ByBySara Preston, RN, LSNSara Preston, RN, LSNLicensed School NurseLicensed School Nurse

Adapted fromAdapted from

MacNeil Environmental, IncMacNeil Environmental, Inc..

And CDCAnd CDC

Bloodborne PathogensBloodborne Pathogens

BBP: are pathogenic micro-BBP: are pathogenic micro-organisms that are present in organisms that are present in human blood, and can cause human blood, and can cause diseases in humans:diseases in humans:

Hepatitis B Virus (HBV)Hepatitis B Virus (HBV)Human Immunodeficiency Virus Human Immunodeficiency Virus

(HIV)(HIV) Other Potentially Infectious Other Potentially Infectious

Materials (OPIMs) include:Materials (OPIMs) include:

vaginal secretions/semenvaginal secretions/semenbrain, joint, organ fluidsbrain, joint, organ fluids

body fluids with body fluids with blood:vomit & urine/fecesblood:vomit & urine/feces

Hepatitis VirusHepatitis Virus

“ “Hepatitis” means inflammation of the Hepatitis” means inflammation of the liver.liver.

Different Types of Hepatitis [A-E]Different Types of Hepatitis [A-E]- HBV and HCV are - HBV and HCV are

bloodbloodborneborne 60 to 80% of people with Hepatitis show 60 to 80% of people with Hepatitis show

no symptomsno symptoms Hepatitis can lead to cirrhosis of the Hepatitis can lead to cirrhosis of the

liver, which can be fatal. liver, which can be fatal.

The Hepatitis B virus can stay alive The Hepatitis B virus can stay alive outsideoutside the body for up to 14 days. HCV the body for up to 14 days. HCV can stay alive can stay alive outsideoutside the body up to 4 the body up to 4 days.days.

Hepatitis B Vaccine!Hepatitis B Vaccine! Offered to employees in “high-risk” Offered to employees in “high-risk”

positions. Ask your School Nurse positions. Ask your School Nurse how to get started.how to get started.

3 - Shot Series:3 - Shot Series: first shotfirst shotnext shot 1 next shot 1

month latermonth later final final shot 6 months latershot 6 months later

Hepatitis CHepatitis C

There is no HCV Vaccine There is no HCV Vaccine

Symptoms: None to flu-like that Symptoms: None to flu-like that may require hospitalizationmay require hospitalization

Human Immunodeficiency Human Immunodeficiency VirusVirus

HIV destroys the HIV destroys the immune system by immune system by destroying white blood destroying white blood cells.cells.

It takes 8-15 years for It takes 8-15 years for symptoms to manifest.symptoms to manifest.

HIV is not AIDS. When HIV is not AIDS. When white Blood Cell count white Blood Cell count falls below 200falls below 200diagnosis is Acquired diagnosis is Acquired Immuno-deficiency Immuno-deficiency Syndrome [AIDS]Syndrome [AIDS]

No vaccine, no cure yet- No vaccine, no cure yet- only only preventionprevention

Workplace Workplace Transmission through-Transmission through-

Accidental injury with a sharp object Accidental injury with a sharp object contaminated with blood.contaminated with blood.

Open cuts, nicks, skin abrasions, even Open cuts, nicks, skin abrasions, even dermatitis and acne.dermatitis and acne.

Mucous Membranes of mouth, eyes, nose.Mucous Membranes of mouth, eyes, nose. Indirect transmission, touching a Indirect transmission, touching a

previously contaminated surface & previously contaminated surface & transfer to mouth, eyes, nose or open skin.transfer to mouth, eyes, nose or open skin.

Workplace ExposureWorkplace Exposure

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

Universal PrecautionsUniversal Precautions

We are not able to tell which people We are not able to tell which people carry BBP: HIV, HBV, and HCV infect carry BBP: HIV, HBV, and HCV infect people of all ages, socio-economic people of all ages, socio-economic classes, state, rural areas & citiesclasses, state, rural areas & cities

Many people carry infections Many people carry infections without even knowing itwithout even knowing it

Thus, treat all human Thus, treat all human blood/OPIMs as if they are blood/OPIMs as if they are known to be infectiousknown to be infectious

Reducing Your RiskReducing Your Risk

Personal Protective EquipmentPersonal Protective Equipment- equipment that protects- equipment that protects

Main exposure is to hands: Main exposure is to hands: GlovesGloves - disposable- disposable

- free of flaws - free of flaws - accessible- accessible

Other exposure throughOther exposure through“splash “splash Generation” Generation”

(Use (Use mask and eye protection and add mask and eye protection and add “gown”/overalls/coveralls if wider exposure is possible“gown”/overalls/coveralls if wider exposure is possible))

Sharps ContainersSharps Containers

““Sharps” are Sharps” are objects that can objects that can pierce the skin, like:pierce the skin, like: needlesneedles razor bladesrazor blades scalpelsscalpels exacta knivesexacta knives pinspins saw bladessaw blades glassglass

Infectious WasteInfectious Waste

PUT IT IN A RED PUT IT IN A RED BIO-HAZARD BAG BIO-HAZARD BAG (available in your (available in your School Nurses office) School Nurses office) IF:IF:

DrippableDrippable SqueezableSqueezable PourablePourable SaturatedSaturated

Reducing Your RiskReducing Your Risk

Good hand washing!!!Good hand washing!!!

Sing Happy Birthday to You….TWICE!Sing Happy Birthday to You….TWICE!

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

T-ZoneT-Zone

The most common Portals of Entry The most common Portals of Entry are the mucous membranes in our T-are the mucous membranes in our T-ZoneZone

Keep hands away from the mouth, Keep hands away from the mouth, nose and eyes, and many illnesses nose and eyes, and many illnesses can be prevented.can be prevented.

4 Principles of Hand Awareness4 Principles of Hand Awareness

Wash your hands when they are Wash your hands when they are dirty, before eating and after dirty, before eating and after cough/sneezecough/sneeze

Never cough into your handsNever cough into your hands

Never sneeze into your handsNever sneeze into your hands

4 Principles of Hand Awareness4 Principles of Hand Awareness

If your hands do not smell clean, If your hands do not smell clean, time to wash or use hand sanitizertime to wash or use hand sanitizer

Above all, do not touch your eyes, Above all, do not touch your eyes, nose or mouth with your handsnose or mouth with your hands

Endorsed by the AMA and AAFP (2001)Endorsed by the AMA and AAFP (2001)

Behaviors that we need to be Behaviors that we need to be aware of and curtailaware of and curtail

Rubbing – touching nose, mouthRubbing – touching nose, mouth

Eye rubbingEye rubbing

Nail or cuticle biting, finger licking, Nail or cuticle biting, finger licking, etcetc

Hand AwarenessHand Awareness

People who are “Hand Aware” are People who are “Hand Aware” are much less likely to contaminate much less likely to contaminate themselves, another person, or a themselves, another person, or a surfacesurface

How many times have you touched, How many times have you touched, or almost touched your T-Zone so far or almost touched your T-Zone so far this hour?this hour?

Bacterial count on surfacesBacterial count on surfaces

2.7 million bacteria cells/square inch 2.7 million bacteria cells/square inch on drinking fountainson drinking fountains

33,800 bacteria/sq inch on a 33,800 bacteria/sq inch on a cafeteria traycafeteria tray

3,200 bacteria/sq inch on toilet seats3,200 bacteria/sq inch on toilet seats

Bacterial Counts on Bacterial Counts on SurfacesSurfaces

260 bacteria/sq inch on keyboards260 bacteria/sq inch on keyboards

740 bacteria/sq inch on telephones 740 bacteria/sq inch on telephones (unless used by many people – then (unless used by many people – then the rate goes way up)the rate goes way up)

The Hand is Quicker than the The Hand is Quicker than the EyeEye

People unknowingly touch a People unknowingly touch a contaminated surface or human and contaminated surface or human and then transmit the organism to then transmit the organism to another surface, themselves or the another surface, themselves or the students they servestudents they serve

People get sick, due to unconscious People get sick, due to unconscious personal habitspersonal habits

How Have Health Care and How Have Health Care and Educational settings made a Educational settings made a

difference?difference?

Question basic beliefs about our part Question basic beliefs about our part in the infection cyclein the infection cycle

Self and group assessment of Self and group assessment of behaviors and behavior changesbehaviors and behavior changes

Standard PrecautionsStandard Precautions

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

Standard PrecautionsStandard Precautions

Hand HygieneHand Hygiene

After contact with potentially After contact with potentially contaminated items (ex: mouthed contaminated items (ex: mouthed toys)toys)

After any contact with blood/body After any contact with blood/body fluidsfluids

Standard PrecautionsStandard Precautions

Respiratory Hygiene – Respiratory Hygiene – Cough EtiquetteCough Etiquette

(Miss Medical Manners (Miss Medical Manners ))

Cover your cough – tissue or into your Cover your cough – tissue or into your sleevesleeve

Be a role model for kids and familiesBe a role model for kids and families

Respiratory HygieneRespiratory Hygiene

Wash hands after coughing/sneezingWash hands after coughing/sneezing

Make sure tissues are readily Make sure tissues are readily availableavailable

Dispose of tissues Dispose of tissues (bring a plastic ziploc bag)(bring a plastic ziploc bag)

AND wash your hands!AND wash your hands!

Cover Your Cough or SneezeCover Your Cough or Sneeze

Standard PrecautionsStandard Precautions

Personal Protective EquipmentPersonal Protective Equipment

Gloves – whenever there is a skin or Gloves – whenever there is a skin or secretions concern – rash, runny nose secretions concern – rash, runny nose (wash hands before doning gloves and (wash hands before doning gloves and after removing gloves)after removing gloves)

Masks – when appropriate to protect your Masks – when appropriate to protect your student and/or to protect youstudent and/or to protect you

Remember This!Remember This!

A little poop goes a long way!A little poop goes a long way!- Wash your hands well- Wash your hands well

If it is wet or sticky, and it isn’t If it is wet or sticky, and it isn’t yours, don’t touch ityours, don’t touch it

Dos and Don’tsDos and Don’ts

Don’t even think about sneezing or Don’t even think about sneezing or coughing without covering up!coughing without covering up!

Keep your hands in your lap or Keep your hands in your lap or pockets, not in your eyes, nose or pockets, not in your eyes, nose or mouthmouth

More DosMore 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 Be Cool – Wash hands with the

Happy Birthday rule!Happy Birthday rule!

Ms Preston saysMs Preston says

If you are ill – for heavens sake stay If you are ill – for heavens sake stay homehome

If a student is too ill to be in class – If a student is too ill to be in class – you know where to send themyou know where to send them

QuestionsQuestions ??

Contact your School Nurse:Contact your School Nurse:

Silver Bay – Karen Brostrom Silver Bay – Karen Brostrom Ext 8108Ext 8108

Two Harbors – Sara PrestonTwo Harbors – Sara PrestonExt 8212Ext 8212