Bloodborne Pathogens Training

Transcription

INSTRUCTOR’S MANUAL
American Red Cross
Instructor’s Manual
This instructor’s manual is part of the American Red Cross First Aid/CPR/AED program.
Visit redcross.org to learn more about this program.
The emergency care procedures outlined in this book reflect the standard of knowledge
and accepted emergency practices in the United States at the time this book was
published. It is the reader’s responsibility to stay informed of changes in emergency
care procedures.
The following materials (including downloadable electronic materials, as applicable),
including all content, graphics, images and logos, are copyrighted by, and the exclusive
property of, The American National Red Cross (“Red Cross”). Unless otherwise
indicated in writing by the Red Cross, the Red Cross grants you (“Recipient”) the
limited right to download, print, photocopy and use the electronic materials only for use
in conjunction with teaching or preparing to teach a Red Cross course by individuals or
entities expressly authorized by the Red Cross, subject to the following restrictions:
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The Recipient is prohibited from creating new electronic versions of the materials.
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The Recipient is prohibited from revising, altering, adapting or modifying the
materials, which includes removing, altering or covering any copyright notices,
Red Cross marks, logos or other proprietary notices placed or embedded in the
materials.
■■
The Recipient is prohibited from creating any derivative works incorporating, in part
or in whole, the content of the materials.
■■
The Recipient is prohibited from downloading the materials, or any part of the
materials, and putting them on the Recipient’s own website or other third-party
website without advance written permission of the Red Cross.
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The Recipient is prohibited from removing these Terms and Conditions in
otherwise-permitted copies, and is likewise prohibited from making any additional
representations or warranties relating to the materials.
Copyright © 2011, 2016 The American National Red Cross. ALL RIGHTS RESERVED.
The Red Cross emblem, American Red Cross® and the American Red Cross logo are
registered trademarks of The American National Red Cross and protected by various
national statutes.
Published by StayWell
Printed in the United States of America
ISBN: 978-1-58480-658-5
ii
| Instructor’s Manual
© 2016 The American National Red Cross. All rights reserved.
Any rights not expressly granted herein are reserved by the Red Cross. The Red Cross
does not permit its materials to be reproduced or published without advance written
permission from the Red Cross. To request permission to reproduce or publish Red
Cross materials, please submit your written request to The American National Red
Cross.
Acknowledgments
The American Red Cross Bloodborne Pathogens Training Instructor’s Manual
was developed through the dedication of both employees and volunteers. Their
commitment to excellence made this manual possible.
Dedication
This manual is dedicated to the thousands of employees and volunteers of the
American Red Cross who contribute their time and talent to supporting and
teaching lifesaving skills worldwide and to the thousands of course participants
who have decided to be prepared to take action when an emergency strikes.
American Red Cross Scientific
Advisory Council
Guidance and Review of the First Aid/CPR/AED program was provided by
members of the American Red Cross Scientific Advisory Council.
The American Red Cross Scientific Advisory Council is a panel of nationally
recognized experts drawn from a wide variety of scientific, medical and academic
disciplines. The Council provides authoritative guidance on first aid, CPR,
emergency treatments, rescue practices, emergency preparedness, aquatics,
disaster health, nursing, education and training.
For more information on the Scientific Advisory Council, visit www.redcross.org/
take-a-class/scientific-advisory-council.
| Bloodborne Pathogens Training
iii
Table of Contents
Section A:
Course Administration
Course Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Course Objectives . . . . . . . . . . . . . . . . . . . . . . . . 1
Course Participants . . . . . . . . . . . . . . . . . . . . . . 2
Course Prerequisites . . . . . . . . . . . . . . . . . . . . . 2
Course Delivery Methods . . . . . . . . . . . . . . . . . 2
Course Instructional Design . . . . . . . . . . . . . . . 2
Course Materials . . . . . . . . . . . . . . . . . . . . . . . . . 3
Eligibility to Teach the Bloodborne
Pathogens Training Course . . . . . . . . . . . . . . . . 4
Course Length and Schedule . . . . . . . . . . . . . . 4
Recommended Class Size and
Instructor-to-Participant Ratios . . . . . . . . . . . . 5
Classroom Space . . . . . . . . . . . . . . . . . . . . . . . . 5
Materials, Equipment and Supplies . . . . . . . . . 5
Criteria for Course Completion
and Certification . . . . . . . . . . . . . . . . . . . . . . . . . 5
Skill Competency . . . . . . . . . . . . . . . . . . . . . . . . 6
Reporting Procedures . . . . . . . . . . . . . . . . . . . . 6
Acknowledging Course Completion . . . . . . . . 6
Obtaining Participant Feedback . . . . . . . . . . . . 6
Section B:
LESSON PLAN
Topic: Maintaining a Safe Environment . . . . 15
Topic: The Chain of Infection . . . . . . . . . . . . . . 9
Topic: If an Exposure Incident Occurs . . . . . 16
Topic: Bloodborne Pathogens . . . . . . . . . . . . 10
Topic: Course Wrap-Up . . . . . . . . . . . . . . . . . . 17
Topic: Staying Safe on the Job:
A Shared Responsibility . . . . . . . . . . . . . . . . . . 11
Bloodborne Pathogens Game
of Chance Activity . . . . . . . . . . . . . . . . . . . . . . . 18
Topic: Personal Protective Equipment . . . . . 13
Skill Chart and Skill Assessment Tool . . . . . 21
Topic: Hand Washing . . . . . . . . . . . . . . . . . . . . 14
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
iv
Topic: Introduction to the Course . . . . . . . . . . 9
SECTION
A
COURSE ADMINISTRATION
Course Purpose
The primary purpose of the American Red Cross Bloodborne Pathogens Training course is
to teach participants how to protect themselves and others from exposure to bloodborne
pathogens on the job, and what to do if an exposure occurs. The course content and activities
will prepare participants to make appropriate decisions about preventing bloodborne pathogen
disease transmission. The course addresses:
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What bloodborne pathogens are.
How bloodborne pathogens are spread.
How to help prevent exposure incidents by following work practice controls, using
engineering controls and personal protective equipment (PPE), practicing good
personal hygiene and properly cleaning and disinfecting equipment and supplies.
How to recognize, report and follow up on employee exposure to blood and other
potentially infectious materials.
The Bloodborne Pathogens Training course is designed to assist employers with meeting the
training mandate as stipulated in the federal Occupational Safety and Health Administration
(OSHA) Bloodborne Pathogens Standard. The course was developed with guidance from
OSHA to comply with the training component of the Standard (29 CFR part 1910.1030),
released January 18, 2001, and April 3, 2012.
Instructor’s Note: This course is intended only to assist employers with meeting
the annual training mandate as stipulated in the OSHA Bloodborne Pathogens
Standard. It is vital that American Red Cross instructors understand and convey to
employers and participants that taking part in the American Red Cross Bloodborne
Pathogens Training course does not constitute full compliance with the OSHA
standard. The employer is responsible for providing employees with workplacespecific information regarding engineering controls, the use of PPE, immunizations,
exposure control plans and procedures for reporting exposure incidents.
Course Objectives
It is your responsibility as an instructor to see that participants meet the learning objectives listed
at the beginning of the lesson in this instructor’s manual. The following are course objectives:
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Understand how infections can be spread from one person to another.
Define the term bloodborne pathogen and list the bloodborne pathogens that are of most
concern in the workplace.
Understand the responsibilities both the employer and the employee have in protecting the
employee from exposure to bloodborne pathogens on the job.
SECTION
A
| Course Administration
1
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Describe the contents of an exposure control plan and understand the importance of
familiarizing themselves with the exposure control plan at their place of employment.
Describe the difference between engineering controls and work practice controls, and give
examples of each.
Explain what it means to take standard precautions, and describe examples of practices that
are included as part of standard precautions.
Describe when and how to use appropriate personal protective equipment (PPE) to limit the
spread of bloodborne pathogens.
Demonstrate proper technique for removing disposable gloves.
Describe when and how to wash the hands to limit the spread of bloodborne pathogens.
Describe proper technique for cleaning equipment and surfaces soiled with blood or other
potentially infectious materials, and for disposing of contaminated materials.
Describe what to do if an exposure incident occurs.
Course Participants
The intended audience for this course includes individuals, as determined by their employer,
who may come in contact with blood or other potentially infectious materials while performing
their job duties. This includes:
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Members of a workplace emergency response team.
Public safety personnel.
Medical personnel, such as athletic trainers, emergency medical technicians, pharmacists,
nurses and physicians.
Employees with a duty to respond.
Participants will be taking this course to fulfill employment requirements. Successful instructors
understand the background and motivation for participants and may modify their teaching style
(not the course) accordingly.
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The participants could represent a broad range of backgrounds.
They may differ in age or levels of maturity.
They may differ in levels of education or experience.
Course Prerequisites
Course Delivery Methods
There are two delivery methods available for the American Red Cross Bloodborne Pathogens
Training course—instructor led and online. In addition, Bloodborne Pathogens Training for Tattoo
Artists is available as an online course.
Course Instructional Design
Participants demonstrate competency throughout the instructor-led course by actively participating
in activities, guided discussions and the skill session. In the Bloodborne Pathogens Training course,
there is no written exam.
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There are no prerequisites to participate in the American Red Cross Bloodborne Pathogens
Training course.
Course Materials
Participant Resources
Fact Sheet and Skill Sheet
The Bloodborne Pathogens Training Fact Sheet and Skill Sheet reinforces key points from the
lecture portions of the course and provides a visual reference for the skill. It serves as an in-class
tool and as a reference tool after the course is completed. The Fact Sheet and Skill Sheet is
available on Instructor’s Corner and redcross.org as a free digital download that can be printed.
Participants are not required to have any course materials during class.
Instructor Resources
The Bloodborne Pathogens Training Instructor’s Manual is required to conduct the American
Red Cross Bloodborne Pathogens Training course. The manual is divided into two
parts—Section A: Course Administration and Section B: Bloodborne Pathogens Training.
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Section A: Course Administration contains information needed to conduct the course and
provides a course overview, explains how to set up and teach the course, gives requirements
for successful course completion and describes what to do when the course is completed.
Section B: Bloodborne Pathogens Training contains the lesson plan to teach the
Bloodborne Pathogens Training course. The lesson plan provides the primary points to
be covered in the lesson, and provides guidelines for activities and the skill session.
Instructor’s Corner
The Bloodborne Pathogens Training course materials on Instructor’s Corner include:
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Information related to instructor bridging.
Information related to the recertification assessment.
The course fact sheet.
Information about reporting teaching activity.
Digital versions of instructor and participant course materials.
The course presentation.
Streaming video segments to support course delivery.
Administrative policies and procedures.
How-To Guides and resources to support administrative processes.
Information about other Red Cross training and education programs.
Frequently asked questions and expert answers to technical questions.
Course Presentation
A course presentation to support the Bloodborne Pathogens Training course is available.
The course presentation is available to download from Instructor’s Corner. The presentation is
saved in PDF format. To view the presentation, save the file to your computer and double click
on the PDF icon to open it. Additional directions for using the course presentation are available
on Instructor’s Corner.
The Bloodborne Pathogens Training course presentation is also available on the
First Aid/CPR/AED DVD.
SECTION
A
3
BOX 1-1: Course Presentation Requirements
SYSTEM
REQUIREMENTS:
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EQUIPMENT
REQUIREMENTS
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Adobe Reader 9
Flash Player 8, 9 for Windows and Mac
Flash Player 9 for Linux and Solaris
Laptop/desktop computer
Power source
Projector
Projection screen/area
Computer speakers
Video Segments
The following video segments support the Bloodborne Pathogens Training course:
■■ “Bloodborne Pathogens: Knowledge Is Your First Defense”
■■ “The Chain of Infection”
■■ “Staying Safe on the Job: A Shared Responsibility”
■■ “Removing Latex-Free Disposable Gloves”
■■ “Hand Washing”
■■ “Cleaning Up Spills of Blood and Other Potentially Infectious Materials”
The video segments are an integral part of the course. Instructors are required to use the video
segments because they contain important information about key concepts and skills to help ensure
the course objectives are met. The course cannot be conducted if the video segments are not
available. They are included on the First Aid/CPR/AED DVD, which is available for purchase from
Instructor’s Corner. The video segments are also available for streaming on Instructor’s Corner.
Eligibility to Teach the Bloodborne
Pathogens Training Course
The following currently certified Red Cross instructors who are knowledgeable in the course
content are eligible to teach the Bloodborne Pathogens Training course as part of their
instructor certification without additional training:
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Course Length and Schedule
The Bloodborne Pathogens Training course is designed to be completed in one 1-hour session.
This estimate is based on a ratio of 25 participants to 1 instructor and includes the minimum
time required for covering the content and class activities. The time allotted in the lesson plan
does not include breaks.
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First Aid/CPR/AED instructors
Basic Life Support for Healthcare Providers instructors
CPR/AED for Professional Rescuers and Health Care Providers instructors
Lifeguarding instructors
Nurse Assistant Training instructors
Wilderness and Remote First Aid instructors
Emergency Medical Response instructors
Recommended Class Size and
Instructor-to-Participant Ratios
The Bloodborne Pathogens Training course is designed for a ratio of 25 participants to one
instructor. If your class is larger, you may not be able to properly supervise the course activities
and skill session in the allotted time. You may need to add more time or arrange for a co-instructor.
Classroom Space
The Bloodborne Pathogens Training course requires a classroom space suitable for lecture,
small group activities, video presentations and the skill session. The classroom should provide
a safe, comfortable and appropriate learning environment. The room should be well lit, well
ventilated and have a comfortable temperature.
Materials, Equipment and Supplies
The specific materials, equipment and supplies needed for the lesson are included at the
beginning of the lesson. Instructors should have the specific equipment needed for the lesson
ready prior to the start of the lesson. To conduct the Bloodborne Pathogens Training course,
instructors must have the following:
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Latex-free disposable gloves (one pair for each participant)
Bloodborne Pathogens Training Course Presentation or the First Aid/CPR/AED DVD
The Bloodborne Pathogens Training Fact Sheet and Skill Sheet (one for each participant, optional)
Examples of engineering controls as appropriate, such as a sharps container, a biohazard
bag and personal protective equipment (PPE) (optional)
Alcohol-based hand sanitizer (optional)
Equipment for the Bloodborne Pathogens Game of Chance Activity
Criteria for Course Completion
and Certification
On successful completion of the Bloodborne Pathogens Training course, participants receive
an American Red Cross course completion certificate.
To successfully complete the Bloodborne Pathogens Training course, the participant must:
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Attend and participate in the entire class session.
Demonstrate competency in the required skill and activities.
Participants must be told of the requirements when they enroll for the course and again during
the course introduction. Remember to provide ongoing feedback to participants about their
performance throughout the course. Feedback should be ongoing so there are no surprises if a
participant’s performance is evaluated as unacceptable.
SECTION
A
5
Skill Competency
To complete the Bloodborne Pathogens Training course requirements and receive a completion
certificate, the participant must be able to demonstrate the required skill (“Removing Latex-Free
Disposable Gloves”) proficiently without any coaching or assistance.
Reporting Procedures
You must submit a completed Course Record and Course Record Addendum to the American
Red Cross Learning Center within the specified time frame (10 days). Instructions for using and
submitting course records are available on Instructor’s Corner.
Acknowledging Course Completion
Awarding Certification
Upon successful completion of the course and after the data has been entered into the
American Red Cross Learning Center, each participant will receive a course completion
certificate from the American Red Cross Learning Center that indicates the details of course
completion and certification. The course completion certificate can be downloaded, printed
or shared, as needed. Each American Red Cross certification contains a QR Code that
can be used by participants, instructors, employers or the American Red Cross to validate
certificate authenticity.
Continuing Education Units for Professionals
Many course takers are professionals who need continuing education units to maintain
a license, certification or both. The American Red Cross is an accredited provider of the
International Association of Continuing Education and Training (IACET). IACET’s Criteria for
Quality Continuing Education and Training Programs are the standards by which hundreds
of organizations measure their educational offerings. For additional information, please see
Instructor’s Corner or redcross.org.
Obtaining Participant Feedback
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Gaining feedback from participants is an important step in any evaluation process. Participants
should have an opportunity to tell you what they thought about the course. A copy of the
Participant Course Evaluation Form is available on Instructor’s Corner. Have participants
complete evaluations each time you teach the course. This information will provide you with
feedback concerning the course and its instruction, and help the Red Cross maintain the high
quality of the course.
SECTION
B
BLOODBORNE PATHOGENS
TRAINING
LESSON PLAN
Lesson Length: 1 hour
GUIDANCE FOR THE INSTRUCTOR
To complete this lesson and meet the lesson objectives, you must:
■■ Discuss all points in the topic, “Introduction to the Course.”
■■ Show the video segment, “Bloodborne Pathogens: Knowledge Is Your First Defense” (2:03).
■■ Show the video segment, “The Chain of Infection” (3:09).
■■ Discuss all points in the topic, “Bloodborne Pathogens.”
■■ Conduct the Risk or Not? Activity.
■■ Show the video segment, “Staying Safe on the Job: A Shared Responsibility” (2:04).
■■ Discuss all points in the topic, “Staying Safe on the Job: A Shared Responsibility.”
■■ Discuss all points in the topic, “Using Personal Protective Equipment.”
■■ Conduct the PPE Small Group Activity.
■■ Show the video segment, “Removing Latex-Free Disposable Gloves” (0:30).
■■ Conduct the skill practice session for the skill “Removing Disposable Gloves.”
■■ Discuss all points in the topic, “Hand Washing.”
■■ Show the video segment, “Hand Washing” (1:54).
■■ Discuss all points in the topic, “Maintaining a Safe Environment.”
■■ Show the video segment, “Cleaning Up Spills of Blood and Other Potentially Infectious
Materials” (2:53).
■■ Discuss all points in the topic, “If An Exposure Incident Occurs.”
■■ Conduct the Bloodborne Pathogens Game of Chance Activity.
■■ Discuss all points in the Course Wrap-Up.
LESSON OBJECTIVES
After completing this lesson, participants will be able to:
■■ Understand how infections can be spread from one person to another.
■■ Define the term bloodborne pathogen and list the bloodborne
pathogens that are of most concern in the workplace.
■■ Understand the responsibilities both the employer and the employee have in
protecting the employee from exposure to bloodborne pathogens on the job.
■■ Describe the contents of an exposure control plan and understand the importance of
familiarizing themselves with the exposure control plan at their place of employment.
SECTION
B
7
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Describe the difference between engineering controls and work practice controls, and give
examples of each.
Explain what it means to take standard precautions, and describe examples of practices that are
included as part of standard precautions.
Describe when and how to use appropriate personal protective equipment (PPE) to limit the
spread of bloodborne pathogens.
Demonstrate proper technique for removing disposable gloves.
Describe when and how to wash the hands to limit the spread of bloodborne pathogens.
Describe proper technique for cleaning equipment and surfaces soiled with blood or other
potentially infectious materials, and for disposing of contaminated materials.
Describe what to do if an exposure incident occurs.
MATERIALS, EQUIPMENT AND SUPPLIES
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Latex-free disposable gloves (one pair for each participant)
Bloodborne Pathogens Training course presentation or DVD
The Bloodborne Pathogens Training Fact and Skill Sheet (one for each participant, optional)
Examples of engineering controls as appropriate, such as a sharps container,
a biohazard bag and personal protective equipment (PPE) (optional)
Alcohol-based hand sanitizer (optional)
Equipment for the Bloodborne Pathogens Game of Chance Activity
Instructor’s Note: The Bloodborne Pathogens Training Fact and Skill Sheet can be
downloaded from Instructor’s Corner.
Instruction Key:
Discussion
Video
Activity
Skill Practice
Lecture
8
TOPIC: INTRODUCTION TO THE COURSE
Time: 10 minutes
WELCOME
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Welcome participants, introduce yourself and explain that you are a certified
American Red Cross instructor.
Have participants introduce themselves.
Have participants print their names on the Course Record Addendum.
Inform participants of course completion requirements.
Review facility policies, including emergency procedures. Give the locations
of restrooms, emergency exits and water fountains. Identify the location of the
automated external defibrillator (AED) and first aid kit.
Distribute copies of the Bloodborne Pathogens Training Fact and Skill Sheet
to participants, if you are using it.
PURPOSE OF THE COURSE
INSTRUCTION:
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REFERENCES:
Course
Presentation
Slides 1–4
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Explain that the purpose of the American Red Cross Bloodborne Pathogens
Training course is to teach participants how to protect themselves and others
from exposure to bloodborne pathogens on the job, and what to do if an exposure
should occur.
Tell participants that they are taking this course because their employer has
determined that they may come in contact with blood or other potentially
infectious materials while performing their job duties.
Explain to participants that “other potentially infectious materials” are human body
materials other than blood that could carry bloodborne pathogens.
Instructor’s Note: Share examples of other potentially infectious
materials that are relevant to the occupations of the participants in the
course. Other potentially infectious materials are defined by OSHA as:
(1) The following human body fluids: cerebrospinal fluid, synovial fluid,
pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in
dental procedures, any body fluid that is visibly contaminated with blood,
semen, vaginal secretions and all body fluids in situations where it is
difficult or impossible to differentiate between body fluids; (2) Any unfixed
tissue or organ (other than intact skin) from a human (living or dead);
and (3) HIV-containing cell or tissue cultures, organ cultures and HIVor HBV-containing culture medium or other solutions; and blood, organs
or other tissues from experimental animals infected with HIV or HBV.
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Show the video segment, “Bloodborne Pathogens: Knowledge Is Your
First Defense.”
Answer participants’ questions.
TOPIC: THE CHAIN OF INFECTION
INSTRUCTION:
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Time: 4 minutes
Explain to participants that understanding how infections spread can help
them to protect themselves and others
Show the video segment, “The Chain of Infection.”
Answer participants’ questions.
REFERENCES:
Course
Presentation
Slides 5–6
SECTION
B
9
TOPIC: BLOODBORNE PATHOGENS
INSTRUCTION:
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REFERENCES:
Course
Presentation
Slides 7–17
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REFERENCES:
Course
Presentation
Slides 18–20
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Tell participants that this course focuses on bloodborne pathogens, which are
infectious agents in human blood that can cause disease in humans.
Ask participants, “What is the reservoir for the bloodborne pathogens
that we are going to be talking about today?”
Responses should include:
{{ The human body
Explain to participants that although these pathogens can cause serious
disease, they are not easily transmitted and are not spread by casual contact.
An infected person’s blood must enter another person’s bloodstream for
infection to occur.
On the job, this could happen through:
{{ Direct or indirect contact with an infected person’s blood or other potentially
infectious material, if the blood or other potentially infectious material comes in
contact with your eyes, the mucous membranes that line your mouth and nose
or an area of broken skin on your body.
●● Direct contact: A bloodborne pathogen is passed from one person to
another through close physical contact between two people.
●● Indirect contact: A bloodborne pathogen is passed from one person to
another via a surface or object contaminated with an infected person’s
blood or other potentially infectious material.
{{ A needlestick injury (an accidental puncture wound caused by a used needle).
{{ An open wound caused by broken glass or another object that has been soiled
with blood or other potentially infectious material.
Ask participants, “A person is injured and bleeding. If you were to come
into contact with the person’s blood, what are some potential portals
of entry for a bloodborne pathogen?”
{{ A break in the skin
{{ The eyes, mouth or nose
Ask participants, “What are some other ways that you could become
infected with a bloodborne pathogen while performing your job duties?”
{{ Through a needlestick injury
{{ Through contact with an object contaminated with blood or other potentially
infectious materials
Anyone’s blood or other potentially infectious material might carry bloodborne
pathogens. Someone you know well or someone who shows no obvious signs
and symptoms could be infected.
Some bloodborne pathogens pose particular risk because they can have longterm effects on a person’s health. These include:
{{ Hepatitis B virus (HBV)
{{ Hepatitis C virus (HCV)
{{ Human immunodeficiency virus (HIV)
Hepatitis is inflammation of the liver, an organ that performs many vital functions for
the body. There are many different types and causes of hepatitis.
{{ Hepatitis B and hepatitis C are caused by infection with bloodborne viruses.
{{ Chronic infection with the viruses that cause hepatitis B and C can lead to liver
failure, liver cancer and other serious conditions.
INSTRUCTION:
Time: 5 minutes
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INSTRUCTION:
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REFERENCES:
Course
Presentation
Slides 21–24
HIV is a virus that invades and destroys the cells that help us to fight off
infections.
{{ A person who is infected with HIV may look and feel healthy for many years.
However, during this time the virus is breaking down the person’s immune
system.
{{ People who are infected with HIV may eventually develop acquired
immunodeficiency syndrome (AIDS). A person with AIDS is unable to fight off
infections that a healthy person would be able to resist or control. The person
dies from one of these infections.
{{ Although medications have been developed to help slow the progression of
HIV infection, currently there is no cure.
Lead the Risk or Not? Activity. Show each slide and ask participants to raise their
hand if they think the person or people shown on the slide could pass a bloodborne
illness on to them. (Participants should raise their hands for every slide.)
Remind participants that it is impossible to tell whether a person is infected with a
bloodborne pathogen just by looking at the person, and that anyone, regardless of
gender, age, race, sexual orientation or any other characteristic, could be infected
with a bloodborne pathogen.
TOPIC: S
TAYING SAFE ON THE JOB:
A SHARED RESPONSIBILITY
INSTRUCTION:
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Time: 6 minutes
Explain to participants that both employers and employees must take
responsibility for minimizing the risk for exposure to bloodborne pathogens in
the workplace.
Show the video segment, “Staying Safe on the Job: A Shared Responsibility.”
REFERENCES:
Course
Presentation
Slides 25–26
INSTRUCTION:
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REFERENCES:
Course
Presentation
Slides 27–39
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Lead participants in a guided discussion to expand on some of the points
made in the video.
Remind participants that:
{{ OSHA requires employers to maintain a written exposure control plan
describing the protective actions that will be taken to eliminate or minimize
employee exposure to blood or other potentially infectious materials on the job,
as well as the actions that will be taken if on-the-job exposure to blood or other
potentially infectious materials occurs.
{{ The exposure control plan details engineering controls (tools that employees
can use to protect themselves and others from exposure) as well as work
practice controls (procedures employees should follow to protect themselves
and others from exposure).
Ask participants, “Can you name some examples of engineering
controls?”
{{ Personal protective equipment (PPE)
{{ Handwashing facilities and supplies
{{ Approved containers for the disposal of sharps (i.e., objects contaminated with
blood or other potentially infectious materials that could cause puncture
wounds or lacerations, such as used needles or broken glass)
SECTION
B
11
{{
{{
{{
Bags or containers marked with the biohazard symbol for disposing of
contaminated materials
Sharps safety devices, such as needleless IV systems, syringes with shielded
needles and self-sheathing needles
Designated equipment for cleaning up blood and other potentially infectious
material spills such as tongs, dustpans, brooms and cones
Instructor’s Note: If you have examples of engineering controls, such
as a sharps container or articles of PPE, pass these items around the
classroom so that participants can examine them.
■■
■■
■■
■■
Instructor’s Note: Encourage participants to obtain a copy of the
exposure control plan at their places of work and familiarize themselves
with it.
12
■■
Ask participants, “Can you name some examples of work practice controls?”
{{ Requiring employees to use appropriate PPE when performing certain
job duties
{{ Establishing protocols for when hands should be washed
{{ Establishing procedures for the safe handling of sharps
{{ Establishing procedures for disposing of contaminated materials
{{ Establishing procedures for cleaning equipment and surfaces soiled with
blood or other potentially infectious materials
Ask participants, “What are standard precautions?”
{{ An approach to infection control that involves treating all blood and other
potentially infectious materials as if they are known to be infectious
Ask participants, “What are some examples of standard precautions?”
{{ Using PPE
{{ Handling sharps, such as needles, carefully
{{ Cleaning up spills promptly and correctly
{{ Handling and disposing of contaminated items carefully
Ask participants, “You saw in the video that OSHA requires employers to
make the hepatitis B vaccine available free of charge to all employees
who have the potential for on-the-job exposure. Remember that
breaking even one link in the chain of infection can prevent an infection
from occurring. What link in the chain of infection does getting
vaccinated against HBV break?”
{{ Susceptible host
Remember, your employer’s exposure control plan only works if you use the tools
that are available to you and follow your employer’s procedures.
TOPIC: PERSONAL PROTECTIVE EQUIPMENT
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 40–49
■■
■■
■■
INSTRUCTION:
■■
Time: 10 minutes
Personal protective equipment (PPE) is a barrier device used to prevent
pathogens in blood and other potential infectious materials from contaminating
your skin, mucous membranes or clothing.
This equipment includes latex-free disposable gloves, gowns, protective
eyewear, masks, resuscitation devices (such as CPR breathing barriers) and
shoe covers.
Appropriate PPE should be used whenever exposure to blood or other
potentially infectious materials is likely. Know and follow your employer’s
guidelines for what PPE to wear and when.
{{ Gloves are worn whenever there is the possibility of contacting blood or other
potentially infectious materials.
{{ A gown is worn to protect your clothes and body from splashes and sprays of
blood and other potentially infectious materials.
{{ A mask is used to protect the mucous membranes of the nose and mouth from
splashes and sprays of blood or other potentially infectious materials.
{{ Wear protective eyewear, such as goggles or a face shield, to keep body fluids
from splashing into your eyes when giving care, cleaning items or disposing of
contaminated fluids.
{{ Shoe covers are worn when it is necessary to walk through a contaminated
area.
{{ CPR breathing barriers and other resuscitation devices are used to prevent
contact with another person’s nose and mouth while giving rescue breaths.
Ask participants, “How does wearing appropriate PPE break the chain of
infection?”
Answers: Responses should include the following:
{{ By blocking a portal of entry for pathogens
Lead the PPE Small Group Activity. Divide participants into small groups. Give
each group a few minutes to discuss the articles of PPE that each participant in
the group is accustomed to using in his or her workplace, and have participants
share examples of situations when they used PPE on the job. Ask a volunteer
from each group to share the group’s findings with the rest of the class. Point out
similarities in when and how PPE is used.
Instructor’s Note: Alternatively, if participants are not accustomed to
using PPE in the workplace, ask each group to brainstorm together to
come up with a job-related situation where it would be necessary to use
PPE, and specify which PPE would be appropriate to use in that situation.
Then ask a volunteer from each group to share the group’s findings with
the rest of the class. Point out similarities in when and how PPE is used.
DISPOSABLE GLOVES
INSTRUCTION:
■■
■■
■■
REFERENCES:
Course
Presentation
Slides 50–51
Latex-free disposable gloves are a very commonly used article of PPE.
Nitrile gloves are preferred over other types of latex-free disposable gloves,
such as those made of vinyl.
Wear latex-free disposable gloves:
{{ Whenever there is a possibility that you will come in contact with a person’s
blood or other potentially infectious materials.
{{ When there is a break in the skin on your own hands (cover any cuts, scrapes
or sores before putting on the gloves).
{{ When you must handle items or surfaces soiled with blood or other potentially
infectious materials.
SECTION
B
13
■■
■■
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 52–53
INSTRUCTION:
■■
■■
■■
■■
■■
When you are wearing gloves, try to limit how much you touch other surfaces
with your gloved hands. Pathogens from your soiled gloves can transfer to other
items or surfaces that you touch, putting the next person who handles the item or
touches the surface at risk for infection.
When you are finished providing care, remove your gloves using proper technique,
dispose of the gloves according to your employer’s policy and wash your hands.
Explain to participants that gloves must be removed using proper technique to
avoid contaminating their own skin.
Tell participants that they are going to watch a video demonstration of how
to remove gloves, and then they will have the opportunity to practice the
skill themselves.
Show the video segment, “Removing Latex-Free Disposable Gloves.”
Give each participant a pair of latex-free disposable gloves.
Guide participants through the steps of the skill for removing disposable gloves.
After demonstrating the skill, have participants put on the gloves and practice
removing them independently.
Observe each participant’s performance of the skill and correct common errors,
such as touching bare skin with a contaminated glove or touching an area of the
glove that is likely contaminated with a bare hand.
TOPIC: HAND WASHING
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 54–58
■■
14
Explain to participants that hand washing is the single most effective way to
prevent the spread of infection.
Ask participants, “How does hand washing break the chain of infection?”
{{ By removing a method of transmission
Tell participants that they should know and follow the guidelines their employer
has established regarding when they should wash their hands. At minimum,
hands should be washed:
{{ Before providing care (if possible), and always after providing care,
even if you wore gloves.
{{ After touching blood, other potentially infectious materials or broken
(non-intact) skin.
{{ After touching objects or surfaces that could be contaminated with blood or
other potentially infectious materials.
{{ After removing gloves or other PPE.
{{ Before and after eating and drinking.
{{ After using the restroom.
Explain to participants that in order to be effective, hand washing must be
done frequently using proper technique.
■■
Time: 4 minutes
INSTRUCTION:
■■
Show the video segment, “Hand Washing.”
REFERENCES:
Course
Presentation
Slide 59
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 60–63
■■
INSTRUCTION:
■■
■■
REFERENCES:
■■
Course
Presentation
Slides 64–66
■■
Lead participants in a guided discussion to expand on some of the points made in
the video.
Ask participants, “How long should it take you to wash your
hands properly?”
{{ At least 20 seconds
Ask participants, “What areas should you be sure to clean while washing
your hands?”
{{ The palms and backs of the hands
{{ In between the fingers
{{ The wrists
{{ Underneath the nails
Explain to participants that an alcohol-based hand sanitizer can be used to
decontaminate the hands if soap and water are not readily available.
Tell participants that alcohol-based hand sanitizers may not be as effective if the
hands are visibly soiled with dirt or body fluids.
Explain how to use an alcohol-based hand sanitizer, making the following points.
{{ Dispense the recommended amount of product into the palm of one hand.
{{ Rub your hands to cover all surfaces of both hands, including underneath the
nails and between the fingers.
{{ Continue rubbing the hands until the product evaporates.
Tell participants that they should wash their hands using soap and water as soon
as handwashing facilities are available because, although alcohol-based hand
sanitizers reduce the number of pathogens on the hands, they do not eliminate all
types of pathogens.
TOPIC: MAINTAINING A SAFE ENVIRONMENT
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 67–68
■■
Time: 6 minutes
Disposable equipment and supplies need to be discarded in a manner that
limits others’ exposure to the contaminated items.
Similarly, reusable equipment and surfaces that have been contaminated by
blood or other potentially infectious materials need to be properly cleaned
and disinfected before the equipment is put back into service or the area is
reopened.
Always wear latex-free disposable gloves (and other PPE as necessary) when
cleaning equipment or surfaces or disposing of contaminated equipment or
supplies.
SECTION
B
15
HANDLING SOILED ITEMS PROPERLY
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 69–73
Place soiled items in labeled biohazard containers for disposal, cleaning or
laundering according to the procedures specified in your employer’s exposure
control plan.
Follow your employer’s procedures for handling sharps (such as needles or broken
glass) safely. In general:
{{ Dispose of sharps in an approved puncture-resistant sharps container
immediately after using them. Be careful and watch as you place the sharp into
the container.
{{ Never recap a sharp object before disposing of it, because you could stick or
cut yourself while trying to replace the cap.
{{ Never overfill a sharps container. Sharps containers should be replaced when
they are two-thirds full, or according to your employer’s policy.
{{ Never open, empty or reuse a sharps container.
{{ Never clean up broken glass using your hands. Use tongs, a broom and dustpan,
or two pieces of cardboard to pick up and dispose of the broken glass.
{{ Trash bags may contain sharp objects, so avoid packing them down with your
hands or swinging them near your legs when you walk.
CLEANING UP BLOOD AND BODY FLUID SPILLS
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 74–76
■■
Explain to participants that spills of blood or other potentially infectious
materials must be cleaned up promptly and properly to limit the potential for
exposure to bloodborne pathogens.
Tell participants that cleaning up spills of blood or other potentially infectious
materials is a two-part process, because the surface must be cleaned before it
can be disinfected.
Show the video segment, “Cleaning Up Spills of Blood and Other Potentially
Infectious Materials.”
CLEANING EQUIPMENT AND CLOTHING
INSTRUCTION:
■■
■■
To clean equipment, boots and leather goods (e.g., shoes, belts), scrub the
item using a brush and hot, soapy water.
Specific procedures for cleaning and disinfecting equipment and work clothes in
your workplace should be outlined in the exposure control plan.
REFERENCES:
Course
Presentation
Slide 77
INSTRUCTION:
■■
■■
REFERENCES:
Course
Presentation
Slides 78–81
16
Time: 5 minutes
If another person’s blood or other potentially infectious material comes into
contact with your eyes, mouth or an opening or break in your skin, or if you
experience a needlestick injury, then you have been involved in an exposure
incident.
In the event of an exposure incident, follow these steps immediately:
{{ Decontaminate.
{{ Notify the appropriate people.
{{ Complete the necessary documentation.
{{ Seek follow-up care.
TOPIC: IF AN EXPOSURE INCIDENT OCCURS
■■
■■
■■
First, decontaminate the exposed area:
{{ Wash needlestick injuries, cuts and contaminated skin thoroughly with soap
and water.
{{ If blood or another potentially infectious material splashes into your mouth or
nose, flush the area with water.
{{ If blood or another potentially infectious material splashes into your eyes, irrigate
them with clean water, saline or a sterile irrigant for 15 to 20 minutes.
Report the incident to the appropriate person at your place of employment and
complete the necessary documentation, per the exposure control plan.
{{ An incident report form is used to record the time and date of the exposure, the
circumstances of the exposure, the actions taken after the exposure and other
relevant information about the incident.
{{ Employers must maintain a sharps injury log for the recording of injuries with
contaminated sharps. The log must maintain employee privacy, list the type and
brand of the device involved in the incident, and include the location and
description of the incident.
Seek immediate follow-up care as identified in your facility’s exposure control plan.
TOPIC: COURSE WRAP-UP
INSTRUCTION:
■■
■■
■■
REFERENCES:
Course
Presentation
Slide 82
■■
■■
■■
■■
Time: 10 minutes
Tell participants that now they will have the opportunity to review what they
have learned.
Lead the Bloodborne Pathogens Game of Chance Activity.
Divide participants into two teams and have them line up along either side of
the room, facing each other.
One at a time, each team sends the first player in line to the front of the room to
roll the die.
You, the host, will pose the question. The number on the die will determine the
category of question:
{{ 1: True or False? The participant must answer a true or false question.
{{ 2: What Should You Do? The participant must state how he or she would
respond to the scenario you present.
{{ 3: Show Me. The participant must demonstrate how to do something.
{{ 4: Sequence the Steps. The participant must put the steps of the skill in the
correct order.
{{ 5: Short Answer. The participant must answer a short-answer question.
{{ 6: Instructor Wild Card. The instructor chooses a question from one of the
other five categories.
If the participant wants help answering the question, he or she can ask
a teammate to be a “lifeline” and the two can work together to answer
the question.
Play continues until all participants have had the opportunity to roll the die and
answer at least one question.
Instructor’s Note: For the Category 3: Show Me questions, have
hand sanitizer, disposable gloves and either an actual sharps container,
biohazard bag and regular waste container available, or cards with images
of the three options for disposing of soiled items.
SECTION
B
17
Instructor’s Note: For the Category 4: Sequence the Steps questions,
prepare sets of index cards in advance (one step per card) so that the
participant can arrange the cards in the correct order.
INSTRUCTION:
■■
■■
REFERENCES:
Thank participants for their efforts during class and ask for any remaining
questions.
Tell participants that they will receive an email with instructions for accessing their
digital course completion certificate indicating Bloodborne Pathogens Training. Tell
participants that the certificate is valid for 1 year.
Course
Presentation
Slide 83
Bloodborne Pathogens Game of Chance Activity
CATEGORY 1 QUESTIONS: TRUE OR FALSE?
QUESTION
ANSWER
True
OSHA requires employers to maintain a written exposure control plan
describing the protective actions that will be taken to eliminate or minimize
employee exposure to blood or other potentially infectious materials on the
job, as well as the actions that will be taken if on-the-job exposure to blood
or other potentially infectious materials occurs.
True
You should recap a needle before disposing of it to protect others from
accidental needlestick injuries.
False
It is easy to identify a person who is infected with a bloodborne pathogen.
False
Employers and employees share the responsibility for preventing
occupational exposures to bloodborne pathogens.
True
Hand washing is an alternative to wearing personal protective equipment.
False
The skin and mucous membranes are part of the body’s natural
defense system.
True
18
An infected person’s blood or other potentially infectious material must
enter your bloodstream in order for a bloodborne infection to occur.
CATEGORY 2 QUESTIONS: WHAT SHOULD YOU DO?
QUESTION
ANSWER
You have been involved in an exposure incident.
What should you do?
Decontaminate, notify the appropriate
people, complete necessary
documentation, and seek follow-up care
per the exposure control plan.
Your supervisor has asked you to clean up a
blood spill. There is a large shard of broken
glass in the middle of the puddle of blood on
the floor. What should you do?
Remove the shard of glass using tongs,
a broom and dustpan or two pieces
of cardboard, and dispose of it in a
biohazard container before wiping up the
blood spill.
You need to clean your hands but you do not
have access to a handwashing facility. Your
hands are not visibly soiled. What should you do?
Use an alcohol-based hand sanitizer and
wash your hands as soon as soap and
water become available.
A co-worker has been injured and is bleeding
from a cut on her arm. What should you do to
protect yourself from bloodborne pathogens
when you go to her aid?
Put on gloves and other appropriate PPE
as needed before going to assist her.
CATEGORY 3 QUESTIONS: SHOW ME
QUESTION
Show me how to remove latex-free disposable gloves.
Show me where to dispose of a sharp.
Show me where to dispose of used PPE.
CATEGORY 4 QUESTIONS: SEQUENCE THE STEPS
QUESTION
ANSWER
Cleaning Up a Blood Spill
Block off the area, put on PPE, clean up
the spill, disinfect the area
Removing Disposable Gloves
Pinch the palm side of one glove and pull
it off inside out, slip two fingers under the
other glove at the wrist and pull the glove
off inside out, wash your hands
Hand Washing
Turn on faucet, wet hands and wrists,
apply soap, rub hands to work up a lather,
wash for at least 20 seconds covering
all surfaces, rinse hands and wrists, dry
hands and wrists, turn off faucet using a
clean paper towel
SECTION
B
19
CATEGORY 5 QUESTIONS: SHORT-ANSWER QUESTIONS
QUESTION
ANSWER
What areas should you pay attention to when
washing your hands?
The wrists, the palms and backs of
the hands, in between the fingers and
underneath the nails
Name the six requirements that must be met for
an infection to spread.
Pathogen, reservoir, portal of exit,
method of transmission, portal of entry,
susceptible host
What are engineering controls?
Tools provided by an employer that
employees can use to protect themselves
and others from exposure
What are work practice controls?
Procedures established by an employer
that employees should follow to protect
themselves and others from exposure
Name a portal of entry for a bloodborne
pathogen.
Cut or break in skin; mucous membranes
of eyes, nose or mouth
What are the three bloodborne pathogens of
most concern in the workplace?
Hepatitis B virus, hepatitis C virus, HIV
When should you wear latex-free disposable
gloves?
Whenever there is a possibility of
contacting blood or other potentially
infectious materials
Why is it important to remove latex-free
disposable gloves using proper technique?
To avoid contaminating your own skin
A vaccine is available to offer protection against
which bloodborne pathogen?
Hepatitis B virus (HBV)
20
SKILL CHART AND SKILL ASSESSMENT TOOL
SKILL CHART
Removing Disposable Gloves
In addition to performing the steps listed in the skill chart in the correct order, participants must
meet the listed objectives at the proficient level to be checked off for the skill.
1.
Pinch the palm side of one glove near your wrist.
2.
Pull the glove toward your fingertips, turning it inside out as you pull it off the hand.
3.
Hold the glove in the palm of your gloved other hand.
4.
Slip two fingers under the wrist of the other glove.
5.
Pull the glove toward your fingertips, turning it inside out as you pull it off your hand. The other
glove is now contained inside.
6. Dispose of the gloves in a biohazard container and wash your hands.
SKILL ASSESSMENT TOOL
Objective
Not Proficient
Does not contact outside of
either glove with bare skin
Touches bare skin to outside
of either glove
Remove gloves without
contaminating skin
Proficient
SECTION
B
21
INDEX
acquired immunodeficiency syndrome
(AIDS), 11
gloves, disposable, 13–14
gown, protective, 13
bloodborne pathogens, 10–11
Bloodborne Pathogens Game of Chance
Activity, 17, 18–21
Bloodborne Pathogens
Training course
acknowledging completion of, 6
criteria for completion of, 5
purpose of, 9
welcome to, 9
wrap-up for, 17–18
blood spill, 16
body fluid spill, 16
hand sanitizer, alcohol-based, 15
hand washing, 14–15
hepatitis, 10, 12
human immunodeficiency virus (HIV), 11
certification, 5, 6
chain of infection, 9
classroom space, 5
class size, 5
clothing, cleaning of, 16
continuing education units, 6
course records, 6
CPR breathing barrier, 13
mask, 13
materials, equipment and supplies, 5, 8
decontamination, 17
disposable gloves, 13–14
22Index
needles. See sharps
objectives, lesson, 7–8
Participant Course Evaluation Form, 6
participant feedback, 6
personal protective equipment (PPE), 13
safe environment, maintenance of, 15–16
sharps
disposal of, 16
injury log for, 17
skill competency, 6
soiled items, 16
standard precautions, 12
supplies. See materials, equipment and
supplies
work practice controls, 11, 12
engineering controls, 11–12
equipment, cleaning of, 16
See also materials, equipment and
supplies
evaluation process. See participant
feedback
exposure control plan, 11
exposure incident, steps to follow
for, 16–17
eyewear, protective, 13
incident report form, 17
infection, chain of, 9
infectious materials, 9
instructor, guidance for, 7
instructor-to-participant ratio, 5
International Association of Continuing
Education and Training (IACET), 6
The American Red Cross Scientific Advisory Council
Behind every American Red Cross health and safety training program stands a team of experts
ensuring what is taught is based on the latest and best in emergency science.
The Council is a panel of nationally recognized experts drawn from a wide variety of scientific,
medical and academic disciplines. The Council provides authoritative guidance on first aid,
CPR, emergency treatments, rescue practices, emergency preparedness, aquatics, disaster
health, nursing, education and training.
For more information on the Scientific Advisory Council, visit redcross.org/science.
Care steps outlined within this handbook are consistent with:
•2015 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science
and Treatment Recommendations for CPR and Emergency Cardiovascular Care (ECC)
•2015 American Heart Association and American Red Cross Guidelines for First Aid
Mission
The American Red Cross prevents and alleviates human
suffering in the face of emergencies by mobilizing the
power of volunteers and the generosity of donors.
122506 10/15

Bloodborne Pathogens Training

Transcription

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