Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease)

Guidelines:

• Infectious agents include bacteria, viruses, and prions
• Biohazardous material = living organisms/toxins = threat to human health
• Hand hygiene is the most important factor in prevention of infection
• Focus on hand hygiene, appropriate use of PPE, and environmental infection control
  measures
  • Meticulous application and removal of PPE is the cornerstone of preventing transmission of bloodborne pathogens within the healthcare setting

Considerations:

• Creutzfeldt-Jakob Disease (CJD)
  • Infectious, human prion disease
  • Symptoms include rapidly progressing dementia, memory loss, rapid physical
    and mental deterioration
• Why is this significant?
  • Positive diagnosis can be made only by direct examination of affected brain tissue
  • CJD is usually resistant to conventional chemical and physical decontamination
    methods
  • Special protocols for instrument care after exposure to prions
  • Prevention of CJD relies primarily on rigorous disinfection of neurosurgical
    instruments

Nurse’s role:

• For all biohazardous material handling:
  • Standard and transmission-based precautions
    • PPE
    • Hand Hygiene
  • Interdisciplinary team communication
    • Professional and regulatory standards
  • Enhanced sharps safety measures
  • Environmental cleaning protocols
  • Instrument care protocols
• Disposition, know your sources of truth:
  • EPA guidelines: waste disposal
  • CDC: infection control and prevention
  • OSHA: employee safety
  • TJC: patient safety
  • AORN: perioperative nursing practice and guidelines
  • APIC: infection preventionist practice and guidelines

Pitfalls:

• SSIs remain a common HAI
• Need for vigilant sterile conscience
• TJC National Patient Safety Goal: Implement Evidence-Based Practices for Preventing
  Surgical Site Infections
  • Elements of performance outlines education, policy, and procedural practices aimed at reducing the risk of SSI.
  • CMS has required reporting by hospitals if they are to receive full Medicare Payment

Examples:

• Bloodborne pathogens of perioperative significance include:
  • Hepatitis B Virus (HBV)
  • Hepatitis C Virus (HCV)
  • Human Immunodeficiency virus (HIV)
• Within the perioperative setting, these pathogens are more common transmitted parenterally via:
  • Needlestick
  • Sharps-related injury
  • Splash exposure to a mucous membrane
• Environmental infection control measures:
  • Single patient room
  • Dedicated, preferably disposable medical equipment
  • Limited use of needles/sharps
  • Heightened sharps safety awareness
  • Avoid aerosol-generating procedures
  • Vigilant hand hygiene

Linchpins (Key Points):

• Appropriate PPE is Key!
• Vigilant Hand Hygiene!
• Environmental Infection Control!
• Interdisciplinary Team Communication!