Bloodborne Pathogens

1. Bloodborne Pathogens What you need to know to stay safe! ~Shanda Brewer, RN

2. Introduction Whether in the classroom, on a playing field or on a school bus, all school employees must know the potential danger of Bloodborne Pathogens.

3. WHAT ? • Do not touch potentially infectious body fluids • How to report an accident • Who should clean up the blood, etc.

4. Occupational exposure to bloodborne pathogens, such as hepatitis B virus (HBV), hepatitis C virus (HCV) And human immunodeficiency virus (HIV), does occur. Blood is the number one source of these viruses in the workplace. Your risk of contracting one of these viruses at school is low because your contact with blood is infrequent. But when the need arises you must be prepared to deal with blood safety.

5. QUESTION 1 The most common sourceof workplace pathogen (Hepatitis B, Hepatitis C & HIV) exposure is:

6. Answer: BLOOD

7. OSHA Regulations • The Bloodborne Pathogens Standard (29 CFR 1910.1030) and the Bloodborne Pathogens Compliance Directive (CPL2-2.44D) require employers to identify the jobs, tasks, and activities that could expose employees to potentially infectious body fluids.

8. Montgomery County School JOB DESCRIPTIONS AND TASKS ARE DIVIDED INTO TWO CATEGORIES High Risk for Exposure This category indicates That it is probable that the staff members will come Into contact with some form of body fluids, at some time while performing their job task. Minimal Risk for Exposure This category indicates that there is only a remote chance that staff members will come into contact with some form of body fluids while performing their job task.

9. What are Bloodborne Pathogens? Blood-borne pathogens are microorganisms carried by human blood and other body fluids. The three most common are: • Hepatitis B Virus (HBV) • Hepatitis C Virus (HCV) • Human Immunodeficiency Virus (HIV) Unfortunately, children are as prone to blood-borne diseases as adults. That means you are as much in danger of infection from the children you work with as any other group in society.

10. Hepatitis B Hepatitis means “inflammation of the liver”. HBV poses a Greater risk to you at school than either the hepatitis C virus (HCV) or HIV, since it is more easily transmitted. HBV can survive for at least 1 week in dried blood on environmental surfaces such as a desks, worktable, knife, tools, broken glass, metal, etc…

11. Hepatitis B—Environmental Contamination Environmental contamination is an effective method of disease transmission for HBV. This is the primary reason for the importance Of properly cleaning and disinfecting any blood-contaminated work surfaces, tools, etc.

12. QUESTION 2 Hepatitis B Virus (HBV) can survive for up to ____________ in dried blood on hard surfaces.

13. Answer: One Week This is why cleaning on a regular basis is VITAL!

14. Hepatitis B • An HBV vaccination has been available since 1982. The vaccine prevents hepatitis B disease and its serious consequences. • The vaccine has been shown to be very safe when given to infants, children, and adults.

15. The Hepatitis B Vaccine Series Is Available to Montgomery County School Employees… 1. If your job description falls in the high exposure risk category, and you have not previously received the series. 2. If you have a documented/reported exposure incident, and have not previously received the series.

16. All employees must have either a request/consent for the series or a decline/refusal on file with the personnel office. Request/Consent This indicates that you Wish to receive the series due to your job description falling into the high risk category. Decline/Refuse This indicates that you have previously received the series; your job description falls into the minimal risk category; you have a medical condition that contraindicates the series; or that you simply do not wish to receive the series at that time.

17. HEPATITIS C VIRUS (HCV) • There is no vaccine for Hepatitis C Virus at this time. • 70 percent of infected persons will suffer from chronic liver disease. Hepatitis C is the leading indication for liver transplantation.

18. HIV • HIV is the virus that leads to Acquired Immunodeficiency Syndrome (AIDS). A person can carry HIV for many years and not have any symptoms until it becomes AIDS. • AIDS attacks the person’s immune system, which makes it difficult for the body to fight off common diseases.

19. HIV • HIV does not survive well outside the body. When HIV-infected human blood or other body fluid is dried, the risk of environmental transmission is essentially reduced to zero because the virus does not survive. • HIV is found in very low quantities in saliva and tears from some AIDS patients. • HIV has not been found in the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in the transmission of HIV

20. Identify Potential Exposure at Work Exposure to blood-borne pathogens or potentially infectious body fluids in a school environment is Very limited. In general, the only time that any employee is exposed is when a student or co-worker suffers an injury that bleeds, or illness causing exposure to bodily fluids with visible blood.

21. Identify Potential Exposure at Work Employees working with special needs & medically Fragile students should take extra caution. These students may be more: • Vulnerable to injury • Likely to have special medical needs • Dependant on adults for personal care

22. QUESTION 3 In general school employees have limited exposure to body fluids and potential blood-borne pathogens. The exception to this is _________

23. Answer Working with Children having severe disability and/or special medical needs

24. You could be exposed: • At the time of an injury if blood/body fluids splashes onto you, • when administering first-aid treatments, such as applying pressure to a wound, wrapping an injury, providing CPR, etc.

25. You could be exposed: • If a work surface, such as a table, tool, or machine control panel, is not cleaned/decontaminated immediately after an incident. • If your job description/task includes clean up after illness or injury.

26. You could be exposed: By cutting yourself with a contaminatedsharp object like: • Broken Glass • Sharp Metal • Needles • Knives • Exposed end of orthodontic wires

27. Transmission of Bloodborne Pathogens You CANNOT become infected with these viruses Through casual contact, coughing, sneezing, a kiss on the cheek, a hug or from drinking fountains or food. Common NON-SCHOOL RELATED transmission occurs with sexual contact and shard needles for drug use.

28. How does it get in? Non-intact skin—The infected blood must make physical contact with skin that is damaged or not completely intact. Blood-borne pathogens could enter your bloodstream through a cut in the skin, abrasions or scratches on the skin, dermatitis or other skin rashes, and even hangnails. COVER CUTS AND OPEN SKIN WITH A BANDAGE WHEN AT WORK!

29. How does it get in? • Mucous membranes—The infected blood could enter your body’s bloodstream through a mucous membrane. • Infected blood that is splashed into your eyes, mouth, or nose could result in a transmission of blood-bornepathogens.

30. What are Infectious Body Fluids? Body fluids that contain potentially infected blood could result in the transmission of a blood-borne pathogen. Potentially infectious body fluids include blood and other bodily fluids that can contain blood, such as: • Saliva • Vomit • Urine Other body fluids that could contain blood, but are not likely to be encountered in a school work environment, include semen, vaginal secretions, cell cultures, etc.

31. Universal Precautions Anticipating Potential Contact • The most important step in preventing exposure to and transmission of infections is the anticipation of potential contact with infectious materials in routine and emergency situations. • Universal precautions and infection control techniques should be used in all situations that present the hazard of infection.

32. Universal Precautions • Diligent and proper hand washing, the use of barriers (e.g., latex or vinyl gloves), appropriate disposal of waste products and needles, and proper care of spills are essential techniques of infection control. • When using universal precautions to prevent the spread of infection, all blood and body fluids are treated as if they contain blood borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV).

33. Question 4 The most important step in preventing exposure is?

34. Answer Anticipate contact with potential infectious materials

35. Question 5 All blood & body fluids should be treated like they…_________.

36. Answer: Contain blood- borne pathogens.

37. Personal Protective Equipment (PPE) The concept of universal precautions includes avoiding contact with all potentially contaminated blood or body fluids. Use protective barriers, including PPE, to avoid contact with blood and body fluids.

38. Personal Protective Equipment (PPE) Gloves • Staff members must wear gloves when applying bandages or putting pressure on wounds. Should be worn for all scenarios involving blood or body fluids. • Cleanup personnel must wear gloves when cleaning up and decontaminating blood or body fluids.

39. Personal Protective Equipment (PPE) Impromptu Barriers:For many accidents in a school environment, the staff responders do not feel that they have time to get and then put on protective barriers such as gloves or aprons Impromptu barriers in your workplace might include a piece of plastic, a clean plastic garbage bag, paper, your shirt, etc. The idea is to use something as a barrier between your skin and the victim’s blood or body fluid.

40. Question 6 True or False: You can use a clean plastic bag as a blood/body fluid barrier if gloves or other PPE is not available.

41. Answer • True

42. HANDWASHING Diligent and proper hand washing is a key component of infection control. Hands should be washed: 1.   Immediately before and after physical contact with a student (e.g., providing first aid, diaper changes, assistance with toileting, or assistance with Feeding)

43. HANDWASHING 2.   Immediately after contact with blood or body fluids or garments or objects soiled with body fluids or blood 3.   After contact with used equipment (e.g., stethoscope, emesis basin, and gloves) 4.  After removing PPE such as gloves or clothing.

44. Hand Washing Good hand washing keeps you from transferring Contamination from your hands to other parts of your body or to other surfaces you may come in contact with later. You should wash your hands with non- abrasive soap and running water for at least 20 seconds: When hand washing facilities are not available, such as on the school bus, your employer will provide an antiseptic hand Cleanser or antiseptic towelettes. Use these as a temporary measure only. You must still wash your hands with soap and running water as soon as you can.

45. ROUTINE CLEAN UP Routine environmental clean up of facilities (e.g., Health unit, buses and bathrooms) do not require modification unless contaminated with visible blood or body fluids. • If the area has been contaminated with visible blood or body fluids, the area should be decontaminated according to district policies. • Regular cleaning of non-contaminated surfaces, such as seats and tabletops, can be done using standard cleaning solutions. • Regular cleaning of obvious soil is more effective than extraordinary attempts to disinfect or sterilize surfaces

46. Cleaning Tools: Brooms and dustpans must be rinsed in disinfectant. Mops must be soaked in disinfectant, washed and thoroughly rinsed. The disinfectant solution should be disposed of promptly down the drain.

47. ACCIDENTAL EXPOSURE Procedure: Always wash the contaminated area immediately with soap and water. If the mucous membranes (i.e., eye or mouth) are contaminated by a splash of potentially infectious material or contamination of broken skin occurs, irrigate or wash area thoroughly.

48. ACCIDENTAL EXPOSURE For cuts or needle injuries, wash the skin thoroughly with soap and water. If broken skin or mucous membranes are contaminated the staff should: • Notify their supervisor immediately. • Document the event • Follow the procedures in the blood-borne pathogen exposure control plan for the district.

49. Higher Risk? Pregnant Women Pregnant women are not at higher risk for infection than other caregivers provided that appropriate precautions are observed. There is, however, the possibility of an in-utero transmission of Viral infections, such as cytomegalovirus (CMJ), HIV, Varicella or HBV to unborn children.

50. “DO” CHECK LIST