Everyone is responsible for keeping the environment safe and effective—this means you!!!!!

What does biosafety mean??Biosafety refers to the protection of persons whose jobs put them at a reasonable risk of coming into contact with blood and other potentially infectious materials

OSHA Bloodborne Pathogens Standard

1991 Bloodborne Pathogen StandardThis standard is an excellent guide that details

what employers must do to protect their workers whose jobs put them at a reasonable risk of coming into contact with blood and other potentially infectious materials.

How do we protect ourselves?

Standard PrecautionsTreat ALL body

fluids and substances as potentially infectious

Bloodborne TransmissionSome pathogens are transmitted primarily

through blood

Transmission occurs through sticks, splashes, or sprays

CDC estimates 600,000 to 800,000 injuries occur annually

1000 needle sticks occur every day

385,000 needle sticks occur annually, reported

Bloodborne Transmission The following are

examples of Bloodborne pathogens that can be transmitted by sticks, splashes and sprays

HIV- Human Immunodeficiency Virus

HBV- Hepatitis B VirusHCV- Hepatitis C Virus

Respiratory TransmissionSome pathogens are transmitted primarily

through respiratory droplets:Coughing

Sneezing

Touching respiratory drops on yourself, another person, or an object, and then touching mucus membranes (e.g. mouth, nose, eyes) without washing hands

Respiratory TransmissionInfluenza virus is transmitted from

person–to-person through respiratory transmission.

Influenza is not spread by food.

You cannot get H1N1 Influenza (Swine flu) from eating pork or pork products.

Knowledge AssessmentStandard Precautions considers…

Answer

A. Only symptomatic patients infectious

B. All patients considered potentially infectious

C. Only patients with positive lab test considered infectious

B. All patients considered potentially infectious

If Influenza Is Suspected Patients should be instructed to cover the

nose/mouth when coughing or sneezing. Tissues should be provided to patients and

visitors to contain respiratory secretions. Waste receptacles will be positioned in

convenient locations to facilitate proper disposal of contaminated tissues.

Alcohol-based hand gel and hand hygiene supplies should be available for patientsand visitors to utilize.

Masks should be available and offered to persons who are coughing.

If Influenza Is SuspectedThe patient should be placed directly into

an individual room with the door kept closed.

Medical personnel entering the room of a patient in isolation should be limited to those performing direct patient care.

If a room is not immediately available, the patient should be given a surgical mask and seated at least 6 feet from other clients and staff.

If Influenza Is SuspectedProcedures that are likely to generate

aerosols (e.g., suctioning, administering nebulized medications) should not be performed on patients with suspected Influenza infection.

Suspected or known influenza patients should not be referred to Dental Clinics, WIC offices, or other services during the illness.

Knowledge AssessmentIf influenza is suspected…

A. Tissues should be provided to patients and visitors to contain respiratory secretions.

B. The patient should be placed directly in a room or seated 6 feet from other patients.

C. Suspected or known influenza patients should not be referred for dental or WIC services.

D. All of the above

AnswerD. All of the above

If SCABIES IS SUSPECTEDScabies is easily spread by close personal

contact and by contact with bedding and clothing

The patient should be placed directly into an individual room with the door kept closed.

Suspected or known Scabies patients should not be referred to Dental Clinics, WIC offices, or other services during the illness.

How Do We Protect Ourselves?

Personal Protective Equipment (PPE)

Select masks, goggles, face shields, and combinations of each according to the need anticipated by the task performed.

Wear a gown, that is appropriate to the task, to protect skin and prevent soiling or contamination of clothing during procedures and patient-care activities when contact with blood, body fluids, secretions, or excretions is anticipated.

Wear gloves when it can be reasonably anticipated that contact with blood or other potentially infectious materials, mucous membranes, non-intact skin, or potentially contaminated intact skin (e.g., of a patient incontinent of stool or urine) could occur.

How To Don A Surgical Mask

1. Place over nose, mouth, and chin

2. Fit flexible nose piece over nose bridge

3. Secure on head with ties or elastic

4. Adjust to fit

How To Don Eye And FaceProtection

1. Position goggles over eyes and secure to the head using the ear pieces or headband

2. Position face shield over face and secure on brow with headband

3. Adjust to fit comfortably

How To Don Gloves1. Don gloves last2. Select correct type and size

3. Insert hands into gloves4. Extend gloves over lab coat cuffs

How To Safely Use PPE

Perform hand hygiene before donning new gloves

Keep gloved hands away from faceAvoid touching or adjusting other PPELimit surfaces and items touchedRemove gloves if they become torn

Sequence For Removing PPE

1.Remove gloves2.Remove face shield or goggles3.Remove lab coat4.Remove mask

Knowledge AssessmentPPE should be worn…

Answer

A. Anytime there is a risk of exposure to skin, clothes, eyes, mouth or other mucous membranes.

B. PPE is not needed in ambulatory settings.

C. When my supervisor tells me to.

A. Anytime there is a risk of exposure to skin, clothes, eyes, mouth or other mucous membranes.

How Do We Protect Ourselves?

Engineering ControlsPhysical or mechanical systems provided to

eliminate hazardsExamples:

Sharps containersSafety needle devices (safety lancets, self-

retracting vacutainers, butterflies with self-retracting needles

Bio-hazard refrigerators Signage identifying bio-hazard refrigerators

(NOT FOR FOOD OR DRINK)Red biohazard leak proof bags

Knowledge AssessmentEngineering controls include… Answer

A. Sharps containers

B. Red biohazard garbage bags

C. Both A and B

C. Both A and B

How Do We Protect Ourselves?

Work Practice Controls

“Work Practice Control” refers to altering or changing the way YOU perform a task to accomplish the task in the safest way possible

Work Practice ControlsExamples include:Handling of specimens

to minimize potential splash, spray or splatter

Safe needle usage (one handed technique to activate safety device) and disposal

Using spill kits to remove spilled specimens

Work Practice Controls - DentalExamples include:Using instruments instead of fingers to retract

tissuesPassing instruments with sharp ends pointing away Safe needle usage and disposal (mechanical device to facilitate one-handed recapping when re-sheathing aspirating syringe needles) Using spill kits to remove spilled specimensPersonal hygiene and work habits

Work Practice Controls- DentalAll dental devices connected to the

dental air/water system that enters the patient’s mouth must be run to discharge water, air or a combination for a minimum of 20-30 seconds after each patient. This procedure is intended to flush out patient material

Flushing out waterlines at the end of each clinical day with a chemical disinfectant. The disinfectant will be left in the waterlines overnight and flushed at the beginning of each clinical day

Work Practice ControlsPersonal hygiene

and work habitsCotton balls, Q-tips,

and tongue depressors must be covered!!!!

Work Practice Controls Personal Items should be very minimumNo decorative items, personal lamps, etcDo not tape, tack or pin items on walls or

doors Remember a patient care area is for the

provision of health care – not an “office”NO FOOD OR DRINK!!

Work Practice ControlsConsumable Items:NO food or drink present or stored in

patient care areas including:Exam roomsNutrition and Social Services officesInterview AreasPatient Registration

Remember you are protecting yourself!!

Knowledge AssessmentWork practice controls include… Answer

A. Changing Sharps containers when < 2/3 full

B. Refraining from eating or drinking in patient care areas

C. Covering containers of cotton balls

D. All of the above

D. All of the above

Continued in Module 2