Infection Control Part 3: Bloodborne Pathogens Basics What You Need to Know and Do

Transcription

1 Infection Control Part 3: Bloodborne Pathogens Basics What You Need to Know and Do Terri Maxwell PhD, APRN VP, Strategic Initiatives Hospice Education Network & Weatherbee Resources Inc. Course Handouts & Post Test To download presentation handouts, click on the attachment icon Course evaluation and post test are available from your course catalog To achieve credit for this course, close the video portion when completed and click on Start Test Part 3. Objectives At the end of this section, participants will be able to: 1.Identify definitions for bloodborne pathogens, other infectious materials, exposure incident, and Personal Protective Equipment (PPE). 2.Identify potential exposure incidents for yourself in your hospice role. 3.Choose effective responses to various hospice case study scenarios about bloodborne pathogens. 4.Describe what a surveyor might look for, to ensure your Hospice is compliant with this OSHA Standard. 1

2 Bloodborne Pathogens --- What You Need to Know What OSHA s Standard Is and Why It Matters Definitions Requirements Your Hospice s Exposure Control Plan OSHA Standard Occupational Safety and Health Administration (OSHA), of the United States Department of Labor Prescribes safeguards to protect workers Against health hazards Exposure to blood Exposure to other potentially infectious materials, To reduce your risk from this exposure Definitions Blood: human blood, human blood components, and products made from human blood [insert graphic] Bloodborne Pathogens: pathogenic (diseased) microorganisms that are present in human blood and can cause disease in humans. Include but not limited to hepatitis B (HBV), human immunodeficiency virus (HIV), and other potentially infectious materials. Contaminated: presence (or possible presence) of blood or other potentially infectious materials on item or surface 2

3 More Definitions Other Potentially Infectious Materials: Body fluids (semen, vaginal secretions, saliva with blood, fluids from the brain/spine, heart, lungs, amniotic sac) Any unfixed tissue or organ (other than intact skin); HIV-containing cell or tissue culture Exposure Incident: A specific eye, mouth, other mucous membrane, non-intact skin, or needlestick with blood or other potentially infectious materials that results from doing your job. More Definitions Personal Protective Equipment (PPE): Specialized clothing or equipment worn by an employee for protection Includes, but not limited to, isolation gown with cuffs, fluid resistant face mask, shoe covers, eye shield, gloves, infectious wastes trash liner, hair cap When? Who? What Tasks? Reasonably Anticipated contact with blood and other potentially infectious materials Direct patient physical care: hospice aides, nurses, nurse practitioners, physicians, physical therapists Tending skin tears or abrasions, open wounds, IV s, catheters, ports, drawing blood, IV s, catheters, fluids or drainage, soiled clothing and linens (etc.) Direct patient care though limited physical care: social workers, spiritual caregivers, counselors, volunteers Family members and caregivers! Educate. Prepare. 3

4 Where Exposure Starts Any blood or blood product Other potentially infectious body fluids, tissues etc. (defined previously) Unbandaged skin tears, abrasions or wounds Needles used with blood or potentially infectious materials Clothing, items, surfaces with blood or infectious fluids Questions To You What hospice tasks do you do that involve any of these? Which hospice patients in your care -- -today--- involves any of these tasks? How Exposure Occurs Contact of mucous membranes (eye, nose, mouth) or broken (cut or abraded) skin with the contaminated blood, fluid, or tissue Needlesticks, cuts from other contaminated sharps Refer back to Part 2 Hand Hygiene for common hospice tasks with risks for infection Question To You Do you have your Personal Protective Equipment (PPE) ready to use? (More info ahead) Basic Universal ( Standard ) Precautions Treat allhuman blood and certain body fluids as if they are infectious. Observe precautions in all situations where there is a potential for contact with blood or other potentially infectious materials. 4

5 Exposure Control Plan Your agency is required by law to have a written Exposure Control Plan that Identifies jobs and tasks where occupational exposures might occur. Describes how your agency Uses engineering controls & work practice controls. Ensures use of Personal Protective Equipment (PPE). Provides training. Provides surveillance, reporting, tracking. Provides information on hepatitis B vaccinations. Uses hazardous warning signs and labels. Your Agency s Exposure Control Plan You Need to Know What these are and why they matter for you in your role Blood, Bloodborne Pathogens, Contaminated, Other Potentially Infectious Materials, Exposure Incident, Personal Protective Equipment Where to find your agency s Exposure Control Plan, or whom to contact in your agency for more information Your agency s information for patients, families & caregivers Where is it written? When and how do they receive it? Know how this information applies to you in your role Is infection control addressed in your Job Description? Is infection control included in your Annual Performance Review? More What You Need to Know Is Ahead in Parts 4-7 Part 4: Standard and Transmission-Based Precautions Part 5: Personal Protective Equipment Part 6: Hepatitis B Part 7: Exposure Incidents 5

6 Why it matters! High Risks High Costs High Preventability IT S THE LAW! Home care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. Am J Ind Med Feb;52(2): Bloodborne Pathogens --- What You Need to Do Maintain your Personal Protective Equipment (PPE) Prevent transmissions through precautions Educate the patient, family and caregivers Report exposure incidents Maintain Your PPE Maintain clean, useable supplies of Personal Protective Equipment. This is supplied to you by your hospice. Show where and how you store it. Demonstrate when and how to use each item. Describe how to discard waste items. Describe where to get new items. 6

7 Educate Your Patients, Families and Caregivers As is appropriate to your role, and defined by your agency. As applies to the patient s risks and caregiving needs. Be aware of what infection control information is given to them. Refer to it. Invite questions. Educate Your Patients, Families and Caregivers Don t assume they ve read the materials. Don t talk at them. Talk with them. Ask and learn from them: What do they already know? What are they already doing? What questions or concerns do they have? How can you support them? Report Exposure Incidents Follow your Hospice s Exposure Control Plan These protocols need to include how to: Wash exposed areas Dispose of waste materials Report the exposure incident Document the incident Test for exposure and evaluate extent Follow-up with the employee 7

8 More What You Need to Do Is Ahead in Parts 4-7 Part 4: Standard and Transmission-Based Precautions Part 5: Personal Protective Equipment Part 6: Hepatitis B Part 7: Exposure Incidents A Surveyor Will Look For Your Hospice s Exposure Control Plan Staff knowledge (like asking staff questions about what they know and would do in case of an exposure) Demonstration of standard and transmissionbased precautions (observations during patient care visits) Documentationof prevention and precautions (like chart audits) A Surveyor Will Look For Exposure Incident Reports, with follow-up actions and outcomes Training records of employees and volunteers (for up to 3 years) Written information for patients, family, and other caregivers in Hospice admission materials on prevention of infections and standard precautions 8

9 Summary Know & Do Know What the OSHA Standard does and why it matters Definitions Your Hospice s Exposure Control Plan How this applies to your hospice role What to do in case of an Exposure Incident, before one occurs Do Complete your annual trainings Educate your hospice patients, families and caregivers Maintain Personal Protective Equipment (PPE) identified for your job Prevent Exposure Incidents Report and follow your hospice s policy for any possible Exposure Incident Me With My Patients & IDG My Role Common Examples / Risks My Responsibilities To Myself To My Patients To My IDG To My Hospice Agency Put It In Action What I m already doing well: What I need to improve: My personal action plan: 9

10 Additional Resources Questions? Clarification? Ask your Hospice s Quality and Compliance Department, and your supervisor. OSHA, Bloodborne Pathogens document?p_table=standards&p_id=10051 CDC, Your state s laws. Your accreditation standards (if applicable) Your agency s Exposure Control Plan. Your agency s Policies and Procedures. Your Job Description. Course Handouts & Post Test Thank you for viewing this course on the Hospice Education Network The Course evaluation and post test are available from your course catalog page To achieve credit for this course, close the video portion when completed and click on Start Test Infection Control Module Overview Hand Hygiene Bloodborne Pathogens Still Ahead 4. Standard and Transmission-Based Precautions 5. Personal Protective Equipment (PPE) 6. Hepatitis B 7. Exposure Control Plan and Exposure Incidents 10