Which are examples of other potentially infectious materials Opim?

The purpose of this policy is to outline measures to reduce occupational exposure to and minimize transmission of bloodborne pathogens, but are not limited to, Hepatitis B virus (HBV), Hepatitis C (HCV), Human Immunodeficiency Virus (HIV) that can be transmitted in the health care environment.

Policy

The Health system and its personnel are responsible for minimizing their risk for exposure to bloodborne pathogens. This plan outlines strategies to minimize and potentially eliminate occupational exposure to blood and other potentially infectious materials (OPIM) by providing a safe and healthful work environment, thereby minimizing the risk of infection in accordance with Occupational Safety and Health Administration (OSHA).

Scope

This policy applies to all members of the Northwell Health work force including, but not limited to employees, medical staff, volunteers, students, physician office staff, and other persons performing work for or at Northwell Health.

Definitions

Bloodborne pathogens are pathogenic microorganisms that are transmitted via human blood and cause disease in humans. They include, but are not limited to, HBV, HCV, and HIV.

Procedures & Guidelines

Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Plan

1. OSHA BLOODBORNE PATHOGEN PLAN
   The Bloodborne Pathogens Standard, codified as 29 CFR 1910.1030, pertains to individuals in facilities who could be "reasonably anticipated" to come in contact with blood or other potentially infectious material (OPIM). This Exposure Control Plan outlines the facilities efforts to decrease the occupational risk of acquiring a bloodborne disease. This plan:

   1. Identifies tasks and procedures as well as job classification where occupational exposure to blood occurs without regard to protective clothing and equipment.
   2. This exposure plan can be obtained upon request from the Safety Officer or Infection Preventionist. It is also accessible online via Health Port under Policies in the Infection Control Manual.
   3. Will be reviewed at least annually by the members of the Infection Prevention and Control Committee.

2. Training
   Training regarding strategies to minimize exposure to those who, as the result of performing their job duties, could be "reasonably anticipated" to come in contact with blood and OPIM occurs upon employment and at least annually thereafter. Each training session should provide an opportunity for questions and answers. Additional training according to responsibilities or prior to performing a new exposure prone task/procedure shall be given. The training shall emphasize prevention and management of an exposure when it occurs. The minimal training program elements are:

   1. A general discussion of bloodborne diseases, emphasizing epidemiology, symptoms of each disease, modes of transmission.
   2. An explanation of the appropriate methods for recognizing tasks and other activities that involve exposure to blood or other potentially infectious materials.
   3. Use of standard precautions.
   4. Explanation of work practices, engineering controls, and protective garments, known as personal protective equipment (PPE) to minimize/eliminate risk.
   5. An explanation of the reasons for selecting PPE.
   6. An explanation of the proper use, location, handling, decontamination, and disposal of PPE.
   7. Handling procedures for sharps, specimens, laundry, and regulated medical waste.
   8. Information on the hepatitis B vaccine, including information on its efficacy, safety, method of administration, benefits of being vaccinated, and availability of the vaccine free of charge.
   9. Information on the appropriate actions to take and persons to contact when exposed to blood or OPIM.
   10. An explanation of the procedures to follow up if an exposure incident occurs.
   11. An explanation of the hazardous communication labels and signs that are in place on containers and around workstations
   12. An explanation of the Exposure Control Plan and how to obtain a copy of the written plan
   13. An opportunity for interactive questions and answers with the person conducting the training session.

3. EPIDEMIOLOGY, SYMPTOMS, MODES OF TRANSMISSION OF BLOODBORNE DISEASES:
   While HIV and hepatitis viruses are specifically identified in this Exposure Control Plan, the terms bloodborne pathogen or bloodborne disease includes any pathogenic microorganism that is present in human blood or OPIM that can infect and cause disease in persons who are exposed to blood containing the pathogen.

   1. HIV, the virus causes acquired immunodeficiency syndrome (AIDS), attacks and destroys the immune system (CD4 helper cells), leaving the individual unable to fight off many disease-producing organisms. In the early stages of HIV, there are no symptoms. As the disease progresses, the individual may develop recurrent fevers, diarrhea, weight loss, swollen lymph glands and yeast infections. When an individual develops diseases such as pneumocystis pneumonia, oropharyngeal candidiasis, Kaposi Sarcoma, etc., the diagnosis of AIDS is made.
   2. HIV is transmitted through sexual contact, exposure to infected blood or blood components and vertically (prenatal from mother to neonate). Infectious materials include semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, and body fluid visibly contaminated with blood and all body fluids in situations where it is difficult or impossible to differentiate between body fluids. They also include any unfixed tissue or organ other than intact skin from a human (living or dead) and human HIV containing culture medium or other solutions, as well as blood, organs or other tissues from experimental animals infected with HIV. Although HIV has been isolated in the above fluids, the modes of transmission in the healthcare setting are: puncture exposure with injury by a needle or other sharp object, mucous membrane exposure, including exposure of mouth, nose, or conjunctiva open wound exposure and contamination of open incisions, abrasions, or lacerations by infectious fluids.
   3. Viral Hepatitis: The predominant agents spread through the bloodborne route are hepatitis B, C and D. Hepatitis B and C have been associated with transmission in healthcare
      1. HBV: HBV replicates in the liver and causes hepatic dysfunction. HBsAg is found on the surface of the virus; it can be detected in serum 30-60 days after exposure to HBV. Another antigen, hepatitis B antigen (HBeAg), may be detected in samples of persons with acute or chronic HBV infection. The presence of HBeAg correlates with high infectivity. The incubation period of hepatitis B is long (45-160 days; average - 75), and the onset of acute disease is generally insidious. Clinical symptoms and signs include anorexia, malaise, nausea, vomiting, abdominal pain, jaundice, skin rashes, arthralgias, and arthritis. The case-fatality rate for reported cases is approximately 1.4%. Transmission occurs via percutaneous or permucosal routes, and infectious blood or body fluids can be introduced at birth, through sexual contact, or by contaminated needles. Infection can also occur in settings of continuous close personal contact (such as in households or among children in institutions for the developmentally disabled), presumably via unapparent or unnoticed contact of infectious secretions with skin lesions or mucosal surfaces. Transmission of infection by transfusion of blood or blood products is rare because of routine screening of blood for HBsAg and because of current donor selection procedures. Transmission of HBV from infected health-care workers to patients is uncommon but has been documented during types of invasive procedures. HBsAgpositive health-care workers need not be restricted from patient contact unless they have been epidemiological associated with HBV transmission or involved with invasive procedures and haves a high viral load.
      2. HCV: Like HBV, HCV virus poses an occupational risk to the HCW. HCV is the agent responsible for most cases (up to 40%) of parenterally transmitted non-A, non-B hepatitis. HCV has epidemiologic characteristics similar to those of HBV although the symptoms are usually milder and most children are asymptomatic. At present, there is no vaccine available to prevent HCV infection. Antiviral drugs have been approved for treatment of chronic HCV.
      3. Summary of Hepatitis B and CTypeMode of Transmission in health careVaccineRecommendations in addition to Standard PrecautionsBParenteral, contact with non-intact skin or mucous membranes.Yes

         -pre-exposure immunization

         -post-exposure prophylaxis (vaccine &/or hepatitis B immune globulin (HBIG)

         CParenteral, contact with non-intact skin or mucous membranes.No

         -baseline/follow-up testing

         -post-exposure prophylaxis based on post-exposure serology results

4. METHODS OF REDUCING EXPOSURE AND TRANSMISSION:
   An exposure is defined as percutaneous or mucous membrane exposure to blood or body fluids of any patient, including needle or other sharp stick or cut, blood splash on an open cut or wound, or splash to mouth or eyes. Individuals incur risk of infection and illness each time they are exposed to blood or OPIM. Therefore, reducing exposure incidents to bloodborne pathogens also reduces the risk of transmission. The following outlines the prevention strategies:

   1. ADMINISTRATIVE CONTROLSinclude the organization’s policies and procedures that aim to decrease the risk of exposure. This includes educating all healthcare workers and allocating resources to purchase safety devices.

   2. ENGINEERING CONTROLS: Engineering design plays an important role in the management of biohazards. The goal for engineering controls is the prevention of healthcare worker exposure to infection or injury by controlling worker exposure to the infectious agent. This is done by the following methods:

      1. Splash guards
      2. Leak proof, puncture-resistant containers for used needles and other contaminated sharp items.
      3. Designated cabinets or areas to hold PPE in proximity to patient care.
      4. Needle safety devices, i.e. safety butterfly, retractable lancet, intravenous connecting sets without needles, a device that covers a needle after use, and plastic capillary tubes. Introduction of a new product will follow the protocol outlined by the Health System Medical/Surgical Value Analysis Committee. Refer to Attachment C for the list of safety devices.
      5. Direct patient care providers’ input is solicited by a Sharps Safety questionnaire. The questions asked include: Can you indicate any work practice controls and/or engineering controls (i.e. sharps safety devices, instruments, equipment) that could further reduce your exposure to blood and/or body fluid, needle sticks and other sharps injuries. Responses are correlated and analyzed for engineering and work practice improvements.

   3. WORK PRACTICE CONTROLS means performing patient care activities in a manner that reduces the likelihood of a worker's exposure to blood or OPIM. Examples:

      1. Disposing of regulated medical waste in a red plastic bag with a biohazard symbol.
      2. Decontaminating equipment before reuse.
      3. Labeling contaminated equipment before servicing. Placing all specimens in a covered well constructed container when transporting a specimen; a secondary container or protective package shall be used if outer container is soiled.
      4. Always take care to minimize the formation of droplets, splatters, splashes, aerosols and spills of blood or body fluids.
      5. All expirations or body parts shall be placed in a fluid resistant body bag prior to transport.
      6. Replacing examination gloves when visibly soiled, torn, or punctured, or when their integrity is compromised.
      7. Not recapping, re-sheathing, bending, or clipping needles. When recapping is the only alternative, use the one-handed technique.
      8. Disposable syringes and needles (including self-sheathing needle products), scalpel blades, and other sharp items are placed in puncture-resistant containers for disposal; the containers shall be located as close as practical to the use area.
      9. Placing sharp containers at a height, which visualization of the opening of the container.
      10. Observing standard precautions.
      11. Adherence to the regulated medical waste protocol.
      12. Contaminated reusable equipment and instruments shall be cleaned and disinfected as per manufacturer guidelines between each patient/resident use.
      13. Use mouthpieces, resuscitation bags, or other ventilation devices for resuscitation.
      14. Never pipette by mouth. Always using pipetting aids.
      15. Using PPEs and removing when no longer needed.
      16. Using a protective covering i.e., plastic wrap, aluminum foil, or imperviously backed absorbent paper, to protect items or surfaces from contamination.
      17. Eating and drinking, plus storage of food shall be in areas separate from contaminated areas.
      18. During invasive procedures, the passing of a sharp object from one individual to another should be done using a neutral zone and announcing the object presence/location.
      19. If any accident occurs, (i.e. puncture, cut, contact with skin, mucous membrane, splash, etc.), wash affected area with large volumes of water. Report immediately to your supervisor and to Emergency Department for immediate medical evaluation.
      20. Do not allow sharps disposal containers to over fill. Replace when ¾ full. In the event a container needs to be changed prior to vendor scheduled pick-up, contact the Environmental Services Department.
      21. Identifying labels (i.e., biohazard, contents) on containers/carts/racks shall face outward.

   4. PPE: Engineering and work practice controls shall be used to eliminate and minimize exposure. Where occupational exposure remains after institution of these controls, personal protective equipment at no cost to the individual, shall also be used. A PPE is a specialized clothing or equipment used by workers to protect them from direct exposure to blood or OPIM. The following listed PPE are selected based on the task performed and the degree of exposure.

      Which of the following is not an example of an other potentially infectious material Opim )?

      Unless visibly contaminated with blood, sweat, feces, tears, saliva, nasal secretions, urine, and vomit are not considered OPIM.

      What is not an example of Opim?

      considered OPIM unless they have visible contamination with blood or are part of a mixture of fluids in which it is impossible to tell if blood is or is not present. These non-OPIM fluids include urine, feces, tears, nasal secretions, sputum or vomit.

      What are the five types of infectious materials?

      There are five types of biohazardous medical waste:.

      Solid Biohazardous Waste. Solid biohazardous waste is any non-sharp material that contacts human or animal specimens. ... .

      Liquid Biohazardous Waste. ... .

      Sharp Biohazardous Waste. ... .

      Pathological Biohazardous Waste. ... .

      Microbiological Waste..

      Which of the following is NOT considered a potentially infectious material?

      Potentially infectious blood and body fluids include Unless visible blood is present, the following body fluids are NOT considered to be potentially infectious: feces. nasal secretions. saliva.