Blood Borne Pathogens Standard Precautions &

1. Blood Borne Pathogens Standard Precautions& HIPPA Created by Jayne Lutz Edited: 6/2011, 6/2012

2. OBJECTIVES At the end of this presentation the student will be able to: • Discuss the major Blood Borne Pathogens • Recognize potentially contaminated material • Identify exposure routes • Choose protection measures • Describe what to do in case of exposure • Discuss the student responsibilities with HIPAA

3. Major Blood Borne Pathogens • HIV • HEP B • HEP C

4. Hepatitis B • Immunized per UNCG SON policy • No routine booster recommended for series completed prior to 1999 • Have a titer drawn only if exposed • If titer low then get a booster • Repeat titer as directed by provider • If titer remains low after booster- Repeat the entire series x 1

5. HBV Received Immunization Series for the First time after 2000: • Get test for surface antigen 1-2 mo after series completed-do not wait longer or you may not get accurate results! • If this is negative repeat series x 1 • Repeat the titer again in 1-2 mo following completion of second series • If negative again, do not repeat series..you are most likely protected but did not sero-convert

6. Hepatitis C • No immunization available • Can live in a drop of dried blood for up to 30 days. • At least 4 million Americans infected • Leading cause of liver failure in the US

7. Hepatitis C • Acute & Chronic Hepatitis C: • Acute develops into a chronic infection in 50-75% of all infected persons • Estimated that HEP C will cause more deaths in the USA than AIDS in the next decade • HCV related deaths will most likely double or triple in the next 10-20 years. • Many with chronic disease are now in the 40-65 age range.

8. Hepatitis C (Continued) Treatment: Between 40-80% successful. Success and length of treatment depends on the point when treatment begins and the specific strain. More successful if started early in the course of the disease. • Interferon alfa-2a & 2b (Pegasys-injection) and • Ribavirin (Copegus and Rebetol-oral meds) • Liver transplantation is the only treatment for decompensated cirrhosis from Hep C

9. Hepatitis C:The Course of the Disease • Acute infection= rarely recognized Flu-like symptoms or no symptoms • Evolution from acute phase to cirrhosis usually requires decades: average time is 20-30 years • When disease discovered, damage to the liver has most likely occurred.

10. Recommendation for HCV • If you are a nurse with any exposure history: get tested. • If you have any of these risk factors: get tested. • Injection drug use • Straw or sniffer use for cocaine • Blood transfusion before 1982 • Use of blood clotting components before 1987 • Tattoos/piercings with questionable sterile technique • Occupational exposure to blood • Sexual contact with an infected partner (risk less)

11. Hepatitis C: The Good News • There has been a decline in diagnosed new cases in the past five years • Hepatitis C is rarely spread from the mother to the baby at time of delivery

12. HIV • There is no known cure for HIV although there are drugs that suppress the infection • HIV causes destruction of the immune system • The terminal state is acquired immunodeficiency syndrome (AIDS) • One Million Americans living with HIV/AIDS & more than 1/5 are unaware

13. HIV-Interesting Facts • Adolescents show the most rapid increase in HIV at present (age 15-24) • The number of older adults who are infected has been rapidly increasing • NC ranks #10 in the US for the rate of persons contracting HIV

14. HIV • What is your risk?

15. HIV • Less than 1% seroconversion rate for health care professionals if exposed to a known HIV positive source. • Taking *ZVD after exposure reduces seroconversion *Zidovudine

16. Standard Precautions • A set of precautions designed to prevent transmission of HIV, HBV, and other blood borne pathogens • Blood and certain body fluids of all patients are considered potentially infectious

17. Potentially Harmful Body Fluids with Universal/Standard Precautions Blood Semen Vaginal Secretions Pleural Fluid Cerebrospinal Fluid Synovial Fluid Synovial Fluid Pleural Fluid Peritoneal Fluid Pericardial Fluid Amniotic fluid

18. Body Fluids to Which Universal/Standard Precautions Do Not Apply Unless Blood is Visible • Feces • Nasal secretions • Sputum • Sweat • Tears • Vomitus • Urine • Saliva • Breast milk* *only in large quantities (breast milk bank)

19. Protect Yourself • Gloves • Gown • Apron • Masks • Hand washing • Safety precautions with sharps • Eye shields

20. Biohazard Areas NOT ALLOWED IN A BIOHAZARD AREA: • Drink • Food • Cosmetics • Lip balm • Handling contact lenses

21. ROUTES OF EXPOSURE An exposure occurs when blood (or other contaminated material contacts: • Non-intact skin (lowest risk) • Mucous membrane(medium risk)* • Is injected(highest risk) • * The most common exposure site

22. Course of Actionif Exposed • Flush splashes to nose, mouth, or skin with water • Irrigate eyes with water or saline • Report to faculty-preceptor • Seek counseling/care within 1-2 hours* after exposure. • *post exposure prophylaxis effective is started up to 7 hours after exposure

23. Course of Action if Exposed) The location of your treatment is your choice: • Your clinical site~ if they have agreed & have the medication you may need • Your personal physician • Gove Student Health Center= • M-F: 8a-8p; Sat. 9-12 ; Sun. 5-8. • Phone: 334-5340

24. Phone Calls You Need to Makeif You Are Exposed Gove Student Health Center: 334-5230 • If you receive your counseling at the Student Health Center they will contact Moses Cone and facilitate care for you there if it is determined you need treatment. • Notify the OSHA Trainer of the School of Nursing. 336-334-5238, jayne_lutz@uncg.edu.

25. Who Pays for Your Care? • You are responsible • The University does not cover these costs.

26. HIPAA • Health Insurance Portability and Accountability Act • A Federal Law that sets standards to protest a patient’s health information • Standards protect the use and sharing of verbal, written, and electronic patient information

27. What is Protected Health Information-PHI? • Information that: • Identifies the individual • Relates to the patient’s health, treatment or payment plan • Is kept or released • Electronically • On paper • Orally

28. Why is Privacy Important? • Patients have a right to privacy • Violation of patient’s privacy (confidentiality) can affect the personal lives and careers of patients It is your job to protect patient privacy

29. What is Your Role with HIPAA? • Keep oral, written, printed, & electronic reports private and secure • Keep telephone calls confidential • Protect computer passwords • *Remove patient/client names or other identifying information before throwing away papers • Refer to patients/clients by initials as Mr. or Ms. J.D, etc in journals/reports. *The best action is to shred all suchpapers

30. Information that can be Given Out Without Prior Consent • Communicable diseases: Certain diseases must be reported to Public Health Agencies. • Reports to 3rd party payers: To verify medical treatment for insurance claims including Medicare payments.

31. Questions or Concerns? • Contact your clinical faculty member.

32. The End!