Universal Health Precautions Dr.T.V.Rao MD

Universal Health Precautions Dr.T.V.Rao MD

1. Universal Health Precautions Dr.T.V.Rao MD 1 1/30/2018 Dr.T.V.Rao MD

2. The term health care worker refers to any person working in health care settings and who has the potential for exposure to infectious materials including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces or contaminated air . They include, but are not limited to, physicians, nurses, Laboratory technicians , therapists, pharmacists, nursing assistants, laboratory personnel, autopsy personnel, emergency medical service personnel, dental personnel, students and trainees Who Is a Health care Worker 2 1/30/2018 Dr.T.V.Rao MD

3. What are Universal Precautions Universal precaution are control guidelines designed to protect workers from exposure to Diseases spread by Blood and other Body fluids. CDC 3 1/30/2018 Dr.T.V.Rao MD

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5. Why Universal Health Precautions. The concept of Universal Health Precautions emphasizes that all our patients should be treated as though they have potential blood born infections, and can infect the caring health care workers. ( CDC ) 5 1/30/2018 Dr.T.V.Rao MD

6. MODES OF TRANSMISSION of Infections in Health Care Puncture wounds or cuts Contact (touch, splash, or spray) with blood or OPIM on: mucous membrane non-intact skin cuts, abrasions, burns acne, rashes paper cuts, hangnails contaminated sharps 6 1/30/2018 Dr.T.V.Rao MD

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8. Human materials/Tissues considered Highly Infectious 1 Blood most infectious 2 Semen 3 Vaginal secretions 4 C S F 5 Synovial fluids 6 Amniotic fluid 7 All other body fluids 8 1/30/2018 Dr.T.V.Rao MD

9. Not Infectious unless contaminated with Blood or Body fluids. Feces, Nasal secretions, Sputum, Sweat, Tears, Urine / Vomitus, Saliva unless blood stained. 9 1/30/2018 Dr.T.V.Rao MD

10. Universal Precaution Steps Gloves (Personal Protective Equipment) Decontamination Hand Washing Waste Disposal 10 1/30/2018 Dr.T.V.Rao MD

11. Use of Gloves Use of a pair of disposable plastic gloves can protect if chances of contact with Blood or Body fluid is anticipated / inevitable. 11 1/30/2018 Dr.T.V.Rao MD

12. Step 1 Gloves... Always wear gloves when Direct contact with body fluids is anticipated (nosebleeds, bleeding abrasions, etc.) Handling clothes soiled by urine, feces, vomit or blood 12 1/30/2018 Dr.T.V.Rao MD

13. Step 2 …Gloves… One time use. If gloves not immediately available, use barrier such as paper towels. When removing, peel off hands and roll glove outside in. Discard gloves in lined waste container. Wash hands after removing gloves. 13 1/30/2018 Dr.T.V.Rao MD

14. HAND WASHING There is no Health precaution like Hand washing. Washing with simple toilet soap - reduces the rate of transmission of common infections including the HIV. 14 1/30/2018 Dr.T.V.Rao MD

15. How to Wash our Hands 15 1/30/2018 Dr.T.V.Rao MD

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17. Indications for Hand Washing In prolonged contact with patient. Before taking care of Immune supressed,New born infants, patients in ICU / ICCU, Dialysis Units, Burn’s Units. Before and after touching wounds. When Microbial contamination of Hands, likely to occur when in contact with mucous membranes, body fluids, and other secretions contaminated with Blood, and serous fluids. 17 1/30/2018 Dr.T.V.Rao MD

18. What to be used for hand washing In most circumstances Non medicated soaps and detergents are effective in removing most transient contaminants. In demanding circumstances, in handling potentially harmful infections, use Ethyl or Isopropyl alcohol . Detergent formulations containing Chlorhexidine Povidone,or Hexachlorophene are effective in prevention of spread of infections. 18 1/30/2018 Dr.T.V.Rao MD

19. Use of Mask, Cap, Eye Wear Will certainly protect us from splashes of Blood or Body fluids. Don't underestimate the importance of Use of Cap and Mask. Most important in collection of swabs in Influenza 19 1/30/2018 Dr.T.V.Rao MD

20. Uses of Cap and Mask Stringent use of Mask and Cap can save several Lives in the Hospital Eg Swine flu 20 1/30/2018 Dr.T.V.Rao MD

21. Use of Foot wear Wearing foot wear covering entire sole protects the entry of Microbes from the contaminated floors with Blood and Body fluids. Remember many of us have cracks on our feet. 21 1/30/2018 Dr.T.V.Rao MD

22. Use of Impervious Gown A simple thin Plastic apron underneath the linen is of great help in preventing the soaking our inner clothes and exposure to harmful microbes. 22 1/30/2018 Dr.T.V.Rao MD

23. Disposal of Needles and Sharps All used needles and sharps should be deposited in thick walled puncture resistant containers. Bending, Reshaping, should be prohibited. Do not recap the needles to avoid needle stick injures, All used Disposable syringes and needles should be discarded into Bleach solution at the work station before final disposal. 23 1/30/2018 Dr.T.V.Rao MD

24. Dealing with Used Needle Shredding continues to be Important Method Of dealing with used Needle 24 1/30/2018 Dr.T.V.Rao MD

25. You can Discard the Used Disposable Needles and Syringes in Bleached Solution 25 1/30/2018 Dr.T.V.Rao MD

26. SHARPS CONTAINERS MUST BE: closable and puncture resistant leak proof labeled or color-coded functional sufficient in number easily accessible and maintained in upright position replaced per agency policy NOT be overfilled 26 1/30/2018 Dr.T.V.Rao MD

27. Accidental Exposure Alert your supervisor. Complete employee injury report. Follow-up with District’s Worker’s Comp medical provider for confidential evaluation. 27 1/30/2018 Dr.T.V.Rao MD

28. Hazards of Needle stick Injuries HIV , HBV and HCV viral infections can spread by Needle stick Injuries Nursing staff are at greater risk Several Injuries are preventable 28 1/30/2018 Dr.T.V.Rao MD

29. REPORTING AN INCIDENT Date and time of incident Job classification - Technician Location in the worksite where incident occurred Work practice being followed Procedure being performed Minimal Information to Report 29 1/30/2018 Dr.T.V.Rao MD

30. MEDICAL EVALUATION POST EXPOSURE Entitled to confidential medical evaluation Personal decision about blood testing Blood may be tested only with consent Blood may be stored for 90 days, while considering testing Interpretation of any test results occurs with health care provider 30 1/30/2018 Dr.T.V.Rao MD

31. BLOOD TESTING Blood may be tested for antibodies to: Human Immunodeficiency Virus (HIV) Hepatitis C Virus (HCV) Hepatitis B Virus (HBV) Other disease-causing organisms Source blood may also be tested with consent Results of tests of source blood will be made known to exposed person 31 1/30/2018 Dr.T.V.Rao MD

32. Dealing with Needle stick Injuries Consider all Needle stick injuries as a serious health hazard in the era of AIDS All events of Needle stick injuries to be reported to the supervisory staff. Wash the injured areas with soap and water. Encourage bleeding if any. Prophylaxis for prevention of HIV/HBV is top priority. Anti retroviral prophylaxis, if necessary should started within 2 hours, ( if injury is from HIV positive or high risk group). 32 1/30/2018 Dr.T.V.Rao MD

33. Do not Recap Needles It can cause Needle Stick Injury 33 1/30/2018 Dr.T.V.Rao MD

34. Decontamination of Hospital Linen All the linen contaminated with Blood or Body fluids should be soaked in 1: 100 bleach solution for 30 minutes. Advised Autoclaving, as the most ideal procedure for decontaminating Linen 34 1/30/2018 Dr.T.V.Rao MD

35. Spillage of Blood/Body fluids A common health hazard in the working environment. Never wipe the spillage with working wet mop. Always cover the spills with Blotting paper and pour 1 % Hypochlorite or Bleaching powder to decontaminate the spills with HIV/HBV virus. 35 1/30/2018 Dr.T.V.Rao MD

36. Decontamination of Metal Instruments Hold all contaminated instruments with Gloved hands. Subject all metal instruments to washing with soap and water. Treat all contaminated instruments with 2% Glutaraldehyde. For at least 30 minutes. Many consider sterilizing in Hot air oven if not sharp instruments. 36 1/30/2018 Dr.T.V.Rao MD

37. Pregnant Health Care Workers Not at more risk than other, Health care workers. Should adopt Universal Health Precautions with more dedication, If neglected the Unborn is at grave risk of attaining congenital infections. The Laboratory supervisors should monitor/ guide the HCW’s for adherence to scientific practices. 37 1/30/2018 Dr.T.V.Rao MD

38. Waste Disposal Bag and tie Place in second bag and tie again (double bag technique) Place all sharps (used needles) in sharps container. Wash hands after removing gloves. 38 1/30/2018 Dr.T.V.Rao MD

39. Do Not Do It break, shear, bend or recap needles reach into used sharps containers pick up contaminated items, such as broken glass with bare hands use a vacuum cleaner to clean up contaminated items 39 1/30/2018 Dr.T.V.Rao MD

40. Do Not Do It pipette or mouth suction blood or OPIM eat, drink, smoke, apply cosmetics, or handle contact lenses in areas of potential occupational exposure store beverages or food in refrigerators, freezers, or cabinets where blood, other Samples are preserved 40 1/30/2018 Dr.T.V.Rao MD

41. Operating on HIV/High risk groups It is a concern all should be cared equally. Adherence of Universal Health precaution bring in safety to all HCW. Follow the precautions even in Non HIV patients as some of our patients are in window period and more dangerous than truly positive with Sero testing. 41 1/30/2018 Dr.T.V.Rao MD

42. HIV PREVENTION There is no vaccine to prevent HIV infection Follow Universal Precautions 42 1/30/2018 Dr.T.V.Rao MD

43. Importance of Vaccination in Hepatitis B Infection. We have > 400 Million carriers with Hepatitis B infections. Every HCW is at risk of Contacting infection. Vaccination is safe -Genetically Engineered vaccination remains the great hope for prevention, apart from Major component of Universal precautions. 43 1/30/2018 Dr.T.V.Rao MD

44. Vaccination for HBV infection All HCW’s must take at least three doses of Vaccine, At 0 – 1 – 6 months. without discontinuation of the schedule. All Health care workers many not attain equal response. High risk HCW’s should undergo estimation of anti HB s ( antibodies ) to know whether they were well protected. 44 1/30/2018 Dr.T.V.Rao MD

45. Problem of HBV vaccines in the Developing world Who pays for the Vaccine. Many who work in unorganized sector, do not get Institutional support of Vaccine. Life, at risk if Infected with HBV More Awareness to be brought in by Managers of the Hospitals, to promote to vaccinate their Employees . 45 1/30/2018 Dr.T.V.Rao MD

46. Never forget to take Hepatitis B Vaccine if You are a HCW 46 1/30/2018 Dr.T.V.Rao MD

47. Every one is a Important Member of the Family Every health care worker is a Important member of the Family, one should take all possible Health Care precaution to save self and other Members of the Family 47 1/30/2018 Dr.T.V.Rao MD

48. 1/30/2018 Dr.T.V.Rao MD 48 BEST WAY TO STOP / PREVENT THE SPREAD OF INFECTIONS IS

49. 1/30/2018 Dr.T.V.Rao MD 49 Program Resources from CDC WHO NIH OSHA Guidelines

50. Program Created for Health care workers on Universal precautions to prevent Infections in oneself and many others in the profession Email [email protected] 50 1/30/2018 Dr.T.V.Rao MD