2. • The purpose of CFHC, Inc.’s OSHA Bloodborne Pathogen Exposure Control
Plan is to provide direction to employees on how to prevent exposure and
infection from bloodborne pathogens
• Each CFHC, Inc.’s site has a designated OSHA Safety Officer (Clinical Site
Managers and Dental Site Manager)
• The plan is updated and reviewed annually
• Employees are trained on the plan at orientation and annually thereafter
• The Plan is available to all staff on the corporate intranet; refer to RM-400
OSHA Bloodborne Pathogen Exposure Control Plan
CFHC, Inc.’s OSHA Bloodborne
Pathogen Exposure Control Plan
4. • Hepatitis B is spread through blood and body fluids
• The virus can live for 7 days outside the body
• It can cause flu-like symptoms
• It can lead to cirrhosis, liver disease and death
• NO cure for Hepatitis B, but vaccine exists to prevent infection
Hepatitis B
5. • Hepatitis C is transmitted through blood and body fluids
• The virus can live outside the body for up to 3 weeks
• Symptoms of Hepatitis C are milder than Hepatitis B, but HCV is more likely
to lead to cirrhosis, liver, cancer and death
• There is no vaccine for Hepatitis C
• Some people, known as carriers, may have no symptoms but can pass the
virus to others
• Curative treatment is available for Hepatitis C
Hepatitis C
6. • HIV attacks the immune system making the body less able to fight
infections, over time this can lead to illness and death
• HIV is passed through blood and body fluids
• No vaccine available for HIV prevention
• Treatment exists to control the virus but there is no cure
• Post-exposure prophylaxis is available to reduce the chances of infection if
you are exposed
Human Immunodeficiency Virus
(HIV)
7. • These diseases can be spread through:
– Needle stick injuries
– Cuts, scrapes, and other break in the skin
– Splashes into the mouth, nose and eyes
– Oral, vaginal and anal sex
– Breast milk
– Using infected needles, razors or sharing pipes
Spreading Bloodborne Pathogens
8. • Universal Precautions
• Exposure Control Plan
• Engineering Controls and Work Practices
Methods to Control Infection
9. • The Centers for Disease Control requires all healthcare workers to
consider the body fluids of all patients potentially contaminated with
communicable bloodborne organisms.
• Simply stated:
To protect yourself, you MUST treat every patient as if he/she has a
contagious bloodborne disease!
Universal Precautions
10. The OSHA Bloodborne Pathogen Exposure
Control Pan exists to provide guidance and
direction for staff on how to protect themselves
from bloodborne pathogens
Refer to RM-400 OSHA Bloodborne Pathogen
Exposure Control Plan
OSHA Bloodborne Pathogen Exposure
Control Plan
11. A. Safer sharps
• Allows and requires employees’ hands to stay behind the needle/blade
after use
• Safety feature is activated with one hand
B. Sharps disposal containers
• Sharps disposal containers are available in each exam room and the
laboratories
• Do not over fill the containers
• Notify the OSHA Safety Officer if the container needs to be removed and
replaced
C. Other containers are also available to transport instruments safely
Engineering Controls and work
Practices
12. • Wash your hands. . .
– Before and after all patient contacts
– After contact with blood, body fluids, or wounds
– Before eating or drinking
– Before donning PPE and upon its removal
– Before and after toileting
– After sneezing/blowing nose
– Whenever hands become soiled
Hand Hygiene
13. • For effective handwashing. . .
• Wet your hands
• Apply soap and scrub for at least 40-60 seconds
• Scrub the wrist, front and back of hands, between
fingers and under nails
• Dry your hands with a paper towel
• Use a paper towel to turn off the water
• Contamination of the mucous membranes requires flushing. Use
the eye wash stations
Hand Hygiene
15. • Use soap and water when hands are visible
soiled (e.g., blood or body fluids)
• After caring for patients with known or
suspected Clostridium Difficile or Norovirus
during an outbreak
• Otherwise, the preferred method of hand
decontamination in clinical situations is with
an alcohol-based hand rub
Hand Hygiene
16. Hand Hygiene – Using Hand Sanitizers
• Video: Hand Rubbing
17. • PPE is available to all staff
• PPE is used to prevent blood or other potentially
infectious material from coming in contact with the
employee
• PPE must be removed and discarded prior to leaving
the patient care area and must be replaced when
damaged or contaminated
Personal Protective Equipment
(PPE)
18. Gloves
– Disposable latex, nitrile or vinyl gloves are available
• Not puncture resistance, nor are they 100% protective against
infectious disease
• DO NOT wash and reuse these gloves
• Wash your hands after removing gloves
• Gloves should be removed before leaving the patient care area
and between patients
– Puncture resistant gloves are available for cleaning instruments
• They can be washed and reused if the integrity of the gloves are
intact
Personal Protective Equipment
(PPE)
19. Eyewear (goggle and face shield)
– If a procedure presents a danger of splashing or if a
manufacturer recommends that goggles be worn when using
his/her product, protective eye wear must be worn
– Face shields have side-shields and shields that open from below
are recommended
– Eyewear must be cleaned with soap and water, disinfected with
a hospital level disinfectant, rinsed with water and air-dried
Personal Protective Equipment
(PPE)
20. Masks
– Masks that cover both the nose and the mouth must be worn during
clinical activities likely to generate splash, spatter, spray and aerosols
– A new mask is worn with each patient
– Contaminated masks are replaced immediately or as soon as feasible
Gowns, Aprons, Lab Coats
– Gowns are worn to protect street wear and the arms and neck areas
from contamination. They must be worn until or unless they become
soiled, damaged or wet.
– Disposable gowns should be disposed of properly and reusable gowns,
coats and aprons are placed into the laundry containers
Personal Protective Equipment
(PPE)
21. • Donning – Gown Mask Eyewear Gloves
• Doffing - Gloves Eyewear Mask Gown
Donning and Doffing PPE
Video
22. Equipment
– Use a EPA or FDA-approved disinfectant to clean and decontaminate all
equipment and surfaces after contact with blood or other potentially
infectious material
– 10:1 water to chlorine bleach solution can be used to wipe up blood and
body fluids
Protective Covering
– Protective covering such as plastic wrap, aluminum foil, or imperviously
backed absorbent paper used to cover equipment or environmental surfaces
Trash Cans
– Trash cans are inspected, cleaned and decontaminated daily
– NEVER reach into a waste basket. Empty contents onto a protected flat
surface
Exam Rooms
– Daily cleaning and disinfectant schedule
Housekeeping
23. Disposing of Sharps
– Place all sharps in approved sharps containers (needles, scalps, razors, broken glass,
slides, extracted teeth with roots, exposed ends of dental wires, and any other objects that
can puncture the skin).
– Approved container must have biohazard labels and remained locked
– Keep the sharps container upright at all times
– If the outside of the sharps container becomes contaminated, it shall be placed into another
leak proof container prior to disposal
Contaminated Reusable Sharps
– Contaminated reusable sharps are placed in a puncture-resistant container that is leak
proof on the sides and bottom, and labeled with a biohazard symbol or color-coded red
– In preparation for cleaning and sterilization, retrieve the instruments by mechanical means
– Employees will wear PPE consisting of puncture resistant gloves, gown, facemask and eye
protection
– Instruments are processed according to the manufacturer instructions (chemical soaks and
autoclave)
Housekeeping
Never recap, break or bend needles!
24. Biohazard Waste
– Regulated wastes must be properly disposed of in biohazard bags
– Regulated wastes include:
• Blood or other potentially infectious body fluids
• Saliva in dental procedures
• Items which would release these fluids if compress (saturated
gauze)
• Items which are coded or died with blood (bloody gloves)
• Other potentially infectious material that are capable of
releasing these material during handling
• Contaminated sharps
• Pathological and microbiological waste containing blood or
other body fluids including saliva
Housekeeping
25. Sterilization of Equipment
Laundry
– Contaminated laundry is placed in a leak-proof container and is not
sorted or rinsed prior to placement in the container
– The container is labeled biohazard
– The handler wears gloves and a wear fluid-resistant gown
– Clothes can be washed at 71°C (160°F) for 25 minutes or at lower
temperatures with bleach
Housekeeping
No employee will wear or transport
contaminated clothing home!
26. • Never eat or drink in areas where bloodborne pathogens are likely to be
present
• Never handle contact lens or apply makeup or lipstick in areas likely to have
bloodborne pathogens
• Store food and beverages away from infectious material
• Cover cuts, rashes and any breaks in the skin with a bandage
Smart Practices
27. • Hepatitis B vaccination is offered free of charge to any employee
determined to have an exposure risk
• Vaccination is encouraged unless:
– The employee has been previously immunized
– An antibody test reveals a protective titer
– The vaccination is medically contraindicated
• An employee may decline the vaccine, but is asked to sign a declination
form
Hepatitis B Vaccination
28. What do you do if you are exposed to blood or body fluids:
1. Wash the area immediately
2. Do not attempt to open or “bleed the wound”
3. When possible, preserve the object involved with the injury
4. Report the incident immediately to your supervisor or an OSHA
Safety Officer
5. Complete CFHC, Inc.’s Incident Report and Bloodborne
Pathogen Post-Exposure Form
6. Staff is directed to the Immediate Care for evaluation and
treatment
• You have 72-hours after exposure to start prophylaxis
treatment to prevent HIV infections
• The Human Resources Department must be notified within 12-
hours (or sooner) of an exposure or other work-related
injuries!
Accidental exposure
30. Tuberculosis
• Can present as a latent infection or active disease
• Active disease can cause cough, fever, weakness, night sweats,
weight loss, decrease appetite and bloody sputum
• A person with active disease can spread the infection through
coughing, sneezing, singing and yelling
• Treatment is mandated by law
• Although it is possible to catch TB with short-term exposure, it is
usually acquired by spending time with an infected person in poorly
ventilated, closed areas
Airborne Infections
31. • Identify the person that may have TB symptoms
• Isolate the person known or suspected of having active TB
• Provide a face mask to the patient to protect family, friends and staff
• Give tissues with instructions to cover mouth and nose when coughing/sneezing
• Notify the provider
• Promptly see the patient to limit time spent in the clinic
• Provide appropriate evaluation
• Report all patients with positive sputum cultures to the local health department
for treatment
• TB patients are not allowed to be seen in the clinic until they are cleared by the
local health department
For more information refer to RM-401 OSHA Tuberculosis Infection Control Plan
Preventing TB
32. • Is spread through respiratory droplets
(cough/sneezing)
• Common symptoms include: cough
shortness of breath, fever, chills, muscle
pain, headache, sore throat, new loss of
taste or smell
• This is a novel virus, meaning no one has
immunity to the virus
Covid-19
33. • Identify the person that may have Covid-19 symptoms
• Provide a face mask to the patient to protect family, friends
and staff
• Notify the nurse/provider
• Full PPE is worn by staff at the time of testing
• Promptly see the patient to limit time spent in the clinic or offer
telehealth visits and curbside testing
• Provide appropriate evaluation and follow up
CFHC, Inc. has developed a list of protocols to protect
employees and to screen, assess and treat patients with Covid-
19. See CFHC, Inc.’s intranet for more information.
Preventing Covid-19
34. • Cover your mouth and nose with a tissue when coughing or sneezing
• Use in the nearest waste receptacle to dispose of the tissue after use
• Perform hand hygiene after having contact with respiratory secretions and contaminated
objects/materials
• Healthcare facilities should ensure the availability of materials for adhering to Respiratory
Hygiene/Cough Etiquette in waiting areas for patients and visitors
• Provide tissues and no-touch receptacles for used tissue disposal
• Provide conveniently located dispensers of alcohol-based hand rub; where sinks are
available, ensure that supplies for hand washing (i.e., soap, disposable towels) are
consistently available
• Stay home if you are sick
• Avoid close contact with individuals who are sick
Respiratory Hygiene/Cough Etiquette
Body fluids: blood, saliva, semen, vaginal secretions, synovial fluid, amniotic fluid, cerebrospinal fluid, pleural fluid, peritoneal and pericardial fluids. This does not include: feces, nasal secretions, sputum, sweat, tears, urine, saliva, breast milk and vomitus unless there is visible blood.
