Bloodborne Pathogens and Universal Precautions Course

Table of Contents for Bloodborne Pathogens Certificate Course:

• BBP and Universal Precautions
• Legal Notice
• Course Objectives
• Introduction
• What is BBP and OPIM?
• Hepatitis B
• Hepatitis C
• Human Immunodeficiency Virus (HIV)
• How are BBPs Transmitted?
• OSHA Universal Precautions and OSHA BBP Standards
• CDC Standard Precautions
• Main Elements of Standard Precautions
• CDC’s Transmission-Based Precautions
• OSHA BBP Standard (29 CFR 1910.1030)
• Complete the Training
• Other Requirements of OSHA’s BBP Standard
• End of Course Exam
• Test and receive BBP Certification (certificate of completion)

Course Content Example 1:

Introduction

Whenever an individual comes into contact with another person’s blood, infectious materials or certain body fluids, there is potential exposure to bloodborne pathogens.

Two government agencies, the Occupational Safety and Health Administration (OSHA) and the Center for Disease Control (CDC) have created regulations and recommendations to reduce this exposure, especially within the workplace.

Anyone who may anticipate coming into contact with blood or body fluids as part of their job should be aware of what BBP are, how they are transmitted, how they can protect themselves and their employer’s responsibility to provide a safe working environment.

Course Content Example 2:

What are bloodborne pathogens and Other Potentially Infections Materials (OPIM)?

BBPs are “pathogenic microorganisms that are present in human blood and can cause disease in humans”

• Most common examples include, Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus (HIV)
• Other body fluids and unfixed human tissue may also possess disease-causing microorganisms, these may be referred to as OPIM
• Urine, Semen, and Saliva are a few common OPIM
• BBPs are most often transmitted through blood-to-blood contact, sexual contact, and drug use involving needles.
• Sharps Injury

According to the CDC, an estimated 3 million healthcare workers are exposed to blood and body fluids via sharps injuries in the United States each year. 

Even with proper PPE, the reality is that the potential for exposure to blood and bodily fluids, especially while responding to an emergency situation, always exists.

One of your greatest defenses from bloodborne pathogen exposure is understanding the hazards associated with them, along with proper preventative measures you can take to protect yourself.

Read on for our guide to everything you need to know about bloodborne pathogen exposure, along with 4 facts that may surprise you.

Who Can Become Exposed to Bloodborne Pathogens?

Short Answer? Anyone.

Most notably, those working in the healthcare field, first responders such as firefighters and policemen and women, those working in a dental setting, and also a vast number of housekeepers in some industries are at an increased risk of exposure to bloodborne pathogens due to the nature of the environments in which they work. 

Fortunately, healthcare workers and those who frequently come into contact with blood and other potentially infectious substances must be trained according to the OSHA Bloodborne Pathogens Standard.

However, despite training and safety procedures, exposure events and infections still occur.

Are you ready for your first surprising fact?

Approximately 64% of nurses have experienced a needlestick injury in their career: that's over half of the nursing population! Reportedly, many of these injuries occur during disengagement of the needles or while attempting to recap the soiled device--both routine procedures which often occur outside of emergencies.  

To speak of needlestick incidences, these injuries encompass a broad range of routine medical sharps equipment, including blood collection needles, hypodermic needles, lancets, and IV stylets, to name only a few. 

While a known hazard, healthcare providers must also be cognizant of potential exposure to blood, saliva, or urine droplets splashing into the eyes, mouth, and nose. This sort of entry is known as mucocutaneous exposure. It extends to exposure occurring when blood or other bodily fluids come into contact with open wounds such as cuts or scrapes and integumentary cracks and sores as seen in certain skin conditions such as eczema or acne.

Personal Protective Equipment: A First Line of Defense

A hot-topic issue beginning in the earlier months of this year which have persisted throughout centered around the scarcity of personal protective equipment for healthcare personnel due to high demands and the direct impact of Covid-19. The implementation and appropriate use of latex gloves, gowns, and face masks with protective eye shields are a vital component of safe workplace practices. While this equipment is not foul-proof, appropriate utilization of this fluid-proof dress reduces risk significantly and acts as a barrier to exposure.

Universal Precautions

One cannot discuss personal protective equipment without also mentioning universal precautions. 

In a nutshell: Treat everyone the same. Treat all fluids as though they are a contaminated fluid. And last, always ensure proper decontamination measures, disposal of equipment and appropriate cleanup, and disinfection of workspaces.

Hand Washing

Dare I say it? A phrase we have become all too familiar with: wash your hands. In the healthcare world, food industry, and beyond- this is nothing new. Proper hygienic practices are a vital component in limiting the spread of any disease. Certainly, the thorough practice of hand-washing is one of the most important steps to preventing infection and, ultimately, the spread of bloodborne pathogens.

Prevalence: The Big Three

The most commonly transmitted blood pathogen infections include:

• Human Immunodeficiency Virus (HIV)
• Hepatitis B (HBV)
• Hepatitis C (HCV)

Approved bloodborne pathogen training programs will include a segment on these infectious diseases. 

Human Immunodeficiency Virus

Human Immunodeficiency Virus or HIV is characterized by the disablement of the immune system. Once your immune system has been compromised, your body's ability to ward off illness becomes difficult, and infected individuals become more vulnerable to upper respiratory infections, the various strains of the flu, and even pneumonia.

In 2018, the CDC estimated that approximately 1.2 million people had HIV in the United States. Further, of that population, roughly 14% were not aware they had HIV. 

Hepatitis B 

While most of the population tends to express they have a strong grasp of the implications of HIV, many are not as well-versed with the Hepatitis viruses. Hepatitis refers to inflammation of the liver. Similar to HIV, there is no known cure or specific treatment for these viruses, though there are some treatments that can temper them if caught in time.

Unlike Hepatitis C, Hepatitis B is vaccine-preventable. Aside from taking appropriate measures when the potential for bloodborne pathogen exposure exists, the best action to take to prevent infection with this disease is to get vaccinated.

In the United States, more than 3,000 cases of HBV were reported to the CDC in 2018.

Hepatitis C

There is no vaccine available for Hepatitis C. The current CDC guidelines for HCV screening recommend that all adults ages 18 and older should be tested at least once. Additionally, all pregnant women should be tested during each pregnancy.

While there is no vaccine, the best way to prevent Hepatitis C infection is to take precautions when working near blood or body fluids and to avoid unsafe behaviors that could spread the disease. 

And now it's time for your second surprising fact:

While the aforementioned are the most commonly transmitted pathogens, there are reportedly more than 20 different pathogens known to have been transmitted occupationally via needlestick and sharps injuries worldwide.

Watch Out: The Most Common Route of Exposure

Despite improvements to safe work practices and training, exposure incidents continue to occur. 

In the workplace, the highest-reported cause of bloodborne pathogen transmission is when the blood of an infected victim enters through an open wound of another person and inevitably reaches their bloodstream. 

While there exists a reasonable risk of coming into contact with bloodborne pathogens in the healthcare, dental and other fields, an exposure control plan must be put in place. The Center for Disease Control and Prevention purports that this is one mandated measure that reduces the hazards associated with occupational exposure to bloodborne pathogens.

Outside of the workplace, on the other hand, the primary method of contracting common bloodborne infectious diseases include sexual contact and intravenous drug usage. Apart from these activities, however, it is a safe practice to always treat any exposure to blood or bodily fluids as though they are potentially infectious. 

Think You've Been Exposed?

Even if blood is not visible or potentially infectious material is not present, any puncture or needlestick of the skin in a work environment is considered an exposure. 

In addition, exposure also includes the splashing or spraying of blood or other body fluids of any quantity into the eyes, nose, and mouth. Further exposure also extends to the splashing of these substances into open sores, cuts, and cracks in the skin. Human bites and assaults from patients are also considered a means of exposure to bloodborne pathogens.

In the Event of Exposure: Steps to Follow

The Center for Disease Control and Prevention outlines a series of important steps to follow immediately after coming into contact with blood or body fluids. 

First and foremost, in the incident of a needlestick or cut, wash the punctured skin thoroughly with soap and water. If blood or other fluids have splashed into your face, flush your mouth and nose with water. Exposure to the eyes requires immediate flushing with clean water or a saline solution.

An important next step requires individuals to report all incidences of exposure to employers.

I think you're ready for the third surprising fact:

Many incidences of needlestick injuries and other methods of exposure to bloodborne pathogens are not reported.

Immediately reporting incidences of exposure are a vital component of safe practices and helps the individual ensure he or she receives the appropriate follow-up care.

Rates of Underreporting: The Reasoning Behind It

Unpacking the reasons behind not reporting exposure to bloodborne pathogens are indeed a complicated matter. 

The CDC details some reasons behind why some individuals fail to report exposures:

• The individual is afraid they will face negative performance reviews or possibly be relieved of duty
•  The individual is not sure if his or her experience constitutes a case of exposure
• The individual is embarrassed
• In some cases, the individual may not have been wearing the appropriate PPE and fears legal action for breaching the proper protocol

In any case, the reality is that failing to report exposure for any reason puts oneself at risk, along with loved ones, coworkers, and their families.

Incidents of Exposure in Nursing School

A perfect segue from the discussion of underreporting exposure is to incidences of exposure in nursing schools.

Nursing students are a purportedly high-risk group for exposure to bloodborne pathogens, particularly through the transmission of sharps handling during training and clinical practicum.

In a long-term study of nursing students from a teaching hospital in India, results found that nearly one-third of the total reported cases of needlestick injuries were from nursing students. What's more, studies have shown that many cases of needlestick injuries among nursing students go underreported.

A Discussion About Body Fluids

Bloodborne pathogens can be transmitted through many other body fluids, not just the blood.

Members of the healthcare field have been trained extensively to take head when coming into contact with body fluids. Basically, if it's a fluid--it's potentially infectious!

Potentially infectious fluids include but are not limited to substances such as vomit, feces, saliva, synovial fluid, amniotic fluid, and, of course, the various secretions from both male and female reproductive organs.

Following that same line, bloodborne pathogens may also be passed from an unborn baby through his infected mother.

Know that anyone, regardless of their age, race, or socioeconomic status, may potentially carry a bloodborne infectious disease.

Ready for your fourth and final surprising fact? 

Many individuals who fit under this category are often completely unaware of their own infection.