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HIV/AIDS
Elaine Kauschinger PhD, MS, ARNP, FNP-BC
Assistant Professor of ClinicalLead Faculty, Family Nurse Practitioner Program
University of MiamiSchool of Nursing & Health Studies
Part 4:Prevention & Infection Control
Infection control practices
Standard precautions• Standard precautions are the basic level
of infection control that should be used in the care of all patients all of the time
Hand hygiene Gloves, gowns, masks, face shield, & eye
protection Patient care equipment 1:10 bleach solution for accidental infectious
fluid/blood spills
Post Exposure Prophylaxis
A bloodborne pathogen is a pathogenic microorganismss that are transmitted via human blood and cause disease in humans. They include, but are not limited to, hepatitis B
virus, and human immunodeficiency virus. Although a number of pathogens can be transmitted percutaneously, HIV remains the most common. Mosby's Medical Dictionary, 8th edition, 2009, Elsevier
What is the Occupational Safety and Health Administration (OSHA)? Created in 1970 to ensure a safe and
healthy workplace. In 1991 the Bloodborne Pathogen
standard was created. In 2001 the Needlestick Prevention Act
required employers to select safer devices.
All institutions are required to develop and implement a bloodborne pathogen exposure control plan.
Types of Bloodborne Pathogen Exposures
Needlestick injuries are wounds caused
by needles that accidentally
puncture the skin.Sharps Injury
scalpels
Splash
Cutaneous Exposure
Exposure These situations require consideration of
treatment with HIV antiretroviral therapy:• Post exposure prophylaxis (PEP)
Average risk of HIV transmission following percutaneous exposure to • Infected blood: 0.3%• Mucous membrane exposure: 0.09%• After skin exposure: unknown • Following exposure to fluids or tissues other
than blood: unknown Risk of transmission of hepatitis B virus after a
large bore needle stick is approximately 5% while to hepatitis C virus is 1.8%
Post Exposure Management
Clean exposed area with soap and water
Apply first aid
Supervisor Assistance –follow instructions located in UM Student Handbook (located on-line).
Counseling to determine need for PEP
Initiation of PEP, as needed, within 2 hrs
Post Exposure Management
Post Exposure drug management dependent upon severity of injury:– Percutaneous
– Mucous membrane
– Skin
Resources
National Clinicians’ Post-Exposure Hotline (PEPLine): 888-448-4911
Post-Exposure Prophylaxis Registry for Health Care Workers: 888-737-4448 (888-PEP-4HIV)
CDC (for reporting HIV seroconversion in health care workers who received PEP): 404-638-6425
National Post-Exposure Prophylaxis Hotline: 888-HIV-4911
Florida/Caribbean AIDS Education & Training Center: www.FCAETC.org