AIDS / HIV and Bloodborne Pathogens
Objectives:
After you take this class, you will be able to:
- Discuss AIDS/HIV and other bloodborne diseases.
- Detail how these diseases are spread and how they can be prevented.
- Adhere to standard precautions and proper handwashing techniques.
- Use personal protective equipment, such as gowns, gloves and masks.
INTRODUCTION TO AIDS/HIV
The HIV (human immunodeficiency virus) virus causes AIDS. This virus is in the blood and ALL other body fluids, like urine, feces, tears and wound drainage. There is no cure for AIDS. All people with AIDS are expected to die as the result of its damage unless a cure is found.
The United States is now testing a vaccine to prevent AIDS, but it is NOT yet ready to use. We now have medicines to help people with AIDS/HIV live longer. But there is still no cure. The one thing that we can ALL do now to stop AIDS/HIV is to prevent its spread.
People with HIV, the virus, may seem to be fine for a while. After the virus has been in the body for some time, they usually become sick with an infection or a cancer. These infections and cancers kill people with AIDS/HIV. People with AIDS/HIV do not die from AIDS. They die from these infections or a cancer.
HIV infected people get these infections and cancer because the HIV virus stops the body from protecting itself against them. The body is no longer able to fight off infections and cancers like other people do. These infections and cancers take the opportunity to attack a weak body that is no longer able to fight back. The body has become too weak. These infections are called "opportunistic infections".
Most people with AIDS/HIV die of a pneumonia called PCP. Others die of cancer, digestive problems and infections caused by a bacteria, virus or fungus.
People with HIV, that do not yet have these illnesses, may NOT even know that they have HIV. They may look great and very healthy. They are able to go to work, enjoy life and do other things. However, these people can spread the HIV virus to other people WITHOUT even knowing that they have it.
Anyone at any age can have AIDS/HIV. Babies can be born with it when their mother had it during pregnancy. Young people and children, adults, nurses, nursing assistants, doctors, mothersfathers and even old people can get this disease from others.
WHAT ARE STANDARD PRECAUTIONS?
A blood test is the best way to know if a person has AIDS/HIV. But, because so many people with HIV feel fine, they do not have a blood test done. There are many, many people with HIV that do NOT know they have it.
We must, therefore, care for all people as if they had AIDS/HIV. In health care we use Standard Precautions (formerly called Universal Precautions) to protect against the spread of AIDS/HIV. When we use Standard Precautions, we treat all blood and body fluids "as if" it has the HIV virus. We treat all patient blood and body fluids the same. We treat it ALL the same regardless of the patient’s diagnosis. The blood and body fluids of a known AIDS/HIV patient are treated EXACTLY the same as a person without an AIDS/HIV diagnosis.
WHAT ARE THE SIGNS OF AIDS/HIV?
Some of the signs of AIDS/HIV are:
- weight loss
- loss of appetite
- a cough
- fever
- sweating at night
- swollen glands
- feeling very tired
- diarrhea
- white spots on the tongue or in the mouth
- pneumonia
- pink, purple, red or brown spots on the skin
- forgetting things
- depression
HOW IS AIDS/HIV SPREAD?
AIDS/HIV is spread from one infected person to another by blood and body fluids like:
- semen from a man's penis
- fluids from the vagina of a women
- breast milk when a mother is feeding her baby
- blood from the mother to the baby before birth
- urine
- feces
Most people get AIDS from sex, or sexual contact, and sharing drug needles with others.
As far as we know AIDS/HIV is NOT spread with:
- touching a person that has it
- being in the same room as the person that has it
- using a public telephone
AIDS/HIV IN THE ELDERLY
Most people think that AIDS/HIV is a disease of only young people. This is not true. AIDS/HIV can affect all age groups, including the elderly. In fact, more and more older adults are getting AIDS/HIV now than other age group. Do NOT think that an old person can't have AIDS/HIV. Many do.
AIDS/HIV among old people:
- is harder to discover, or diagnose, than it is in young people
- causes the person to get sicker and die faster than younger people because the body gets weaker as it gets older
THE PREVENTION OF AIDS/HIV
Stopping the spread of HIV depends on EVERYONE.
You can prevent AIDS/HIV your work life when you do the following:
- WASH YOUR HANDS before and after you have, or may have touched any body fluids
- Follow your infection control policies and procedures
- ALWAYS use Standard Precautions for EVERYONE even if you think a person may not have AIDS/HIV
- Use gloves whenever you are about to touch, or may touch, any body fluids. This means that you must wear gloves when you are emptying a urinary drainage bag, cleaning a patient who is soiled with feces, and when you are washing a person that may have blood or other body fluids on them.
- Throw out supplies, like urinary drainage bags and used gloves, in the proper place. Many hospitals and nursing homes use red bags for this waste. This waste is called "hazardous waste".
- Clean up blood and body fluids, according to your hospital or nursing home policy and procedure. A bleach and water solution, gloves and a gown are usually used for blood and body fluid spills.
- IMMEDIATELY report a needle or sharp stick. Immediately report it if you get stuck with a needle or another sharp object that has been left in a bed, chair or trash bag. Also WASH your hands with lots of water. You may be given medication to prevent AIDS/HIV, if needed and you want it.
- Learn about AIDS/HIV. Get the latest information about AIDS/HIV and its prevention.
MORE ABOUT HANDWASHING & GLOVES
Handwashing is the single most important thing that you can do to prevent the spread of infections, including AIDS/HIV. Wash your hands for at least 20 seconds using soap, water and a lot of rubbing.
Wash your hands before and after each patient contact. Gloves do NOT take the place of handwashing. Wash your hands before putting gloves on. Wash you hands after you take the gloves off. NEVER wash gloves. Gloves are used for contact with each person. They must be thrown out after each patient.
NEVER walk through the halls or handle another patient without changing gloves. Gloves prevent patient to patient infection. If you touch a door knob in the hall with dirty gloves, ANYONE that touches that door knob will have on their hands what you had on your dirty gloves!
Special gloves must be given to you if you have an allergy to latex gloves. If you have a latex allergy, report it to your nurse.
OTHER DISEASES THAT ARE CARRIED BY BODY FLUIDS
AIDS/HIV is NOT the only disease that is spread with blood and body fluids. There are several other diseases that are spread in blood and bodily fluids. Syphilis, malaria and hepatitis are a few of them. Of these, hepatitis is the most common.
There are several forms of hepatitis:
- Hepatitis A. Poor personal hygiene and poor food handling most often cause this form of hepatitis.
- Hepatitis B. This form is carried in the blood and body fluids, just like the AIDS/HIV virus and Hepatitis C are.
- Hepatitis C. This form is also carried in the blood and body fluids like AIDS/HIV.
There is now also a hepatitis D, E, F and G. Hepatitis B and C are the two forms of hepatitis that are of greatest concern to those who work in health care. It is present in blood and body fluids like AIDS/HIV.
Patients with hepatitis B and C can feel and look perfectly well for a long period of time. They may not know they even have it. They too, like AIDS/HIV patients, can spread it to others even when they have NO signs of it. Again, Standard Precautions MUST be used for ALL patients at ALL times.
WHAT ARE THE SIGNS OF HEPATITIS?
Hepatitis hurts the liver, the largest organ in the body. The liver performs 100s of functions for the body. Hepatitis destroys the liver and it puts the person in danger of death. There is now a blood test for Hepatitis A, B and C.
The signs of hepatitis B and C are:
- fever
- feeling very tired
- nausea and vomiting
- stomach aches
- loss of appetite
- weight loss
- dehydration
- dark brown urine
- yellow color skin and eyes
- diarrhea
- skin rash
- bone joint pain
THE PREVENTION OF HEPATITIS
Hepatitis B and C, the forms of hepatitis that can be spread like AIDS/HIV in blood and body fluids, are prevented in the same way that AIDS/HIV is prevented. Hepatitis B can also be prevented with a vaccine. All health care workers and children should get this vaccine so that they can never get hepatitis B.
SUMMARY
In summary, you can prevent hepatitis and all other diseases carried by the blood and body fluids. You must do all of the things listed below when you work with ALL patients, not just those you know have AIDS/HIV, hepatitis B or hepatitis C.
- Wash your hands EVERYTIME. Do NOT skip this step of patient care.
- Follow all infection control and Standard Precautions procedures.
- Throw away all used supplies that are touched with body fluids in the proper place.
- Make sure you know the latest information about these diseases, how they are spread, how you can protect yourself and how you must protect your patients and residents.
References
Berman, Audrey, Shirlee Snyder, Barbara Kozier and Glenora Erb.(2010). Kozier & Erb's Fundamentals of Nursing: Concepts, Process, and Practice. 8th Edition. Pearson Prentice Hall.
Centers for Disease Control and Prevention. (2010). “HIV/AIDS” [online] http://www.cdc.gov/hiv/dhap.htm
Centers for Disease Control and Prevention. (2010). “Viral Hepatitis” [online] http://www.cdc.gov/hepatitis/
Healthcentral.com. (2010). “Stress Information”. [online]http://www.healthcentral.com/anxiety/search-stress.html
Monahan, Frances Donovan and Wilma J. Phipps (2007). Phipps’ Medical-Surgical Nursing: Health and Illness Perspectives. 8th Edition. Elsevier Mosby.
Nettina, Sandra M. (2009). The Lippincott Manual of Nursing Practice. 7th Ed. Lippincott, Williams and Wilkins.
Copyright © 2010 Alene Burke