Slide 1 - Slide 1 Welcome to the training on Universal Precautions. Written by the DCS Nurse Consultants. Presented by the Indiana Department of Child Services and the Indiana Child Welfare Education and Training Partnership. Page 1 of 52
Slide 2 - Slide 2 The information presented is for general educational purposes only. Consult with your Physician regarding any concerns you have about your personal health and well-being. Contact your DCS Nurse Consultant for any questions. Page 2 of 52
Slide 3 - Slide 3 Universal Precautions are a set of established procedures for infection control. They may also be referred to as, Standard Precautions. They were developed to limit the spread of blood borne diseases such as Hepatitis B, Hepatitis C, and HIV. And they were developed by the Centers for Disease Control and the Occupational Safety and Health Administration. Page 3 of 52
Slide 4 - Slide 4 Universal Precautions should be used at Workplaces; Schools; Medical Facilities; Shelters; Child Care Facilities; They should be used EVERYWHERE! Page 4 of 52
Slide 5 - Slide 5 Universal Precautions should be followed by ALL staff at ALL times on ALL persons. Universal Precautions should be used for handling or cleaning-up blood and other potentially infectious material such as soiled diapers, bandages, etc. Universal Precautions Supplies should be available and accessible: including: Gloves, bleach, plastic or biohazard bags, CPR, barrier mask, gown or protective clothing, protective eyewear, and a mask or face shield. Page 5 of 52
Slide 6 - Slide 6 Blood borne pathogens are infectious microorganisms in human blood that can cause diseases in humans such as HIV, Hepatitis B and Hepatitis C. Infectious microorganisms can also be found in other bodily fluids, but unless there is blood contained in the other bodily fluids, they do not transmit blood borne diseases. Treat ALL bodily fluids as if they are infected! Page 6 of 52
Slide 7 - Slide 7 Other Bodily Fluids include: semen, vaginal secretions, amniotic fluid, breast milk, vomit, feces, urine, saliva, perspiration, tears, mucus or sputum and nasal secretions. These Bodily Fluids can also transmit diseases, so precautions should be used when in contact with these fluids as well. Again Treat ALL bodily fluids as if they are infected! Page 7 of 52
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Slide 9 - Slide 9 At some point, you may be in contact with blood and or other bodily fluid. You could become infected with a dangerous disease. It is important for you to utilize Universal Precautions to protect yourself and others. Page 9 of 52
Slide 10 - Slide 10 Some potential activities that may involve risk, include: Providing first aid to injuries, cuts, scrapes, blisters, splinters, etc.; If a bloody wound needs pressure have the individual apply the pressure themselves if they are able; Dealing with a child who bites; Helping with nosebleeds; Giving injection medications; Helping with health procedures; Loose tooth; Handling breast milk; Performing CPR. and Any task that may involve blood. Page 10 of 52
Slide 11 - Slide 11 Communicable Diseases fall into four categories or types including Viruses, Bacteria, Fungi and Parasites Communicable Diseases are spread from person to person by four different routes: - Air or Respiratory; - Direct Contact; - Fecal or Oral; - Blood Transmission and Pregnancy;. Keep in mind - Many diseases can be spread or transmitted by more than one route Page 11 of 52
Slide 12 - Slide 12 Air or Respiratory transmission occurs through: Breathing germs in the air; Contact with infected mucus and mucus drainage or discharge; Behaviors that can spread disease include: Not washing hands, coughing or sneezing, kissing on the mouth, sharing mouthed toys, sharing cups and utensils, wiping noses, sharing tissues, towels, wash cloths, and pillowcases, poor ventilation, singing, laughing, or speaking. Page 12 of 52
Slide 13 - Slide 13 Examples of air transmission include: Influenza, Measles, Mumps, Rubella, Conjunctivitis, Pertussis, Respiratory Syncytial Virus, Roseola, Strep Throat, Scarlet Fever, Tuberculosis, Fifth Disease, Herpes, Chicken Pox, Impetigo, Meningitis, and Hand Foot and Mouth Disease. Common Symptoms may include, but are not limited to: Cough, fever, runny nose, congestion, earache, sore throat, rash, and eye irritation or discharge Page 13 of 52
Slide 14 - Slide 14 Direct contact transmission occurs through: Skin to Skin Transmission; Contact with skin, hair, or objects that have been infected; Behaviors that can spread disease include: Frequent and prolonged close contact, sharing personal items such as clothing, hats, combs, brushes, hair ribbons, towels, wash cloths, and bedding);, touching infected skin, hair, or objects, contact with a pet, or sexual contact. Page 14 of 52
Slide 15 - Slide 15 Examples of direct contact transmission include: Lice, Scabies, Ringworm, Impetigo, Chicken Pox, Herpes, Methicillin-Resistant Staphylococcus Aureus, and Methicillin-Susceptible Staphylococcus Aureus Common Symptoms may include, but are not limited to: Open sores that may be oozing, rash, itching, and possibly the presence of live insects and, or nits. Page 15 of 52
Slide 16 - Slide 16 Fecal or Oral transmission occurs through: Mouth contact with hands and items, including food, contaminated by infected feces. Behaviors that can spread disease include: Not washing hands, toileting and improper diapering procedure, unsafe foods and food preparation, sharing mouthed toys, swimming, or contact with a pet. Page 16 of 52
Slide 17 - Slide 17 Some examples of fecal and oral transmission include: Salmonella, Shigella, Giardiasis, Pinworms, Hepatitis Ae, Rotavirus, Crytosporidiosis, Polio, E. Coli, Campylobacteriosis, Norovirus, Meningitis, and Hand Foot and Mouth Disease. Common Symptoms may include, but are not limited to: Stomach ache, nausea, diarrhea, and vomiting Page 17 of 52
Slide 18 - Slide 18 Blood transmission occurs through: Contact with infected blood and or other bodily fluids Infected blood and bodily fluids can enter the body through broken skin and or mucous membranes including the eyes, mouth, and nose. Pregnancy transmission from mother to baby during delivery or by breastfeeding Behaviors that can spread disease includes: Improper diapering procedures, providing first aid or doing dressing changes, injuries involving needles or other sharp items, not covering sores or wounds properly, kissing, or sexual contact Page 18 of 52
Slide 19 - Slide 19 Some examples of Blood transmission include: HIV, AIDS, Hepatitis B, Hepatitis C, Mononucleosis, and Cytomegalovirus. Common Symptoms may include, but are not limited to: Fatigue, weight loss, weakened immune system, fever, sore throat, swollen glands, joint pain, or jaundice. ; However, there may be no signs of illness or infection. Page 19 of 52
Slide 20 - Slide 20 There is no cure or vaccination for HIV. HIV is the virus that causes AIDS; HIV is spread through contact with blood or other body fluid of an infected person, which include breaks in the skin by bites, cuts, and sores; through the mucous membranes; the birth process, breastfeeding, unprotected sex, sharing needles, getting a needle stick, blood transfusions, unsterile tattooing and piercings, and objects like toothbrushes, razors, etc.).; HIV does not survive well outside of the body. Page 20 of 52
Slide 21 - Slide 21 HIV is not easily transmitted in average daily activities for adults or children HIV is NOT TRANSMITTED by: Casual contact with infected people; Holding or hugging infected people; Sharing food, utensils, clothing, bed linens, art equipment, e.g., play-dough, clay or water play; Kissing on the lips or cheeks; Coming into contact with perspiration, tears, saliva, vomit, urine, or stool that does not contain visible blood; Shaking hands; Sharing restrooms; Bathroom fixtures; Drinking fountains; Eating with carriers; Mosquitoes Page 21 of 52
Slide 22 - Slide 22 Hepatitis means inflammation of the liver. Hepatitis is the name of a family of viral infections that affect the liver. Toxins, certain drugs, some diseases, heavy alcohol use, both bacterial and viral infections can all cause Hepatitis. The most common types are: Hepatitis Ae, Hepatitis B, and Hepatitis C. Page 22 of 52
Slide 23 - Slide 23 Hepatitis Ae, Hepatitis B, and Hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently. Hepatitis Ae appears only as an acute or newly occurring infection and does not become chronic. People with Hepatitis A usually improve without treatment. Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, the virus remains in the body, resulting in chronic disease and long-term liver problems. There are vaccines to prevent Hepatitis Ae and B; however, there is not one for Hepatitis C. If a person has had one type of viral hepatitis in the past, it is still possible to get the other types. Page 23 of 52
Slide 24 - Slide 24 There is no cure for Hepatitis B; There is a vaccination available for Hepatitis B; Hepatitis B is spread through contact with blood or other body fluids of an infected person; for example: breaks in skin by bites, cuts, and sores; through the mucous membranes; the birth process; breastfeeding; unprotected sex; sharing needles; getting a needle stick; blood transfusions; non-sterile tattooing or piercings; and objects such as toothbrushes, razors, etc.; there are Two phases Acute and Chronic; Hepatitis B can survive for at least one week in dried blood on a surface; There is no cure for Hepatitis There is no vaccination available for Hepatitis C; Hepatitis C can be spread by the same instances as Hepatitis B, including hemodialysis, with the exception of breastfeeding and tattooing or piercings.; Hepatitis C is the most common chronic blood borne infection in the United States and 80% of those infected do not show signs or symptoms.; Hepatitis C virus can survive outside the body at room temperature, on environmental surfaces, for up to 3 weeks. Page 24 of 52
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Slide 26 - Slide 26 A Rule of Thumb for prevention is If it s wet and it s not yours, don t touch it! Be aware of how diseases can be spread Specific routes of transmission; Use Universal Precautions and proper cleanup & waste disposal; Proper handwashing and glove use; Updated immunizations and routine health checks; Disinfect diapering and changing area; Practice proper food handling, cooking, storage and service; Clean and vacuum the environment; Cover and properly care for all cuts, injuries, and wounds and sores; Cover your cough (this includes the mouth and nose); Wash clothes and clothing items; Do not share personal items, cups or utensils. Page 26 of 52
Slide 27 - Slide 27 Handwashing is the simplest way to prevent disease transmission, yet it can be the least used. Gloves do not eliminate the need for hand washing. Hand Sanitizers Do Not replace handwashing! They are to be used WITH handwashing. Page 27 of 52
Slide 28 - Slide 28 The proper hand washing procedure includes: Wet Hands using Warm Water; Use Soap; preferably antibacterial. Rub vigorously for approximately 20-30 seconds (include all surfaces including thumbs, wrists, back of hands, between fingers, and around and under nails); Rinse Hands using Warm Water; Use Disposable Paper Towel or Air Hand Dryer; Turn off Water Using the Paper Towel. Page 28 of 52
Slide 29 - Slide 29 You should wash your hands: After toilet use (including diaper changes); Before and after meals; Before and after feeding a child, serving food, or handling food (especially raw meat, chicken, fish, and eggs); After blowing nose; After handling pets or animals of any kind; After contact with any bodily fluids (including providing first aid); And whenever hands are visibly dirty or after being engaged in an activity that would cause them to become unclean. Page 29 of 52
Slide 30 - Slide 30 If you do not wash your hands: Bacteria and viruses are picked up and stay on your hands. You can pass them to other people when you touch them with your hands. Bacteria and viruses can get into your body when you touch your face, eyes, mouth, or nose with your hands. Page 30 of 52
Slide 31 - Slide 31 Personal Protective Equipment Includes: Gloves; CPR Barrier Mask; Gown or Protective Clothing, Face Shield, Eye Protection; Sanitizable Surfaces - For Diaper Changes; And when visiting a child in the hospital, ALWAYS read signs posted on the child s hospital doors. Use Personal Protective equipment as recommended. If you are not sure, ask a Nurse before entering the room. Page 31 of 52
Slide 32 - Slide 32 Use disposable latex, vinyl, or medical grade synthetic gloves (for latex allergies). * Always inspect gloves for holes prior to use. Wear gloves when handling any object that may have been soiled with blood or bodily fluids. Wear gloves when there is potential for hand or skin contact with blood, other potentially infectious material, or items and surfaces contaminated with these materials. Wear gloves when performing first aid contact with skin that may have sores, open wounds, cuts, or scratches. Wear gloves when you have a cut or scratch on your hands. Wash hands before putting on a new pair of gloves, when changing gloves, and when removing gloves. Gloves should not be removed until the task is completed and proper clean-up is done. Never reuse gloves- discard after one use. Page 32 of 52
Slide 33 - Slide 33 The proper glove removal procedure includes the following steps: Pinch palm of glove on one hand and pull glove down and off fingers. Form glove into a ball and place in palm of gloved hand. Insert (2) fingers of ungloved hand under inside rim of gloved hand. Push glove inside out, down over fingers and around balled up glove. Grasp inside out gloves and discard into plastic bag, seal bag. Wash hands. In order to perform safe glove removal- don't touch the outside of the glove. Page 33 of 52
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Slide 35 - Slide 35 There are two Types of Hazardous Waste: 1. Contaminated Waste such as diapers, Band-Aids or bandages, tissues, gloves, cleaning items from vomit, PPE items, and sanitary napkins. Contaminated waste should be double-bagged in plastic bags, and disposed of in covered trash containers that are not accessible to children; Clothing should be laundered. 2. Biohazard items completely soaked /saturated with blood or fluids that contain blood, items caked with dried blood, contaminated sharps for example, needles, lancets, broken glass). Biohazard waste must be placed in special Medical Waste containers, not accessible to children, and handled by a hazardous waste disposal company; contaminated sharps must be placed in a Sharps container the container must be closeable, puncture resistant, leak proof on the sides and bottom, and labeled with a biohazard label or color-coded red. Page 35 of 52
Slide 36 - Slide 36 The following are the steps to proper disposal of materials. Wear gloves; Mop or clean up spill with paper towels or other absorbent material; Use a cleaning procedure that minimizes droplet spread, splashing, spraying, and splattering; A solution of household bleach diluted with water is an effective disinfectant against HIV and Hepatitis; Use a solution of 1 part household bleach and 10 parts water, wash area well (* the solution must be mixed daily to be an effective disinfectant); Dispose of gloves, soiled towels and other waste in a sealed plastic bag and double-bag; Wash hands. Page 36 of 52
Slide 37 - Slide 37 If you are exposed to blood or bodily fluids: Wash exposed skin with soap and water; Irrigate eyes with running water or saline; Flush nose and mouth with water; Remove contaminated clothing; Report the Exposure to Supervisor (and notify H R for Workers Compensation). Seek Medical Care within H R - Review Workers Compensation Guidelines for exposure to blood and needle sticks (The Physician will determine significance and will dictate any treatment and follow-up care): And document the incident. Page 37 of 52
Slide 38 - Slide 38 If you experience a needle stick or sharps injury Immediately: Wash the needle stick area or cut or wound with soap and water; If a splash occurred, irrigate eyes with running water or saline and flush nose and mouth with water; Seek Medical Care Immediately within H R Review Workers Compensation Guidelines for exposure to blood and needle sticks (The Physician will determine significance and will dictate any treatment and follow-up care); and Report the incident to your Supervisor Immediately (and Notify HR for Workers Compensation) Page 38 of 52
Slide 39 - Slide 39 Please take time to know the location of the First Aid Kit in your county office. An appropriately supplied stock is key to safety and protection of employees. Listed are recommended supplies, but kits may vary. First Aid Kits should be checked quarterly for need to restock or replace used and expired products See the website below for ordering details. Page 39 of 52
Slide 40 - Slide 40 Located on the next few slides is a quiz to test your knowledge. Click Next to start the quiz. Page 40 of 52
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Slide 52 - Slide 52 Thank you for taking the training on Universal precautions. ELM will reflect your completion in 24 to 48 hours. Page 52 of 52