Universal Precautions

Blood borne diseases, such as Hepatitis B and HIV are transmitted through direct contact with blood, body fluids, mucus membranes and non-intact skin. Standard Precautions are used for anticipated and actual contact with all blood or body fluids. Standard Precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in a healthcare setting.

Question: Blood borne diseases are transmitted only through direct contact with blood?

Hepatitis B is a disease of the liver caused by the Hepatitis B Virus (HBV). Many people infected with HBV never feel sick, while others may get a mild flu-like illness. Other people get jaundice (yellowing of eyes, skin, mucous membranes, urine and stools). Other symptoms may be nausea, vomiting, abdominal pain and decreased weight. Hepatitis B can occur in two phases. The acute phase occurs just after a person becomes infected and can last from a few weeks to several months. Some people recover after the acute phase, but others remain infected for the rest of their lives. These people go into a chronic phase and become chronic carriers. The virus will remain in the liver and blood for the rest of the person’s life. Currently, Progress Industries offers Hepatitis B vaccination injections in a series of three shots. The series is presently good for a lifetime and is 85-97% effective if the series is completed as ordered.

Question: If a person remains infected with HBV and goes into the chronic phase, the virus remains in their liver and blood for the rest of the person’s life.

The Human Immunodeficiency Virus (HIV) is the virus that causes Aids. HIV destroys the body’s natural defense against a wide range of illnesses and has led to death in many cases. A person infected with HIV may carry the virus for years before starting to feel sick. They are still infectious and can transmit the virus to others. HIV is spread mainly through contact with blood, semen, and vaginal secretions. Survival of the virus outside the body is several hours until dried, and then it is no longer active. No cure or vaccination is available.

Question: A person infected with HIV may not feel sick for years.

You can be exposed to the HBV/HIV virus if you have direct contact with infected blood and/or body fluids in one or more of the following ways: stuck by a used needle, contact with an open wound, contact with any bodily fluid, contact with non-intact skin (chapped, abraded, weeping, or dermatitis), contact with mucous membranes (mouth, nose, eyes), being bitten by a human (if the skin is broken). All persons should be taught that potentially infectious agents are present in their body substances and the environment and that they may be susceptible to infections from others. Hand washing and good hygiene should be emphasized for their protection and the protection of others.

Question: A human bite (skin is broken) is considered an exposure to HBV/HIV.

Procedures that can put you at risk to exposure are: administering first aid or emergency care, assisting in bathing or personal cares, incontinence care, giving oral care, collecting laboratory specimens, transporting or changing soiled laundry/linens, emptying bed pans or urinals, emptying trash, dealing with menses care, dealing with illness/vomiting, administering topical medications, eye drops, nasal drops, and suppositories. Direct contact with a virus does not always mean that you will become infected. However, the more frequently you are exposed to infected blood or body fluids, the more likely you are to become infected. You are unlikely to catch either HBV or HIV through casual every day contact such as touching or shaking hands with an infected person, eating food prepared by an infected person, or from contact with drinking fountains, telephones, toilets, or other surfaces.

Question: Administering first aid can put you at risk of becoming infected.

Post-Exposure Treatment and Evaluations:

1) Wash exposed area with soap and water immediately after exposure (unless exposure is to eyes or mucous membranes, then flush with water).

2) Complete an Incident Report and Workers Compensation form as soon as feasible after exposure.

3) The employee will notify the manager, nurse, or Human Resources Department of the exposure and obtain information about where to seek treatment.

4) Medical Evaluation or Treatment should consist of the following: exposure type; Hepatitis B status; wound or area will be cleaned, treated and covered; Tetanus shot may be given; Gamma Globulin shot may be given; Hepatitis B Antibody Titer (blood test) will be drawn; Hepatitis C Titer level (blood test) will be drawn; HIV Test can be drawn if you request it. (The initial test will be your baseline test and most doctors will draw another one at 6 weeks, 12 weeks, and 6 months); Counseling by a licensed health care professional.

The above steps will be made at no expense to the employee if exposure occurs on the job.

Question: If you have an accidental exposure, immediately wash exposed skin with soap and water or flush exposed mucous membranes with water, and then report the incident to your supervisor so that proper treatment can be started.

Transmission Based Precautions: These precautions are used for persons known or suspected to be infected with a pathogen that can be transmitted by airborne, droplet, or by contact with dry skin or contaminated surfaces. There are three types of Transmission Based Precautions:

1. Airborne precautions

2. Droplet precautions

3. Contact precautions

Transmission Based Precautions are always used in combination with Standard Precautions.

Question: Transmission Based Precautions are the precautions we take when a pathogen is spread through the air, by droplets or by contact.

Gloves are a second line of defense against the transmission of microorganisms between a caregiver and a person served and the physical environment. Hand washing must always accompany glove use because gloves may have inappropriate holes or tears and contaminate the hands during removal. Wear gloves when performing any procedure where blood, body fluids, secretions or excretions are present, or soiled linens or clothes are being transferred. For example: toileting, administering perineal care, brushing teeth, inserting rectal medications, examining skin breakdown/irritation, giving first aid, cleaning and disinfecting bathrooms and equipment, phlebotomy, bathing, supervising diabetic treatment. Put clean gloves on just before touching any mucous membranes or non-intact skin.

Question: Gloves only need to be worn if you are assisting with toileting.

Gloves should be worn when the worker’s hands are abraded, non-intact skin or if dermatitis is present. Remove gloves promptly after use, before touching non-contaminated items and environment surfaces and before going to help another person. They may not be reused. Gloves should be removed from the wrist turning them inside out and placing them in a plastic bag. The plastic bag will be closed and tied and removed on a daily basis and disposed of properly. Wash hands immediately to avoid transfer of microorganisms to other clients or environments.

Question: As long as your disposable latex gloves are not punctured or torn, you can wash them on your hands with soap and running water for use with the next person.

Hand-washing is the single most important measure to reduce the risk of transmitting microorganisms from one person to another or from one site to another on the same person.

Wash hands after touching blood, body fluids, secretions, and contaminated items, whether or not gloves are worn. Wash hands immediately after gloves are removed, between significant personal contacts and when otherwise indicated to avoid transfer of microorganisms to others.

Use warm running water, soap and friction for at least 60 seconds, paying attention to nails and fingers. Following contact with body fluids, hands and forearms should be scrubbed for at least one minute. Liquid soap dispensers should be used. Antibacterial soap should be used for general use. Rinse hands under running water from arms toward fingers. Dry hands thoroughly and turn off the faucet with a paper towel.

Question: Every time you remove your gloves, you must wash your hands with soap and water as soon as possible.