|INFECTION CONTROL - BLOODBORNE PATHOGENS
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.”
1. Bloodborne pathogens include the hepatitis B virus (HBV), the hepatitis C virus, 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) if 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.
Standard precautions apply to:
- Vaginal secretions
- Cerebrospinal fluid
- Synovial fluid
- Pleural fluid
- Peritoneal fluid
- Pericardial fluid
- Amniotic fluid
- Nasal secretions
All human blood and body fluids should be treated as if they are infectious.
Remember who are you protecting -- YOURSELF!!!
Standard Precaution #1 – Handwashing
Handwashing is the single most important thing you can do to prevent the spread of infection. Thorough
handwashing removes pathogens from the skin. It is one of the most important and easiest practices used to
prevent transmission of bloodborne pathogens.
Wash hands before and after all client or body fluid contact. Immediately wash hands and other skin surfaces that
are contaminated with blood or body fluids. When wearing gloves, wash hands as soon as the gloves are removed.
Germicidal hand-rubs are recommended only when you can’t wash.
Standard Precaution #2 – Gloves
Use gloves in all situations where you may come in contact with blood or body fluids.
Use gloves for client care involving contact with mucous membranes, such as brushing teeth. Change gloves and
wash hands between client contacts. Use gloves when you have scrapes, scratches, or chapped skin. Do not
wash or disinfect disposable gloves for reuse.
Use thick rubber household gloves to protect your hands during housekeeping chores or instrument cleaning
involving potential blood contact.
Standard Precaution #3 – Protective Barriers
Protective barriers, including gloves, reduce the risk of your skin or mucous membranes being exposed to
potentially infective blood and body fluids. You should wear the appropriate barriers for the work you are doing.
Personal protective equipment (PPE) includes gloves, gowns, masks, eye protection, face shields, mouthpieces,
resuscitation devices, and gloves. Gloves may be hypoallergenic, powderless, latex, or vinyl. Use CPR breathing
barriers when giving ventilations.
The equipment you need depends on your work. When splashing of blood or body fluids is likely, wear the follow
PPE in addition to gloves:
- Mask if your face could be splashed with blood or body fluids. It can be worn along with goggles for
- Goggles can be work to protect your eyes if there is a risk of splashing or vaporization of contaminated
- Gown if your clothing or skin could be splashed. This will protect your clothing and will provide protection
from contaminated fluids soaking through to your skin.
If you find yourself in a situation where you have to come on contact with blood or other body fluids and you don’t
have any standard personal protective equipment handy, you can improvise. Use a towel, plastic bag, or some
other barrier to help avoid direct contact.
Standard Precaution # 4 – Proper Disposal of Sharp Items
A “sharp” is any object that can penetrate the skin, such as needles, scalpels, broken glass capillary tubes, and
exposed ends of wires. A sharp is contaminated if it has been in contact with flood, body fluids, or body tissues.
Contaminated sharps must be disposed of properly. Follow your company’s policies. A puncture-proof
biohazardous container must be used. Biohazardous waste must be disposed of by specially-licensed companies.
- 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.
- Do not recap needles. If it is absolutely necessary to recap a needle, use one hand to slide the needle into
a cap lying on a flat surface. Do not hold the cap in your other hand while recapping.
Standard Precaution # 5 – Work Practice Controls
- Work practice controls are vital in preventing the spread of bloodborne pathogens.
- Use biohazard bags to dispose of contaminated materials such as used gloves and bandages. Place all
soiled clothing in marked plastic bags or disposal or cleaning. Biohazard warning labels are required on any
container holding contaminated materials.
- Use sharps disposal containers to place sharps items, such as needles.
- Clean and disinfect all equipment and work surfaces soiled by blood or body fluids.
- Use a fresh disinfectant solution of approximately 1 ½ cups of liquid chlorine bleach to 1 gallon of water and
allow it to stand for at least 10 minutes.
If an Exposure Occurs
Immediately following an exposure to blood or body fluids:
- Wash needle sticks and cuts with soap and water.
- Flush splashes to the nose, mouth, or skin with water.
- Irrigate eyes with clean water, saline, or sterile irrigants.
- Report the 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 your exposure.
- Remember that mandatory testing of a client is not legal. Clients who might be the source of an infection
must give consent to be tested.
- Human immunodeficiency Virus (HIV) is the virus that causes AIDS
- Risk of infection after exposure
- Needlestick is the most common cause of work-related infection.
- Risk factors include the amount of blood or fluid, the puncture depth, and the disease stage of the infected
- The average risk of HIV infection after a needlestick or cut exposure is 1 in 300. The risk after exposure of
the eye, nose, skin or mouth to positive blood is less than 1 in 1000. If the skin is damaged, the risk may be
- Treatment after exposure
- There is no vaccine against HIV.
- Post-exposure treatment is not always recommended. A physician or exposure expert should advise you.
- Drugs used to prevent infection may have serious side effects.
- Perform HIV-antibody testing for at least 6 months after exposure.
- 99.7% of needlestick/cut exposures do not result in HIV infection.
Hepatitis B Virus (HBV)
Risk of infection after exposure:
- Hepatitis B vaccine prevents this disease. Persons who have received the vaccine and developed immunity
are at virtually no risk for infection. A series of three (3) injections are required, given initially, then 1-2
months later, then 4-6 months after the first injection.
- Workers should be tested 1-2 months after the vaccination series to make sure the vaccination has
- For the unvaccinated person the risk from a single needlestick or cut exposure ranges from 6-30%,
depending on the level of virus in the infected person’s blood. A higher concentration of virus makes it more
likely that someone exposed to that blood will become infected.
- Treatment after exposure
- Everyone with a chance of exposure to blood or body fluids should receive hepatitis B vaccine, preferably
during training, unless it is contraindicated because of allergies, pregnancy, or potential pregnancy.
- Hepatitis B immune globulin (HBIG) effectively prevents HBV infection after exposure. Recommendations for
post-exposure management of HBV may include HBIG and/or hepatitis B vaccine. The decision to begin
treatment is based on several factors, such as:
- Whether the source person is Hepatitis B positive.
- Whether the worker has been vaccinated.
- Whether the vaccine provided immunity.
- Hepatitis C Virus (HCV)
- Infection with HCV carries a great potential for chronic liver disease and can lead to liver failure, liver
transplants and liver cancer.
- Risk of infection after exposure
- Hepatitis C Virus (HCV) is a growing problem.
- The risk for infection after a needlestick or cut exposure to HCV-infected blood is 1.8%.
- The risk after a blood splash is unknown, but is believed to be very small.
- Treatment after exposure
- There is no vaccine against Hepatitis C and no treatment after an exposure that will
- Prevent infection.
- Immune globulin (IBIG) is not recommended.
- Following recommended infection control practices is vital.
- There are several tests that should be performed in the weeks after an exposure and for 4-6 months
afterward. Confer with a physician or an exposure specialist.
- Additional Precautions for Infection Control
- If you know or suspect that a client has a disease that is spread in one of the following ways, use these 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: chickenpox, TB, shingles.
- Wear a mask. If the client has, or might have, tuberculosis, wear a special respiratory mask (ask your
supervisor). A regular mask will not protect you.
- Remind the client to cover nose and mouth when coughing or sneezing.
- Treat the client’s used tissues or handkerchiefs as infected material.
- Contact germs can cause the spread of disease by touch. Examples of disease caused by contact germs:
pink-eye, scabies, wound infections, MRSA.
- Wear gloves.
- Treat bed linens, clothes, and wound dressings as infected material.
- Wear a gown if the client has drainage, diarrhea, or is incontinent.
- Use a disinfectant to clean stethoscopes, blood pressure cuffs, or other equipment.
- Droplet germs can travel short distances through the air, usually not more than three feet. Sneezing,
coughing, and talking can spread these germs. Examples of diseases caused by droplet germs: flu,
- Wear a mask when working close to the client (within three feet).
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