Module #1 Bloodborne Pathogens - Tri-County Home Care of Florida

Module #1
Bloodborne Pathogens

Module #1 focuses on your understanding of bloodborne pathogens and the safety precautions to follow. Bloodborne pathogens are microorganisms that cause disease and are present in human blood, including, but are not limited to human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV).

As a Home Health Care Professional, you are responsible for the safe use and disposal of sharps equipment that you use in a patient home. However, patients or family members may put themselves and others at risk by not appropriately disposing of sharps themselves.

Read carefully because at the end of this module is a quiz. There are 10 questions in total and 5 minutes to complete. 7 questions (70%) must be answered correctly. Your results will be forwarded to admin. You have 8 chances to pass this module.

In-Service Exams provided by Essential In-Services for Home Health, 2021

Upon completion of the Bloodborne Pathogens module. You should be able to:

Understand and discuss harmful organisms that may be present in blood.

Demonstrate precautions to prevent the spread of bloodborne diseases.

Understand and demonstrate precautions to prevent the spread of bloodborne diseases.

Understand the importance of vaccination against hepatitis B.

Why Is It Important to Protect Yourself From Contact With Blood and Body Fluids?

Though they can’t be seen, there are hundreds of tiny organisms living in blood and other body fluids that can cause disease in humans. These are called “bloodborne pathogens.” Some of these organisms are harmless and can be handled easily by the body’s immune system, but others can cause severe illness, such as hepatitis or AIDS.

Bloodborne Diseases: HIV/AIDS, Hepatitis B, Hepatitis C
Bloodborne pathogens include the hepatitis B virus (HBV), the hepatitis C virus (HCV), the human immunodeficiency virus (HIV) that causes autoimmune deficiency syndrome (AIDS) and others.

These pathogens are transmitted through contact with infected body fluids such as blood, semen and vaginal secretions.

Exposures occur (a) when the skin is punctured by a contaminated needle, razor or other sharp item or (b) when broken skin or mucous membranes are splashed with blood or body fluid.

Fortunately, most exposures do not result in infections. Standard precautions are designed to prevent transmission of HIV, HBV and HCV.

Standard precautions must be observed in all situations where there is potential for contact with blood or other potentially infectious body fluids.

If you must recap a needle, do so with caution. Use one hand to gently glide the needle into a cap placed on a level surface.

To safeguard your hands during housekeeping chores or instrument cleaning where there may be a risk of blood contact, utilize durable rubber household gloves.

Treat all bedding soiled with blood or body secretions as potentially infectious.

Surfaces that have been contaminated with blood or body fluids should be thoroughly cleaned with a disinfectant, according to your organization’s policies.

Standard Precaution #1 – Proper Handwashing

Remove watch or push it up your arm. Note: You should not wear rings or bracelets during work.
Do not touch sink with your hands while you are washing, and stand back from the sink to keep water from touching your clothes.
Use warm water. Hot water may dry out your skin.
Either bar soap or liquid soap is okay. If using a bar, rinse it first and hold it the whole time you are lathering. Soap does not have to be an antiseptic type, unless you are doing an invasive procedure such as catheterization.
Apply plenty of soap. Work up a thick lather all over your hands and wrists, between your fingers and thumbs, and on the back of your hands and wrists.
Vigorously cleanse all areas of your hands, fingers and wrists for a minimum of 20 seconds. 60 seconds is better. Friction helps remove dirt and microorganisms.
Thoroughly clean beneath nails by using the nails on your other hand, or rub nails into the palm of other hand. Clean around the top of your nails.
Rinse with warm water, letting water run down from wrists to fingertips and into the sink.
Dry with a clean paper towel and discard.
Turn off the faucet with another clean, dry paper towel and discard.
Use lotion on your hands to prevent irritation and chapping, which makes skin more prone to infection.

Standard Precaution #2 – Gloves

Use gloves in every situation, particularly if you might come in contact with blood or body fluids.
Use gloves for patient care involving contact with mucous membranes, such as brushing teeth.
Change gloves and wash hands between patient contact.
Use gloves if you have scrapes, scratches, or chapped skin.
Do not wash or disinfect disposable gloves for reuse.

Standard Precaution #3 – Protective Barriers

Protective barriers, including gloves, reduce the risk of skin or mucous membranes being exposed to potentially infective blood and body fluids. You should wear the appropriate barriers.
Employers must provide suitable personal protective equipment (PPE) in the right sizes. Protective equipment includes gloves, gowns, masks, eye protection, face shields, mouthpieces, resuscitation devices, etc.
Hypoallergenic gloves, glove liners, powderless gloves or other alternatives must be available for those who are allergic to the regular latex gloves.
The equipment you need depends on your work. When splashing of blood or body fluids is likely, wear the following PPE in addition to gloves:
Mask if face could be splashed with blood or body fluids;
Eye protection if eyes could be splashed with blood or body fluids;
Gown if clothing or skin could be splashed.

Standard Precaution #4 – Proper Disposal of Sharp Items

A “sharp” is any object that can penetrate the skin, such as needles, scalpels, broken glass, broken capillary tubes and exposed ends of wires. A sharp is contaminated if it has been in contact with blood, body fluids or body tissues. Contaminated sharps must be disposed of properly. Follow your agency’s policies.

Be careful to prevent injuries from needlesticks and other sharp instruments after procedures, when cleaning used instruments and when disposing of used needles. Do not recap or manipulate needles.
If possible, use needleless injection systems or needles with injury protection.

If exposure to blood or body fluids occurs:

Wash needlesticks and cuts with soap and water.
Flush splashes to the nose, mouth or skin with water.
Irrigate eyes with clean water, saline or sterile irritants.
Report exposure at once. Treatment may be recommended, and it should be started as soon as possible.
See a medical professional. Discuss the possible risks and the need for treatment with the person managing exposure.
Remember that mandatory testing of a patient IS not legal. Patients who might be the source of an infection must give consent to be tested.

If handwashing facilities aren’t available, use an agency-approved antiseptic hand cleaner or an antiseptic towelette. As soon as possible, rewash your hands with soap and water following the correct handwashing procedure.

Workers’ Rights

The Occupational Safety and Health Administration (OSHA) is a federal agency that guarantees rights to a safe workplace. Under OSHA’s rules, workers who might be exposed to contaminated blood or body fluids have specific rights.

Employers must train workers that might be exposed to blood or body fluids about the hazards and how to protect themselves. This training must occur during working hours at no cost to employees, at orientation and annually thereafter.

Standard precautions must always be practiced. Puncture-proof and leak-proof containers must be provided for disposal of sharp items. There must be a system for reporting exposures to blood or body fluids.

Employers must provide free Hepatitis B vaccination, protective equipment and immediate medical evaluation and follow-up for anyone exposed to blood or body fluids. Employees must receive confidential treatment, and their medical records must be protected.

Workers’ Responsibilities

Always use standard precautions.
Actively participate in evaluating safer equipment and encouraging your organization to purchase safer equipment.
Be open to new products or practices that could prevent exposure and protect workers and patients.
Be immunized against hepatitis B, getting the series of three injections.
Report all exposures immediately after cleaning and disinfecting the exposed skin or mucous membranes.
Comply with post-exposure recommendations of your organization.
Support other workers who have been exposed. HIV-infected workers who continue working deserve support and confidentiality.
Know your own HIV/HBV/HCV status. If you are positive for any of these viruses, you do not pose a risk for patients if you don’t do invasive procedures.

Specific Exposure & Treatments

Human Immunodeficiency Virus (HIV)

Hepatitis B Virus (HBV)

Hepatitis C Virus (HCV)

Additional Precautions for Infection Control
If you know or suspect that a patient has a contagious disease that is spread in one of the following ways, familiarize yourself with the following extra precautions in addition to standard precautions.

Airborne germs can travel long distances through the air and are breathed in by people. Examples of diseases caused by airborne germs are TB, chickenpox and shingles.

Precautions include the following:

Remind the patient to cover nose and mouth when coughing or sneezing.
Treat the patient’s used tissues or handkerchiefs as infected material.

Bloodborne germs
The blood of an infected person comes in contact with the bloodstream of another person, allowing germs from the infected person into the other person’s bloodstream. Blood and bloodborne germs are sometimes present in other body fluids. such as urine, feces, saliva and vomit. Examples of diseases caused by bloodborne germs are HIV/AIDS and viral hepatitis.

Droplets
Some germs can travel only short distances through the air, usually not more than six feet. Sneezing, coughing and talking can spread these germs. Examples of diseases caused by droplet germs are flu and pneumonia. The virus commonly known as COV ID-19, SARS-CoV-2, is also known to spread via droplet transmission.

Contact germs can cause the spread of disease by touch. Examples of diseases caused by contact germs are pink eye, scabies, wound infections and methicillin-resistant Staphylococcus aureus.

Precautions include the following:

Wear gloves.
Treat bed linens, clothes and wound dressings as infected material.
Wear a gown if the patient has drainage, has diarrhea or is incontinent.
Use a disinfectant to clean stethoscopes, blood pressure cuffs and/or other equipment.
Droplet germs can travel short distances through the air, usually not more than 3 feet. Sneezing, coughing and talking can spread these germs. Examples of diseases caused by droplet germs are flu, pneumonia and COVID-19

Precautions include the following:

Wear a mask when working close to the patient (within 3 feet).

Tier 1: Standard Precautions
Based on type of disease and how that disease is transmitted (airborne, contact, droplet). You should wash your hands with soap and warm water, especially if visibly soiled, or with alcohol-based hand rub if not visibly soiled.

Guidelines on hand hygiene:

Any hand washing should always utilize an antimicrobial hand soap and water and any disinfectant gels, foams or rinses should be approved alcohol-based products.
Wash your hands anytime they are visibly soiled.
Use a disinfectant product OR wash your hands before contact with a patient.
Use a disinfectant product OR wash your hands before performing certain tasks that require clean technique such as wound care or catheter changes
Use a disinfectant product OR wash your hands after contact with any body fluids, blood, or contaminated surface
Use a disinfectant product OR wash your hands when moving from working on a part of the patient’s body that is contaminated then to a part that is clean.
Use a disinfectant product OR wash your hands after removal of personal protective equipment (PPE).

Guidelines on wearing gloves:

Wear gloves whenever you touch or potentially could come in contact with blood, body fluids or contaminated surfaces
Wear gloves before touching a patient’s broken skin or mucous membranes (mouth, nose). Put on clean gloves if you already have a pair on.
Change gloves between tasks. Dirty gloves spread germs, just like dirty hands!
Remove gloves immediately after use and discard before touching noncontaminated items or other surfaces.
Always wash hands after removing gloves.

Guidelines on wearing personal protective equipment:

Wear a gown, mask and goggles if there is a potential for you to get splashed with blood or body fluids
Use a waterproof gown if you might get heavily splashed
Personal eyeglasses and contact lenses are not considered adequate eye
Remove protective clothing as soon as you can and wash your hands afterward.
Dispose of protective equipment per agency policy. Gowns should not be worn for more than one patient.

As a last precaution, keep everything clean and clean up spills as soon as possible

Standard Precautions for Handling Objects

Dispose of dangerous waste, such as needles, very carefully. Needles and other sharp devices should go into clearly marked puncture-proof containers, not the regular trash container! Do not recap used needles — put them in the puncture-proof container without the cap on.
Trash that is contaminated with germs such as wound dressings should be disposed of according to your agency’s procedures.
Any container marked “biohazard” is only for discarding contaminated Don’t remove anything from it! If you must handle anything in the container, always use gloves. Don’t put your hand in anything that contains needles or other sharp objects.
Check your gloves and other protective clothing If you see tears or holes, remove the gloves, wash your hands, and apply clean gloves.

Clean any equipment that has been used by one patient before giving it to another. You should wear gloves when cleaning contaminated equipment. Follow your agency’s cleaning procedures.
Use disposable equipment only
Dirty linens should be rolled, not shaken, and should be held away from your body. Linens soiled with body fluids can be washed with other laundry, using your agency’s procedures.
No special precautions are needed for dishes or silverware. Normal dish soap and hot water (water temperature must be hot enough to meet state requirements) will kill germs.
Change cleaning rags and sponges
Stethoscopes, blood pressure cuffs and thermometers should be cleaned between each use, using your agency’s procedures.

Don’t touch your face (nose, mouth, eyes) when giving patient care, unless you remove your gloves and wash your hands first. Protect yourself from infection.

Tier 2: Additional Precautions
Always use precautions with every patient to prevent transmission of bloodborne disease. Use additional precautions in addition to standard precautions when a patient has an illness requiring extra infection control measures. If you know that a patient has a disease that is spread in one of the following ways, use these extra precautions:

Frequent handwashing
Wear gloves when you touch blood and body fluids.
Safe use and disposal of sharp items. Do not recap needles at any time.
When splashing of blood or body fluids is likely, wear the following, depending on the situation:
- Masks
- Safety Goggles
- Gloves

Airborne:

The patient should have a private room, possibly one with a special air filter.
Keep the patient’s room door closed.
Wear a mask. If the patient has or might have TB, wear a special respiratory mask (ask your supervisor). A regular mask will not protect you.
Remind the patient to cover nose and mouth with a tissue when coughing or sneezing
Dispose of the tissue in nearest waste receptacle and wash your hands Ask the patient to wear a mask if he or she wants or needs to be around others.
If the patient is suspected of having a cough or respirator y symptoms due to COVID-19, be sure to follow all droplet precautions as well and disinfect all “high touch” surfaces in the patient’s area
Social distancing, keeping at least 6 feet of distance between yourself and the patient, as well as any others in the home, should always be practiced as a method of preventing droplet transmission, but is especially important to maintain whenever possible when caring for a patient who is has a confirmed or suspected diagnosis of COVID-19.

Contact:

If the patient is cognitively impaired, is unable to follow standard precautions, or has open draining wounds, then the patient should be encouraged to stay in one room (the door may stay open). Encourage at least daily cleaning of the patient’s room and disinfect frequently touched surfaces and equipment.
Gloves should be worn prior to entering the room.
Change gloves after touching a contaminated object (bed linens, clothes, wound dressings).
Remove gloves right before leaving the room. Don’t touch anything else until you wash your hands. Wash your hands as soon as possible.
Wear a gown in the room if the patient has drainage, has diarrhea or is incontinent. Remove the gown right before leaving the room.
Limit the amount of non-disposable equipment bought into the room.
Utilize disposable equipment or patient-dedicated equipment if at all possible.
If equipment cannot remain in the home, then clean and disinfect items per agency policy

Droplets

Patients that are cognitively impaired or noncompliant with covering their mouth when sneezing or coughing should be maintained in one room, but the door may stay open.

Wear a mask when working close to the patient (within 6 ft) and follow standard precautions. This is especially important for patients who have tested positive for COVID -19.
Instruct the patient on using a tissue when coughing and disposing of it in a waste receptacle immediately.
Ask the patient to wear a mask if he or she wants or needs to be around others. This is especially important for patients who have tested positive for COVID-19.
Assure that high-touch surfaces in the patient’s area are disinfected daily using soap and water, followed by a household disinfectant.
Social distancing, keeping at least 6 feet of distance between yourself and the patient, as well as any others in the home, should always be practiced as a method of preventing droplet transmission, but is especially important to maintain whenever possible when caring for a patient who is has a confirmed or suspected diagnosis of COVID-19.

Module #1 – Bloodborne Pathogens Quiz

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