Bloodborne Pathogens Training

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Bloodborne Pathogens Training

• School District of New Berlin
• 2008

2
Bloodborne Pathogens Training

• Overview of BBP Standard
• Types of pathogens
• Exposure Control Plan

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Purpose of Exposure Control Plan

• Eliminate or minimize employee occupational
  exposure to blood or certain other body fluids
• Comply with the OSHA Bloodborne Pathogens
  Standard, 29 CFR 1910.1030 and incorporate
  changes in the OSHA Compliance Directive CPL
  2-2.44D, dated November 5, 1999.
• Provide a safe and healthful working atmosphere
  in the School District of New Berlin
• The School District of New Berlin has appointed
  an exposure control manager. The manager is the
  district nurse.

4
Bloodborne Pathogens

• Human immunodeficiency virus (HIV)
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)

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Bloodborne Pathogens

• Can acquire from
• Blood
• Body fluids containing visible blood
• Other potentially infectious material (OPIM)
• Cerebral spinal fluid (CSF), synovial fluid,
  pleural fluid, peritoneal fluid, amniotic fluid

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Bloodborne Pathogens

• Exposure Incident
• Contact with blood or other potentially
  infectious material on the employees non-intact
  skin, eye, mouth, or other mucous membrane by
  piercing the skin or mucous membrane through such
  events as needle-sticks.

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Bloodborne Pathogens

• Occupational exposure occurs by
• Percutaneous injury (ie needle stick, cut, bite
  etc.)
• Contact with mucous membranes
• Contact with non-intact skin in which there is
  blood, body fluids with visible blood, OPIM

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Bloodborne Pathogens

• HIV
• Virus that causes AIDS
• Incubation period 1
• to 3 months
• Person is infectious from
• Onset of infection throughout life
• All persons are susceptible

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Bloodborne Pathogens

• HBV
• virus that causes hepatitis B
• Incubation period 45 to 180 days
• Person is infectious if test for antigen (HBsAG)
  is positive
• Unvaccinated persons are susceptible
• Vaccination is recommended for persons with
  occupational exposure

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Bloodborne Pathogens

• HCV
• Virus that causes hepatitis C
• Incubation period 6 to 9 weeks
• Most persons are infectious for life
• All are susceptible

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Exposure Control Plan

• Universal/standard precautions
• Hand hygiene
• PPE
• Engineering and controls
• Work practice controls
• HBV vaccination
• Post-exposure management
• Training

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Exposure Control Plan

• Available to all employees
• Copies available in District office

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Exposure Control Plan

• Exposure Determination
• The district has identified the following job
  classifications as those in which employees of
  the district could be exposed to BBP in the
  course of fulfilling their job requirements.

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Exposure Control Plan

• Job Classifications
• Nurses
• Building Administrators
• Secretaries Elementary/Secondary
• Athletic Trainers
• Custodians
• Health Room volunteers
• Occupational Therapists
• Physical Therapists
• Those working with early childhood,
  moderate/severe cognitively disabled, and
  physically handicapped students

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Universal Precautions

• Part of OSHA BBP standard
• Used on ALL individuals
• Used for ALL contact with
• Blood, body fluids, OPIM
• Mucous membranes
• Non-intact skin
• To protect against bloodborne pathogens

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Standard Precautions

• Part of CDC guidelines on infection control
• Used on ALL individuals
• Blood, all body fluids, secretions, excretions
  (except sweat) considered infectious (regardless
  of visible blood)
• Used to protect against all infectious agents
• Hand hygiene
• Use of PPE

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Hand Hygiene

• Wash hands
• After touching blood, body fluids, secretions,
  excretions, contaminated items, regardless if
  gloves are worn
• Immediately after removing gloves
• Before leaving work area
• Whenever hands are dirty or contaminated

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Hand Hygiene

• Hand washing technique
• Turn on faucets to comfortable water temperature
• Wet hands, apply soap, lather
• Rub with friction for at least 15 seconds, making
  sure to wash back of hands, fingers, fingertips,
  in between fingers
• rinse with fingertips pointing downward
• Dry hands with paper towel
• Discard paper towel and turn off faucets with
  clean paper towel

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PPE

• Gloves, safety glasses or goggles, and masks
• Used when there is a reasonable anticipation of
  exposure to blood, body fluids, mucous membranes,
  non-intact skin
• Provides protection for clothing, skin, eyes,
  mouth, nose

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PPE

• Employer responsibilities
• Provide in appropriate sizes
• Make accessible
• Require use by employees
• Clean, launder, repair, replace as needed
• Provide training

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PPE

• Employee responsibilities
• Use appropriately
• Dispose of appropriately

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PPE

• Gloves
• Disposable
• Wear when it can be reasonable anticipated that
  the employee may have hand contact with blood,
  OPIM, mucous membranes, and non-intact skin and
  when handling or touching contaminated items or
  surfaces.
• Select correct size
• Have readily available at work station

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PPE

• Protective eye wear safety glasses, goggles,
  masks, and/or solid eye shields
• To be worn whenever splashes, spray, spatter or
  droplets of blood or OPIM may be generated and
  eye, nose or mouth contamination can be
  reasonably anticipated
• All PPE used at this facility will be provided
  without cost to employees.
• PPE is located in the Custodial department and
  health rooms.

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PPE Removal

• 1) Remove gloves by grasping outside of gloved
  hand with other gloved hand and peel off. Hold
  removed glove
• in gloved hand.
• 2) Slide fingers of ungloved hand under
• remaining glove.
• Discard gloves.

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PPE Removal

• Wash hands!

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Engineering and Work-Practice Controls

• Engineering work-practice controls will be
  utilized to eliminate minimize exposure to
  employees at this facility. The following
  engineering controls will be utilized
• Gloves and other necessary PPE
• Clean-up kits (Impact Products inc.)
• Bio-Hazard bags
• Sharps containers
• Sharps definition any object that can penetrate
  the skin including but not limited to, needles,
  scalpels, broken glass, and blades.

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Engineering Controls

• Place used sharps in disposal containers
  immediately after use
• Sharps containers
• Puncture resistant
• Leak-proof
• Labeled and red in color
• Maintained in upright
• position

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Engineering Controls

• Sharps containers
• Replace sharps containers when 2/3 full
• The users of the containers are responsible to
  contact the District Nurse to replace when
  necessary

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Work Practice Controls

• Do not place hands into used sharps containers
• Use a brush and dustpan or tongs or forceps to
  pick up broken glass or other sharp items

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Work Area Restrictions

• Do not eat, drink, apply make-up or lip balm,
  smoke, or handle contact lenses with likely
  exposure to blood or OPIM
• Do not store food and beverages in refrigerators,
  freezers, shelves, cabinets, or on counter tops
  or bench tops where blood or OPIM are present.

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Waste Disposal

• Infectious waste
• Sharps
• Disposable items that are saturated with blood or
  OPIM to the point where such material can be
  squeezed, poured, dripped, or flaked off the
  items
• Place in red biohazard bags, seal to prevent
  spillage during handling
• Contact the Custodian to store in designated
  areas for collection by waste haulers

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Labels

• Infectious waste fluorescent orange or
  orange-red bag with biohazard label
• Sharps containers red container with
• biohazard label

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Cleaning/Disinfection

• Cleaning and disinfection of all equipment and
  environmental surfaces after contact with blood
  or OPIM will be done by the Custodial staff or
  Health room personnel as necessary.
• Use EPA registered disinfectant with activity
  against HIV, HBV, HCV or 110 bleach
• Follow instructions on disinfectant label

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Handling Blood Spills

• Procedure for Cleaning Blood Spills
• Wear PPE gloves, goggles, and/or mask
• Wet cloth with the disinfectant
• Wipe item/area with wet cloth
• Spray disinfectant on item/area
• Wipe with clean cloth, let air dry

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Hepatitis B Vaccination

• Any one with occupational exposure to blood or
  OPIM should be vaccinated
• Recommended unless
• Employee has documentation of receipt of series
• Antibody testing shows immunity
• Employee has medical contraindications

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Hepatitis B Vaccination

• Available free of charge, within 10 working days
  of work start date
• If employee declines, must sign statement of
  declination
• Employee may request the series later

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Hepatitis B Vaccination

• Safety
• Very safe vaccine
• US as of 2000 more than 100 million adults have
  received vaccine with few side effects
• Serious reactions are rare
• Mild symptoms may occur soreness at injection
  site, low-grade fever
• May be given during pregnancy

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Hepatitis B Vaccination

• Effectiveness
• At least 90 of adults are immune after
  completing the three doses of vaccine
• since 1985, 90 reduction of number of HCW
  infected with HBV, largely due to vaccine

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Hepatitis B Vaccination

• Vaccine provided at Aurora Health Center New
  Berlin
• Administered by deep intramuscular injection
• 3 doses given 1st two doses 1 month apart, last
  dose is given 5 months after second dose

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Post Exposure Management

• 1) Clean the site
• Percutaneous injuries
• wash with soap and water
• Mucous membranes
• rinse copiously with water
• 2) All first aid incidents involving the presence
  of blood or OPIM shall be reported to the
  District Nurse by the end of the work day on
  which the incident occurred.

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Post Exposure Management

• 3) The districts exposure incident investigation
  form must be used to report first aid incidents
  involving blood or OPIM.
• 4) Employee Accident Report from must be
  completed.
• 5) The full hepatitis B vaccination series shall
  be made available as soon as possible, but in no
  event later than 24 hours, to all unvaccinated
  employees.

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Completion of BBP

• You have completed the Bloodborne Pathogens
  program.
• Please complete I form verifying you have
  completed the program.
• Call Pam Jesse RN, District Nurse at x6439 with
  questions or concerns.