1. Blood-borne Pathogens
What you need to know to stay safe!
~Shanda Brewer, RN

2. WHY ARE YOU HERE? All employees need basic information regarding blood
borne pathogens:
• Do not touch potentially infectious body fluids
• How to report an accident
• Who should clean up the blood, etc.

3. Introduction Whether in the classroom, on a playing field or
on a school bus, all school employees must
Know The potential danger of Blood-borne
Pathogens.

4. Occupational exposure to bloodborne pathogens, such
as hepatitis B virus (HBV), hepatitis C virus (HCV) and
human immunodeficiency virus (HIV), does occur.
Blood is the number one source of these viruses in
the workplace.
Your risk of contracting one of these viruses at
school is low because your contact with blood is
infrequent. But when the need arises you must be
prepared to deal with blood safety.

5. QUESTION 1
The most common source of workplace pathogen (Hepatitis B, Hepatitis C & HIV) exposure is:

6. Answer:
BLOOD

7. OSHA Regulations
The Bloodborne Pathogens Standard (29 CFR ) and the Bloodborne Pathogens Compliance Directive (CPL2-2.44D) require employers to identify the jobs, tasks, and activities that could expose employees to potentially infectious body fluids.

8. Minimal Risk for Exposure
Montgomery County School JOB DESCRIPTIONS AND TASKS ARE DIVIDED INTO TWO CATEGORIES
High Risk for Exposure This category indicates That it is probable that Staff members will come Into contact with some form of body fluids, at some time.
Minimal Risk for Exposure
This category indicates that
there is only a remote chance
that staff members will come
into contact with some form
of body fluids, at some time.

9. What are Bloodborne Pathogens?
Blood-borne pathogens are microorganisms carried by
human blood and other body fluids.
The three most common are:
Hepatitis B Virus (HBV)
Hepatitis C Virus (HCV)
Human Immunodeficiency Virus (HIV)
Unfortunately, children are as prone to blood-borne
diseases as adults. That means you are as much in danger
of infection from the children you work with as any other
group in society.

10. Hepatitis B HBV can survive for at least 1 week in dried
Hepatitis means “inflammation of the liver”. HBV poses a
Greater risk to you at school than either the hepatitis
C virus (HCV) or HIV, since it is more easily
transmitted.
HBV can survive for at least 1 week in dried
blood on environmental surfaces such as a
worktable, knife, tools, broken glass, sharp metal,
etc…

11. Hepatitis B
Environmental contamination is an effective method of disease transmission for HBV. This is the primary reason for the importance of properly cleaning and disinfecting any blood- contaminated work surfaces, tools, etc.

12. QUESTION 2
Hepatitis B Virus (HBV) can survive for up to ____________ in dried blood on hard surfaces.

13. Answer:
One Week
This is why cleaning on a regular
basis is VITAL!

14. Hepatitis B
An HBV vaccination has been available since The vaccine prevents hepatitis B disease and its serious consequences. The vaccine has been shown to be very safe when given to infants, children, and adults.

16. The Hepatitis B Vaccine Series Is Available to Montgomery County School Employees…
If your job description falls in the high exposure risk category, and you have not previously received the series. If you have a documented/reported exposure incident, and have not previously received the series.

17. All employees must have either a request/consent for the series or a decline/refusal on file with the personnel office.
Request/Consent
This indicates that you
Wish to receive the
series due to your job
description falling into
the high risk category.
Decline/Refuse
This indicates that you have
previously received the series,
Your job description falls into
the minimal risk category, you
have a medical condition that
contraindicates the series, or
that you simply do not wish to
receive the series at that time.

18. Hepatitis C Virus (HCV)
70 percent of infected persons will suffer from chronic liver disease. Hepatitis C is the leading indication for liver transplantation.
There is no vaccine for Hepatitis C Virus at this time.

19. HIV
HIV is the virus that leads to Acquired Immunodeficiency Syndrome (AIDS). A person can carry HIV for many years and not have any symptoms until it turns into full-blown AIDS.
AIDS attacks the person’s immune system, which makes it difficult for the body to fight off common diseases.

20. HIV
HIV does not survive well outside the body. When HIV-infected human blood or other body fluid is dried, the risk of environmental transmission is essentially reduced to zero because the virus does not survive.
HIV is found in very low quantities in saliva and tears from some AIDS patients.
HIV has not been found in the sweat of HIV- infected persons. Contact with saliva, tears, or sweat has never been shown to result in the transmission of HIV

21. Identify Potential Exposure at Work
Exposure to blood-borne pathogens or potentially
infectious body fluids in a school environment is very
limited.
In general, the only time that any employee
is exposed is when a student or co-worker
suffers an injury that bleeds, or illness
causing exposure to bodily fluids with
visible blood.

22. Identify Potential Exposure at Work
Employees working with special
needs/medically fragile students should take
extra caution. These students may be more:
Vulnerable to injury
Likely to have special medical needs
Dependant on adults for personal care

23. QUESTION 3
In general school employees have limited exposure to body fluids and potential blood-borne pathogens. The exception to this is _________

24. Working with Children having severe or special medical needs
Answer
Working with Children having severe or special medical needs

25. Identify Potential Exposure at Work
You could be exposed at the time of injury if blood/body fluids splashes onto you, and when administering first-aid treatments, such as applying pressure to a wound, wrapping an injury, providing CPR, etc.

26. Identify Potential Exposure at Work
OR…Before a work surface, such as a table, tool, or machine control panel, is cleaned/decontaminated after an incident. Employees assigned to clean up after an illness or injury may also be exposed to blood-borne pathogens.

27. Transmission of Blood-borne Pathogens
You can also become infected by cutting yourself
With a contaminated sharp object like:
Broken Glass
Sharp Metal
Needles
Knives
Exposed end of orthodontic wires

28. Transmission of Bloodborne Pathogens
You CANNOT become infected with these
viruses through casual contact, coughing,
sneezing, a kiss on the cheek, a hug or from
drinking fountains or food.
Other ways of transmission not usually associated
With a school workplace include:
Unprotected sexual contact
Drug use with unclean needles

29. How does it get in? Non-intact skin—The infected blood
must make physical contact with skin
that is damaged or not completely
intact.
Blood-borne pathogens could enter your
bloodstream through a cut in the skin,
abrasions or scratches on the skin,
dermatitis or other skin rashes, and
even hangnails.
COVER CUTS AND OPEN SKIN
WITH A BANDAGE WHEN AT
WORK!

30. How does it get in?
Mucous membranes— The infected blood could enter your body’s bloodstream through a mucous membrane.

31. What are Infectious Body Fluids?
Body fluids that contain potentially infected blood
could result in the transmission of a blood-borne pathogen.
Potentially infectious body fluids include blood and other
bodily fluids that can contain blood, such as:
Saliva
Vomit
Urine
Other body fluids that could contain blood, but are not likely to be encountered in a school work environment, include semen, vaginal secretions, cell cultures, etc.

32. Universal Precautions
Anticipating Potential Contact
The most important step in preventing exposure to and transmission of infections is the anticipation of potential contact with infectious materials in routine and emergency situations.
Universal precautions and infection control techniques should be used in all situations that present the hazard of infection.

33. Universal Precautions
Diligent and proper hand washing, the use of barriers (e.g., latex or vinyl gloves), appropriate disposal of waste products and needles, and proper care of spills are essential techniques of infection control.
When using universal precautions to prevent the spread of infection, all blood and body fluids are treated as if they contain blood borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV).

34. The most important step in preventing exposure is?
Question 4
The most important step in preventing exposure is?

35. Anticipate contact with potential infectious materials
Answer
Anticipate contact with potential infectious materials

36. All blood & body fluids should be treated like they…_________.
Question 5
All blood & body fluids should be treated like they…_________.

37. Contain blood- borne pathogens.
Answer:
Contain blood- borne pathogens.

38. AVOIDING CONTACT WITH BODY FLUIDS
PERSONAL PROTECTIVE EQUIPMENT (PPE) is
vital to prevent exposure to blood-borne pathogens.
Remember, the concept of universal precautions includes
avoiding contact with all potentially contaminated blood or
body fluids. Use protective barriers, including PPE, to avoid
contact with blood and body fluids.

39. AVOIDING CONTACT WITH BODY FLUIDS
Gloves: should be worn for all scenarios involving blood or body fluids. Staff members must wear gloves when applying bandages or putting pressure on wounds.
Cleanup personnel must wear gloves when cleaning up and decontaminating blood or body fluids.

40. Impromptu Barriers: For many accidents in a
PPE continued…
Impromptu Barriers: For many accidents in a
school environment, the staff responders do not feel
that they have time to get and then put on protective
barriers such as gloves or aprons.
Impromptu barriers in your workplace might include
a piece of plastic, a clean plastic garbage bag, paper,
your shirt, etc.
The idea is to use something as a barrier
between your skin and the victim’s blood or
body fluid.

41. Question 6 True or False: You can use a clean plastic bag as a
blood/body fluid barrier if gloves or
other PPE is not available.

42. Answer
True

43. HANDWASHING Diligent and proper hand washing is a key component of
infection control. Hands should be washed:
1.   Immediately before and after physical contact with a student (e.g., providing first aid, diaper changes, assistance with toileting, or assistance with Feeding)
2.   Immediately after contact with blood or body fluids or garments or objects soiled with body fluids or blood
3.   After contact with used equipment (e.g., stethoscope, emesis basin, and gloves)
4.  After removing PPE such as gloves or clothing.

44. Hand Washing
Good hand washing keeps you from transferring contamination
from your hands to other parts of your body or to other surfaces
you may come in contact with later.
You should wash your hands with nonabrasive soap and running
water for at least 20 seconds:
When hand washing facilities are not available, such as on the
school bus, your employer will provide an antiseptic hand cleanser
or antiseptic towelettes. Use these as a temporary measure only.
You must still wash your hands with soap and running water as
soon as you can.

45. ROUTINE CLEAN UP
Routine environmental clean up of facilities (e.g., Health
unit, buses and bathrooms) do not require modification
unless contaminated with visible blood or body fluids.
If the area has been contaminated with visible blood or body fluids, the area should be decontaminated according to district policies.
Regular cleaning of non-contaminated surfaces, such as seats and tabletops, can be done using standard cleaning solutions.
Regular cleaning of obvious soil is more effective than extraordinary attempts to disinfect or sterilize surfaces

46. Cleaning Tools:
Brooms and dustpans must be rinsed in disinfectant. Mops must be soaked in disinfectant, washed and thoroughly rinsed. The disinfectant solution should be disposed of promptly down the drain.

47. ACCIDENTAL EXPOSURE Procedure:
Always wash the contaminated area immediately with soap and water.
If the mucous membranes (i.e., eye or mouth) are contaminated by a splash of potentially infectious material or contamination of broken skin occurs, irrigate or wash area thoroughly.
For cuts or needle injuries, wash the skin thoroughly with soap and water.
If broken skin or mucous membranes are contaminated the staff should: Notify their supervisor immediately. Document the event, then follow the procedures in the blood-borne pathogen exposure control plan for the district.

48. Higher Risk? Pregnant Women Pregnant women are not at higher
risk for infection than other
caregivers provided that appropriate
precautions are observed.
There is, however, the possibility
of an in-utero transmission of
Viral infections, such as
cytomegalovirus (CMJ), HIV,
Varicella or HBV to unborn
children.

49. Check List--DO
Do check PPE for damage before putting it on. Do remove PPE carefully to prevent the spread of contamination. Do place contaminated PPE, towels, etc. in closable, leakproof bags or containers for disposal or decontamination. Do wash exposed skin immediately and thoroughly with soap and water. Do wash thoroughly with soap and water after removing personal protective equipment. Do flush exposed eyes, nose, or mouth quickly and thoroughly with water.

50. Do… Do cover open cuts, rashes, and other broken skin.
Do minimize splashing or spattering of potentially infectious materials.
Do cover open cuts, rashes, and other broken skin.
Do dispose of used needles carefully and immediately in assigned
puncture-resistant, leak proof containers identified by the biohazard
symbol.
Do clean and decontaminate pails and other reusable containers
regularly—immediately after contact with potentially infectious
materials.

51. Do… Do follow Blood-borne Pathogens Standard precautions to enable
Do report any on-the-job exposure to blood or other
Body fluids promptly and get medical attention.
Do follow Blood-borne Pathogens
Standard precautions to enable
you to respond to an injury without
fear of infection.

52. Don’t
Don't practice unsafe sex, inject illicit drugs or share needles. Don't worry that casual contact with an infected person will transmit a blood-borne disease. Don't mix contaminated clothing or linens with other laundry. Don't keep food or drink in work areas that could contain infectious materials.

53. Don’t… Don't eat, drink, smoke, apply makeup or lip balm, or
handle contact lenses in areas with exposure potential.
Don't touch any contaminated surfaces, clothing, or
equipment.
Don't touch needles or other sharps that may be
contaminated by blood.

54. Don’t…
Don't bend, recap or remove sharps unless specifically instructed to do so. Don't reach by hand into a container holding sharps. Don't clean up broken glass by hand; use tongs, a brush and pan, etc. Don't let fear of exposure to blood-borne pathogens keep you from helping an injured person.

55. In Summary If it’s wet, and it’s not yours, don’t touch it!
Have gloves readily available.
If it’s wet, and it’s not
yours, don’t touch it!
Report any exposure incidents to
your supervisor immediately.

56. All Employees have access to a copy of the Bloodborne Pathogen Exposure Control Plan from their supervisor, the personnel office and on the district web site.
Forms required to properly report an exposure incident, make arrangements for physician assessment and treatment, and receive hepatitis b vaccination (if needed) are in the BBP Exposure Control Plan.

57. Questions? Contact Shanda Brewer, RN, DHSC