Hepatitis C Testing Training

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  • There are other hepatitis virus (D, E, G), but they are far less common in the U.S.
  • New treatments for HCV are expected to increase “cure” rates from 40% to up to 80%.
  • Remind students: HIV cannot survive outside of the body.
  • Risk assessment examples are available here in both English and Spanish Pre-paid mailing boxes are in each kit Individual results are faxed to your office… Event and individual data reports are available by request from Home Access
  • If you are giving
  • Maria mention heat pack…especially in winter when hands are cold
  • Either the person getting tested or you can prick their finger for them. More often than not we’ve found that most people want you to do it for them. The best way we have found to poke the finger is more on the side of the finger than the finger tip…the skin is tighter and there is more pressure there. The idea is not to touch the finger to the paper because it will both make the finger clot and it could also mess up the sample. However, it is OKAY to touch the drop of blood to the paper. Squeeze the finger to produce blood drops…I have found it easier and more productive to have them squeeze their own finger. Squeezing from the base of the finger to the tip where the puncture is has been found to be very effective. Sometimes it is necessary to poke them more than once…if that is the case make sure you have extra lancets (from previous tests) and extra band-aids…since they only give you one in the kit.
  • While the circle must be completely filled…it is okay for blood to drop outside of the circle.
  • I only squeeze the finger from base to puncture site if I am having trouble getting blood to come out of the puncture site alone.
  • Allow the sample to dry for about 15-30 minutes…if it is out longer don’t worry about it…I’ve never had an issue with any result because it has dried for too long. However, the new info is you technically don’t have to let it dry first…this is up to you Make sure the pin number is written on the risk assessment before you place it into the foil pouch!!!
  • It is possible for results to come back earlier but I’ve found that they’re generally back in 2 to 3 weeks. Test results are best given in person but can be given over the phone if necessary Home Access can send out a data reports after an event to track demographics and risk levels but you have to call and ask for them to be generated. Results are faxed to your office…for those who don’t have a fax machine…I would call home access to determine the best solution for your program.
  • Hepatitis C Testing Training

    1. 1. Home Access Hepatitis C Test Kit Training Hepatitis Education Project Seattle, Washington
    2. 2. Hepatitis Education Project <ul><li>HEP is a non-profit organization based in Seattle that offers resources, support and services to people affected by hepatitis. </li></ul><ul><li>HEP receives Home Access test kits for free through the WA Dept. of Health, as a result we’re able to offer the test for free in different settings around King County. </li></ul>
    3. 3. The Liver & Hepatitis <ul><li>The Liver </li></ul><ul><ul><li>Performs over 500 different functions… </li></ul></ul><ul><ul><ul><li>Filter, Factory, Storage facility </li></ul></ul></ul><ul><ul><li>Regenerative </li></ul></ul><ul><ul><li>Non-complaining </li></ul></ul><ul><li>Hepatitis is a general term meaning liver inflammation… </li></ul><ul><ul><li>“ Hepa” refers to the liver </li></ul></ul><ul><ul><li>Any “itis” means inflammation </li></ul></ul>
    4. 4. Causes of Hepatitis <ul><li>Viruses </li></ul><ul><li>Alcohol </li></ul><ul><li>Drugs/prescriptions </li></ul><ul><li>Herbs </li></ul><ul><li>Genetic disorders </li></ul><ul><li>Obesity </li></ul>
    5. 5. Hepatitis viruses <ul><li>Hepatitis A: fecal-oral transmission cycle; acute infection; contaminated food or water. </li></ul><ul><li>Hepatitis B: blood and body fluids; can occur as an acute or chronic infection; sexual, mother-to-child and injection drug use. </li></ul><ul><li>Hepatitis C: blood borne infection; direct blood-to-blood contact. </li></ul><ul><li>All 3 viruses can remain active/infectious outside of the body for several days. </li></ul>
    6. 6. Hepatitis B & Hepatitis C <ul><li>2 millions Americans HBV+. </li></ul><ul><li>In the United States most people get over this infection on their own (90-95%). </li></ul><ul><li>People infected for a long time have a higher risk of getting liver cancer. </li></ul><ul><li>People with chronic HBV can get liver cancer before cirrhosis. </li></ul><ul><li>Cancer screening is important. </li></ul><ul><li>Treatment is available for those who need it; there is no cure for HBV. </li></ul><ul><li>5 million Americans HCV+. </li></ul><ul><li>Approximately 75-80% of those exposed to HCV will develop the chronic infection. </li></ul><ul><li>At least 10,000 deaths from HCV annually in U.S. </li></ul><ul><li>Leading cause of liver transplantation in the U.S. </li></ul><ul><li>People with chronic HCV are at risk for cirrhosis, liver cancer and liver failure. </li></ul><ul><li>40% of patients are cured on current treatment </li></ul><ul><li>Hepatitis B (HBV) </li></ul><ul><li>Hepatitis C (HCV) </li></ul>
    7. 7. When does infection happen? <ul><li>Hep C: blood-to-blood contact </li></ul><ul><ul><li>Injection drug use </li></ul></ul><ul><ul><li>Intranasal drug use (snorting cocaine) </li></ul></ul><ul><ul><li>Tattooing/piercing (needles & ink) </li></ul></ul><ul><ul><li>Blood-transfusions (pre-1992) </li></ul></ul><ul><ul><li>Re-use of medical equipment </li></ul></ul><ul><ul><li>Sharing personal hygiene tools (razors, toothbrushes) </li></ul></ul><ul><ul><li>Occupational exposures: firefighters, ER nurses, EMTs </li></ul></ul><ul><li>Hep B: blood-to-blood or bodily fluid contact </li></ul><ul><ul><li>All of the above, plus… </li></ul></ul><ul><ul><li>Mother-to-child </li></ul></ul><ul><ul><li>Sexual </li></ul></ul>
    8. 8. Know This <ul><li>The hepatitis C virus can be infectious out of the body for up to 4 days. </li></ul><ul><li>The hepatitis B virus can be infectious out of the body for up to 8 days. </li></ul>
    9. 9. Who should get tested? <ul><li>Anyone who has ever injected drugs, vitamins and steroids. </li></ul><ul><li>Anyone who has received a tattoo or piercing from an uncertified tattoo/piercing parlor. </li></ul><ul><li>Anyone who frequently shares cocaine papers that may have been contaminated with blood. </li></ul><ul><li>Persons who received a blood transfusion prior to 1992 or clotting factors prior to 1987. </li></ul><ul><li>Persons who received an organ transplant prior to 1992. </li></ul><ul><li>Healthcare workers, EMTs, public safety workers who may have had an occupational exposure (needle stick). </li></ul><ul><li>Persons who were ever on long-term kidney dialysis. </li></ul>
    10. 10. The Home Access System <ul><li>The Home Access System provides all the tools needed to: </li></ul><ul><ul><li>Determine risk </li></ul></ul><ul><ul><li>Collect a fingerstick sample </li></ul></ul><ul><ul><li>Send to a CLIA-certified, CAP accredited laboratory </li></ul></ul><ul><ul><li>Receive individual result reports </li></ul></ul><ul><ul><li>Receive aggregate data report </li></ul></ul>
    11. 11. Pre-test discussion <ul><li>Greet and make client feel comfortable. </li></ul><ul><li>Explain that this is a screening test; if the results are positive that only means that the person has been exposed to the virus – it doesn’t necessarily mean that he/she is currently infected with the virus. If the test results come back positive, the client must get a 2 nd test to determine whether the virus is present. This 2 nd test is called a confirmatory/PCR test – PHRA has a list of clinics that offer this test. </li></ul><ul><li>Note that if the client has ever tested positive for hepatitis C in the past he/she will definitely test positive on this test, this is because this test is screening for antibodies and not the actual virus. </li></ul>
    12. 12. Pre-test Discussion Continued… <ul><li>Briefly review how hepatitis C is transmitted. </li></ul><ul><li>Explain that the results of the test will take about 3 weeks to be processed and ask the client to fill out the screening form. </li></ul><ul><li>Ensure that the client’s name and address are written legibly. </li></ul><ul><li>Ask if he/she has any questions before you begin. </li></ul>
    13. 13. Complete the paperwork <ul><li>In the space provided, write the date of collection. Note if the date is missing or incorrect the lab will not run the sample ( samples must be received by the lab within 14 days of collection ). </li></ul><ul><li>Write the given pin number on the screening form. </li></ul><ul><li>Tear off the yellow portion of the card and give it to the client </li></ul><ul><ul><li>Staple the yellow portion to the top right corner of the screening form. </li></ul></ul>
    14. 14. Prepare hands for testing <ul><li>Have client wash his/her hands or use hand sanitizer </li></ul><ul><li>Rub hands together vigorously and/or shake – this will increase heart rate and get blood flowing </li></ul>
    15. 15. Select the Puncture Site <ul><li>Wipe puncture site with alcohol wipe </li></ul><ul><li>Use ring or middle finger as they tend to be less calloused than the thumb or index finger </li></ul><ul><li>Place drops of blood on card until circle is completely filled </li></ul>
    16. 16. Collect the Sample <ul><li>Clean the finger with an alcohol wipe </li></ul><ul><li>FIRMLY press finger on the lancet </li></ul><ul><li>Place blood drops on collection card, completely fill the circle </li></ul><ul><li>Place bandage on finger (bring extras!) </li></ul>
    17. 17. Tips for Collecting an Adequate Sample <ul><li>Wiping with gauze pad between drops may help increase blood flow. </li></ul><ul><li>Wait for larger drops of blood to form before touching them to the circle. </li></ul><ul><li>Place drops next to each other NOT on top of each other. </li></ul><ul><li>Do not worry about staying inside the circle. </li></ul><ul><li>If necessary prick the finger again, or prick another finger. </li></ul>
    18. 18. Tips for Collecting an Adequate Sample cont’d… <ul><li>Blood must soak through to the back of the card </li></ul><ul><li>Do not place blood on the back of the card </li></ul><ul><li>Gently squeeze finger from base to puncture site </li></ul>
    19. 19. Package the Sample <ul><li>Allow sample to dry for 15-30 minutes </li></ul><ul><li>Remove foil pouch from clear wrapper </li></ul><ul><li>Place sample inside Foil Pouch – do not remove desiccant, this will keep the sample stable during shipment to our lab </li></ul><ul><li>Place unsealed foil pouches inside of the “Specimens” envelope for HEP to pick up and process </li></ul>
    20. 20. Results <ul><li>Results will be available in roughly 3 weeks from date that test is mailed to lab </li></ul><ul><li>Test results will be provided by HEP. Clients who receive a positive test result will be contacted by phone whenever possible. Those with negative test results will receive the results by mail </li></ul><ul><li>For clients that do not have a mailing address or phone number, provide them with HEP’s toll free telephone number </li></ul><ul><li>Confirmed positives must be reported to DOH </li></ul>
    21. 21. Questions… <ul><li>Contact the Hepatitis Education Project: </li></ul><ul><li>(206) 732-0311 or (800) 218-6932 </li></ul><ul><li>www.hepeducation.org </li></ul>

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