Medical Surgical Nursing

 A. PREVENTING TRANSMISSION

o Continued screening of blood donors for the presence of hepatitis B

antigens

o The use of disposable syringes, needles, and lancets and the introduction

of needleless IV

o Good personal hygiene is fundamental to infection control. In the

clinical laboratory, work areas should be disinfected daily. Gloves are

worn when handling all blood and body fluids as well as HBAg positive

specimens.

o Eating and smoking are prohibited in the laboratory and in other areas

exposed to secretions, blood products.

 B. Active Immunization: Hepatitis B Vaccine

o Active immunization is recommended for individuals at high risk for

hepatitis B (eg, health care personnel and hemodialysis patients). In

addition, individuals with hepatitis C and other chronic liver diseases

should receive the vaccine.

o Administered IM (in the deltoid muscle in adults) in three doses, the

second and third doses 1 & 6 months after the first dose. The third dose

is very important in producing prolonged immunity.

o Antibody response may be measured by anti-HBs levels 1 to 3 months

after completing the basic course of vaccine

o Universal vaccination of all infants.

 C. PASSIVE IMMUNITY: HEPATITIS B IMMUNE GLOBULIN

o Hepatitis B immune globulin (HBIG) provides passive immunity to

hepatitis B and is indicated for people exposed to HBV who have never

had hepatitis B and have never received hepatitis B vaccine. Specific

indications for postexposure vaccine with HBIG include :

) 1 (inadvertent exposure to HBAg-positive blood through percutaneous

(needlestick) or transmucosal (splashes in contact with mucous

membrane) routes ,

) 2 ( sexual contact with people positive for HBAg, and

) 3 ( perinatal exposure (babies born to HBV-infected mothers should

receive HBIG within 12 hours of delivery .)