Blood Borne Pathogens
Standard Precautions
&
HIPPA
Created by Jayne Lutz
Edited: 6/2011, 6/2012, 1/2013,
7/2013; 7/2014
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 as a
UNCG School of Nursing student
• Discuss the student responsibilities with HIPAA
Major Blood Borne Pathogens
• HIV
• HEP B
• HEP C
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 boosterRepeat the entire series x 1
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
Hepatitis C
• No immunization
available
• Can live in a drop of dried blood for up to 4 days.
• At least 4.1 million Americans have been infected
• Estimated 3.2 million Americans living with
chronic infection
• Leading cause of liver failure in the US
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.
Hepatitis C (Continued)
New treatment available is highly even if treatment started
late in the disease process.
Very expensive: $84,000 for six weeks of treatment.
New meds are: Olysio and Sovaldi
Hopefully these will eliminate the need to take interferon
These drugs will need to be taken with ribavirin.
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.
Recommendation for HCV
• Born between 1945-1965 get tested once, regardless of risk
factors. (CDC April 2013)
• 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
(decreased risk)
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
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)
• 1.1 million Americans living with HIV/AIDS
& more than 1 in 6 are unaware
HIV-Interesting Facts
• Newly diagnosed cases highest in 25-34 age group
• Adolescents-young adults show the second most
rapid increase of any age group (age 15-24)
• NC ranks #8 in the US for the rate of persons
contracting HIV….increase. We were 10th 2 yrs.
ago
HIV
• What is your risk?
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
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
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
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)
Protect Yourself
•
•
•
•
•
•
•
Gloves
Gown
Apron
Masks
Hand washing
Safety precautions with sharps
Eye shields
Biohazard Areas
NOT ALLOWED IN A BIOHAZARD
AREA:
• Drink
• Food
• Cosmetics
• Lip balm
• Handling contact lenses
ROUTES OF EXPOSURE
An exposure occurs when blood (or other
contaminated material contacts:
• Non-intact skin (lowest risk)
• Mucous membrane(medium risk)*
• Injected, especially deep injection(highest
risk)
• * The most common exposure site
Course of Action
if Exposed
• Flush splashes to nose, mouth, or skin with water
• Irrigate eyes with water or saline
• Report to faculty and preceptor
• Seek counseling/care within 1-2 hours* after
exposure.
• *post exposure prophylaxis effective if started up to 7 hours after
exposure although 1-2 hours preferred
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
Phone Calls You Need to Make
if 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 faculty and preceptor
Who Pays for Your Care?
• You are responsible
• The University does not cover these costs.
HIPAA
• Health Insurance Portability and
Accountability Act
• A Federal Law that sets standards to protect
a patient’s health information
• Standards protect the use and sharing of
verbal, written, and electronic patient
information
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
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
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 such papers
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.
Questions or Concerns?
• Contact your clinical faculty member.
The End!