SECTION F: TRAINING OUTLINE

ETIOLOGY

Risk of infection to anybody with direct exposure to blood, body fluids or tissues.

CLINICAL PRESENTATION

1. No symptoms

2. Test positive for HIV, symptoms less severe than AIDS but include loss appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of resistance to infection, swollen lymph nodes.

3. All of those related to ARC plus opportunistic infections, kaposi sarcoma and a variety of other infectious diseases.

MODES OF TRANSMISSION

1. Sexual contact

2. Sharing infected syringes

3. Infected mother to baby

4. Occupational - needle stick, exposure to blood or other body fluids to broken or non-intact skin, mucous membranes of eyes, nose, throat

PROTECTIVE MEASURES TO PREVENT EXPOSURE

1. Use protective procedures and equipment such as:
   1. gloves - wash hands after removing

   2. gowns, aprons and lab coats

   3. Masks, protective eyewear

   4. resuscitation equipment

   5. universal precautions

2. List PPE provided and circumstances under which each is to be used in your particular facility.

3. Location and availability of personal protective equipment.

HOUSEKEEPING

1. Establish policies to be followed to clean blood spills and when handling laundry.

2. Discuss use of disinfectants:
   1. Must be EPA approved

   2. If Clorox (sodium hypochlorite) is used, dilutions must be prepared fresh daily (1:10 - 1:100)

DISPOSAL OF CONTAMINATED MATERIAL

1. Do not recap or manipulate needles by hand. EVER!

2. Sharps are to be placed in non-puncture, leak-tight, properly labeled containers.

3. All infectious waste must be placed in closable, leak proof containers that are labeled as BIOHAZARD.

4. Disposal of all infectious waste must be in accordance with all federal, state and local regulations particularly those of Tennessee Department of Environment and Conservation, Division of Solid Waste Management.

5. Waste containers must be readily accessible and properly labeled.

6. Contaminated linen containers must also be properly labeled.

HEPATITIS B VACCINATION

1. Identify individuals of substantial risk of directly contacting body fluids.

2. All applicable employees must be offered the vaccination. NOTE: Employees who fall into the collateral category are not required to be offered pre-exposure immunization.

3. Employees who refuse the immunization must sign a refusal form to be kept on file in the respective department.

REUSABLE EQUIPMENT

Must be sterilized according to acceptable practices after each use.

FOLLOW-UP PROCEDURES AFTER EXPOSURE

1. Individuals must notify the proper University official (usually the department head) if a needle stick, non-intact skin exposure or mucous membrane exposure occurs. Notification for employees starts with the immediate supervisor.

2. Collect blood from exposed individuals as soon as possible for HIV testing.

3. Employees or students shall have confidential medical evaluation and follow-up.

4. Collect blood at 6 weeks, 12 weeks, and 6 months post exposure.

5. Counsel to report any ARC (Aids Related Complex) or AIDS signs or symptoms.