantee organization and does not necessarily reflect the official position of the U.S. Department of Labor. All references to non-governmental companies or organizations, their services, products, or resources are offered for informational purposes and should not be construed as an endorsement by the Department of Labor. This product is copyrighted by the institution that created it and is intended for individual organizational, non- commercial use only.

3. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 3 Types of Infection Nosocomial infection Local infection Systemic infection

4. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 4 Infection Control A communicable disease is capable of spreading from person to person.

5. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 5 Means of Transmission of Infection Contact (direct and indirect) Droplet Vehicle Airborne

6. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 6 Employers are held responsible for worker safety OSHA: Federal agency: Occupational Safety and Health Administration If workers are exposed to blood or bodily fluid capable of transmitting blood-borne pathogens, then these workers must be provided protection Phlebotomists are exposed to blood and bodily fluids Blood-borne pathogens refers to organisms (virus or bacteria) that can be spread through blood or body fluids

7. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 7 Blood-borne Pathogens (BBP) The two most predominant BBP are: 1. HIV (the virus that causes AIDS) 2. Hepatitis B (virus)

8. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 8 HIV Transmission HIV cannot be transmitted by: Casual person to person contact at home or work or in social or public places Food, air, water Insect/mosquito bites Coughing, sneezing, spitting Shaking hands, touching, dry kissing or hugging Swimming pools, toilets, etc.

9. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 9 Hepatitis The term “hepatitis” means inflammation of the liver. Causes of hepatitis include: Toxic chemicals Alcohol Viruses

10. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 10 Hepatitis B Hepatitis B virus (HBV), formerly called serum hepatitis, is much more prevalent than HIV ( the virus that causes AIDS). Spread in numerous ways including sexual contact, blood products, and contaminated needles. Readily preventable by vaccination.

11. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 11 Transmission of Hepatitis B Through infected blood and other body fluids (seminal fluid, vaginal secretions, breast milk, tears, saliva and open sores). In the U.S., Hepatitis B is spread predominantly through sexual contact. Other risk groups include health care workers, prison inmates/personnel, IV drug users, and recipients of blood transfusions prior to 1975. In families, it appears that the virus can be casually spread from adults to children.

12. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 12 Hepatitis B The incubation period is 50 to 180 days. Jaundice is typically seen with type B. According to statistics, most people fully recover from Hep B in 1 to 2 months. It should be noted, however that 1-2% of individuals with Hepatitis B die shortly after infection due to liver failure.

13. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 13 AS A HEALTHCARE PROVIDER…. YOU ARE AT GREATEST RISK FOR CONTRACTING HEPATITIS B!!

14. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 14 Hepatitis B Vaccination As part of your admission to Calhoun’s Health Education Division, you are required to either receive the vaccine or sign a waiver. The vaccine involves a series of three injections. Side effects are minimal and may include soreness and warmth at the injection site.

15. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 15 Although there is no guarantee of immunity, it is very important that you consider receiving the vaccine. The CDC has made it mandatory for employers to provide vaccinations to healthcare employees because the risk is so much greater for us.

16. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 16 Healthcare workers always use: Standard Precautions Treat all patients as if they are possibly infectious for blood and body fluid pathogens. Previously known as Universal Precautions. (In this class, they are exactly the same)

17. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 17 Five Points of Standard Precautions Wash hands. Wear gloves. Wear protective covering. Wear mask and eye protection when appropriate. Use designated sharps containers.

18. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 18 Types of Body Fluids Capable of Transmitting BBP Amniotic Peritoneal Pericardial Synovial Pleural Edematous Seminal Cerebrospinal

19. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 19 OSHA Requires: Tactics to Reduce Risk of Exposure

20. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 20 1. Engineering Controls Physical and mechanical devices to reduce or eliminate the potential for the transfer of infectious diseases

21. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 21 Examples of Engineering Controls Sharps containers Transport bags and containers Self-sheathing needles and holders

22. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 22 2. Work Practice Controls Handwashing Proper disposal of sharps No eating, drinking, smoking, or applying cosmetics or lip balm in a work area. Food and drink must be stored separate from infectious materials.

23. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 23 3. Personal Protective Equipment Masks Goggles Face shields Gowns Gloves

24. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 24 4. Housekeeping Clean spills. Disinfect contaminated areas with commercial disinfectant or 10% fresh bleach solution. Do not pick up broken glass with hands.

25. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 25 5. Hepatitis B Vaccination Best defense against hepatitis B infection Must be provided free of charge to the phlebotomist once become employed

26. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 26 6.Isolation Category-Specific Isolation Strict Contact Respiratory Drainage Enteric Protective

27. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 27 OSHA Standards An exposure control plan must be developed. Engineering controls consisting of the safest device available must be in use.

28. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 28 OSHA Standards (cont.) There must be employee input into which devices to use. Records must be kept of any injuries.

29. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 29 Material Safety Data Sheets Hazards are identified by the hazard identification system. Information sheets that must be on file to indicate the hazards of the chemicals used in the laboratory

30. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 30 Response to a Needlestick Injury Wash the exposed area. Bandage the site. Record the patient’s name and identification information. Report incident to your supervisor. Fill out an incident report.

31. Copyright © 2005 Thomson Delmar Learning. ALL RIGHTS RESERVED. 31 Latex Allergy Allergic reactions to latex – Type IV latex allergy is contact dermatitis resulting in skin irritation. – Type I latex allergy is more serious. This is an immunological reaction up to anaphylactic shock.

32. OSHA / Safety Quiz Will cover material in Chap. 2 of text and material in this lecture