1. By Sara Preston, RN, LSN Licensed School Nurse Adapted from MacNeil Environmental, Inc. And CDC

2. Bloodborne Pathogens BBP: are pathogenic micro-organisms that are present in human blood, and can cause diseases in humans: Hepatitis B Virus (HBV) Human Immunodeficiency Virus (HIV) BBP: are pathogenic micro-organisms that are present in human blood, and can cause diseases in humans: Hepatitis B Virus (HBV) Human Immunodeficiency Virus (HIV) Other Potentially Infectious Materials (OPIMs) include: Other Potentially Infectious Materials (OPIMs) include: vaginal secretions/semen brain, joint, organ fluids body fluids with blood:vomit & urine/feces vaginal secretions/semen brain, joint, organ fluids body fluids with blood:vomit & urine/feces

3. Hepatitis Virus “Hepatitis” means inflammation of the liver. “Hepatitis” means inflammation of the liver. Different Types of Hepatitis [A-E] - HBV and HCV are bloodborne Different Types of Hepatitis [A-E] - HBV and HCV are bloodborne 60 to 80% of people with Hepatitis show no symptoms 60 to 80% of people with Hepatitis show no symptoms Hepatitis can lead to cirrhosis of the liver, which can be fatal. Hepatitis can lead to cirrhosis of the liver, which can be fatal. The Hepatitis B virus can stay alive outside the body for up to 14 days. HCV can stay alive outside the body up to 4 days. The Hepatitis B virus can stay alive outside the body for up to 14 days. HCV can stay alive outside the body up to 4 days.

4. Hepatitis B Vaccine! Offered to employees in “high-risk” positions. Ask your School Nurse how to get started. Offered to employees in “high-risk” positions. Ask your School Nurse how to get started. 3 - Shot Series:first shot next shot 1 month later final shot 6 months later 3 - Shot Series:first shot next shot 1 month later final shot 6 months later

5. Hepatitis C There is no HCV Vaccine There is no HCV Vaccine Symptoms: None to flu-like that may require hospitalization Symptoms: None to flu-like that may require hospitalization

6. Human Immunodeficiency Virus HIV destroys the immune system by destroying white blood cells. HIV destroys the immune system by destroying white blood cells. It takes 8-15 years for symptoms to manifest. It takes 8-15 years for symptoms to manifest. HIV is not AIDS. When white Blood Cell count falls below 200diagnosis is Acquired Immuno- deficiency Syndrome [AIDS] HIV is not AIDS. When white Blood Cell count falls below 200diagnosis is Acquired Immuno- deficiency Syndrome [AIDS] No vaccine, no cure yet- only prevention No vaccine, no cure yet- only prevention

7. Workplace Transmission through- Accidental injury with a sharp object contaminated with blood. Accidental injury with a sharp object contaminated with blood. Open cuts, nicks, skin abrasions, even dermatitis and acne. Open cuts, nicks, skin abrasions, even dermatitis and acne. Mucous Membranes of mouth, eyes, nose. Mucous Membranes of mouth, eyes, nose. Indirect transmission, touching a previously contaminated surface & transfer to mouth, eyes, nose or open skin. Indirect transmission, touching a previously contaminated surface & transfer to mouth, eyes, nose or open skin.

8. Workplace Exposure Let your School Nurse and Administrator know right away if you have exposure to blood or body fluids at work Let your School Nurse and Administrator know right away if you have exposure to blood or body fluids at work

9. Universal Precautions We are not able to tell which people carry BBP: HIV, HBV, and HCV infect people of all ages, socio-economic classes, state, rural areas & cities We are not able to tell which people carry BBP: HIV, HBV, and HCV infect people of all ages, socio-economic classes, state, rural areas & cities Many people carry infections without even knowing it Many people carry infections without even knowing it Thus, treat all human blood/OPIMs as if they are known to be infectious Thus, treat all human blood/OPIMs as if they are known to be infectious

10. Reducing Your Risk Personal Protective Equipment - equipment that protects Personal Protective Equipment - equipment that protects Main exposure is to hands: Gloves- disposable - free of flaws - accessible Main exposure is to hands: Gloves- disposable - free of flaws - accessible Other exposure through “splash Generation” (Use mask and eye protection and add “gown”/overalls/coveralls if wider exposure is possible) Other exposure through “splash Generation” (Use mask and eye protection and add “gown”/overalls/coveralls if wider exposure is possible)

11. Sharps Containers “Sharps” are objects that can pierce the skin, like: “Sharps” are objects that can pierce the skin, like: needles needles razor blades razor blades scalpels scalpels exacta knives exacta knives pins pins saw blades saw blades glass glass

12. Infectious Waste PUT IT IN A RED BIO- HAZARD BAG (available in your School Nurses office) IF: Drippable Squeezable Pourable Saturated

13. Reducing Your Risk Good hand washing!!! Sing Happy Birthday to You….TWICE!

15. T Zone - Keep hands away from eyes, nose and mouth

16. T-Zone The most common Portals of Entry are the mucous membranes in our T-Zone The most common Portals of Entry are the mucous membranes in our T-Zone Keep hands away from the mouth, nose and eyes, and many illnesses can be prevented. Keep hands away from the mouth, nose and eyes, and many illnesses can be prevented.

17. 4 Principles of Hand Awareness Wash your hands when they are dirty, before eating and after cough/sneeze Wash your hands when they are dirty, before eating and after cough/sneeze Never cough into your hands Never cough into your hands Never sneeze into your hands Never sneeze into your hands

18. 4 Principles of Hand Awareness If your hands do not smell clean, time to wash or use hand sanitizer If your hands do not smell clean, time to wash or use hand sanitizer Above all, do not touch your eyes, nose or mouth with your hands Endorsed by the AMA and AAFP (2001) Above all, do not touch your eyes, nose or mouth with your hands Endorsed by the AMA and AAFP (2001)

19. Behaviors that we need to be aware of and curtail Rubbing – touching nose, mouth Rubbing – touching nose, mouth Eye rubbing Eye rubbing Nail or cuticle biting, finger licking, etc Nail or cuticle biting, finger licking, etc

20. Hand Awareness People who are “Hand Aware” are much less likely to contaminate themselves, another person, or a surface People who are “Hand Aware” are much less likely to contaminate themselves, another person, or a surface How many times have you touched, or almost touched your T-Zone so far this hour? How many times have you touched, or almost touched your T-Zone so far this hour?

21. Bacterial count on surfaces 2.7 million bacteria cells/square inch on drinking fountains 2.7 million bacteria cells/square inch on drinking fountains 33,800 bacteria/sq inch on a cafeteria tray 33,800 bacteria/sq inch on a cafeteria tray 3,200 bacteria/sq inch on toilet seats 3,200 bacteria/sq inch on toilet seats

22. Bacterial Counts on Surfaces 260 bacteria/sq inch on keyboards 260 bacteria/sq inch on keyboards 740 bacteria/sq inch on telephones (unless used by many people – then the rate goes way up) 740 bacteria/sq inch on telephones (unless used by many people – then the rate goes way up)

23. The Hand is Quicker than the Eye People unknowingly touch a contaminated surface or human and then transmit the organism to another surface, themselves or the students they serve People unknowingly touch a contaminated surface or human and then transmit the organism to another surface, themselves or the students they serve People get sick, due to unconscious personal habits People get sick, due to unconscious personal habits

24. How Have Health Care and Educational settings made a difference? Question basic beliefs about our part in the infection cycle Question basic beliefs about our part in the infection cycle Self and group assessment of behaviors and behavior changes Self and group assessment of behaviors and behavior changes

25. Standard Precautions Assume that every person is potentially infected or colonized with an organism that could be transmitted in the school or home setting and apply the following infection control practices during the delivery of services. Assume that every person is potentially infected or colonized with an organism that could be transmitted in the school or home setting and apply the following infection control practices during the delivery of services.

26. Standard Precautions Hand Hygiene Hand Hygiene After contact with potentially contaminated items (ex: mouthed toys) After contact with potentially contaminated items (ex: mouthed toys) After any contact with blood/body fluids After any contact with blood/body fluids

27. Standard Precautions Respiratory Hygiene – Cough Etiquette (Miss Medical Manners ) Respiratory Hygiene – Cough Etiquette (Miss Medical Manners ) Cover your cough – tissue or into your sleeve Cover your cough – tissue or into your sleeve Be a role model for kids and families Be a role model for kids and families

28. Respiratory Hygiene Wash hands after coughing/sneezing Wash hands after coughing/sneezing Make sure tissues are readily available Make sure tissues are readily available Dispose of tissues (bring a plastic ziploc bag) Dispose of tissues (bring a plastic ziploc bag) AND wash your hands! AND wash your hands!

29. Cover Your Cough or Sneeze

30. Standard Precautions Personal Protective Equipment Personal Protective Equipment Gloves – whenever there is a skin or secretions concern – rash, runny nose (wash hands before doning gloves and after removing gloves) Gloves – whenever there is a skin or secretions concern – rash, runny nose (wash hands before doning gloves and after removing gloves) Masks – when appropriate to protect your student and/or to protect you Masks – when appropriate to protect your student and/or to protect you

31. Remember This! A little poop goes a long way! - Wash your hands well A little poop goes a long way! - Wash your hands well If it is wet or sticky, and it isn’t yours, don’t touch it If it is wet or sticky, and it isn’t yours, don’t touch it

32. Dos and Don’ts Don’t even think about sneezing or coughing without covering up! Don’t even think about sneezing or coughing without covering up! Keep your hands in your lap or pockets, not in your eyes, nose or mouth Keep your hands in your lap or pockets, not in your eyes, nose or mouth

33. More Dos Be immunized – to save lives! Be immunized – to save lives! Be wise – Hand Sanitize! Be wise – Hand Sanitize! Be Cool – Wash hands with the Happy Birthday rule! Be Cool – Wash hands with the Happy Birthday rule!

34. Ms Preston says If you are ill – for heavens sake stay home If you are ill – for heavens sake stay home If a student is too ill to be in class – you know where to send them If a student is too ill to be in class – you know where to send them

35. Questions? Contact your School Nurse: Contact your School Nurse: Silver Bay – Karen Brostrom Ext 8108 Two Harbors – Sara Preston Ext 8212 Silver Bay – Karen Brostrom Ext 8108 Two Harbors – Sara Preston Ext 8212