Barbara Maley, RN, BSN, School Nurse

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Blood Borne Pathogens To view this training.
Read each slide. Then touch any key or click the
right mouse to advance to the next slide. To
return to the previous slide touch the Backspace
key. At the end you will need to print the quiz
and submit the completed quiz to get credit for
completing this training. This training will
take approximately 30 minutes. To listen to the
audio portions in the demonstration videos,
please make sure your computer speakers are
turned on and volume turned up.

• Barbara Maley, RN, BSN, School Nurse

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Why Learn About BloodBorne Pathogens?

• Exposure to bloodborne pathogens can potentially
  lead to long term disease or death.
• Knowing the risks involved in blood borne
  pathogen exposure and taking precautions to
  prevent exposure will protect you from being
  exposed to a blood borne disease.
• State federal law require annual training on
  blood borne pathogens

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What will you learn?

• At the end of this training, you will be able to
• Identify the most common Bloodborne Pathogens
• Identify strategies to reduce exposure to
  Bloodborne Pathogens
• Identify appropriate actions to take and persons
  to contact in an emergency involving blood or
  other potentially infectious materials

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Who is Covered?

• All employees who could reasonably anticipate
  contact with blood or other potentially
  infectious body fluids as a result of performing
  their job duties are covered by the BloodBorne
  Pathogens policy.

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Your Responsibilities

• As a member of the school community, you have the
  following responsibilities
• Minimize the risk of bloodborne pathogen exposure
  
• When an incident occurs, respond quickly and
  correctly
• Comply with the SDWD Exposure Control Plan - know
  your role
• Check with the principal or school nurse if you
  have questions.

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Your Responsibilities

• PLEASE NOTE
• Substitute teachers do NOT receive bloodborne
  pathogen training.
• Be prepared to step in and immediately assist a
  substitute teacher with any first aid incident.

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What are Blood Borne Pathogens

• Bloodborne Pathogens are VIRUSES, BACTERIA and
  other microorganisms that
• cause disease
• are carried in the
• blood or in Other
• Potentially Infectious
• Materials.

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What are
Other Potentially Infectious Materials?
There are other body fluids you may come in
contact with that have the ability to transmit a
blood borne pathogen. These body fluids (other
potentially infectious materials) include

• Semen
• Breast Milk
• Please note saliva, urine and feces are not
  considered Other Potentially Infectious
  Materials unless these materials contain
  visible blood.

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BloodBorne Pathogens

• There are over 20 different bloodborne pathogens,
  this training will focus on the three most
  common
• Hepatitis B
• Hepatitis C
• HIV

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How do pathogens enter the body?

• Break in skin integrity
• Cuts, scrapes breaks in skin
• Needle sticks
• Mucous Membranes
• Splashes to eyes, nose mouth
• Unprotected sex with an infected partner

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Indirect transmission

• Remember, microorganisms can be transmitted
  indirectly by touching a contaminated surface and
  then touching your eyes, nose, mouth or broken
  skin

Reference http//www.kcsd.k12.pa.us/nurses/blood
borne-pathogens.pdf
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Hepatitis B Virus

• Hepatitis B Virus attacks the liver.
• Hepatitis B Virus can cause inflammation,
  infection, cirrhosis, cancer, and failure of the
  liver. Most adults will recover after an
  infection with Hepatitis B Virus, but this
  infection can lead to death.
• Individuals with Hepatitis B Virus do not always
  have signs or symptoms of the infection.
• Hepatitis B Virus is more infectious than HIV.

Reference http//www.cdc.gov/ncidod/diseases/hepa
titis/b/fact.htm
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Hepatitis B Vaccine

• There is a vaccine to prevent Hepatitis B.
• Hepatitis B Vaccine is a series of three shots
• Safe for infants, children, and adults
• The Hepatitis B Vaccine is available to employees
  who have not previously received the vaccinations.

http//www.cdc.gov/ncidod/diseases/hepatitis/b/fac
tvax.htm
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Test Your Knowledge

• Do you know how long Hepatitis B Virus can
  survive outside the body and still have the
  potential to cause disease?
• Less than one minute
• Seven Days
• Twelve hours
• One Hour

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The correct answer is 7 days

• Hepatitis B Virus can survive in dried blood on
  surfaces outside the body for 7 days and still
  have the potential to cause infection.

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Hepatitis C Virus

• Most common chronic bloodborne disease in the
  United States.
• Hepatitis C Virus attacks the liver.
• Hepatitis C Virus causes inflammation, cirrhosis,
  failure of the liver and death. Most people
  infected with Hepatitis C Virus do not have signs
  or symptoms of the infection.
• Hepatitis C Virus can survive in the environment
  from approximately 16 hours up to 4 days at room
  temperature.
• There is NO vaccine to prevent Hepatitis C Virus

http//www.cdc.gov/ncidod/diseases/hepatitis/c/fac
t.htm
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HIV

• HIV (Human Immunodeficiency Virus) causes AIDS
  (Acquired Immune Deficiency Syndrome).
• HIV attacks the immune system
• Transmitted through contact with infected blood
  or body fluids (unprotected sex with an infected
  person, sharing needles, blood transfusion prior
  to 1985)

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HIV, continued

• Signs and Symptoms of HIV include swollen lymph
  nodes, diarrhea, weight loss, fever, cough, and
  shortness of breath.
• Individuals may be symptom free for years!

http//www.mayoclinic.com/health/hivaids/DS00005/D
SECTION2
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Test Your Knowledge

• How long can the HIV survive outside the body?
• Less than one minute
• 7 Days
• 24 hours
• 4 hours

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The correct answer is 4 hours

• HIV is a very fragile virus that is not stable in
  the environment.
• The possibility of contracting HIV from an
  environmental surface is extremely low.

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Risk of Exposure

• As a school employee your risks of contracting a
  Bloodborne Pathogen at school is very low
• However, there may be situations that potentially
  expose you to Bloodborne Pathogens

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Risk of Exposure

• Situations that put you at risk for an exposure
  to a Bloodborne Pathogen in the school setting
  include
• Having infected blood and/or Other Potentially
  Infectious Materials come in contact with your
• mouth
• eyes
• Nose or
• a break in your skin, even breaks you cannot see
• Accidental injury from an object such as a needle
  broken glass, that was contaminated with blood or
  Other Potentially Infectious Materials

http//www.kcsd.k12.pa.us/nurses/bloodborne-pathog
ens.pdf
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Universal Precautions

• Universal precautions are a set of procedures
  used to prevent the transmission of Bloodborne
  Pathogens and other disease causing conditions
• These procedures should be used in every
  situation because you never know who is infected
  with a Bloodborne Pathogen

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Universal Precautions include

• Hand washing
• Cleaning work surfaces
• Avoiding contact with sharp objects
• Disposing of hazardous materials safely
  (i.e., using a sharps box to dispose of a used
  syringe)
• Immediately reporting all Bloodborne Pathogen
  exposure incidents to the school nurse or
  principal
• Using barrier devices (described on next slide)

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Universal Precautions Barrier Devises

• Barrier devices include gloves, gowns, and
  protective eyewear (in most situations school
  staff will only need gloves)
• Barrier devices are used to protect your hands,
  skin, eyes, mouth, nose, and clothing from coming
  in contact with potentially infectious materials
• Use these barriers when you anticipate exposure
  to blood or Other Potentially Infectious Materials

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Universal Precautions Barrier Devises - Gloves

• Disposable gloves must be worn when you
  anticipate contact with/or handle items that
  contain blood or Other Potentially Infectious
  Materials (OPIM)
• Gloves are not to be reused
• Gloves need to be replaced if they are torn,
  punctured, or the ability of glove to act as a
  barrier is compromised

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How to remove gloves

• Slide ungloved finger under the wrist of the
  remaining glove
• Peel off from inside, creating a bag for both
  gloves
• Discard

• Grasp outside edge near wrist
• Peel away from hand, turning glove inside-out
• Hold in opposite gloved hand

Reference http//www.cdc.gov/ncidod/dhqp/ppe.htm
l
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Universal Precautions Hand Washing

• Immediately after removal of gloves or after
  coming in contact with blood or potentially
  infectious material.
• Before and after use of the bathroom
• Prior to and after meal breaks
• If hand washing facilities are not available, use
  hand sanitizer. Hands must be washed as soon as
  washing facilities are available.

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Hand Washing clip
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Proper Hand Washing

• How to wash your hands
• Wet your hands with warm running water
• Apply a generous amount of soap
• Rub your hands together for 15-20 seconds. Be
  sure to scrub backs of hands, between fingers,
  wrists, and under the fingernails
• Rinse your hands with warm running water
• Dry your hands with a paper towel
• Use the paper towel to turn off the faucet

Reference http//rds.yahoo.com/_yltA9G_bDmw._RHJ
jUA_EWjzbkF/SIG12c1kugs8/EXP1207323952/http3A
//www.lung.ca/protect-protegez/germs-microbes_e.ph
p
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Universal Precautions Cleaning Surfaces

• When surfaces are contaminated with blood or
  Other Potentially Infectious Materials the
  custodian needs to be contacted immediately to
  properly clean up, decontaminate, and dispose of
  contaminated items correctly
• Remember that dried blood may be infectious and
  the custodian must be contacted in this situation
  as well

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Universal Precautions Proper Disposal

• Paper, etc. grossly contaminated with blood or
  Other Potentially Infectious Materials should be
  placed in a trash bag, sealed and properly
  disposed of immediately by the custodian
• School laundry with blood or Other Potentially
  Infectious Materials should be placed in a
  plastic bag and labeled with masking tape with
  the word BLOODY

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Universal Precautions Proper Disposal

• Be aware of sharp objects such as needles or
  broken glass when emptying the trash
• Never push down trash with hands or feet
• Always hold trash bags away from you during
  transport
• NEVER pick up broken glass with your bare hands
  (use a broom and dust pan or other mechanical
  method)

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Universal Precautions Proper Disposal Sharp
Objects

• Needles or anything that can puncture must be
  placed in a Sharps container
• You will see this red or fluorescent orange
  biohazard label on Sharps containers.

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What is an Exposure?

• An exposure is contact with blood or other
  potentially infectious materials on
• non-intact skin
• eyes
• mouth
• or other mucous membrane.

Reference Wisconsin Public Schools Model
Bloodborne Pathogens Plan
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Reporting an Exposure?

• If you have been exposed it must be reported to
  the principal and/or school nurse immediately!
• An Exposure Incident Investigation Form must be
  completed.

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Medical Follow-Up

• The district will provide for a medical
  evaluation within 24 hours and follow-up care for
  an exposure incident at no cost to the employee.

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Confidentiality

• It is everyones right to have their health
  information kept in a confidential manner.
• Any health information the school acquires about
  you is treated confidentially.
• If a student is infected with a Bloodborne
  Pathogen this information will not be shared with
  school staff.
• Failure to maintain confidentiality can result in
  fines and jail time.

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When an Injury Occurs

• Assess the situation
• Administer First Aid
• Report any serious first aid incident to the
  principal.

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Special Considerations

• Fieldtrips
• Remember to take necessary supplies including
• Gloves
• Band-Aids
• Garbage Bag
• Hand Sanitizer
• Box of tissue or paper towel

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Test Your Knowledge

• A child has a nosebleed and you have to provide
  first aid to this child. You do not have to worry
  about using Universal Precautions or barrier
  devices such as gloves since you know this child
  and their family
• False
• True

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The answer is False

• Not all individuals carrying Bloodborne Pathogens
  appear to be sick or have symptoms
• Remember that symptoms of HIV, HBV, and HCV
  closely mimic those of common illnesses such as a
  cold or the flu
• Every child regardless of how well you know them
  could be carrying a Bloodborne Pathogen
• Regardless of who the person is - WEAR gloves!

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Test Your Knowledge

• What is the best measure in preventing the spread
  of disease?
• Wearing disposable gloves
• Regular visits to the doctor
• Hand washing
• Driving your car safely

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The answer is

• Hand washing

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Potential Exposure to Blood

• You will see a short dramatization on the next
  slide.

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(No Transcript)
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• In the scenario,
  the following actions were correct.
• The student was allowed to care for their own
  injury as much as possible
• The secretary wore gloves to touch any blood or
  bloody tissues
• The blood tissues and used gloves were placed in
  a plastic lined trash basket
• The secretary washed her hands after caring for
  the student

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Second Potential Exposure to Blood

• Now you will see a situation where several things
  are done incorrectly.
• Please try to identify what is wrong in the
  following.

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• What were the actions that were incorrect in the
  second incident?

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• Actions that were incorrect included
• The secretary did not wear gloves
• The secretary didnt wash her hands
• The student didnt wash her hands
• The student didnt wash the area on her skin
  where the blood had been
• An exposure occurred and it was not reported

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• With any questions regarding Bloodborne
  Pathogens, please contact
• Barbara Brancel Maley
• Wisconsin Dells School Nurse
• [phone] ext. 107
• bmaley_at_sdwd.k12.wi.us

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Thank you for viewing the Bloodborne Pathogen
training. In order to receive credit for
completing this required training you must
complete the quiz Please see the next slide.
54
Please print off the Quiz. To print first click
on the link, then click on the word File in the
upper left hand corner, then click on Print and
then click on OK Complete the quiz and send it
by interdepartmental mail to the School Nurse,
Barbara Maley
Click Here for The Quiz
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If you are new employee to the District please
print off the Hepatitis B form, complete it and
send it by interdepartmental mail to the School
Nurse, Barbara Maley To print first click on the
link, then click on the word File in the upper
left hand corner, then click on Print and then
click on OK
Click here for the Hepatitis Form
56
Want a copy of the laws or policies?

• To obtain a copy of the Wisconsin Dells Schools
  exposure control plan or relevant laws contact
  the school nurse.
• SDWD policy is based on Model blood borne
  pathogens exposure control pan for Wisconsin
  public schools. Wisconsin Department of Public
  Instruction Madison, WI.
• Wisconsin Statues regarding Blood borne
  Pathogens
• http//www.legis.state.wi.us/rsb/stats.html
  Search 101.055
• Federal Statues regarding Blood borne Pathogens
• http//www.legis.state.wi.us/rsb/stats.html
  Search 29 CFR 1910.1030

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References

• www.jus.state.nc.us/NCJA/p-blpath.ppt
• http//www.kcsd.k12.pa.us/nurses/bloodborne-pathog
  ens.pdf
• http//www.kcsd.k12.pa.us/nurses/bloodborne-pathog
  ens.pdf
• Fight germs and wash hands properly (2006).
  Retrieved April 3, 2008 from
• http//rds.yahoo.com/_yltA9G_bDmw._RHJjUA_EWjzbk
  F/SIG12c1kugs8/EXP1207323952/http3A//www.lung
  .ca/protect-protegez/germs-microbes_e.php
• Hepatitis B Vaccine (2008). Retrieved April 3,
  2008 from http//www.cdc.gov/ncidod/diseases/hepat
  itis/b/factvax.htm
• HIV/AIDS (2008). Retrieved April 3, 2008 from
  http//www.mayoclinic.com/health/hivaids/DS00005/D
  SECTION2
• Personal Protective Equipment (2008). Retrieved
  April 3, 2008 from http//www.cdc.gov/ncidod/dhqp/
  ppe.html
• Hepatitis C Virus (2008). Retrieved April 3,
  2008 from http//www.cdc.gov/ncidod/diseases/hepat
  itis/c/fact.htm
• Hepatitis B Virus (2008). Retrieved April 3,
  2008 from http//www.cdc.gov/ncidod/diseases/hepat
  itis/b/fact.htm