Bloodborne Pathogen Training

Reviewed 01/2020

Objectives
Provide a basic understanding of:

1. Bloodborne pathogens (BBP).

2. Common modes of transmission of BBP.

3. Methods to prevent transmission of BBP.

4. Information to help school staff maintain compliance with the BBP standard.

Why do I need this training
Schools are responsible for identifying and educating staff who could be “reasonably anticipated,” as a result of performing their job duties, to be in contact with bloodborne pathogens.

What are Bloodborne Pathogens?
Viruses, bacteria and other microorganisms that are carried in the bloodstream and can cause disease. The most common bloodborne pathogens are:

• Hepatitis B Virus (HBV)

• Hepatitis C Virus (HCV)

• Human Immunodeficiency Virus (HIV)

Hepatitis B Virus (HBV)

1. Hepatitis means “inflammation of the liver.”

2. Most infectious bloodborne hazard.

3. Can survive outside the body for up to a week.

4. Vaccination for HBV is available and very effective at preventing the disease.

If you become infected with HBV you may have:

1. Flu-like symptoms.

2. Pain on the right side of the abdomen.

3. A condition in which the skin and the whites of the eyes turn yellow in color (jaundice).

4. Dark urine (like cola or tea).

5. Pale stools.

Some people have no symptoms at all!

Hepatitis B Vaccine

1. Staff considered at risk should be notified by the district.

2. Vaccination is a series of three injections over seven months, with relatively few side effects.

Hepatitis B vaccine series must be offered at no cost to all staff who are at risk of an occupational exposure to blood or Other Potentially Infectious Materials (OPIM).
OPIM includes all of the following:

• Human cells or tissue

• Any body fluid visibly contaminated with blood or OPIM

• Cerebrospinal, pericardial, synovial, pleural and peritoneal fluids

• Vaginal secretions

• Amniotic fluid

• Semen

• Saliva during dental procedures

• Any fluid where it is difficult to identify the presence or absence of blood

• Urine, feces, vomit, sweat, tears and saliva are not considered to be a risk for BBP transmission unless there is visible blood in them.

Hepatitis C Virus (HCV)

1. Long-term effects include chronic liver disease and death.

2. No treatment or vaccine is available for HCV.

3. Virus does not survive well out of the body.

HCV Symptoms
Hepatitis C symptoms are very similar to Hepatitis B symptoms:

1. Pain on the right side of abdomen.

2. Jaundice.

3. Fatigue.

4. Appetite loss.

5. Nausea.

6. Dark-colored urine.

7. Stools become pale in color.

Human Immunodeficiency Virus (HIV)

1. HIV attacks immune system & can cause the disease known as AIDS.

2. AIDS is the second-leading cause of death for age group 25-44 years.

3. Mostly commonly spread by unprotected sex or sharing needles.

Symptoms of HIV

1. Flu-like symptoms.

2. Night sweats or fever.

3. Weight loss.

4. Fatigue.

5. Swollen glands.

6. May also develop AIDS-related illnesses including neurological problems and cancer.

A person with HIV may carry the virus without developing symptoms for 10 years or more.

Transmission: How BBP Enter Your Body

Bloodborne pathogens can be transmitted when there is direct contact with blood or OPIM of an infected person.

1. Blood or OPIM entering open cuts, wounds, rashes, chapped skin or non-healthy skin.

2. Blood or OPIM splashing into your eyes, nose or mouth area (mucous membranes).

3. Percutaneous inoculation-misuse of sharps (broken glass and needles)

Exposure Control Plan Written plan to protect staff from BBP

1. Identifies staff at risk.

2. Identifies jobs and tasks at risk.

3. Vaccination program.

4. Work practice controls.

5. Use of personal protective equipment.

6. Post exposure incident procedure.

The plan must be accessible! Available in each Nurse’s Office and FCSD Google. Ask your supervisor or nurse.

Work Practice Controls
Are methods that reduce the chance of exposure to BBP

1. Universal precautions.

2. Hand washing.

3. Engineering control (such as sharps containers).

4. Other work practice controls

When occupational exposure risk remains, personal protective equipment (PPE) must be used.

Universal Precautions

1. Assists in the prevention of contact with blood and other body fluids.

2. The practice of treating ALL human blood as if it is infectious.

Apply when there is a possibility of coming in contact with:

1. Blood.

2. OPIM.

Bloodborne pathogen does not apply to the following unless blood is visible:

1. Feces.

2. Urine.

3. Sweat.

4. Nasal secretions.

5. Vomit.

Hand Washing

Wash hands before:

• Eating.

Wash hands after:

• Any contact with blood, body fluids or soiled objects.

• Using the toilet.

• Assisting with personal hygiene.

This is the single most important technique for preventing the spread of infectious diseases.

Hand Washing Technique

1. Wet hands

2. Wash with soap for 20 seconds

3. Scrub backs of hands, wrists, between the fingers, and under fingernails.

4. Rinse and dry

5. Use paper towel to turn off faucet

Alcohol-based Hand Sanitizers Procedure, if soap and water are not available:

1. Apply to palm of one hand.

2. Rub hands together.

3. Rub the product over all surfaces of hands and fingers until hands are dry.

Remember: if hands are visibly soiled, wash with soap & water!

Personal Protective Equipment (PPE)
Specialized clothing or equipment that provides protection against infectious material.

• Gloves

• Gowns

• Masks

• Eye protection

• Resuscitation devices

Personal Protective Equipment (PPE) in the School

1. PPE is provided at no cost to staff.

2. Must be accessible.

3. Type of PPE used is determined by task you are performing.

4. BBP protection kits are available at every AED

PPE Guidelines: Gloves

• Wear gloves when contact with potentially infectious materials is anticipated.

• Check gloves before use (no small holes, tears, cracks).

• Remove contaminated gloves before leaving the work area.

• Wash hands after removing gloves.

• Never reuse disposable gloves.

• Types of gloves than can be used include vinyl, latex, neoprene or utility gloves.

Glove Removal

• Grasp the outside of one glove at the wrist. Do not touch your bare skin.

• Peel the glove away from your body, pulling it inside out.

• Hold the glove you just removed in your gloved hand.

• Peel off the second glove by putting your fingers inside the glove at the top of your wrist.

• Turn the second glove inside out while pulling it away from your body, leaving the first glove inside the second.

• Dispose of the gloves safely. Do not reuse the gloves.

• Clean your hands immediately after removing gloves.

Cleaning Blood Spills

1. All surfaces and equipment that come in contact with blood must be decontaminated with appropriate cleaning solution.

2. Take your time and be careful.

3. Avoid splashing contaminated fluids.

4. Wear appropriate PPE.

Cleaning Up a Blood Spill
Cleaning process:

1. Apply gloves.

2. Absorb spill.

3. Apply 10% bleach solution or approved disinfectant .

4. Let solution sit for appropriate time:

   • Bleach solution = 15 minutes.

   • Follow label on other products.

Always follow your supervisors instructions.

Engineering Controls
Engineering controls are the first line of worker protection that provide physical or mechanical systems that eliminate the hazard at their source.

• Self-sheathing needles, no capping, shearing, breaking, bending or removing needles

• OAR 437-002-1030 requires that every employer with employees who use sharps in direct patient care must identify, evaluate, and select engineering and work-practice controls, including safer medical devices, at least annually. Evaluation of safer medical devices must involve non-managerial employees responsible for direct patient care.

• Use Sharps containers; must be easily accessible and not overfilled.

• Use mechanical means such as tongs or forceps to clean up broken glass not your hands

• Placement of regulated waste in a closable, leak-proof, and labeled/color coded containers for washing, decontamination or disposal

• Regulated waste includes liquid or semi-liquid blood or OPIM; items contaminated with blood or OPIM that would release these substances in a liquid or semi-liquid state if squeezed; items caked with dried blood or OPIM capable of releasing these materials during handling.

Other Work Practice Controls
Work practice controls alter the manner in which a task is performed in work areas where a likelihood of occupational exposure exists

• No eating or drinking in these areas

• No applying cosmetics or lip balm or handling of contact

• No food or drink in refrigerators with where blood or OPIM are kept

• Provide handwashing and requiring the use of handwashing facilities

• Routinely check equipment and decontaminating it before servicing and using

Disposing of Sharps

1. All contaminated sharps are discarded as soon as feasible in a designated sharps container.

2. Containers will be found where sharps are used.

3. Disposal is regulated.

Signs and Labels

1. Check for the Biohazard Sign which warns that the container holds blood or other infectious material.

2. Staff responsible for biohazard waste disposal will be informed of the district policy.

3. Waste such as bloody tissues can be disposed of in plastic lined trash cans and do not need a biohazard label, as long as when they are squeezed they do not release the blood.

What is an Exposure Incident?
A specific incident, while providing job duties, that results in blood or OPIM “getting in” through:

1. Non-intact skin.

2. Mucous membranes (eyes, nose, mouth).

What to do if an Exposure Occurs

1. Immediately:

   • Wash the exposed area with soap & water.

   • Flush splashes to nose, mouth or skin with water.

   • Irrigate eyes with water or saline.

2. Report the incident to your supervisor, nurse or administrator. Follow the Exposure Control Plan which will have you complete some forms and see the MD.

3. The district will provide for additional medical evaluation and treatment, if needed, at no cost to the staff member.

Scenario

James has cut his finger ...and there is blood everywhere. You rush to help.
What should have been your second instinct? To grab a pair of gloves or, if they weren’t readily accessible, give James a towel to control his own bleeding. You can now take time to find gloves and protect yourself or seek help and take him to the nurse. Please secure the area from others being exposed.
If James’ blood got into your eyes, mouth, or a cut on your skin — or if your blood got into James’ cut — there was an exposure.
If James’ got a few drops of his blood on your intact skin that is not an exposure.
Blood kits are available for all staff from the nurse This kit contains gloves, towels, wipes, alcohol and bandages.

If you have any questions or concerns, contact the nurse.
Please be aware that BBP Training Must be completed, annually.

To finish this training you must complete the post test.

Please write your name and answers to the post test on a piece of paper and bring it to one of the nurses offices to self correct. You can then complete the Hepatitis B Vaccination form which is mandatory per OSHA.

Bloodborne Pathogen Post Test

1. Bloodborne pathogen transmission never applies to vomit, urine, feces, perspiration, or tears.

   1. True

   2. False

2. The hepatitis B vaccine is very effective in preventing the disease.

   1. True

   2. False

3. Which of the following are potential routes of entry for bloodborne pathogens?

   1. Mucous membrane of the eyes, nose, and mouth

   2. Non-intact skin

   3. Penetration by a contaminated sharp object

   4. All of the above

4. Non-intact skin can include:

   1. Open cuts and nicks

   2. Skin that has a rash

   3. Skin that is chafed or chapped

   4. Non-healthy skin

   5. All of the above

5. Regulated waste means liquid or semi-liquid blood or OPIM contaminated items that would release these substances if squeezed.

   1. True

   2. False

6. All regulated waste items must be placed in an appropriate container for washing, decontamination, or disposal.

   1. True

   2. False

7. If you have been exposed to blood or potentially infectious materials at work, you should first wash or flush the affected body part then report the exposure to a supervisor and nurse, complete the blood exposure form and see MD.

   1. True

   2. False

8. If there is broken glass or any sharp object in a body fluid spill, you should pick it up using mechanical means such as tongs and take it to a sharps container.

   1. True

   2. False

9. Engineering controls are mechanical means of isolating or removing bloodborne pathogens hazards from the workplace, such as sharps containers and biohazard waste bags.

   1. True

   2. False

10. The Hepatitis B virus can live outside of the body for one week.

    1. True

    2. False

11. The Exposure Control Plan is a written health and safety strategy for reducing employeeʼs risk of exposure to bloodborne diseases and is available in the nurse’s office.

    1. True

    2. False

12. You can get HIV or Hepatitis B from infected blood or OPIM that comes in contact with your broken skin, or mucous membranes.

    1. True

    2. False

13. If one or two drops of blood come in contact with your healthy, intact skin, you have had an exposure incident as defined by OSHA.

    1. True

    2. False

14. Universal Precautions means treating all human blood and certain body fluids as if they are infected with bloodborne pathogens.

    1. True

    2. False

15. Bloodborne Pathogen Protection Kits are available at every AED.

    1. True

    2. False

16. Bloodborne diseases can only be transmitted by infected blood.

    1. True

    2. False

17. What actions can you take at work to help keep yourself safe from bloodborne pathogens

    1. complete the annual training on bloodborne pathogens

    2. Use appropriate personal protective equipment (PPE)

    3. Use universal precautions any time you might be exposed to a bloodborne pathogen

    4. All of the above

18. Handwashing includes which of the following

    1. Lather hands with soap and water and rub together

    2. Wash for at least 15 – 20 seconds

    3. Rinse and dry

    4. Use paper towel to turn off faucet

    5. All of the above

19. If you have an exposure incident while on the job, you will be provided confidential post-exposure medical evaluation and follow-up at no cost to you.

    1. True

    2. False

20. Personal Protective Equipment (PPE) must be provided, at no cost to the employee, where there is a risk of occupational exposure.

    1. True

    2. False

21. PPE includes gown, gloves, mask and eye protection.

    1. True

    2. False

22. If soap and water is not available use hand sanitizer.

    1. True

    2. False

23. Hepatitis B is an inflammation of the:

    1. Kidneys

    2. Liver

    3. Lungs

    4. Larynx

24. If a co-worker or student is bleeding you should

    1. Seek help

    2. Give them a paper towel to control their own bleeding

    3. secure the area from others being exposed

    4. All of the above