Download Lovington Municipal Schools Universal Precautions against

Lovington Municipal Schools
Standard Precautions against Bloodborne Pathogens
THE OCCUPATIONAL
SAFETY AND HEALTH
ADMINISTRATION
STANDARD
Bloodborne Pathogens for School
Employees
The Occupational Safety and Health Act 1910.1030
mandates training for employees regarding the
Bloodborne Pathogens Standard in order to reduce the
occupational transmission of infections caused by
microorganisms sometimes found in human blood and in
other potentially infectious materials. The training is
mandated upon being hired and annually. These
pathogens include, but are not limited to, human
Immunodeficiency Syndrome (HIV), Hepatitis B (HVB)
and Hepatitis C (HVC).
Specific Bloodborne Pathogens
Hepatitis B (HBV)
• Stable Virus can survive outside of the body after blood
dries.
• It affects the liver of those infected.
• It is spread through blood contact, vaginal fluid, semen,
and blood tinged fluids. Also can be passed from a
mother to her baby at birth.
• Some individuals become chronic carriers while most
recover completely.
• One hundred times more infectious then Human
Immunodeficiency Syndrome (HIV)
Mode of Transmission of HBV
• Primarily transmitted through “Blood to
Blood contact” by accidental needle sticks
or other contaminated sharp object
injuries, sexual contact, mucous
membrane, and through open cuts.
• Not transmitted by casual contact.
Signs and Symptoms of HBV
• Jaundice – yellow color to the skin and whites of the
eyes.
• Fatigue
• Fever
• Headaches
• Abdominal pain
• Loss of appetite
• Nausea and vomiting
• Dark urine
Symptoms may not become noticeable for one to nine
months after exposure.
Course of HBV Infection
• Incubation period averages twelve weeks.
• Most cases of HBV resolves without complications and
infected individuals do not become infectious carriers.
• Five percent of infected adults become carriers of the
HBV virus and are able to infect others. They may or
may not show physical signs or symptoms.
• Chronic liver disease may occur in six to seven percent
of those infected with HBV.
HBV Prevention
• A vaccine does exist to
prevent HBV infection.
• Employers are required to
offer HBV vaccination to
employees covered under
the Bloodborne Pathogen
Standards.
• Follow universal
precautions.
• HBV is declining because
of vaccine use.
HBV Vaccine
History of the Vaccine
• The current form of the hepatitis B vaccine has been used in the United
States since 1986. To make the vaccine researchers copy the genetic
sequence of a protein contained in the virus into a yeast cell which is then
cultured, purified, and prepared into a vaccine. These recombinant vaccines
are safe, induce an immune response, and are incapable of infecting
recipients with the hepatitis B virus.
• Prior to 1991 the vaccine was recommended only for people who were
identified to be at a high risk for acquiring the infection.
• In 1991 the recommendation was extended to include all infants as well.
This new recommendation was made for several reasons, including:
Approximately 30% of people who get hepatitis B do not have any
identified risk factors, so people at high risk often were not immunized.
When infants and children are infected with hepatitis B the odds that
they will develop chronic liver disease or cancer are at least three
times higher than those infected as adults. Therefore, preventing
infection in infants and children is very important.
Hepatitis B Vaccine
The series of immunizations with recombinant hepatitis B vaccines
are 95% effective at inducing sero-immunity. Because the vaccine
has only been in use 20 years, that is how long immunity is known to
last. Immunity is probably lifelong.
• Known Side Effects
The majority of people who receive the hepatitis B vaccine (65%) do
not experience any reactions to it. About 3% of those immunized will
develop pain and tenderness where the shot was given. Low-grade
fever occurs in about 1 to 6% of vaccine recipients. Serious
reactions are extremely rare. In far less than 1 out of 10,000 shots
given, or about .001%, serious allergic reactions including
anaphylaxis (a rapid life-threatening allergic response affecting more
than one part of the body; it can also be a systemic, whole-body
response that causes the airway to swell, close off, and prevent the
intake of oxygen) may occur.
HBV Post-Exposure
Prophylaxis and Follow-ups
• No definite cure for HBV infections.
• Post-exposure prophylaxis should begin within twentyfour hours, but no later then seven days after the time of
exposure.
• Treatment requires a health care provider.
• OSHA requires that all treatments meet the CDC’s most
recent guidelines.
• Exposed person should receive HBV vaccine.
• HBV infection treatment may require a liver transplant for
more severe cases.
Specific Bloodborne Pathogens Continued
Hepatitis C (HCV)
• Stable Virus can survive outside of the body after blood
dries for a least four hours but no longer then sixteen
days.
• Sixty to seventy percent of persons infected have no
signs or symptoms of infection.
• Seventy-five to eighty-five percent of infected persons
continue to have chronic infections and are able to
spread the infection to others.
• Can range from acute illness to chronic liver cirrhosis
and death.
Mode of Transmission of HCV
• Most common transmission mode is through sharing
needles and syringes to inject drugs.
Needle stick injuries in healthcare settings
Being born to a mother who has HCV
• Less common way of transmission is sharing personal
items that may have come in contact with another
persons blood (razors and toothbrushes).
Having sexual contact with an infected person
(though risk is low).
Signs and Symptoms of HCV
•
•
•
•
•
•
•
•
Jaundice – yellow color to the skin
and whites of the eyes.
Fatigue
Fever
Headaches
Abdominal pain
Loss of appetite
Nausea and vomiting
Dark urine
Symptoms may not become
noticeable for two weeks to six
months after exposure. However
many people do not develop
symptoms.
Course of HCV Infection
• Most people with chronic HCV do not show symptoms, though those
infected over a course of years may have liver damage.
• It is the leading cause of cirrhosis and liver cancer. It is also the
leading reason for liver transplants in the US.
• There is no vaccine or medical treatment available for HCV.
• Approximately 8,000 to 10,000 people die every year from HCV
related liver disease.
• What are the long-term effects of hepatitis C?
Of every 100 people infected with the hepatitis C virus, about
75–85 people will develop chronic hepatitis C virus infection; of those,
60–70 people will go on to develop chronic liver disease
5–20 people will go on to develop cirrhosis over a period of 20–30 years
1–5 people will die from cirrhosis or liver cancer
Specific Bloodborne Pathogens Continued
Human Immunodeficiency Syndrome (HIV)
• HIV can cause acquired immune deficiency syndrome
(AIDS)
• Risk of a HIV infection from a puncture injury which
allows exposure to HIV infected blood is extremely
low - 0.3% - but can still happen.
• HIV is a fragile virus which cannot survive outside of the
body for an extended period of time after body fluid
dries.
Mode of Transmission of HIV
• HIV (human immunodeficiency virus) is the virus that
causes AIDS.
• This virus may be passed from one person to another
when infected blood, semen, or vaginal secretions come
in contact with an uninfected person’s broken skin or
mucous membranes.
• In addition, infected pregnant women can pass HIV to
their baby during pregnancy or delivery, as well as
through breast-feeding.
• People with HIV have what is called HIV infection. Some
of these people will develop AIDS as a result of their HIV
infection.
Signs and symptoms of HIV
•
•
•
•
•
•
•
•
Weight loss
Night sweats or fever
Gland swelling or pains
Muscle and/or joint pains
Dry cough
Unexplained fatigue
Memory loss, depression or other neurological disorders
Other symptoms may vary by individual basis.
The only way to know if you are infected with HIV is to be tested
for HIV infection.
Course of HIV Infection
• Many people who are infected with HIV do not
show any symptoms for ten years or more.
• There is no vaccine or medical treatment for the
cure of HIV but there are antiretroviral
treatments in existence to slow the process of
HIV turning into the AIDS virus.
Transmission of Bloodborne Pathogens
Anytime there is blood-to-blood contact with infected
blood or body fluids there is potential for transmission.
Unbroken skin forms a barrier against bloodborne
pathogens but infected blood can enter your system
through open cuts, sores, abrasions, acne, burns open
rashes or blisters.
There is also the potential for transmission of infection
through body fluid contacts of mucous membranes such
as the lining of your eyes, nose and mouth.
How does a person become
infected?
Three conditions must exist
• Source blood must be infected
• Port of exit from infected person such as
an injury, needle stick, etc.
• Port of entry into susceptible person such
as a break in the skin, mucous
membrane,(i.e. nose, mouth, eyes).
Personal Risk Factors
• Unprotected sexual contact
• Sharing used needles or other sharps
• Drug use, body piercing, razors,
toothbrushes, tattooing
• Perinatal (mother to baby during birth)
• Blood transfusion (low risk)
Exposure Prevention
• Universal Precautions
Treat all blood and certain body fluids as if
they are known to contain bloodborne
pathogens.
Materials That Require Precautions
•
•
•
•
•
•
•
Blood
Semen
Vaginal secretions
Cerebrospinal, synovial or pleural fluid
Body fluids containing visible blood
Any unidentifiable body fluid
Saliva from dental procedures
Materials That Do Not Require
Precautions
• Universal Precautions
do not apply to these
fluids UNLESS blood
is visible:
• Feces
• Sputum
• Nasal secretions
• Sweat
• Urine
• Vomit
Exposure Prevention
• Treat all blood and body fluids as if they
are infectious
• Use personal protective equipment such
as gloves when applying first aid. Wash
hands after removing gloves
• Use a pocket mask or other respiratory
device when you have to resuscitate
someone in an emergency
Exposure Prevention
• Dispose of needles
and other sharp
objects in punctureproof containers.
Each school health
office is equipped with
a sharps container.
• Do not share razors
or toothbrushes.
• Proper hand washing!
Proper Handwashing Technique
• Use liquid soap.
• Use running water ( NO
standing water).
• Lather all surfaces
creating ample friction for
at least 30 seconds.
• Rinse well.
• Dry thoroughly with paper
towels.
• Turn off faucet with same
paper towel.
• Discard paper towel.
Personal Protective Equipment
PPE
•
•
•
•
•
Gloves
Masks
Aprons/Gowns
Goggles/Eye shields
Resuscitation devices
Exposure Prevention
• Disinfect surfaces contaminated with blood
and body fluid. Contact building custodian
for correct disinfectant solutions and PPE.
• Double-bag items contaminated with blood
or body fluid for disposal.
• “Regulated” waste that should be doublebagged: Contains blood or bloody fluids.
Communications of Hazards
• Labels and Signs
• Warning labels should
be affixed to
containers of
contaminated sharps
and regulated waste
and include the
following legend.
Labels and Signs
• Red bags or red containers may be
substituted for labels.
Exposure Prevention
• Get vaccinated. The
only bloodborne
pathogen for which a
vaccine is available is
Hepatitis B (HBV).
• This vaccine is
available to everyone
through primary care
providers and other
agencies.
Occupational Risk Factors
What are the risks involved in a
school setting.
• Contact with infectious body
fluid to broken skin or mucous
membranes.
• Playground injuries, shop
classes, athletic or physical
education injuries, and fights.
• Puncture wounds with used
needles or other sharps
objects.
• In the Health offices
• During any scientific class
dissections.
Exposure Classifications
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
All school district employees in the following job classifications have been identified as having
occupational exposure risk to bloodborne pathogens.
Daily Risk of Exposure
􀂃 Nurses/Health Assistants
􀂃 Security Officers
􀂃 Coaches/Athletic Director
􀂃 Special Education Teachers/Assistants
􀂃 Physical Education Teachers/Assistants
􀂃 Custodians
Occasional Risk of Exposure
􀂃 Administrators
􀂃 Classroom Teachers
􀂃 Secretaries
􀂃 Educational Assistants
􀂃 Food Service Workers
􀂃 Maintenance Workers
􀂃 Bus Drivers
􀂃 Bus Aides
􀂃 Students who work with children in nursery, work as lab assistants or work in coop programs
Lovington Municipal Schools
Emergency Exposure Procedures
• Although most contact does not result in
infection, there are procedures that must
be followed when there is the possibility of
exposure to bloodborne pathogens
• The following procedures can reduce the
risk and are required by the district.
Emergency Exposure Procedures
• If you have accidental contact with blood or
bloody fluids:
WASH: Immediately wash affected area with
sudsy soap and running water. May need to
flush eyes with large amounts of water or saline.
DISINFECT: All spills of blood or bloody fluid
must be disinfected. If clean up is needed,
contact the building custodian who has training
and materials to disinfect area.
Reporting Procedure
• If you have accidental contact with blood
or bloody fluids:
Inform your principal, supervisor and/or
school nurse immediately
Seek medical advice if recommended
Complete the appropriate forms:
Notice of Accident Form
AND
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Lovington Municipal Schools
Potentially Infectious Exposure
Form
CONFIDENTIAL
Incident Reporting Form
for exposure to blood or other potentially infectious material
SCHOOL DISTRICT ____________________________________________
DATE OF INCIDENT________________________LOCATION OF INCIDENT _____________________
NAME OF PERSON'S INVOLVED________________________________________________________
SOURCE INDIVIDUAL _________________________________________________________________
EMPLOYEE'S WORKSITE _____________________________________________________________
DESCRIPTION OF INCIDENT BY INDIVIDUAL/S INVOLVED __________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
INVESTIGATIVE DESCRIPTION OF INCIDENT_____________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
EXPOSURE CONTROL PLAN GUIDELINES FOLLOWED ____ YES ____ NO (If NO, describe.)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
DETERMINATION OF EXPOSURE INCIDENT ____YES ____NO
EXPOSURE ROUTE________________________________________________________
REPORT COMPLETED BY___________________________________DATE___________
Medical Evaluation Post Exposure
• Entitled to confidential medical evaluation
• It is your personal decision about blood
testing.
• Blood may be tested only with a persons
consent.
• Interpretation of any test result occurs with
a health care provider.
MEDICAL RECORDS ARE
CONFIDENTIAL
Questions?
Bloodborne Pathogens Exposure Quiz
You are considered to be exposed to Bloodborne
Pathogens if blood or other potentially infectious
materials come in contact with …
A) dresses, scarves, coats and pants
B) gloves
C) mucous membranes of the eyes, mouths or nose
or if a contaminated sharp object punctures the
skin
D) pencils
ANSWER
C) Mucous membranes
of the eyes, mouth or
nose or if a
CONTAMINATED
sharp object
punctures the skin.
Bloodborne Pathogens Exposure Quiz
HBV and HVC are both infections of the…
A) Lungs
B) Lymphatic Systems
C) Intestines
D) Liver
ANSWER
• Liver
The liver is the largest
organ in the body and
provides many
functions that are
necessary for
survival.
Bloodborne Pathogens Exposure Quiz
All of the following are ways to protect
yourself from exposure except…
A) follow the instructions in the
exposure control
B) treat everyone as if they are infected
C) always use a barrier mouthpiece
when performing CPR
D) never get the Hepatitis B vaccine series
ANSWER
• Never get the Hepatitis B vaccine series.
If you are in a high risk category you are
offered at no charge the vaccine series.
You can accept or decline the vaccine
series. If you decline you do have the right
to receive the vaccine in the future if you
are in a high risk category.
Bloodborne Pathogens Exposure Quiz
The first thing you must do when you have been exposed
to bloodborne pathogens is…
A) call your wife /husband
B) call your doctor
C) immediately wash the exposed area with
warm water and soap or flush mucous membranes
and eyes with large amounts of water
D) notify your principal
ANSWER
• Immediately wash the
exposed area with
warm soap and water
and or flush mucous
membranes or eyes
with large amounts of
water or saline. Then
notify your supervisor
and/or principal.
Bloodborne Pathogens Exposure Quiz
• As an employee of the school system,
your chances of contracting HIV are much
greater than contracting HBV and HBC.
» True of False
ANSWER
• FALSE
HIV is a fragile virus
that usually dies
outside the body
when body fluid dries.
HBV and HCV are
stable viruses that
can survive up to a
week outside the
body.
Bloodborne Pathogens Exposure Quiz
•
Most people with HIV/AIDS
A)
B)
C)
D)
Have numerous symptoms and die quickly
Must be hospitalized
Have no symptoms and feel well
Must wear mask and gloves when they are
in public
ANSWER
C) Have no symptoms
and feel well
Bloodborne Pathogens Exposure Quiz
• There are only two conditions necessary
for exposure to bloodborne pathogens:
1) Source of blood must be infected and
2) Port of exit from infected person
True or False
ANSWER
False
•
1)
2)
3)
Three conditions must exit:
Source of blood must be infected
Port of exit from infected person
Port of entry into the susceptible person
Bloodborne Pathogens Exposure Quiz
All spills of body fluids must be cleaned with
soap and water.
True or False
ANSWER
• False
All spills of body fluids must be
DISINFECTED. If clean up is needed,
immediately contact building custodian
who has training and materials to disinfect
the area or equipment.
Bloodborne Pathogens Exposure Quiz
If you don’t have soap and water handy, it is
ok to use the instant hand sanitizing gel
until proper handwashing facilities are
available.
True or False
Answer
True
Sanitizing gels of 60% ethonal are
effective in reducing bacteria and viruses.
However good handwashing with soap
and water should follow as soon as
possible when known exposure to body
fluids.
Bloodborne Pathogens Exposure Quiz
What item listed below should be double
bagged or placed in a red trash container
A)
B)
C)
D)
Used tissue
A bloody paper towel
Cleaning cloth
Gum found stuck underneath desk
Answer
• B) Bloody paper towel
All materials contaminated with blood should
always be double bagged or placed in a
red biohazard container.