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Infection Control

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  • We talk about Hepatitis A because people associate it with a bloodborne pathogen. It is not. Good hand washing of course is the key to this one. The vaccine for this hepatitis is NOT required by OSHA !
  • A few years ago 5,000 to 8,500 cases a year were reported (in Ohio). That has dropped dramatically to about a 1,000 reported cases a year. OUTCOMES 1) Get it ; Get Over it 2) Carrier 3) Chronic Liver Disease
  • Blood is the main emphasis here. It takes so many parts per million of saliva to cause transmission it is not to be concerned about.
  • These symptoms can be mistaken for flu like symptoms.
  • Previous name: Before 1992 there was no test, diagnosis was by exclusion and was referred to as NON A/NON B. The test: 1) Initial Exposure 2) 6 weeks Later 3) then follow up 2 months later Degree of Risk ( talk about a good rule of 3 here shortly) 85 % of Hepatitis C exposures are carriers for life. IV Drug users Prison Population Social Economic Problem Bad Liver ( Cost to you) Drug therapy-- $1200 per month
  • Early 80’s really became noticeable. Degree of Risk--- Rule of 3 is the best way to remember this. Good Needle Stick 1) 30 % Chance Hep B 2) 3% Chance Hep C 3) .3% Chance Hiv
  • Sterile Body Fluids: Spinal Fluids Plural Fluids The “Does not Include” -- OSHA does not care about these
  • What do you think they are ? Engineering Controls --- Manufacturing ? Federal State Level Only Health Care Nursing Home Front Line Worker Involve Record Keeping Sharps Container Needle Sticks --- Senate Bill 183 Legislation
  • Healthcare workers should wash hands with soap and water when hands are visibly dirty, contaminated or soiled and use an alcohol-based handrub when hands are not visibly soiled to reduce bacterial counts.
  • Hand Washing Not a Harsh Soap (Talk about How to and emphasize it is friction that helps to remove harmful bacteria and viruses) Should be in your exposure control Plan Eating Drinking Smoking Soap Selection Alternatives Squirt Gels Foams Universal Precautions Discrimination (Violation if not)
  • Clean -up Kits Health Care -- Have to have two way breathing barrier.
  • Def of Exposure ? Selecting Medical Service : Do this ahead of tiical me. Decide where you want to send them Medical Record--not the Boss, not HR…. If you don’t have this set up,leave the record at the Urgent Care Facility. Keep these records 30 years beyond employment. Needle Sticks recorded on the OSHA log.
  • Do not have to have a Kit -EPA Approved -Tuberculosis (cidal) -Hepatitis B approved Absorbent, Disinfect & Through away -1part bleach & 10 parts water -No older than 24 hours -Education thing - Bleach ….corrosive Dispatch -- a stabilized bleach solutiion has a shelve life of 1 year Lysol IC (Infection Control) Don’t be impressed by just AIDS control
  • Transcript

    • 1. BLOODBORNE PATHOGENS DHO UNIT 13.:1-13:3 DHO UNIT 13:1-13:3
    • 2. Objectives: Identify five classes of microorganisms by describing their characteristics List six components of the chain of infection Differentiate between antisepsis, disinfect ion and sterilization DHO UNIT 13:1-13:3
    • 3. Basic Understanding of Infection Control Normal Flora Nonpathogens Pathogens Virulence Host Health Care Workers need to know how diseases are transmitted and avoid being the link to further transmission. DHO UNIT 13:1-13:3
    • 4. Bacteria Cocci are round, one celled plants classified according to shape and arrangement. Diplococci are arranged in pairs Examples: Gonorrhea, Meningitis and Pneumonia DHO UNIT 13:1-13:3
    • 5. Streptococci are spherical bacteria arranged in chains: Examples: Strept. throat, Scarlet Fever, Rheumatic Fever Staphlococci are clusters of cocci. Examples: Wound infections, Impetigo, Toxic Shock Syndrome. Often causing purulent material to be formed. DHO UNIT 13:1-13:3
    • 6. OTHER BACTERIA BACILLI (RODS) are large,rod- shaped cells Found singly or in groups Examples Anthrax, Salmonella, TB, Tetanus, Typhoid SPIRILLA are curved or spiral bacteria That are arranged singly or in colonies. Examples: Campylobacter, Syphilis, Lyme Disease ANTIBIOTIC ARE OFTEN EFFECTIVE AGAINST A BACTERIAL INFECTION DHO UNIT 13:1-13:3
    • 7. Another version of Bacteria: RICKETTSIA Rickettsia species are small, Gram-negative bacilli that are obligate intracellular parasites. Called “oblate” because they can reproduce only inside other living cells. Examples: Rocky Mountain Spotted Fever, Chlamydia, The Lone Star tick, Amblyomma americanum, a common, human- biting tick. DHO UNIT 13:1-13:3
    • 8. OTHER PATHOGENS: PROTOZOA are complex one-celled animals that can live in human fluids and cause disease. Many have flagella. Examples: Giardia (Travelers Diarrhea) Trichomonas, Malaria Fungi are simple plants but without chlorophyll. Yeast and mold are types Fungi. They must parasitize as they cannot make food. Examples; Candida (Thrush), Tinea (Ringworm), DHO UNIT 13:1-13:3
    • 9. Viruses Viruses are intracellular parasites that consist of a DNA or RNA core surrounded by a protein coat and sometimes a lipoprotein envelope. They invade cells and insert their own genetic code into the host. Thus, the pirate the hosts nutrients and organelles, multiply and infect other cells. Examples: Cold, Influenza, West Nile Virus, Avian Flu, Polio,Mono, Measles, Mumps, HBV,HCV, HIV. DHO UNIT 13:1-13:3
    • 10. Hepatitis A • Not bloodborne • Severity of disease • Poor sanitation • Raw seafood • Daycare centers • Vaccine DHO UNIT 13:1-13:3
    • 11. Hepatitis B • Most common occupationally-acquired infection • Blood borne, sexual contact and perinatal • Virus attack livers and can cause lifelong infection, cirrhosis of the liver, liver cancer, liver failure and death. • Vaccine available. Required by OSHA. DHO UNIT 13:1-13:3
    • 12. Hepatitis B Found in: • Blood • Vaginal Secretions • Semen • Saliva DHO UNIT 13:1-13:3
    • 13. Signs and Symptoms: • Nausea • Lack of appetite • Fatigue • Joint pain • Dark urine • Jaundice • Fever DHO UNIT 13:1-13:3
    • 14. Hepatitis C • The hepatitis C virus (HCV) is a blood-borne virus that was previously referred to as non- A/non-B hepatitis •As many as 80-85% of people initially infected with HCV may become chronically infected •No vaccine available •Today HCV is the leading reason for liver transplants Bloodborne Pathogens Division of Safety & Hygiene DHO UNIT 13:1-13:3
    • 15. Hepatitis D A defective virus that needs the HBV to exist Co-infection with HBV Chronic liver disease with cirrhosis, liver cancer, and fulminant hepatitis also possible. DHO UNIT 13:1-13:3
    • 16. HIV • HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight. • People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others. • No vaccine, no cure DHO UNIT 13:1-13:3
    • 17. HIV Signs & Symptoms • Night sweats • Fever, chills • Joint Pain •Swollen glands • Flu-like • Fatigue • Rash (many have all, none, or some) DHO UNIT 13:1-13:3
    • 18. Factors required for growth Warm Moist Dark Aerobic require oxygen to live Anerobic live and reproduce without oxygen DHO UNIT 13:1-13:3
    • 19. CLASSIFICATIONS OF DISEASES AND INFECTIONS  ENDOGENOUS  EXOGENOUS  NOSOCOMIAL  OPPORTUNISTIC DHO UNIT 13:1-13:3
    • 20. The Chain of Infection Reservoir Host Portal of Exit Mode of TransmissionPortal of Entry Susceptible Host Infectious Agent DHO UNIT 13:1-13:3
    • 21. As healthcareAs healthcare professionals, itprofessionals, it is important tois important to understand twounderstand two things aboutthings about infectioninfection: DHO UNIT 13:1-13:3
    • 22. 1.The various ways infection can be transmitted 2. The ways the infection chain can be broken DHO UNIT 13:1-13:3
    • 23. There are six linksThere are six links in the Chain ofin the Chain of InfectionInfection :: DHO UNIT 13:1-13:3
    • 24. 11stst - Causative Agent- Causative Agent -Any disease-causing microorganism (pathogen) DHO UNIT 13:1-13:3
    • 25. 2nd - The Reservoir Host2nd - The Reservoir Host -The organism in which the infectious microbes reside. -Common reservoirs are: human body, vectors, fomites, & environment. DHO UNIT 13:1-13:3
    • 26. Hosts that do not show any outward signs or symptoms of a disease but are still capable of transmitting the disease are known as carriers. What are “Carrier Hosts”What are “Carrier Hosts” DHO UNIT 13:1-13:3
    • 27. 3rd - The Portal of Exit3rd - The Portal of Exit -Route of escape of the pathogen from the reservoir. Examples: respiratory secretions, blood, urine, feces, sexual secretions, wound drainage. DHO UNIT 13:1-13:3
    • 28. 4th - The Route of4th - The Route of TransmissionTransmission -Method by which the pathogen gets from the reservoir to the new host DHO UNIT 13:1-13:3
    • 29. Transmission may occur through: Direct Contact: Person-to-Person… contaminated hands are the most common What other means of direct transmission areWhat other means of direct transmission are there?there? DHO UNIT 13:1-13:3
    • 30. Air Indirect Contact: as inIndirect Contact: as in the case of inanimate objectsthe case of inanimate objects transmitting the pathogen. Such as:transmitting the pathogen. Such as: DHO UNIT 13:1-13:3
    • 31. Insects Vector: animal or insect that transmits the pathogen from infected to noninfectied individuals. Can you think of others?Can you think of others? DHO UNIT 13:1-13:3
    • 32. 5th - The Portal of Entry5th - The Portal of Entry -Route through which the pathogen enters its new host DHO UNIT 13:1-13:3
    • 33. Respiratory System inhalation inhalation DHO UNIT 13:1-13:3
    • 34. Gastrointestinal Systemingestion ingestion DHO UNIT 13:1-13:3
    • 35. Urinary & Reproductive TractsSexual Sexualcontact contact Or acrossOr across thethe placentaplacenta DHO UNIT 13:1-13:3
    • 36. Breaks in Protective Skin Barrier Aka: nonintact skin DHO UNIT 13:1-13:3
    • 37. 6th - The6th - The Susceptible HostSusceptible Host -The organism that accepts the pathogen The support of pathogen life & its reproduction depend on the degree of the host’s resistance. DHO UNIT 13:1-13:3
    • 38. -The essential part of patient care & self- protection. How to interrupt the Chain of Infection:How to interrupt the Chain of Infection: DHO UNIT 13:1-13:3
    • 39. Remember--breaking the chain ofRemember--breaking the chain of infection is the responsibilityinfection is the responsibility of each health professional.of each health professional. DHO UNIT 13:1-13:3
    • 40. ASEPTIC CONTROL ASEPSIS CONTAMINATED ANTISEPSIS DISINFECTION STERILIZATION DHO UNIT 13:1-13:3
    • 41. Exposure Control Bloodborne Pathogens Division of Safety & Hygiene UNIT 13:2 DHO UNIT 13:1-13:3
    • 42. DHO UNIT 13:1-13:3 OBJECTIVES FOR 13:2 AND 13:3 Recognize need for and demonstrate Handwashing Identify need for and demonstrate standard precautions
    • 43. Potentially Infectious Materials Blood Mucus Semen Vaginal Secretions Sputum Saliva Other Body fluids “Visible soiled” objects Tissue/Cell specimens Mucous Membranes Non-intact skin “IF IT IS WET AND FROM THE BODY, CONSIDER IT INFECTIOUS”…..better safe than sorry. DHO UNIT 13:1-13:3
    • 44. Universal Precautions An approach to infection control. All human blood and certain body fluids are treated as if known to be infectious. STANDARD PRECAUTIONS: are the rules designed to protect the patient and HCW DHO UNIT 13:1-13:3
    • 45. Methods of Control DHO UNIT 13:1-13:3
    • 46. DHO UNIT 13:1-13:3
    • 47. Indications for Hand Hygiene  When hands are visibly soiled  Before and after each patient  Before and after each procedure  Before you eat  As you begin your shift  After you use the restroom  Before and after you use glovesBefore and after handling a specimen
    • 48. Methods of Control (Cont.) Hand sanitizers with 60% or more alcohol are very effective. • Always wash hands: •Visibly contaminated •After using bathroom •Before you eat •When hands feel “sticky” • Pathogens that are spores ( C-Difficile) DHO UNIT 13:1-13:3
    • 49. DHO UNIT 13:1-13:3
    • 50. Gloves • Disposable - not reused • Change if torn or punctured • Awareness of latex allergic reactions • Use of utility gloves DHO UNIT 13:1-13:3
    • 51. PPE Syringes with protection devices Gloves with choices to avoid latex Masks with various filters (e.g N95) Face Shields Biohazard symbol to warn of body fluid DHO UNIT 13:1-13:3
    • 52. Exposure Incident A specific eye, mouth, or other mucous membrane, non-intact skin or parenteral contact with blood or other potentially infectious material that results from the performance of an employee’s duties. DHO UNIT 13:1-13:3
    • 53. Post-exposure follow-up • Definition of “exposure” • Selecting medical service • Informing the employee • Recordkeeping • Confidentiality of results DHO UNIT 13:1-13:3
    • 54. Blood spill clean-up • Use correct “–cidal” • Follow “wait” time • Performed by someone with HBV vaccine DHO UNIT 13:1-13:3
    • 55. DHO UNIT 13:1-13:3 http://www.youtube.com/watch?v=- _kwXNVCaxY

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