Bloodborne Pathogens Training

Infectious Disease Control, Bloodborne Pathogens, and Exposure Control

Every employee and contractor must pass a training course on infection control and blood borne pathogens each year. This is your chance to do just that. There is a short test at the end.

Universal Precautions = to act as if all blood and other body fluids are infected with diseases.

Bloodborne Pathogens = the diseases you can catch from germs in blood and other types of body fluids.

Exposure Control = the actions you and Turning Point Services take after any exposure to blood and other body fluids.

OSHA stuff

The Occupational Safety and Health Administration (OSHA) requires Turning Point Services to determine which employees might be exposed to blood or other infectious stuff while at work. We must list all job titles of such employees. Well, here’s the list:

Qualified Professional • Habilitation Technician • Respite Provider • Alternative Family Living Provider
Supported Employment Specialist • Early Intervention Specialist • RN • Psychologist

Ok, so now that you’ve worried you might run into infected blood or body fluids, what next?

The diseases you are at the greatest risk of catching while at work are Hepatitis B, Hepatitis C, and the Human Immunodeficiency Virus. Even if you are exposed to blood containing one of these viruses, you have a very small chance of being infected.

Hepatitis B = HBV

  • Attacks the liver
  • Can go unnoticed
  • May cause problems, even death
  • But most people overcome
  • Can be prevented by a vaccine
Hepatitis C – HCV

  • Attacks the liver
  • Causes chronic long-term disease
  • May cause death
  • There is no vaccine
Human Immunodeficiency Virus = HIV

  • Attacks the immune system
  • Someone can carry the disease for years without knowing
  • Many people develop AIDs over time
  • No vaccine
  • Treatments are getting better all the time

Universal Precautions

The Centers for Disease Control (CDC) recommends that people who are likely to come into contact with blood or other body fluids should use Universal Precautions. At TPS, that means anyone who comes into direct contact with consumers.

It is not always possible to tell when someone is infected with diseases that are transmitted by contact with blood. Many people with a blood borne disease do not know that they are infected That means it is best to act as if all (universal) blood and body fluids are infected and we need to be very careful with it (precautions). So, remember this more than anything else in this training…

Universal Precautions must be used with every consumer.

Fluids to worry about include…

  • blood
  • any body fluid containing blood
  • spinal fluid
  • fluid from joints
  • vaginal secretions
  • semen
  • pericardial fluid (I didn’t know either – it’s the fluid around your heart)

Other body fluids can be dangerous if blood is visible. These less dangerous fluids are:

  • sputum (also called mucous or phlegm, it’s what you cough up)
  • saliva (spit)
  • feces (poop)
  • nasal secretions (snot)
  • vomit (puke)
  • urine (pee)
  • tears (tears)

These fluids can be sources of other germs and should be handled very carefully.

What should you do to prevent infection?
The most important step to prevent the transmission of infection is to prevent contact with blood, body fluids, and other germs. Work practices are used to stop or minimize employee exposure to blood and body fluids. At TPS, these are the work practices you should use are….

Top Ten TPS Practices to Stop Infections

bbp01#1 Hand Washing

  • Wash hands before any physical contact with a consumer and after.
  • Wash hands after contact with any personal care equipment.
  • Wash hands (or other skin) immediately soiled with blood or body fluids
  • Wash hands after gloves are removed.
  • Hand washing facilities are located in the bathrooms of consumer homes and public facilities.
  • Rub hands together at least 10 seconds including all surfaces of lathered hands. Rinse under a stream of water.
  • Dry hands with paper towels.
  • If soap and water are unavailable, wet towelettes or antiseptic hand cleaners may be used.

#2 Good personal hygiene practices

  • Do not eat, drink, smoke, apply cosmetics or lip balms, or handle contact lenses where you may be exposed to blood or other body fluids.
  • Remove jewelry from the hands and wrists before personal care tasks.
  • Avoid petroleum-based lubricants that may eat through disposable gloves.
  • Applying hand cream is OK if you thoroughly wash your hands first.

#3 Personal protective equipment

Personal protective equipment (PPE) includes disposable gloves, protective eye wear, masks, lab coats, and gowns. The use of personal equipment is intended to reduce the risk of contact with blood and body fluids for the caregiver. It also controls the spread of infection from staff to consumer. Your TPS supervisor and TPS Nurse will determine what PPE you should use while working. TPS is responsible to see that you have this equipment. Ask questions about this at any time during your work here at Turning Point Services.

Gloves should be worn when direct care of the consumer involves possible contact with blood or body fluids. It is highly recommended that gloves be worn for contact with feces and mucous. Gloves should be disposed of after each use and not re-used. Gloves will be available to employees from the supervising QP and provided at no cost to the employee. Use gloves when…

  • changing a diaper or assisting the consumer with cleansing after toileting
  • changing wound dressings or sanitary napkins
  • providing mouth, nose, or tracheal care
  • you have broken skin on your hands (even around nails) and need to provide personal care.
  • cleaning up spilled blood or body fluid, body waste, or soiled clothes/bedding.

Proper Glove Removal
This is the best way to take off gloves so that your skin does not contact anything on the outside of the gloves.

  1. Grasp the bottom of one glove on the outside with your other gloved hand.
  2. Carefully pull the glove off your hand, turning it inside-out.
  3. Ball the removed glove up, keeping it in your gloved hand.
  4. Slide your ungloved finger into the opening at the bottom of the other glove. Avoid touching the outside.
  5. Carefully pull the glove off your hand, turning it inside out again.
  6. Throw the used gloves into a plastic trash bag.

Other forms of protective equipment include:

  • Lab coats, gowns, or aprons
  • Protective eyewear and masks
  • Chux or other waterproof barriers
  • Disposable CPR masks. Gauze or some other porous material can be placed over the mouth and mouth-to-mouth resuscitation given.

All personal protective equipment used by TPS employees is provided at no cost to employees.

#4 Cleaning Up

Spills of blood and body fluids that are covered under Universal Precautions should be cleaned up immediately. All contaminated surfaces will be decontaminated immediately, or as soon as possible, after any spillage of blood or other body fluids. To clean up a spill…

  1. Wear gloves.
  2. Mop up the spill with paper towels or other absorbent material.
  3. Using a solution of one part household bleach in 10 parts of water, wash the area well.
  4. Dispose of gloves, soiled towels and other waste in a labeled, sealed double plastic bag and place garbage can.

Routine cleanup of facilities (such as bathrooms) does not require bleach cleaners unless blood or body fluids are involved. Soiled bandages or disposable pads, used medical gloves, and other medical items that are not sharp should be placed securely fastened plastic trash bags before you put them in the garbage can. Bodily wastes such as urine, vomit or feces should be disposed of in the toilet.

#5 Sharps

  • NEVER recap a needle by holding the syringe in one hand and the cap in the other.

    NEVER recap a needle by holding the syringe in one hand and the cap in the other.

    Needles, syringes, lancets, and other sharp objects should be placed in an empty plastic detergent container or coffee can, and when full, the lid should be securely fastened.

  • When full, make sure the lid is securely fastened, place it in a separate plastic trash bag, and throw away in regular household garbage.
  • Take a small container with you when you travel for safe, easy sharps disposal.
  • Do not bend, recap, or remove contaminated needles from syringes.
  • In those rare circumstances when needles must be recapped, use the following procedure.

One-Hand Scoop – recap the needle by using the same hand holding the needle to scoop up the needle cap from a flat surface. The second hand is kept well away from the scooping procedure and is never used to assist with the recapping. This video show the proper way to recap a needle.

Sources: Environmental Protection Agency (1998). Disposal Tips for Home Health Care: http://www.epa.gov

#6 Hepatitis B Vaccine

All employees who might have exposure to blood or other body fluids will be offered the Hepatitis B vaccine at no cost. This vaccine is offered within 10 working days of initial assignment unless you have already had the vaccine. You may also submit antibody testing which indicates immunity. If you don’t want the Hepatitis B vaccine, you will need to sign a waiver, but you can always accept one later, also at no cost. Vaccines will be administered through the local county Health Departments.

#7 Isolation Precautions

There are medical guidelines for isolation care in hospitals, nursing homes and for home care. Isolation refers to methods used to restrict the transmission of infections by “isolating” the infection. The type of isolation precautions used for a consumer with a communicable disease depends upon how the disease is transmitted from one person to another. Always contact the TPS nurse for consultation concerning diseases and isolation precautions. Methods include:

  • Contact precautions, such as wearing gloves and gown when entering the consumer’s room. The gloves/gown are removed and hands washed with an anti-microbial agent before leaving the area.
  • Droplet precautions, say from sneezes of coughs, calls for wearing a mask when working within three feet of a consumer.
  • Airborne Precautions are a higher level of isolation. Usually it means that the person is placed in a room with a special ventilation system. The door to the room is kept closed to prevent the room air from circulating outside the room. Special respiratory equipment that filters the air must be worn by people entering the isolation room.

#8 Accidental Exposure

Accidental exposure to blood, body products or body fluids places the exposed person at risk of infection. If you find blood or body fluids on you, or are stuck with a used needle, you should….

  1. Wash the skin area, needlestick, or cut immediately with lots of soap and water.
  2. If it splashes in your eyes or mouth, or gets into broken skin, flush with lots of water and then wash the area thoroughly.
  3. Document this as an incident by calling for your supervisor’s help.
  4. Then be sure to follow the steps in #9 below.

#9 Post-Exposure Evaluation and Follow-up

These steps must be followed whenever you are exposed to blood or body fluids.

  1. Report the possible exposure to your supervisor as soon as possible following the incident.
  2. An incident form is processed.
  3. The Turning Point Services Nurse is involved as soon as possible.
  4. You are referred to a Medical Provider for immediate care.
  5. TPS contacts the person who was the source of exposure to discuss responsibilities as required by OSHA guidelines.

The important thing to remember is that Turning Point Services will do everything possible following federal and state guidelines to provide testing and follow up care after any exposure to blood and body fluids. If you want to know more details about exactly what support we offer exposed employees, click here.

#10 Care and Cleaning of Consumer Equipment

Equipment used to provide care for a consumer must be cleaned regularly and stored properly.

Most of the equipment used in providing care to TPS consumers does not touch the consumer or touches only intact skin. Generally it is sufficient to wash this equipment with detergent. The cleaning process includes:

  1. washing with a detergent or a disinfectant detergent
  2. rinsing well
  3. thoroughly drying it
  4. returning cleaned equipment to storage.

Tuberculosis and Testing

Employees will receive TB screening prior to employment if that employee is a member of a high-risk group or if the employee will be working with consumers from a high-risk group (“high-risk group” is defined here if you are interested). Most employees do not need TB testing.

Residential program employees and AFL providers will be TB tested initially at hire; other testing will occur according to the Infectious Disease Control policy. TPS will reimburse employees for these tests. Contractors must pay for TB tests.

For a few employees, their work will bring them into contact with someone who has active TB. These employees will receive annual TB tests, or as often as ordered by a health official.

Employees who support consumers with weak immune systems will receive TB testing as recommended by the TPS Nurse. The TPS Nurse may recommend more testing and immunizations.

For Alternative Family Living providers, medical statements must be obtained from a physician, nurse practitioner, or physician’s assistant that attests to (1) the general health of the employee related to duties, (2) the absence of active tuberculosis or other communicable diseases, and (3) the absence of any other condition that poses a threat to consumers. Medical statements (employee TB tests and AFL provider medical statements) must be updated according to the Infectious Disease Control policy or recommendations from the TPS Nurse.

A Final Note about Latex Allergy

Allergic reactions to latex (rubber) have been reported, particularly in children with conditions such as Spina Bifida. These reactions include watery eyes, wheezing, rash, hives, swelling and, in severe cases, life-threatening shock.
Personnel who use latex products should be aware of the possibility of allergic reactions. If you are allergic to latex, please communicate this to your Qualified Professional or the Turning Point Nurse. Use of latex gloves at Turning Point Services must be approved by the Turning Point Services, Inc. RN or must be ordered by a licensed health care professional for a specific purpose.

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