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					Bloodborne Pathogens Training:
Preventing Disease Transmission

               Lacordaire Academy
               Annual Employee Training
               By Tammy Zolnowsky, RN
Annual Bloodborne Pathogen Training

   Required by OSHA (Occupational Safety and Health
    Administration)
   To protect employees in the workplace by
    decreasing the hazards of bloodborne pathogens
   All employees MUST annually receive bloodborne
    pathogen training
        This self-paced course will:

   Provide information about bloodborne pathogens (BBP) and the
    diseases they cause
   Outline precautions and procedures you should take to protect
    yourself and others from exposure to bloodborne illness
   This online module is designed as an annual renewal course. If
    you are a new employee taking this training for the first time,
    please complete the test and arrange to personally give it to the
    school nurse. The purpose for this is to allow an opportunity for
    any questions or discussion related to this topic. Employees
    using this training for renewal may print & complete test page
    and place in the school nurse mailbox.
         Bloodborne Pathogen (BBP)
             Training Objectives

   To eliminate or minimize job related exposure to
    BBP
   To provide some information about the potential
    sources of BBP exposure in the school setting
   To provide some information about diseases
    transmitted by BBP
   To review some universal precautions for limiting
    exposure to BBP
   To review procedure you should take if you
    experience a potential BBP exposure
What Are Bloodborne Pathogens?

   Bloodborne pathogens (BBP) are
    microorganisms such as viruses or
    bacteria that are carried in blood and
    can cause disease in people. These
    pathogens include viral hepatitis and
    human immunodeficiency virus (HIV),
    which causes acquired
    immunodeficiency syndrome (AIDS)
           Where Are BBP Found?

   In the school setting, potentially infectious
    materials are most often found in human
    body fluids such as:
    –   Blood
    –   Saliva
    –   Vomit
    –   Urine
    –   Semen
    –   Vaginal secretions
        Who Is At Risk Of Exposure?
       School employees have a low to moderate risk of exposure to
        bloodborne pathogens. Employees most at risk of exposure are:

    •      School Nurses
    •      Athletic Coaches
    •      Custodians
    •      Special Education Teachers
    •      Regular Classroom Teachers
    •      Secretaries

       Because risks for exposure do exist, all Lacordaire Academy
        employees must be prepared to respond using standard precautions
      How Does Exposure Occur?

   In the school setting potential exposure to
    bloodborne pathogens occur from direct contact
    with:
    • Body fluids from the nose, mouth and eyes that contain
      blood
    • Bleeding wounds caused by cut, punctured and abraded
      skin
    • Bleeding skin conditions such as acne and athlete’s foot
    • Human bites by students
    • Chronic or sudden onset of diarrhea or vomit that is
      contaminated with blood
      How Does Exposure Occur?

   In the school setting exposure to bloodborne
    pathogens occurs most often when you
    and/or an offending party transfers infectious
    blood products from their body, a surface or
    object to your mouth, eyes, nose or skin.
   Skin exposure can occur through open cuts,
    nicks, abrasions, dermatitis and acne.
    Pathogens of Greatest Concern

The pathogens of primary concern are:

   Hepatitis B virus (HBV)
   Hepatitis C virus (HCV)
   Human Immunodeficiency Virus (HIV)
            Hepatitis B Virus (HBV)

   Liver infection caused by the Hepatitis B Virus (HBV)
   May be severe or even fatal
   The disease may be in the body for up to 6 months before
    signals appear
   Is found in the blood and body fluids of an infected person
   HBV can live for an extended time in dry blood and on dry
    surfaces
   In the school setting the most common method of exposure is
    through direct contact with blood from an open wound or from a
    human bite from an infected person
Hepatitis B Virus (HBV) Symptoms
   Not everyone will present symptoms
   Adults and teens will have symptoms more often than young
    children
   Symptoms may include flu-like signals such as:
    –   Fatigue
    –   Abdominal Pain
    –   Loss of Appetite
    –   Nausea
    –   Vomiting
    –   Joint Pain
   Later stage symptoms include
    –   Yellowing of the skin and eyes (Jaundice)
    Hepatitis B Virus (HBV) Vaccine

   Hepatitis B vaccine is a safe and effective way to
    prevent hepatitis B disease
   Hepatitis B vaccine is recommended for:
    –   All infants
    –   All children and adolescents
    –   School employees in high risk job assignments
            School Nurses
            Athletic Coaches
            Special Education Teachers
   Hepatitis B vaccine for adults is usually given as a
    series of three shots over a 4-6 month period
          Hepatitis B Prevention

In the school setting
 The most effective way to prevent exposure to the
   Hepatitis B virus is to wear gloves if you have to
   touch any blood or body fluids
 If your skin is exposed to blood or body fluids,
   immediately wash the area with soap and water
 Flush exposed eyes, nose or mouth with water for at
   least 15 minutes
 If you are exposed to blood or body fluids file an
   exposure report/accident report with your supervisor
   and request the Hepatitis B vaccine
            Hepatitis C Virus (HCV)
   Liver infection caused by the Hepatitis C virus
   Most common chronic bloodborne infection in the United States
   Symptoms are similar to Hepatitis B including:
     – Fatigue
     – Abdominal Pain
     – Loss of Appetite
     – Nausea
     – Vomiting
     – Jaundice
   There is no vaccine against Hepatitis C and no treatment after an
    exposure occurs that can prevent infection
   Leading cause of liver transplants
   In the school setting, the most common method of exposure is through
    direct contact with blood from an open wound or from sharing items
    that have blood on them
          Hepatitis C Prevention

In the school setting:
 The most effective way to prevent exposure to the
   Hepatitis C virus is to wear gloves if you have to
   touch any blood or body fluids
 Do not share items that have blood on them
 If your skin is exposed to blood or body fluids,
   immediately wash the area with soap and water
 Flush exposed eyes, nose or mouth with water for at
   least 15 minutes
 If you are exposed to blood or body fluids file an
   exposure report/accident report with your supervisor
    Human Immunodeficiency Virus (HIV)

   HIV is a bloodborne infectious disease
   Attacks a person’s immune system
   Destroys white blood cells and the body’s ability to fight
    infection
   Can lead to AIDS (Acquired Immunodeficiency Syndrome)
   AIDS is a fatal disease
   Diagnosed with a blood test
   In the school setting, the most common method of exposure is
    through direct contact with blood from an open wound or from
    sharing items that have blood on them
               HIV/AIDS Symptoms

   An infected person can pass on the HIV infection
    before symptoms appear
   Symptoms of HIV vary and often include:
    –   Physical weakness
    –   Fever and sore throat
    –   Nausea
    –   Headaches
    –   Diarrhea
    –   Thrush (a fungal infection of the mouth)
    –   Weight loss
    –   Swollen lymph glands
               HIV/AIDS Prevention

   HIV is a fragile virus and will not survive for long
    outside of the human body
   In the school setting, the most effective way to
    prevent exposure to HIV is to:
    –   Practice and use Universal Precautions
    –   Use appropriate protective equipment including gloves if
        you have to touch any blood or body fluids contaminated
        with blood
    –   Properly dispose of any materials contaminated with blood
        and other body fluids
    –   Document and report any potential exposure to your
        supervisor immediately
              HIV/AIDS Prevention

   In the school setting, those most at risk of HIV
    infection are:
    –   School Nurses
    –   Custodians
    –   Special Education Teachers
   Exposure and transmission are most likely to occur
    while:
    –   Providing first aid to students
    –   Cleaning up blood and vomit in bathrooms, hallways and
        classrooms
           HIV/AIDS Treatment

   There is no known cure for HIV/AIDS
   Persons infected with HIV/AIDS should take
    precautions to prevent exposure to diseases
    that may further weaken their immune
    system
       Facts About Transmission

   HIV, HBV, and HCV are all spread by contact
    with an infected person’s blood, body fluid
    containing visible blood, or through sexual
    transmission
   To actually get HIV, HBV or HCV, the virus
    must get inside your body
   In a school environment the chance of
    becoming infected is very small, but could
    happen
Bloodborne Pathogens are NOT…

   Spread through the air like a cold or the flu
   Transmittable by working next to someone
    who is infected
   Spread via drinking fountains, food, coughing
    or sneezing
    Pathogens can enter the body…

   When contaminated blood
    or body fluid gets into your
    eyes, nose, mouth or open
    areas of the skin
   Indirectly when you touch
    an infectious material and
    then touch your mouth,
    eyes, nose or an open cut
       Bloodborne Pathogens can get
           through the skin by…


   Cut/scratch
   Sharing needles
   Razor nick
   Skin abrasion
   Dermatitis/acne
Standard Precautions/Risk Reduction

   Standard Precautions are procedures used to
    reduce risks of exposure to bloodborne pathogens
   In applying Standard Precautions, you should always
    treat ALL blood and body fluids “as if they are
    infections materials”
   Standard Precautions should be used even when
    you think there is no risk involved
   The use of Standard Precautions will help to protect
    Lacordaire Academy employees and students from
    contact with infectious agents.
    Personal Protective Equipment (PPE)

   Probably the first thing to do in any situation where you may be exposed to
    bloodborne pathogens is to ensure you are wearing the appropriate personal
    protective equipment (PPE). Wearing gloves is a simple precaution you can
    take in order to prevent blood or potentially infectious body fluids from coming
    in contact with your skin.
   When you are faced with a bleeding student or co-worker, take a minute to
    collect yourself. Be calm and reassure the victim. If you are in a situation where
    a student or co-worker requires basic first aid measures, take the extra time to
    put gloves on. If possible, you may hand the student a cloth to control bleeding
    themselves until you can obtain the personal protective equipment that is
    needed per situation. If the student is unable to do this, there should still be
    ample time to apply gloves prior to any added harm coming as a result of the
    extra time it takes to glove up!
   CPR mouth shields and extra gloves are available in each school's office.
   To protect yourself, it is essential to have a barrier between you and the
    potentially infectious material.
 Personal Protective Equipment (PPE)

Rules to follow:
 Always wear personal protective equipment
  in exposure situations.
 Remove PPE that is torn or punctured, or
  has lost its ability to function as a barrier to
  bloodborne pathogens.
 Replace PPE that is torn or punctured.
 Remove PPE before leaving the work area.
          Standard Precautions –
      Playground and Athletic Injuries

   The risk of disease
    transmission is considered very
    low during a playground or
    sports injury, but should still be
    considered a possibility
   If gloves are not available have
    the injured person apply
    pressure until appropriate
    equipment can be used.
Standard Precautions – Hand Hygiene

   The single most effective way to
    prevent bloodborne pathogen exposure
    in the school setting is to use Standard
    Precautions hand hygiene including:
     –   Hand washing using soap and water
     –   Hand washing using alcohol-based
         hand rubs
     –   Proper use of protective gloves
   Even if your hands appear to be clean,
    the process of providing first aid or
    cleaning up a contaminated area may
    lead to hand contamination
     Hand Hygiene – Soap & Water

   Use soap and water to clean hands when:
     –   Hands are visibly dirty
     –   Hands have been contaminated with blood
         or body fluids
     –   You have handled contaminated material
     –   You remove protective gloves
   Liquid soap is preferred to bar soap
   Warm or tepid water is preferred to cold
    water
   Running water is preferred to a bowl of
    water
    Hand Hygiene – Soap & Water
The Center for Disease Control recommends
the following hand washing method for soap
and water:
 Wet hands with water
 Apply a quarter size dollop of liquid hand soap to the palm of
   one hand
 Rub hands together vigorously for at least 15 seconds, covering
   all surfaces of the hands and fingers
 Scrub nails by rubbing them against the palms of your hands
 Rinse under running water
 Dry thoroughly with a disposable towel
 Use towel to turn off the faucet
     Hand Hygiene – Alcohol Rubs
   Infection control products including
    waterless antiseptic hand cleaners, such
    as alcohol-based hand rub, allow you to
    cleanse your hands when soap and water
    are not readily available
   These simple methods of infection control
    can help prevent bacteria or germs that
    may come in contact with the skin from
    transmitting an infectious disease
   When these types of alternatives are
    used, you must wash your hands (or
    other affected areas) with soap and
    running water as soon as possible
     Hand Hygiene – Alcohol Rubs

   When decontaminating hands with an alcohol-based
    hand rub:
    –   Apply the product to the palm on one hand
    –   Rub hands together, covering all surfaces of hands and
        fingers until hands are dry
    –   Follow manufacturer’s recommendations regarding the
        proper use of the product
   OSHA states that these alternatives are acceptable
    only at workplaces where soap and running water
    are not available
               Hand Hygiene - Gloves

   Disposable gloves (single-use) should be
    used when hands may become contaminated
    with blood or body fluids, or when touching
    contaminated surfaces or objects
   Common problems with glove use in a school
    setting are failure to:
     –   Wear gloves when touching an open wound
     –   Wear gloves when touching items that are
         likely to be contaminated with blood or body
         fluids
     –   Change gloves between students
     –   Change gloves if a tear or puncture occurs
     –   Remove gloves after problem is mitigated
           Hand Hygiene - Gloves

   Disposable gloves should be made of latex, nitrile or
    vinyl
   Put gloves on without touching the inside of the
    glove except with the skin of your hand
   Remove gloves carefully so the outside of the glove
    does not touch your bare hand or other skin
   Dispose of used gloves in an appropriate disposal
    container
   Use Standard Precaution hand hygiene to wash
    hands immediately after removing gloves
    Standard Precautions - Needles

   Needles should never be recapped, broken
    or sheared
   Needles should only be disposed of in
    labeled sharps containers
   Sharps containers should be closable,
    puncture-resistant, leak-proof on the sides
    and bottom and must be labeled
   Sharps containers should have a secure,
    closable cover to prevent spillage when
    handled
   All needles should be handled as
    contaminated material
       Standard Precautions - Glass
   Broken glassware that has been visibly contaminated
    with blood or other body fluids must be sterilized with
    an approved disinfectant solution before it is disturbed
    or cleaned up (See your custodian for appropriate
    disinfectant)
   Glassware that has been decontaminated may be
    disposed of in an appropriate sharps container: i.e.,
    closable, puncture-resistant, leak-proof on sides and
    bottom, with appropriate labels.
   Uncontaminated broken glassware may be disposed of
    in a closable, puncture resistant container such as a
    cardboard box or coffee can.
   Broken glass must be swept or brushed into a dust
    pan. Broken glass must never be picked up directly
    with the hands
    Standard Precautions - Surfaces

   All surfaces – floors, tables, books, etc –
    that come in contact with blood or other
    potentially infectious materials must be
    decontaminated as soon as possible and
    before the surface is returned to normal
    use
   Custodians have received training and
    can help you with surface
    decontamination
   If the custodian is not available and you
    have not received specialized training in
    surface decontamination, restrict access
    to the contaminated area until the
    custodian can decontaminate the area
 Decontamination and Sterilization

Decontamination should be accomplished by using
 A fresh mixture of bleach and water in a 1:10 ratio.
  (1 part bleach and 9 parts water) This is adequate
  to sterilize or disinfect items contaminated with
  blood or other potentially infectious material. Fresh
  solutions should be made every 24 hours.
 Lysol or some other EPA-registered tuberculocidal
  disinfectant. Check the label of all disinfectants to
  make sure they meet this requirement. Keep in
  mind that aerosol disinfectants should be used
  away from students to avoid any potential allergy
  or asthma triggers.
Decontamination and Sterilization
   If you are cleaning up a spill of blood, you can carefully cover the spill
    with paper towels or rags, then gently pour the 10% solution of bleach
    over the towels or rags, and leave it for at least 10 minutes. This will
    help ensure that any bloodborne pathogens are killed before you
    actually begin cleaning or wiping the material up. By covering the spill
    with paper towels or rags, you decrease the chances of causing a
    splash when you pour the bleach on it.
   If you are decontaminating equipment or other objects upon which
    someone has been cut, you should leave the disinfectant in place for
    at least 10 minutes before continuing the cleaning process.
   Of course, any materials you use to clean up a spill of blood or
    potentially infectious materials must be decontaminated immediately,
    as well. This would include mops, sponges, re-usable gloves, buckets,
    pails, etc.
           Exposure Procedures

If you are exposed, you should:
1. Wash the exposed area thoroughly with soap and
    running water. Use non-abrasive, antibacterial soap
    if possible.
    If blood is splashed in the eye or mucous membrane,
    flush the affected area with running water for at least
    15 minutes.
2. Report the exposure to the school principle and
    school nurse as soon as possible for evaluation.
              Standard Precautions –
             Post Exposure Follow-up

   Any Lacordaire Academy employee who
    experiences a potential bloodborne pathogen
    exposure shall document and report the incident
   The employee shall document:
    –   The time & location of the incident
    –   The parties involved in the incident
    –   How the exposure occurred
    –   The standard precautions followed to mitigate the incident
   The employee shall report the incident to their
    immediate supervisor
    Standard Precautions – Hepatitis B
                Vaccine

   Each employee whose duties may reasonably be anticipated to
    involve exposure to blood or other potentially infectious
    materials will be offered Hepatitis B vaccine by the district.
   A Hepatitis B vaccine shall be available to any employee who
    experiences a potential exposure to bloodborne pathogens.
    The following conditions may qualify as exceptions:
    –   The employee has previously received the complete Hepatitis B
        vaccination series
    –   Antibody testing reveals that the employee is immune
    –   The vaccine is contraindicated for medical reasons
    –   The employee declines the vaccination
    Hepatitis B Vaccination Refusal

   If an employee initially declines the Hepatitis
    B vaccination; but later decides to accept the
    vaccination, the vaccination shall then be
    made available
   If an employee declines the Hepatitis B
    vaccination when offered, the employee shall
    be required to sign the OSHA required
    waiver indicating their refusal
                    Course Review

   Bloodborne pathogens are microorganisms such as virus and
    bacteria that are carried in blood and body fluids and can cause
    disease in people.
   Bloodborne pathogens are found in human body fluids such as
    blood, saliva, vomit, and urine.
   School employees have a low to moderate risk of exposure to
    bloodborne pathogens. Employees most at risk are school
    nurses, athletic coaches, custodians, special education
    teachers and classroom teachers.
   Exposure to bloodborne pathogens can occur when
    contaminated blood comes in contact with open cuts, skin
    nicks, abrasions, dermatitis, acne and athletes foot.
                 Course Review

   Bloodborne pathogens of greatest concern in the
    school setting are Hepatitis B, Hepatitis C, and HIV.
   Hepatitis B vaccine is safe and effective.
   Teachers who are exposed to blood or body fluids
    should file an exposure report with their principal and
    request a Hepatitis B vaccine.
   Hepatitis B virus is many times more infectious than
    HIV or Hepatitis C virus.
   “Standard Precautions” are procedures used to
    reduce risks of exposure to bloodborne pathogens.
                 Course Review

   Standard precaution hand hygiene is the single most
    effective way to prevent bloodborne pathogen
    exposures in schools.
   Hands should be rubbed together with soap for at
    least 15 seconds when using soap and water to
    wash hands.
   When using alcohol-based rubs to clean hands you
    should use enough gel or foam to rub hands for at
    least 15 seconds before they dry.
                   Course Review

   Gloves should be used when hands may become contaminated
    with blood or body fluids or when touching contaminated
    surfaces or objects.
   All surfaces including floors, tables and books that come into
    contact with blood or body fluids should be decontaminated
    before returned to normal use.
   Any teacher who experiences a potential bloodborne pathogen
    exposure should document the incident and report it to their
    principal.
   All Lacordaire Academy employees are required to participate
    in bloodborne pathogen training at least once a year.
               Resources

Check the Center for Disease Control (CDC)
 website for additional information about:
           Bloodborne pathogens
                   Hepatitis
                   HIV/AIDS
            Standard Precautions
                Hand hygiene
             http://www.cdc.gov
    End of the Bloodborne Pathogens
             Training Module

Thank you for participating in
  “Bloodborne Pathogens
  Training: Preventing Disease
  Transmission”.
To receive credit for this training,
  print out and take the
  Bloodborne Pathogen Post
  Test on the following pages
  and give to your school nurse.
     Bloodborne Pathogen Post Test

Name: __________________________________________________ Date: __________________
1.   Which disease is NOT a bloodborne pathogen?
            A.   Hepatitis A
            B.   Hepatitis B
            C.   Hepatitis C
            D.   HIV
2.   Bloodborne pathogens may enter your bloodstream through:
            A.   Skin abrasions
            B.   Open cuts
            C.   Mucous membranes
            D.   All of the above
3.   Observing “Standard Precautions” means treating all blood and body fluids as if infectious.
            A.   True
            B.   False
4.   Wearing gloves is one of the most important personal protective measures for preventing an
     exposure to bloodborne pathogens.
            A.   True
            B.   False
5.   If you wear gloves when cleaning up blood or body fluids, it is not necessary to wash your
     hands afterwards.
            A.   True
            B.   False
      Bloodborne Pathogen Post Test
Name: __________________________________________________ Date: __________________


6.    If antiseptic wipes or gels are used, it is not necessary to wash your hands afterwards.
             A.   True
             B.   False
7.    A person will show symptoms right away if infected with a bloodborne pathogen.
             A.   True
             B.   False
8.    When cleaning up a bloodborne pathogens spill, which of the following should you NOT
      do?
             A.   Use disposable gloves
             B.   Reuse disposable gloves if you wash them
             C.   Wash hands thoroughly with warm water and soap
             D.   Contact the school nurse and custodian
9.    You should complete an incident report if you have been exposed to bloodborne
      pathogens.
             A.   True
             B.   False
10.   There are no vaccines to protect against Hepatitis B and C viruses.
             A.   True
             B.   False
        Training Acknowledgement

In order to comply with Occupational Exposure to Blood Borne Pathogens
    (OSHA's) Blood Borne Pathogen Standard, 29 CFR part 1910.1030, training
    records need to be maintained for each employee.
Please read and sign the statement below and forward this page to your school
    nurse.
I have viewed and understand the PowerPoint on Bloodborne Pathogens and
    agree to comply with the policies. I understand that if I have questions about
    bloodborne pathogens, I may contact my school nurse for clarification.

__________________________________________________________________
(Signature of Employee)                          (Date)

___________________________________
(Printed Name)

				
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