4. Angka kecelakaan & penyakit industri swasta & sektor kesehatan per 100 pekerja (Data US Bureau of Labor Statistics 1994) AS - K3 BIOLOGIS RS December 18, 2011
8. Working in a Healthcare Setting:How Risky? AS - K3 BIOLOGIS RS December 18, 2011
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13. Risiko HCV Risiko penularan HCV setelah luka tusuk jarum suntik yang mengandung HCV 3 - 10 : 100
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15. AS - K3 BIOLOGIS RS December 18, 2011 Prevalensi HIV pada donor darah di Indonesia: 1992 - 2001 Per 1000 HIV-positive 0.000 0.002 0.004 0.006 0.008 0.010 0.012 0.014 0.016 1992 – 1993 1993 – 1994 1994 – 1995 1995 – 1996 1996 – 1997 1997 – 1998 1998 – 1999 1999 – 2000 2000 – 2001 Source: National AIDS Programme, Indonesia July 2002
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18. Needle Stick Injuries & PROCEDURE SPECIFIC RATES AS - K3 BIOLOGIS RS December 18, 2011 INJURY RATE/100,000 Housekeeping: 9 Lukas, JHL et al. 2001
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20. Cairan Tubuh dan Risiko Terpercik RISIKO TINGGI Risiko tidak diketahui RISIKO RENDAH* Darah, serum Cairan Amnion Lendir serviks Semen Cairan Serebrospinalis Bahan muntahan Sputum, nanah Cairan Pleura Tinja Vaginal secretions Cairan Peritoneal Air liur Cairan Pericardial Keringat Cairan Sinovial Air mata Urin ASI * Kecuali terlihat terinfeksi dengan darah
38. Wear Gloves AS - K3 BIOLOGIS RS December 18, 2011 When performing a procedure When handling soiled instruments, gloves and other items When disposing of contaminated waste items
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45. Penatalaksanaan Pascapaparan Apabila percikan terjadi: Kulit Cuci dengan air dan sabun Jangan menggunakan bahan pemutih Mata, hidung dan mulut Bilas dengan air selama 10 menit Tertusuk jarum atau luka sayat Cuci dengan air dan sabun Biarkan darah mengalir Gunakan pembalut
46. Penatalaksanaan Pascapaparan Pertimbangan Pencegahan Pascapaparan (Post-exposure prophylaxis (PEP) : Menilai risiko Sumber cairan atau benda Cara terpajan (tertusuk, terciprat) Status HIV /HBV/HCV dari sumber pajanan Tes HIV pada petugas kesehatan untuk data basis Imunisasi HBV atau kadar imunoglobulin
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50. AS - K3 BIOLOGIS RS December 18, 2011 Terima Kasih!
Editor's Notes
This slide triggers a series of questions related to the most common process of becoming infected while working. When using these questions, it would be useful, time permitting, to wait for responses. Responses may or may not be coming, but people will at least be thinking about them. How risky is working in a healthcare setting? Do you know how many of your friends or colleagues have been stuck with a needle, or cut during work, or know of someone who has been injured with another sharp during surgery? ( Most everyone who works with clients or patients personally knows of at least one person.) Do any of you know how many of your friends or colleagues have been infected with HIV or HBV or HCV from work? Maybe one or two or ten? How many of you don’t know? Most people don’t want that type of information made public. No slide or leave slide #6-51 up while asking the following questions. Do you know what the risk is of contracting HIV after a needle stick from a HIV+ client? Is the risk high or low? Before you answer that, I want to ask you some questions about what you think the risk is of dying from some other activities. (You can list the number of people responding positively to the questions on a whiteboard or a flip chart so they can see real number s and not forget as you continue the presentation.) If you were outside during a lightning storm, how many of you would be afraid of being hit by lightning and dying? Don’t we all run for cover or quickly get out of the water when we are swimming if we hear thunder or see lightening? How many of you get nervous in an airplane when there is air turbulence and the plane starts to bounce around? Don’t we immediately put on or tighten our seat belts? How many of you are afraid of dying from a plane crash? ...or from a car crash? We make our kids use seat belts and now we even buy cars with air bags, right? We do this because we are trying to reduce the risk of dying if we are in an accident. How many of you sky dive or bungee jump for fun? No one? How many of you don’t because you are afraid of dying if you did? Most of you. Me too.
Now put up slide #6-53. The risk is 4 per 1000 or .04%. Doesn’t sound too bad, or is it? A bit higher than bungee jumping (which is 1 in a 1000)—but remember if you do become HIV+, you will die. So is that really risky? Yes, I think so. What is the risk of contracting Hepatitis B after a needle stick from a HB+ client?
Now put up slide #6-54. The risk is 27-37%. Now this is really risky, chances are pretty high that you would become positive after an exposure. This risk is much greater than the risk of dying from the other things we talked about and admitted that we were afraid of. Yet, why don’t healthcare workers use barrier precautions with each and every client? We use seat belts and get inside during a storm just to be safe. So why don’t healthcare workers use barriers with every client? I don’t know, maybe they don’t feel or believe the risk is real. Some areas of healthcare are even more risky than others. Labor and delivery and the emergency room are two areas where people are frequently exposed to blood and body fluids. Just look at healthcare workers’ glasses or their scrubs or their feet for splashes or spills of blood or body fluids. The risk is high, yet some people working in these areas haven’t even had hepatitis B vaccine. And this vaccine has been available since 1982.
Wear gloves: When performing a procedure in the clinic or operating room When handling soiled instruments, gloves and other items When disposing of contaminated waste items (cotton, gauze or dressings)
Wear protective goggles, face masks, aprons and rubber boots or closed shoes: In any situation where splashes and spills of any body fluids are likely.
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