CMC Annual Review of BLOODBORNE DISEASES Prevention of Transmission for School Staff
Standard on Bloodborne Pathogens OSHA sets the standard of care We must have standards to follow in schools for everyone s safety All staff must review the standard annually to remain safe and in compliance with the Massachusetts Division of Occupational Safety
QUESTION 1 Why do we follow OSHA s Standards on Bloodborne Pathogens in schools? a. Because the Nurses tell us we have to b. So that we remain safe and in compliance with the Massachusetts Division of Occupational Safety c. So we don t get diseases d. I have no idea (Please answer on post-test and print out)
Bloodborne Disease: Definition A disease potentially transmitted when an infected person s blood or bodily fluids enters another person s body
BLOODBORNE DISEASES are NOT.. transmitted through casual contact. You will not get them by shaking an infected person s hand or by using the same bathroom or kitchen facilities
QUESTION 2 Bloodborne disease are transmitted by a. Holding hands with an infected person b. Using the same water fountain as an infected person c. An infected person s blood or bodily fluids entering another person s body d. None of the above (Please answer on post-test and print out)
BLOODBORNE DISEASES: EXAMPLES Hepatitis B Hepatitis C AIDS (HIV)
Hepatitis B (HEP B) Hep B is inflammation of the liver by the Hepatitis B virus The disease is not always evident. It can be misdiagnosed or go undiagnosed Preventive vaccine is available
Hepatitis B: Symptoms Fatigue Loss of appetite Fever Achy muscles and joints Nausea, vomiting Jaundice (yellowish color of skin) Dark urine, light feces
Hepatitis B (cont.) May lead to cirrhosis or liver cancer Some people who develop Hepatitis B become chronic carriers and may potentially be infectious to others for the rest of their lives
Hepatitis C (HEP C) Currently the most common cause of Hepatitis in the United States Leading cause for liver transplants No cure No vaccine available
Hepatitis C (cont.) Signs and symptoms of Hepatitis C are the same as those for Hepatitis B Signs and symptoms may take decades to show up. Hepatitis C is called the silent epidemic
HIV Infection HIV (Human immunodeficiency virus) may lead to the disease AIDS HIV attacks the immune system of a person making them unable to fight off other infections No vaccine available Treatment is available
AIDS Symptoms may take years to appear and include: Swollen lymph glands Recurrent fever Night sweats Rapid weight loss Fatigue Other illnesses
Question 3 Which of the following are bloodborne diseases? a. Hepatitis B, Hepatitis C, HIV/AIDs b. Hepatitis B, Influenza, The common cold c. Hepatitis C, Influenza, The common cold d. HIV/Aids, Influenza, The common cold (Please answer on post-test and print out)
Question 4 Which of these diseases has a vaccine? a. Hepatitis B b. Hepatitis C c. HIV/Aids d. All of the above (Please answer on post-test and print out)
IMPORTANT! With Hepatitis B, C, and HIV some infected people may look and feel healthy, sometimes for years Despite this they are still potentially infectious to others
Timeline: Hepatitis B Blood test for Hepatitis B does not become positive immediately Hepatitis B surface antigen (sign of infection) can be found one to two weeks after infection
Timeline: Hepatitis C Blood test for antibodies (sign of infection) may take up to 3 months to detect A test that detects the virus within 1 to 3 weeks after potential infection may be available. Check with your health care provider
Timeline: HIV Infection Blood test to determine if person is HIV positive does not become positive immediately Takes about two weeks to six months for blood test to be positive Blood test examines the antibodies a person develops in response to the infection
Body Fluids that Potentially Transmit these Diseases Blood Semen Vaginal secretions Breast milk Fluids that surround internal organs
Potentially Infectious Substances Substances that could be considered potentially infectious ONLY IF contaminated with blood: Saliva, urine, feces, vomitus, sweat, tears
Question 5 Infectious bodily fluids can be found in: a. Blood b. Saliva c. Urine/Feces d. Vomit e. All of the above (Please answer on post-test and print out)
Virus Survival Outside the Body Bloodborne diseases may be transmitted indirectly This can happen when you touch an object or surface contaminated with blood or infectious materials and transfer them to your mouth, eyes, nose or opening in your skin
Survival Outside the Body (cont.) Hepatitis B may be able to survive in dried blood on environmental surfaces for one to two weeks HIV begins to die almost immediately once it is outside the body and exposed to air Hepatitis C limited information is available
Modes of Transmission Sexual contact Sharing needles (drug needles, tattooing, body piercing, body mutilation
Modes of Transmission in Schools Openings in the skin Through the mucous membranes (eyes, nose, mouth) Needle stick
Opening in the Skin Intact skin is a good barrier If body fluids get into broken skin there is a possibility for transmission The risk is under 1% if infected blood or fluids gets into an opening in the skin
Mucous Membranes Infected blood or body fluids get splashed into the eyes, nose or mouth There is under a 1% possibility of becoming infected through mucous membranes
Needlesticks and Sharps Sharps are: needles, razors, broken glass, sharp metal, knives, orthodontic wires, sewing needles Risk of becoming HIV+ is about 0.3% Risk of becoming Hep B+ is up to 30% Risk of becoming Hep C+ is about 2%
Modes of Transmission There is evidence that Hep B can be transmitted through a human bite (if the bite breaks the skin) There is no evidence that HIV can be transmitted through a bite There is no indication at this time that Hep C can be transmitted
Question 6 Which virus can survive on an environmental surface for up to two weeks? a. Hepatitis B b. Hepatitis C c. HIV/AIDs d. None of the above (Please answer on post-test and print out)
Question 7 Can you get a bloodborne disease from a human bite? a. Yes b. No c. What is a bloodborne disease again?? d. I have no idea (Please answer on post-test and print out)
Universal Precautions?? There is a better way
In Order to Protect Yourself and Your Families: Consider ALL PERSONS to be potentially infectious and use precaution
Body Substance Isolation This is an alternative to universal precautions and considered to be more protective ALL body fluids or substances are considered to be potentially infectious regardless of whether blood is visible or not
Means of Prevention: Hep B Vaccine Series of three shots If you get your first shot today, the second will be in one month and the third will be four to six months after the first shot
Hepatitis B Vaccine The series of three shots is effective for approximately 90% of the population At the current time the CDC does not recommend a booster even if it has been several years since receiving the original series
Personal Protective Equipment (PPE) Gloves to prevent skin contact with blood and body fluids Gloves should be removed inside out so the outside of the gloves are not touched Wash hands after gloves are removed
Facial Protection If there is a potential for blood or other body fluids to splash facial protection should be available Facial protection: Goggles Surgical mask
Question 8 What does Body Substance Isolation mean? a. To treat ALL body fluids or substances as if they are potentially infectious regardless of whether blood is visible or not b. To wear UV Sunglasses outside c. To never leave your house d. To wear rubber gloves all the time even when you drive home (Please answer on post-test and print out)
Tips To Consider Avoid exposures: PROTECT YOURSELF FIRST If you have an open cut or sore put a bandaid over it Always have gloves available in classrooms, on the playground (in your pocket) Use your classroom first aid kits!!!
Tips Top Consider If possible: Have the student hold pressure on their own wound Wash their own cuts on hands and arms Pinch their own nose Remind students to wash their hands as often as possible
Cleaning and Disinfecting Procedures Wear gloves (avoid latex) Apply absorbent or kitty litter Dispose of waste in red biohazard bags Use detergent/ soapy water, mop and pail to wash area (call for janitorial staff for clean-up as they will have the absorbent and biohazard bags)
Bioharzardous Symbol
Disinfection (cont.) Apply disinfectant Bleach is not used at CMSEC but can be used at home. Mix one part bleach to 10 parts water. Wash area with solution and let dry Commercial disinfectant, such as the one we use, should be EPA approved
Disinfection of Mop and Pail Mops must be disinfected Soak mop in pail in a disinfectant solution
Personal Hygiene After removing gloves wash hands with liquid soap and running water for at least 20 seconds Use waterless cleanser if running water is not available. Wash with soap and water as soon as possible
Safety Procedures If found, sharps should be disposed of in the sharps container located in the nurses office Any material saturated with blood or other body fluids must be placed in a red biohazard bag with the universal biohazard symbol
Biohazardous waste (cont.) Biohazardous waste is disposed of by: Contracting with a licensed waste hauler Agreement with a hospital or other agency
Question 9 What steps should be taken if potentially infectious substances are found on the floor? a. Wear gloves, Apply absorbent or kitty litter, Dispose of waste in red biohazard bags, Use detergent/ soapy water, mop and pail to wash area b. Walk away, someone else will take care of it c. Run away screaming d. None of the above (Please answer on post-test and print out)
Laundry Ideally clothes soiled with someone else s blood should be discarded If not it they should be washed in hot water without other clothing Do a double rinse
If an Exposure Occurs If blood or body fluids gets into an opening in the skin, vigorously wash the area with soap and running water Applying bleach to the skin is NOT recommended
If an Exposure Occurs.. If blood or body fluids get into the eyes go immediately to the nurses office and have eyes flushed with saline solution. If saline solution is not available flush eyes with water
Steps to Take if Exposed Report any incident of exposure to the nurse and director Complete incident report Seek medical attention immediately as warranted
Medical Attention? Blood splashing in the eyes or into open cut Accidental needle stick A bite that breaks the skin
Treatment After Exposure Depends upon the type of exposure If medication is indicated the sooner it is started after exposure the more effective it will be
Question 10 When should you seek medical attention for a potential bodily fluid exposure? a. Blood splashing in the eyes or into an open cut b. Accidental needle stick c. A bite that breaks the skin d. All of the above (Please answer on post-test and print out)
IMPORTANT!! Please remember, even if you are exposed the odds of becoming infected are very, small. Please take care of yourself, follow Body Substance Isolation, and our school exposure plan Please print out the post-test and hand it into the Nursing staff when completed. If you have any questions don t hesitate to ask either of us!
THE END Thank you from the Health Center Staff! Barbara Leon RN and Michelle Caron RN