Bloodborne Pathogens (BBP) Training

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Questions and Answers

Explain how the OSHA Bloodborne Pathogens Standard aims to protect employees in the workplace.

It mandates training, engineering controls, work practice controls, PPE use, and establishes procedures for exposure incidents to minimize risks.

Describe the difference between engineering controls and work practice controls in preventing exposure to bloodborne pathogens, providing specific examples of each.

Engineering controls are physical items like sharps containers, while work practice controls are safe behaviors, such as proper hand hygiene.

If an employee experiences a needlestick injury, outline the immediate steps they should take and the subsequent actions required by their employer according to OSHA guidelines.

Employee washes the area, seeks medical attention and reports to supervisor. Employer documents the source, offers testing, and arranges medical care.

Differentiate between high-risk and low-risk body fluids in the context of bloodborne pathogen transmission, providing examples of each and explaining why the distinction is important.

<p>High-risk fluids like amniotic fluid pose a direct transmission risk, while low-risk fluids like nasal secretions have lower potential for transmission.</p> Signup and view all the answers

Explain why an individual could still be contagious even if they are not showing symptoms of HIV.

<p>HIV can lay dormant for many years, and the infected individual can still transmit the virus even without showing symptoms.</p> Signup and view all the answers

You splashed blood into your eyes and you do not know the bloods origin. What is the immediate action that you should take? What is the next action? Explain.

<p>The first action is to flush with water or saline. The next action is to seek medical attention and inform your supervisor.</p> Signup and view all the answers

Describe the standard precautions that should be observed when handling all blood and body fluids, and explain why these precautions are necessary in healthcare settings.

<p>Standard precautions include hand hygiene, PPE use, and safe handling of sharps. These are needed because all fluids may contain transmissible diseases.</p> Signup and view all the answers

Discuss the significance of annual bloodborne pathogen training for employees, and outline the key topics that should be covered during these training sessions.

<p>Annual training reinforces knowledge, covers pathogen infections, transmission, and prevention. It also reviews exposure procedures.</p> Signup and view all the answers

Explain how a 'titer' is used to determine immunity to Hepatitis B, and then describe the steps someone should take if they are not immune after completing the vaccine series.

<p>A titer measures blood antibody levels. If not immune after the series, revaccination and further testing may be needed.</p> Signup and view all the answers

In the context of TB prevention, discuss the role of work practice controls such as using HEPA filters and negative-pressure rooms, and explain how they help to minimize the risk of transmission.

<p>HEPA filters remove TB bacteria from air, while negative-pressure rooms prevent airborne spread to other areas of the facility.</p> Signup and view all the answers

How would you differentiate between HIV and AIDS? Explain the relationship between the two.

<p>HIV is the virus that attacks the immune system; AIDS is the syndrome that develops when HIV has severely damaged the immune system.</p> Signup and view all the answers

Describe the purpose of Pre-Exposure Prophylaxis (PrEP), and identify the populations who might benefit from receiving it.

<p>PrEP is used to prevent HIV infection in high-risk individuals, such as those with HIV-positive partners or those engaging in high-risk activities.</p> Signup and view all the answers

Explain why there are requirements for regular TB testing for healthcare workers, even though TB primarily affects the lungs.

<p>Healthcare workers are at higher risk of exposure, plus TB can spread to other organs, making regular testing essential for early detection.</p> Signup and view all the answers

Outline the information that an employee must document following an exposure incident to blood or OPIM according to OSHA guidelines.

<p>The employee must document the date/time, controls/PPE used, job classification, procedure performed, worksite, training, and work practices followed.</p> Signup and view all the answers

Name some symptoms common among Hepatitis infections and then explain why not all

<p>Common symptoms include abdominal pain, fatigue, jaundice, nausea, and loss of appetite. Not all infected individuals are symptomatic, due to varying immune responses.</p> Signup and view all the answers

Describe the key components that must be included in an Exposure Control Plan to meet the requirements of the OSHA Bloodborne Pathogens Standard.

<p>The plan should identify those needing training, list engineering and work practice controls, mandate precautions, state PPE, and outline exposure procedures.</p> Signup and view all the answers

You're creating your company's Exposure Control Plan. What are some key things you should include? How often should it be reviewed?

<p>Identify individuals who need BBP training, engineering and work practice controls, mandatory standard precautions, required PPE, and exposure procedures. It should be reviewed annually.</p> Signup and view all the answers

Why is it important to know if organisms were present during a blood/OPIM exposure? What other exposure factors are important to consider?

<p>Presence of organisms dictates infection risk. Other key factors are the extent of organisms (viral load), type of exposure, and employee health.</p> Signup and view all the answers

Explain why HBV has a vaccine, yet HIV does not. What makes it difficult to make a vaccine for HIV?

<p>HBV is a DNA virus that has a predictable, stable structure. HIV is an RNA virus that mutates quickly, making it hard to find a vaccine.</p> Signup and view all the answers

A patient states they were vaccinated against HBV at birth, and they want to decline further measures. What test can you perform to prove they are immune?

<p>A titer can be performed. It measures the blood antibody levels to determine immunity.</p> Signup and view all the answers

If an employee is exposed to a bloodborne pathogen, what are the employer's responsibilities regarding testing and medical care?

<p>The employer must identify and document the source, get consent to test the source, offer testing to the employee, and arrange medical care.</p> Signup and view all the answers

Describe the difference between standard precautions and transmission-based precautions in healthcare settings.

<p>Standard precautions apply to all patients, while transmission-based precautions are for known or suspected infections.</p> Signup and view all the answers

Explain why Hepatitis C is more likely to become chronic compared to Hepatitis B and briefly outline a reason why

<p>Hepatitis C is more likely to become chronic because the body mounts a weaker immune response and there is a higher mutation rate.</p> Signup and view all the answers

How is Tuberculosis (TB) spread and name one work practice control to decrease the risk of transmission?

<p>TB is spread through airborne droplets. A work practice control is to use masks.</p> Signup and view all the answers

Can employers charge employees for PPEs needed on the job? Explain.

<p>No, employers cannot charge employees for PPEs. They are responsible for providing necessary protective equipment.</p> Signup and view all the answers

Flashcards

Bloodborne Pathogens (BBPs)

Infectious microorganisms, such as viruses, bacteria, or parasites, present in blood and high-risk body fluids.

How BBPs are transmitted?

Exposure to infected blood or Other Potentially Infectious Materials (OPIM).

OSHA

Occupational Safety and Health Administration.

Who OSHA Protects?

Employees, ensuring a safe and healthy work environment.

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Who needs BBP training?

All healthcare workers and anyone with potential contact with blood or body fluids as part of their job.

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Frequency of BBP training?

Every year.

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3 Common Bloodborne Pathogens

Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV).

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OSHA BBP Standard Components

Recognizing BBP infections, transmission methods, prevention of exposures, and actions after exposure.

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Tissues at risk (BBP)

Mucous membranes and non-intact skin.

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OPIM

Other Potentially Infectious Material.

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Examples of OPIM

Amniotic fluid, vaginal secretions, semen, cerebrospinal fluid, etc.

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Non-intact skin

Lacerations, abrasions, rashes, burns, hangnails, punctures, or cracks in the skin.

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Exposed mucous membranes

eyes, nose, and mouth

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Actions after exposure

Wash, flush, seek treatment, and inform supervisor.

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Documentation after exposure

Date/time, controls/PPE used, job classification, procedure, location, training, and work practices.

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Employer's actions after exposure

Identify/document source, test source (if possible), test employee, and arrange medical care.

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Exposure Risk Factors (BBP)

Presence and extent of organisms, type of exposure, and health of employee.

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Hepatitis

Inflammation of the liver from a viral infection.

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HBV Vaccine Cost

Yes, employers must offer the HBV vaccine for free.

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How HCV is transferred vocationally

Needlesticks and mucous membrane exposure.

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HIV

Human Immunodeficiency Virus.

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PrEP

Pre-Exposure Prophylaxis.

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Standard Precautions

Infection prevention practices that apply to all patients and body fluids.

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Engineering Controls

Items that isolate or remove a hazard.

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PPE Examples

Gloves, masks, face shields, eye protection, gowns, and aprons.

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Study Notes

  • Infectious microorganisms, like viruses, bacteria, and parasites, in a patient's blood and other high-risk bodily fluids are bloodborne pathogens (BBPs).

Transmission of Bloodborne Pathogens

  • Exposure to infected blood and other potentially infectious materials (OPIM) causes transmission.

OSHA

  • OSHA stands for Occupational Safety and Health Administration.
  • OSHA protects employees.
  • All healthcare workers and anyone required to administer first aid as part of their job, or those with potential contact with blood or bodily fluids must complete Bloodborne Pathogens Standard Training.
  • Training on bloodborne pathogens must be given to employees every year.

Common Bloodborne Pathogens

  • The three most common bloodborne pathogens are:
    • HBV (Hepatitis B virus)
    • HCV (Hepatitis C virus)
    • HIV (human immunodeficiency virus)

OSHA Bloodborne Pathogens Standard Components

  • Recognizing bloodborne pathogen infections
  • How BBP infections are transmitted
  • Prevention of exposures
  • Steps to take in case of exposure

Occupational Exposure

  • Mucous membranes (MM) and non-intact skin are the two types of tissue at risk when employees come into contact with blood or OPIM.
  • OPIM stands for Other Potentially Infectious Material.

Examples of OPIM (High-Risk Body Fluids)

  • Amniotic fluid
  • Vaginal secretions
  • Peritoneal fluid
  • Semen
  • Pericardial fluid
  • Cerebral spinal fluid
  • Tissue fluid
  • Pleural fluid
  • Synovial fluid
  • Saliva in dental procedures
  • Any fluid visible with blood
  • Any fluid where it is impossible to tell if there is blood

Additional Substances Possibly Carrying BBPs (Low-Risk)

  • Urine
  • Feces
  • Nasal secretions
  • Sputum
  • Vomit
  • Breastmilk
  • Saliva (other than dental procedures)

Examples of Non-Intact Skin

  • Lacerations
  • Incisions
  • Abrasions
  • Rashes
  • Burns
  • Hangnails
  • Punctures
  • Cracks in skin

Exposed Mucous Membrane (MM) Facial Areas

  • Eyes
  • Nose
  • Mouth

Actions After Exposure

  • Immediately wash the affected area with antimicrobial soap if skin contact occurs.
  • Flush eyes, nose, or mouth immediately with lots of water or saline for 15-20 minutes.
  • Seek treatment immediately at the Emergency Department or Employee Health Department and inform the supervisor as soon as possible after initial flushing/washing.

Employee Documentation

  • Date and time of exposure
  • Engineering controls and PPE used
  • Job classification
  • Procedure being performed
  • Work site location
  • Training for the activity
  • Work practices being followed

Employer Actions Following Exposure

  • Identify and document source of exposure.
  • Get consent and have source individual tested for HBV, HCV, HIV (if possible).
  • Have employee tested for BBPs and arrange medical care (immediate and future).

Exposure Factors Determining Infection Risk

  • Presence of any organisms
  • Extent of organisms (viral load)
  • Type of exposure (needlestick, MM splash)
  • Health of employee, including immunity to Hepatitis B

Hepatitis

  • Inflammation of the liver from a viral infection.

Common Hepatitis Symptoms

  • Abdominal pain
  • Fatigue
  • Jaundice
  • Nausea
  • Light colored stools
  • Lack of appetite
  • Not all infected individuals are symptomatic; symptoms may take 4 weeks - 6 months to appear.

Hepatitis B Vaccination

  • Employers must offer the vaccine for free.
  • The series contains 3 shots.
  • The first vaccine is usually given at birth.
  • 98% will become immune after completing the series.
  • A "titer" measures blood antibody levels to determine immunity to HepB.
  • There is no cure for Hepatitis B, and those infected will continue to be contagious.

Hepatitis C

  • Most common type of chronic hepatitis in the U.S.
  • 10x less likely to be contracted in the workplace compared to Hep B.
  • There is no vaccine for HCV.
  • Occupationally transferred through needlesticks and MM exposure.
  • 95% of those with chronic Hep C can now be cured with treatment.
  • Hepatitis C is more likely to become chronic than Hepatitis B.

HIV

  • HIV stands for human immunodeficiency virus, a viral infection that attacks the immune system.
  • HIV can lie dormant for 10 years, and individuals remain contagious during this time.

Acute (Early) Symptoms of HIV

  • Swollen lymph nodes
  • Fatigue
  • Nausea/vomiting/diarrhea
  • Muscle joint pain
  • Sore throat/mouth sores
  • Headaches
  • Skin rash
  • Night sweats
  • There is no vaccine or cure for HIV.
  • PrEP (pre-exposure prophylaxis) is for high-risk individuals.
  • Occupational exposures make up less than 1% of all HIV cases.
  • AIDS stands for acquired immunodeficiency syndrome.
  • AIDS is diagnosed in HIV+ patients when labs show extremely low CD4+ counts.

Prevention of Occupational Exposure

Standard Precautions

  • Infection prevention practices applying to all patients and body fluids, regardless of suspected or confirmed infection status, in any healthcare setting (CDC Terminology).

Standard Precautions are Based on the Principle That

  • All blood, body fluids, and secretions MAY contain transmissible infectious agents.
  • Includes hand hygiene, use of PPEs, safe injection and resuscitation practices, care of equipment and laundry, and respiratory hygiene.
  • Strategies prevent transmission of infectious agents not only to healthcare personnel but also to other patients and hospital visitors.

Engineering Controls

  • Manufactured items used to isolate or remove a hazard and reduce risk of exposure (things employer buys or installs).

Examples of Engineering Controls

  • Hand/eyewash stations
  • Sharps containers
  • Biohazard labels
  • Safety devices on all needles

PPE

  • Stands for personal protective equipment.

Examples of PPE

  • Gloves
  • Masks
  • Face shields
  • Eye protection
  • Gowns
  • Aprons
  • Lab coats
  • Hair/shoe covers
  • Employers cannot charge employees for required PPE.

Work Practice Controls

  • Behaviors that reduce the risk of exposure.

Examples of Work Practice Controls

  • Handling sharps safely
  • Using safety devices on sharps
  • Performing proper hand hygiene
  • Wearing PPE
  • Removing soiled gloves properly

Exposure Control Plan

  • A written document prepared by the employer to meet the provisions of the OSHA BBP standard.

Exposure Control Plan Must Include

  • Identification of individuals who need BBP training.
  • Establishment of engineering controls and work practice controls.
  • Mandates the use of standard precautions.
  • States PPE provided necessary for specific situations.
  • Identifies what to do in the event of an exposure.
  • Employers must create the plan for each facility.
  • Employers must review the plan once a year.

Airborne Pathogens

  • TB stands for tuberculosis.
  • TB is a bacterial infection that attacks the lungs and other internal organs.

Symptoms of TB

  • Coughing for 3+ weeks
  • Coughing up blood
  • Chest pain, pain with breathing/coughing
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Unintentional weight loss
  • TB is spread through airborne droplets from coughing and sneezing.

Who is Regularly Tested for TB

  • Healthcare workers
  • Workers in homeless shelters
  • Teachers
  • Correctional officers
  • Workers in rehab programs

Work Practice Controls Decreasing TB Transmission Risk

  • Screening
  • Using masks
  • Using HEPA filters
  • Using negative-pressure rooms
  • Using respirators
  • TB is tested for via PPD skin test or bloodwork.
  • TB is treated with antibiotics.
  • Treatment is not always effective.
  • There is no vaccine for TB.

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