Universal Health Precautions

Universal Health Precautions illustrated:

Universal Health Precautions illustrated Dr.T.V.Rao MD 1 Dr.T.V.Rao MD

Who Is a Health care Worker:

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, L aboratory 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 Dr.T.V.Rao MD

What are Universal Precautions:

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 Dr.T.V.Rao MD

Why Universal Health Precautions.:

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 ) 4 Dr.T.V.Rao MD

MODES OF TRANSMISSION of Infections in Health Care:

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

Human materials/Tissues considered Highly Infectious:

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 6 Dr.T.V.Rao MD

Not Infectious unless contaminated with Blood or Body fluids.:

Not Infectious unless contaminated with Blood or Body fluids. Feces, Nasal secretions, Sputum, Sweat, Tears, Urine / Vomitus, Saliva unless blood stained. 7 Dr.T.V.Rao MD

Universal Precaution Steps:

Universal Precaution Steps Gloves (Personal Protective Equipment) Decontamination Hand Washing Waste Disposal 8 Dr.T.V.Rao MD

Use of Gloves:

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. 9 Dr.T.V.Rao MD

Step 1 Gloves...:

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 10 Dr.T.V.Rao MD

Step 2 …Gloves…:

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. 11 Dr.T.V.Rao MD

HAND WASHING:

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. 12 Dr.T.V.Rao MD

How to Wash our Hands:

How to Wash our Hands 13 Dr.T.V.Rao MD

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Indications for Hand Washing:

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. 15 Dr.T.V.Rao MD

What to be used for hand washing:

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. 16 Dr.T.V.Rao MD

Use of Mask, Cap, Eye Wear:

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 17 Dr.T.V.Rao MD

Uses of Cap and Mask:

Uses of Cap and Mask Stringent use of Mask and Cap can save several Lives in the Hospital Eg Swine flu 18 Dr.T.V.Rao MD

Use of Foot wear:

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. 19 Dr.T.V.Rao MD

Use of Impervious Gown:

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. 20 Dr.T.V.Rao MD

Disposal of Needles and Sharps:

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. 21 Dr.T.V.Rao MD

Dealing with Used Needle :

Dealing with Used Needle Shredding continues to be Important Method Of dealing with used Needle 22 Dr.T.V.Rao MD

You can Discard the Used Disposable Needles and Syringes in Bleached Solution:

You can Discard the Used Disposable Needles and Syringes in Bleached Solution 23 Dr.T.V.Rao MD

SHARPS CONTAINERS MUST BE::

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 Dr.T.V.Rao MD 24

Accidental Exposure:

Accidental Exposure Alert your supervisor. Complete employee injury report. Follow-up with District’s Worker’s Comp medical provider for confidential evaluation. 25 Dr.T.V.Rao MD

Hazards of Needle stick Injuries:

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 26 Dr.T.V.Rao MD

REPORTING AN INCIDENT:

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 27 Dr.T.V.Rao MD

MEDICAL EVALUATION POST EXPOSURE:

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

BLOOD TESTING:

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

Dealing with Needle stick Injuries:

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). 30 Dr.T.V.Rao MD

Do not Recap Needles It can cause Needle Stick Injury:

Do not Recap Needles It can cause Needle Stick Injury 31 Dr.T.V.Rao MD

Decontamination of Hospital Linen:

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 32 Dr.T.V.Rao MD

Spillage of Blood/Body fluids:

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. 33 Dr.T.V.Rao MD

Decontamination of Metal Instruments:

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. 34 Dr.T.V.Rao MD

Pregnant Health Care Workers:

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. 35 Dr.T.V.Rao MD

Waste Disposal:

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. 36 Dr.T.V.Rao MD

Do Not Do It:

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 37 Dr.T.V.Rao MD

Do Not Do It :

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 38 Dr.T.V.Rao MD

Operating on HIV/High risk groups:

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. 39 Dr.T.V.Rao MD

HIV PREVENTION:

HIV PREVENTION There is no vaccine to prevent HIV infection Follow Universal Precautions

Importance of Vaccination in Hepatitis B Infection. :

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. 41 Dr.T.V.Rao MD

Vaccination for HBV infection:

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. 42 Dr.T.V.Rao MD

Problem of HBV vaccines in the Developing world:

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 . 43 Dr.T.V.Rao MD

Never forget to take Hepatitis B Vaccine if You are a HCW:

Never forget to take Hepatitis B Vaccine if You are a HCW 44 Dr.T.V.Rao MD

Every one is a Important Member of the Family:

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 45 Dr.T.V.Rao MD

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Created by Dr.T.V.Rao MD for ‘ e ‘ Learning resources for Medical and Paramedical Staff in the Developing World Email doctortvrao@gmail.com Dr.T.V.Rao MD 46