Bloodborne Pathogens Standard Training For Healthcare Professionals

Bloodborne Pathogens
Standard Training
For Healthcare
Professionals
Because Getting It Right Matters
© Copyright 2018 The Compliance Store, LLC. All rights reserved

Knowledge Objectives:
• Recognize OSHA standards related to

bloodborne pathogens.
• Learn the basics of bloodborne diseases.
• Exposure Prevention.
OSHA Bloodborne pathogens standard 29 CFR 1910.1030

What are Bloodborne Pathogens?
Bloodborne pathogens are pathogenic

microorganisms such as viruses,
bacteria and other microorganisms
that are present in human blood and
can cause disease in humans.
There are over 20 different

bloodborne pathogens.
OSHA Bloodborne pathogens standard 29 CFR 1910.1030 © Copyright 2018 The Compliance Store, LLC. All rights reserved
Bloodborne Pathogens
3 Most Common are:
• Human Immunodeficiency Virus (HIV)
• Hepatitis B Virus (HBV)
• Hepatitis C Virus (HCV)
Getting to Know the Pathogen: HIV
• It is a virus that causes AIDS.
• At the end of 2015, an estimated 1.1 million were

living with HIV in the US.
• HIV wipes out the immune system.
• Doesn’t survive well outside the human body.
• Symptoms first appear as fever, rapid weight loss,

night sweats and pneumonia.
Getting to Know the Pathogen: Hepatitis B (HBV)
• At the end of 2015, an estimated 850,000 persons

were living with Hepatitis B in the US.
• May lead to chronic liver disease, liver cancer, and

death.
• Unvaccinated persons are at risk.
• Symptoms first appear as fever, muscle ache,

fatigue, abdominal pain and jaundice.
• Can live outside the human body for 7 days.
Getting to Know the Pathogen: Hepatitis C (HCV)
• It is the most common bloodborne infection in the

US.
• At the end of 2015, an estimated 3.5 million persons

were living with Hepatitis C in the US.
• It leads to chronic liver disease, liver cancer and

death.
• Everyone is at risk.
• Symptoms if present, include fever, muscle ache,

fatigue, abdominal pain and jaundice.
Potentially Infectious Bodily Fluids
• Blood
• Saliva
• Vomit
• Urine
• Semen or Vaginal Secretions
• Skin, Tissue, Cell Cultures
• Other Body Fluids
How is it Transmitted into Your Body?
Break in Your Skin: Mucous Membranes:
• Sustaining an injury with a device that is • Splash into your eyes, nose or
visibly contaminated with blood. mouth.
• Injured by a needle stick.
• It enters via a cut, scrape or other break in

your skin.
Questions So far ?????
OSHA’S Bloodborne Pathogen Standard
What is the Purpose?
The purpose of OSHA’s Bloodborne Pathogens

Standard is to minimize or eliminate health care
workers’ exposure to bloodborne pathogens.
Who is covered by the standard?
All employees who could be “reasonably anticipated”

to face contact with blood or other potentially
infectious materials as the result of job duties.
Exposure Control Plan
As part of the Bloodborne Pathogens Standard, OSHA

requires employers to develop an Exposure Control Plan
(ECP).
• This plan explains the steps employers are taking

to provide protection for all healthcare workers
who might be exposed to bloodborne pathogens.
OSHA Bloodborne pathogens standard 29 CFR 1910.1030 (c)(1) © Copyright 2018 The Compliance Store, LLC. All rights reserved
Requirements of the BBP Standard
Facilities are required to have in place….
Exposure Control Plan which covers:
• Standard precautions
• Engineering and workplace controls
• Personal protective equipment (gloves, gown, etc.,)
• Housekeeping practices, including decontamination
• Regulated waste procedures
• Labels and signs to communicate hazards
• Hepatitis B vaccination
• Post-exposure follow up
• Hazard Communication training
• Recordkeeping of exposures
Tasks That May Involve Exposure
Tasks with potential for exposure to

bloodborne pathogens:
 Performing phlebotomy
 Performing finger sticks
 Administering immunizations
 Collecting/handling specimens of
blood or body fluids
Standard Precautions
• Precautions to be used on all individuals.
• Used for all contact with:

•Blood
•All body fluids (except sweat)
•Mucous membranes
•Non-intact skin
• If it comes from the human body it has the potential to

be infectious… so protect yourself!
OSHA Bloodborne pathogens standard 29 CFR 1910.1030 (d) © Copyright 2018 The Compliance Store, LLC. All rights reserved
Standard Precautions
Components of Standard Precautions :
• Hand Hygiene
• PPE (gloves, gown, mask, eye protection or face shield)
• Safe Injection Practices
• Cleaning/Decontamination of Equipment
• Respiratory Hygiene/Cough Etiquette
DID YOU KNOW?...
• Standard Precautions are also intended to protect residents by

ensuring staff members do not carry infectious agents to
residents via their hands or via equipment used during resident
care.
CDC Guidelines for Isolation Precautions in a Healthcare Settings © Copyright 2018 The Compliance Store, LLC. All rights reserved
Hand Hygiene
• The most important and simplest way to prevent and control
the spread of infections.
• Methods- Hand washing or alcohol hand gel.
• Facility responsibilities:
• Staff are to be trained on appropriate technique.
• Provide materials such as hand gel, soap, paper towels.
• Monitor for compliance.
• Reinforce and remind.
Hand Hygiene Methods
Alcohol-Based Hand Cleansers:
• Most convenient and takes less time to perform.

• Most preferred method.
• Gentler on skin than soap and water.
• To be used when hands are not visibly dirty, if soap and water are not
available.
• Frequent use is recommended, apply good amount, rubbing into all surfaces of
hands until dry.
Hand Washing:
• Use if hands are visibly dirty.

• When caring for a patient with a C. Difficile infection.
OSHA Bloodborne pathogens standard 29 CFR 1910.1030 (d)(2) © Copyright 2018 The Compliance Store, LLC. All rights reserved
Hand Washing Technique
Hand Washing with Soap and Water:
• Wet hands with water, apply soap, rub hands together

for 20-30 seconds.
• Rinse and dry with paper towel.
• Use paper towel to turn off faucet.
• Use if hands are visibly dirty and when caring for a

patient with a C. Difficile infection.
When to Perform Hand Hygiene
Before:
 Resident contact
 Donning gloves
 Inserting urinary catheters or other invasive
devices that do not require surgery
 Eating meals
After:
 Contact with resident’s skin
 Removal of gloves
 Using the restroom
 Eating meals
 Coughing and/or sneezing
 Contact with body fluids or excretions, non-
intact skin, wound dressings
Hand Hygiene: Prevents the Spread of Pathogens
MOST COMMON MODE OF TRANSMISSION IS BY HANDS
Sequence of Events for Transmitting from Residents to Staff:

 Organisms present on resident’s skin, or inanimate object
transferred to hands of staff members.
 These organisms must be capable of surviving for at least a few

minutes on the hands of staff.
 Hand hygiene is not performed or performed incorrectly
 Contaminated hands of staff members touch another resident
Personal Protective Equipment (PPE):
• Should be used when there is a reasonable chance of exposure

to blood, body fluids, mucous membranes and/or non-intact
skin.
• Provides protection for your clothing, skin, eyes, nose and

mouth.
• May include: gloves, gowns, face shields or masks, eye

protection, mouthpieces, resuscitation bags, pocket masks or
other ventilation devices.
Personal Protective Equipment (PPE): Gloves
• Should be worn when it is reasonably anticipated that the employee may have contact with
blood or other body fluids, mucous membranes or non-intact skin.
• Gloves should be removed & replaced when torn, punctured or no longer a barrier.
• Disposable gloves are a single use item and should not be washed or decontaminated for re-use.
• Should be worn if the employee has cuts, scratches or other breaks in his/her skin.
• Ensure you wear the proper fitting gloves. Do not wear gloves that do not fit.
OSHA Bloodborne pathogens standard 29 CFR 1910.1030(d)(3) © Copyright 2018 The Compliance Store, LLC. All rights reserved
Personal Protective Equipment (PPE)
MASKS, NOSE and EYE PROTECTION

• Masks in combination with eye protection devices, such as goggles or
glasses with solid side shields or face shields that fully cover the front
and sides of the face, should be worn during resident care activities
when ever splashes, spray, splatter or droplets of blood or other body
fluids may be generated.
• Worn when contamination to the eye, nose or mouth is reasonably

anticipated.
Personal Protective Equipment (PPE): Gowns
• Gowns are to be worn to protect skin and prevent

soiling or contamination of clothing during
procedures and resident-care activities when contact
with blood, body fluids, secretions or excretions are
possible.
• Remove gown and perform hand hygiene before

leaving the resident’s room.
• Do not reuse gowns.
Personal Protective Equipment (PPE)
• The following PPE is required for situations in which you

anticipate spraying, splashing, dripping with blood or other
body fluids:
 Glasses or goggles
 Masks/face shields
 Gloves
 Gown
 Mouthpieces/CPR pocket masks
Removal of PPE after Use
 Remove gloves by grasping palm area of one glove with the other gloved
hand and peel off first glove. Hold removed glove in gloved hand.
 Slide fingers of ungloved hand under remaining glove to remove.
 Discard both gloves.
 Remove any PPE from the face next, handling by ear loops or ties.
 Discard.
 Remove gown by pulling away from neck and shoulders, touching ties
only. Pull arms out of sleeves, turning gown inside out and away from
body.
 Discard.
THEN PERFORM HAND HYGIENE!!!!!!
CDC Guideline for Isolation Precautions © Copyright 2018 The Compliance Store, LLC. All rights reserved
Engineering & Work Practice Controls
• Purpose is to eliminate or minimize employee exposure
• Engineering and work practice control methods:

• Having readily accessible hand washing facilities
• Sharps disposal containers
• Self sheathing needles
• Keeping food and drink out of the work area
• Process for transporting specimens
• Process for management of contaminated equipment
• Hand Hygiene
Regulated Waste
Contaminated sharps shall be discarded in containers that are:
 Closable
 Puncture resistant
 Leak-proof on sides and bottom
 Labeled with biohazard label or color-coded (red) in accordance
with OSHA standards
 Shall be easily accessible to personnel and located as close to the
immediate area where sharps are or can be used
 Maintained in an upright position
 Replaced when 2/3 full and not allowed to overfill
 Never place your hands in the sharps container or red bag to retrieve
something
Housekeeping Practices
• Facility should be in a clean and sanitary condition.
• Facility should have a written schedule for cleaning and

decontamination.
• All equipment and work surfaces should be cleaned and

decontaminated after contact with blood or body fluids
using an appropriate disinfectant.
• Broken glassware should not be picked up directly by the

hands. It should be cleaned up with brush, dustpan, tongs
or forceps.
Cleaning and Decontamination of Equipment
• Clean and disinfect areas with visible

contamination of blood/body fluids
• Clean and disinfect re-usable resident care

equipment before next use
• Cleaning must be done before disinfection

can occur
• Disinfectant must remain on item or surface

for specified contact time
Cleaning Up Blood Spills
• Wear gloves. Gown may also be worn if needed.

• Wipe up blood thoroughly before applying disinfectant.
• Dispose of cloth used to clean up blood spill in an approved
container for medical waste.
• Wet cloth with the disinfectant.
• Wipe item/area with wet cloth.
• Apply disinfectant on item/area.
• Surface should be left wet with the disinfectant for 30
seconds for HIV and 10 minutes for Hepatitis B virus.
• Wipe with clean cloth and let air dry.
Regulated Waste: Laundry
Contaminated laundry shall:
Be handled as little as possible with a minimum of agitation.
 Be bagged or placed in a container at the location where it was used.
 Be placed and transported in bags or containers that are leak proof,

labeled with biohazard label and color-coded (red) in accordance
with OSHA standards.
 Protective gloves and other PPE shall be worn while handling

contaminated laundry.
Respiratory Hygiene/Cough Etiquette
• Covering the mouth/nose with a tissue or bend of elbow when

coughing
• Disposal of used tissues
• Hand hygiene after contact with respiratory secretions
• Spatial separation, ideally > 3 feet of persons with respiratory

infections in common areas when possible
CDC Guidelines for Isolation Precautions in a Healthcare Settings

Safe Injection Practices
• Use aseptic technique
• Do not use same syringe for multiple patients, even if

needle is changed
• Use single dose vials whenever possible
• If multi dose vials are used, needles, cannulas,

syringes used to access vials must be sterile
Labeling and Signs
Labels must include the universal biohazard symbol, the term “Biohazard”,
colored red or orange-red and must be attached to:
 Containers of regulated waste
 Biohazard waste
 Refrigerators or freezers containing blood or OPIM
 Containers used to store, transport, or ship blood or OPIM
 Red bags or red containers may be substituted for labels
OSHA Bloodborne pathogens standard 29 CFR 1910.1030(f)(2) © Copyright 2018 The Compliance Store, LLC. All rights reserved
Specimens
 Label with appropriate information at site

where specimen was collected
 Place in plastic biohazard bag
 Place paperwork in outside pouch of

biohazard bag
Hepatitis B Vaccinations
• Offered to all employees with the potential to be exposed.
• Provided at no cost by employer.
• Available within 10 working days of initial assignment.
• Employees can decline but must sign statement of declination.
• Reasons employee should not receive vaccination:

 Previously received complete Hepatitis B vaccination series.
 Antibody testing (titers) has revealed the employee is immune.
 Vaccine is contraindicated for medical reasons.
What to do When an Exposure Incident Happens
Clean the site:
 Percutaneous injuries – wash with soap and water.
 Mucous membranes – rinse with copious amounts of

water.
 Report to your supervisor immediately.
 Seek medical attention.
 Complete an incident report and exposure incident

report.
Post Exposure Evaluation & Follow Up
 Confidential medical evaluation
 Performed by a licensed healthcare professional
 Document route of exposure
 Document source individual
 Testing of source individual and employee
 Results provided to exposed employee
 Post exposure prophylaxis for HIV, HBV and

HCV offered
Recordkeeping Requirements
Employee Post-Exposure records include:

 Hepatitis B vaccination status
 Post-exposure examination, testing and follow-up
procedures
Employee Training records include:

 Training dates
 Contents or summary of the training
 Name and qualifications of trainer
 Maintained for 3 years from date of training
Sharps Injury Log:

 Employers must keep a sharps injury log of all
percutaneous injuries from sharps
Transmission Based Precautions
Transmission-Based Precautions are for residents who are known or suspected to

be infected or colonized with infectious agents which require additional control
measures to effectively prevent transmission.
Types:
• Contact Precautions
• Droplet Precautions
• Airborne Precautions
Contact Precautions
• To prevent transmission of infectious agents spread

by direct or indirect contact with the resident or the
resident’s environment.
• Don gown and gloves upon entering room.
• Remove gown and gloves and perform hand hygiene

before leaving resident room.
• Bag linen in resident’s room and use disposable or

dedicated equipment.
Contact Precautions: When to Use Them
EXAMPLES:
• Conjunctivitis
• MRSA
• Excessive wound drainage
• Fecal Incontinence
• VRE
• C-Diff
• Noroviruses
• RSV
• Other intestinal tract pathogens
Droplet Precautions
• To prevent transmission of pathogens spread through close

respiratory or mucous membrane contact with respiratory
secretions.
• Equipment: Staff should wear a surgical mask if within 3

feet of infected resident. Don surgical mask upon room
entry.
• Resident should wear a surgical mask if transported

outside of the room.
• Bag resident’s linen in room.
• Pull Bed curtain between residents.
Droplet Precautions: When to Use Them
EXAMPLES:
• Pertussis
• Influenza virus (Flu)
• Adenovirus
• Rhinovirus
• Bacterial Meningitis (N. Meningitidis)
• Group A streptococcus
Airborne Precautions
• Prevent transmission of infectious agents that remain infectious

over long distances when suspended in the air.
• Place residents in an Airborne Isolation room with special air

handling and ventilation (negative pressure).
• Staff wear a mask or respirator depending on the disease-

specific recommendations donned prior to entering the room.
Airborne Precautions: When to Use Them
EXAMPLES:
• Measles (Rubeola Virus)
• Chickenpox (Varicella Virus)
• TB (M. Tuberculosis)
• SARS
Who Must be Trained?
All employees who could possibly come in contact with

blood or other potentially infectious body fluids as a
result of their job duties such as:
• Nurses and CNAs
• Phlebotomy/Laboratory
• Housekeepers
• Laundry
• Therapy staff
• Other employees
Any Questions????????

References
1. OSHA Bloodborne Pathogens Standard 29CFR 1910 1030
2. Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control
Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing
Transmission of Infectious Agents in Healthcare Setting
3. Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-
Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory
Committee and the HICPAC/SHEA/APIC/IDSA Hand
Hygiene Task Force. MMWR 2002;51(No. RR-16)

Bloodborne Pathogens Standard Training For Healthcare Professionals

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Bloodborne Pathogens

© Copyright 2018 The Compliance Store, LLC. All rights reserved

• Recognize OSHA standards related to

• Learn the basics of bloodborne diseases.

OSHA Bloodborne pathogens standard 29 CFR 1910.1030

© Copyright 2018 The Compliance Store, LLC. All rights reserved

Bloodborne pathogens are pathogenic

There are over 20 different

3 Most Common are:

• Human Immunodeficiency Virus (HIV)

• Hepatitis B Virus (HBV)

• Hepatitis C Virus (HCV)

• At the end of 2015, an estimated 1.1 million were

• HIV wipes out the immune system.

• Doesn’t survive well outside the human body.

• Symptoms first appear as fever, rapid weight loss,

• At the end of 2015, an estimated 850,000 persons

• May lead to chronic liver disease, liver cancer, and

• Unvaccinated persons are at risk.

• Symptoms first appear as fever, muscle ache,

• Can live outside the human body for 7 days.

• It is the most common bloodborne infection in the

• At the end of 2015, an estimated 3.5 million persons

• It leads to chronic liver disease, liver cancer and

• Symptoms if present, include fever, muscle ache,

• Semen or Vaginal Secretions

• Skin, Tissue, Cell Cultures

• Other Body Fluids

Break in Your Skin: Mucous Membranes:

• Injured by a needle stick.

• It enters via a cut, scrape or other break in

What is the Purpose?

The purpose of OSHA’s Bloodborne Pathogens

Who is covered by the standard?

All employees who could be “reasonably anticipated”

As part of the Bloodborne Pathogens Standard, OSHA

• This plan explains the steps employers are taking

Facilities are required to have in place….

Exposure Control Plan which covers:

Tasks with potential for exposure to

 Performing finger sticks

• Precautions to be used on all individuals.

• Used for all contact with:

• If it comes from the human body it has the potential to

Components of Standard Precautions :

DID YOU KNOW?...

• Standard Precautions are also intended to protect residents by

• Methods- Hand washing or alcohol hand gel.

Alcohol-Based Hand Cleansers:

• Most convenient and takes less time to perform.

• Use if hands are visibly dirty.

Hand Washing with Soap and Water:

• Wet hands with water, apply soap, rub hands together

• Rinse and dry with paper towel.

• Use paper towel to turn off faucet.

• Use if hands are visibly dirty and when caring for a

MOST COMMON MODE OF TRANSMISSION IS BY HANDS

Sequence of Events for Transmitting from Residents to Staff:

 These organisms must be capable of surviving for at least a few

 Hand hygiene is not performed or performed incorrectly

 Contaminated hands of staff members touch another resident

• Should be used when there is a reasonable chance of exposure

• Provides protection for your clothing, skin, eyes, nose and