By Sara Preston, RN, LSN Licensed School Nurse Adapted from MacNeil Environmental, Inc . And CDC

1. BySara Preston, RN, LSNLicensed School Nurse Adapted from MacNeil Environmental, Inc. And CDC

2. Bloodborne Pathogens • BBP: are pathogenic micro-organisms that are present in human blood, and can cause diseases in humans: Hepatitis B Virus (HBV) Human Immunodeficiency Virus (HIV) • Other Potentially Infectious Materials (OPIMs) include: vaginal secretions/semen brain, joint, organ fluids body fluids with blood:vomit & urine/feces

3. Hepatitis Virus • “Hepatitis” means inflammation of the liver. • Different Types of Hepatitis [A-E] - HBV and HCV are bloodborne • 60 to 80% of people with Hepatitis show no symptoms • Hepatitis can lead to cirrhosis of the liver, which can be fatal. • The Hepatitis B virus can stay alive outside the body for up to 14 days. HCV can stay alive outside the body up to 4 days.

4. Hepatitis B Vaccine! • Offered to employees in “high-risk” positions. Ask your School Nurse how to get started. • 3 - Shot Series: first shot next shot 1 month later final shot 6 months later

5. Hepatitis C • There is no HCV Vaccine • Symptoms: None to flu-like that may require hospitalization

6. Human Immunodeficiency Virus • HIV destroys the immune system by destroying white blood cells. • It takes 8-15 years for symptoms to manifest. • HIV is not AIDS. When white Blood Cell count falls below 200 diagnosis is Acquired Immuno-deficiency Syndrome [AIDS] • No vaccine, no cure yet- only prevention

7. Workplace Transmission through- • Accidental injury with a sharp object contaminated with blood. • Open cuts, nicks, skin abrasions, even dermatitis and acne. • Mucous Membranes of mouth, eyes, nose. • Indirect transmission, touching a previously contaminated surface & transfer to mouth, eyes, nose or open skin.

8. Workplace Exposure • Let your School Nurse and Administrator know right away if you have exposure to blood or body fluids at work

9. Universal Precautions • We are not able to tell which people carry BBP: HIV, HBV, and HCV infect people of all ages, socio-economic classes, state, rural areas & cities • Many people carry infections without even knowing it • Thus, treat all human blood/OPIMs as if they are known to be infectious

10. Reducing Your Risk • Personal Protective Equipment - equipment that protects • Main exposure is to hands: Gloves - disposable - free of flaws - accessible • Other exposurethrough “splash Generation” (Use mask and eye protection and add “gown”/overalls/coveralls if wider exposure is possible)

11. Sharps Containers • “Sharps” are objects that can pierce the skin, like: • needles • razor blades • scalpels • exacta knives • pins • saw blades • glass

12. Infectious Waste • PUT IT IN A RED BIO-HAZARD BAG (available in your School Nurses office) IF: • Drippable • Squeezable • Pourable • Saturated

13. Reducing Your Risk Good hand washing!!! Sing Happy Birthday to You….TWICE!

15. T Zone - Keep hands away from eyes, nose and mouth

16. T-Zone • The most common Portals of Entry are the mucous membranes in our T-Zone • Keep hands away from the mouth, nose and eyes, and many illnesses can be prevented.

17. 4 Principles of Hand Awareness • Wash your hands when they are dirty, before eating and after cough/sneeze • Never cough into your hands • Never sneeze into your hands

18. 4 Principles of Hand Awareness • If your hands do not smell clean, time to wash or use hand sanitizer • Above all, do not touch your eyes, nose or mouth with your handsEndorsed by the AMA and AAFP (2001)

19. Behaviors that we need to be aware of and curtail • Rubbing – touching nose, mouth • Eye rubbing • Nail or cuticle biting, finger licking, etc

20. Hand Awareness • People who are “Hand Aware” are much less likely to contaminate themselves, another person, or a surface • How many times have you touched, or almost touched your T-Zone so far this hour?

21. Bacterial count on surfaces • 2.7 million bacteria cells/square inch on drinking fountains • 33,800 bacteria/sq inch on a cafeteria tray • 3,200 bacteria/sq inch on toilet seats

22. Bacterial Counts on Surfaces • 260 bacteria/sq inch on keyboards • 740 bacteria/sq inch on telephones (unless used by many people – then the rate goes way up)

23. The Hand is Quicker than the Eye • People unknowingly touch a contaminated surface or human and then transmit the organism to another surface, themselves or the students they serve • People get sick, due to unconscious personal habits

24. How Have Health Care and Educational settings made a difference? • Question basic beliefs about our part in the infection cycle • Self and group assessment of behaviors and behavior changes

25. Standard Precautions • Assume that every person is potentially infected or colonized with an organism that could be transmitted in the school or home setting and apply the following infection control practices during the delivery of services.

26. Standard Precautions • Hand Hygiene • After contact with potentially contaminated items (ex: mouthed toys) • After any contact with blood/body fluids

27. Standard Precautions • Respiratory Hygiene – Cough Etiquette(Miss Medical Manners ) • Cover your cough – tissue or into your sleeve • Be a role model for kids and families

28. Respiratory Hygiene • Wash hands after coughing/sneezing • Make sure tissues are readily available • Dispose of tissues (bring a plastic ziploc bag) • AND wash your hands!

29. Cover Your Cough or Sneeze

30. Standard Precautions • Personal Protective Equipment • Gloves – whenever there is a skin or secretions concern – rash, runny nose (wash hands before doning gloves and after removing gloves) • Masks – when appropriate to protect your student and/or to protect you

31. Remember This! • A little poop goes a long way!- Wash your hands well • If it is wet or sticky, and it isn’t yours, don’t touch it

32. Dos and Don’ts • Don’t even think about sneezing or coughing without covering up! • Keep your hands in your lap or pockets, not in your eyes, nose or mouth

33. More Dos • Be immunized – to save lives! • Be wise – Hand Sanitize! • Be Cool – Wash hands with the Happy Birthday rule!

34. Ms Preston says • If you are ill – for heavens sake stay home • If a student is too ill to be in class – you know where to send them

35. Questions ? • Contact your School Nurse: Silver Bay – Karen BrostromExt 8108Two Harbors – Sara PrestonExt 8212