Bloodborne Pathogen

Training

Presented by:
Jill Sheeley, R.N. BSN
Nurse for Waterford Cooperative
Schools

Bloodborne Pathogen Standard

To reduce, minimize or eliminate occupational exposure to
potentially infectious materials which could cause disease or
death. It does so by outlining what procedures and practices are
needed to accomplish this goal.

The reason this training is provided is to meet OSHA and DILHR

standards which state that this type of training must be provided
to employees who could have a "reasonable anticipated
occupational exposure to bloodborne pathogens. The training is
intended to teach you methods of prevention to reduce or eliminate
the potential for transmission of bloodborne pathogens.

Components of the Bloodborne

Pathogen Standard
Evaluation of employee activities
Assess risk of exposure based on job activities and responsibilities
An exposure control plan
A working document
Objectives of regulation
Engineering Controls- sharps containers, hand-washing facilities
Work Practices- proper hand-washing, sharps handling and blood
clean-up
Personal Protective Equipment- gloves, goggles, face shield, gown
Specific cleaning/decontamination and general housekeeping
Vaccination- Hepatitis B vaccination available to employees at risk to
BBP exposure
Provide information and Training
Response system for exposure incidents
Record keeping requirements

Occupational Exposure
Definition:
reasonably anticipated contact with blood or
OPIM by eye, mouth or other mucous membrane, skin
or piercing of the skin with a sharp object as part of

assigned job tasks.

Typical Activities in a School

District
Activities which may qualify employees for coverage under the standard:

delivery of first aid/health care

restraining aggressive behavior
handling of sharps
clean up of blood or OPIM
assisting with personal hygiene
other medically delegated tasks
other activities with potential for blood exposure

Employees covered under

the Standard
Those of you who, as a required component of your
position, may have exposure to blood or OPIM
May include: nurses, health care aides, first aid
providers, coaches, staff of special needs programs,
custodial staff and teachers of classes using sharps or
cutting tools (art, science, or Tech. Ed.)

Exposure control plan

The districts document to help comply with DILHRs standards:
contains forms and information necessary to comply with State and Federal regulations
identifies in writing the tasks, procedures, and job classifications where occupational exposure
to blood occurs
specifies work activities, engineering controls, and PPE to help prevent potential exposures
discusses specific circumstances of possible exposure incidents and proper follow-up procedures
ECP is readily accessible to all employees and DILHR

In this school the ECP is located THE HEALTH ROOM/MAIN

OFFICE
the plan needs to be reviewed/updated annually and more often if necessary to accommodate
changes in the workplace

Chain of Infection
In order for the

infection to occur,
all the parts of the
chain must be
intact.
If a link is broken
at any point,
infection will not
occur.

Hand Hygiene
Hand washing Technique
Turn on water to comfortable temperature, wet
hands, apply soap and lather
Rub with friction for at least 15 seconds making sure
to rub backs of hands, palms and in between fingers
Rinse hands with fingers pointing down
Dry hands with paper towel, use paper towel to turn
off water (if necessary). Dispose of paper towel.

Bloodborne Pathogen
Definition
Bloodborne pathogens are:
disease causing micro-organisms present in human blood
can infect and cause disease in humans
three of greatest concern are HIV, Hepatitis B and Hepatitis C
others include: Syphilis, and Hepatitis D

Characteristics of BBPs
HIV

Attacks immune system

Modes of Transmission
sexual contact
needle sharing
mother to baby
other blood and
body fluid contact
not vaccine
preventable
virus is killed easily
outside of body

HBV

Attacks liver
Modes of Transmission
sexual contact
needle sharing
mother to baby
other blood and
body fluid contact
vaccine preventable
virus is killed by
high level
disinfectants

HCV

Attacks liver
Modes of Transmission

Sexual contact

Needle sharing

Mother to baby

Other blood and

body contact

Not vaccine
preventable

Virus is very difficult

to kill

HIV

Destroys immune system in humans

Antibody response within 3-6 months (usually 6 weeks)
Treatment prophylaxis AZT (start within 2-24 hours)
Blood tests available (ELISA, Western Blot)
Post exposure testing at:
6 weeks
3 months
6 months
HIV progresses to AIDS. Current treatments have allowed AIDS to

become a chronic and manageable disease.

Symptoms of HBV
Fatigue
Loss of appetite
Nausea
Jaundice
Darkened urine
Possible stomach pain
50% have no symptoms
Most HBV sufferers recover, however,
10% retain the disease for life.
HBV causes 5,000deaths per year

HBV Incubation
1-6 months (usually 60-90 days)
Onset
asymptomatic
mild flu-like symptoms
severe flu-like symptoms

HBV vaccination
3 injections in deltoid muscle
Mild to no side effects
Second injection is given 1 month after the first and the

third is given 4-6 months after the second

If you are pregnant, discuss immunization with your
physician
Please make sure you are up to date with all 3 shots of
HBV. If you are unsure, please speak with your
physician.

Hepatitis C
3.9 million Americans are infected
2006 there were 19,000 new cases in U.S.
2010 WI had 2550 new HCV cases (total WI

HCV cases 85,000)

There is no vaccine for HCV and there is no
definitive cure
8,000-10,000 people die every year from
Hepatitis C related liver disease
HCV is leading cause of liver transplants

HCV symptoms
Loss of appetite
Fatigue
Nausea and vomiting
Vague abdominal pain
Jaundice
Most HCV are asymptomatic
Some individuals carry the virus in their bloodstream
and may remain contagious for years. 75-85% of
people infected with HCV will develop chronic hepatitis C
No vaccine for HCV

BBP Modes of Transmission

Sexual contact
Infected mother to child
Exposure to blood (contaminated needle sharing, blood

contact with non-intact skin or mucus membrane)

Greatest risk is in ones personal life, not work

Casual contact is not a mode of transmission for

HIV, HBV, or HCV

Bites
At school we are concerned about bites that
break the skin.
These are reported as BBP exposure incidents
The risk is not saliva, but the potential for a
lesion or cut in the mouth when the bite occurs.
If a bite breaks the skin it is considered a
potential HBV exposure but not a high risk for
HIV.

Universal Precautions
All human blood and certain body fluids

are treated as if known to be infectious

for HIV, HBV, HCB and other bloodborne
pathogens
Make certain to use proper precautions
every time you might have contact with
infectious fluids

Universal Precautions/Engineering &

Work Controls
Treat all blood and body fluids as if infectious
Handwashing facilities/suitable cleaners
Never recap needles
Proper storage and disposal of contaminated materials
Decontamination of surfaces after any blood or OPIM
exposure
PPE (gloves, goggles, etc)
Labeling
Cleaning schedule

Other Potentially Infectious

Materials (OPIM)

semen
vaginal secretions
cerebrospinal fluid
synovial fluid
pleural fluid
pericardial fluid
peritoneal fluid
amniotic fluid
saliva in dental procedures
any body fluid in situations where it is difficult or impossible
to differentiate between body fluids

What goes in a red biohazard

bag?
If it is dripable, pourable or flakeable

it goes in a red biohazard bag.

If it is not dripable, pourable or flakeable

it goes in the regular garbage.

PPEPersonal Protective
Equipment
Gloves, safety goggles/glasses and masks
Use whenever there is a potential for contact
with blood or OPIM.
Help to protect mucus membranes, open
non-intact skin and clothing

Gloves
Use prior to contact with blood or OPIM
Check for proper fit
Check for punctures
Wash hands after use
Roll or pull gloves off from wrist to fingers (inside out)
to minimize contamination
Do not reuse
Get new gloves at the start of each school year and
replace as needed.

Glove Removal
Remove glove by grasping cuff of one glove with thumb
and pointer finger of other hand. Pull glove inside out.
Set this glove in the palm of remaining gloved hand
Use thumb and pointer finger to grasp cuff of glove on
other hand and pull this glove inside out.
Both gloves are now inside out, inside each other
Dispose in garbage and wash your hands.

Sharps Disposal
Sharps may include needles, syringes, broken glass,

lancets or scalpels
Broken glass must not be picked up by hand.
Mechanical means will be used (tongs, broom and
dust pan)
Contact District Nurse for disposal of sharps buckets
when they are at or near the full line

Sharps disposal cont.

Nothing other than sharp

objects are to go in the sharps

bucket (NO kleenex, tissue,
etc.)

What to do in the case of

a first aid incident
Instruct person on self-care of injury (hand them gauze

while you put on your gloves)

Use PPE (gloves)
Call for assistance if needed
Use a barrier (paper towel, gauze) when treating injury
Dispose of barrier material in appropriate container
Remove gloves &wash hands thoroughly

Blood clean-up procedure

Most schools prefer that custodians be contacted to

perform clean-up
Area should be isolated until a custodian arrives

Use gloves
Use disposable towels and other materials to absorb spill
Clean spill area with soap and water
Utilize proper disinfectant (1:10 bleach solution)
Dispose of waste in proper container
Remove gloves & wash hands

Whats an exposure?
Blood contact with mucus

membranes (eyes, nose or mouth)

Blood contact with broken skin
Piercing mucus membrane or skin
(needlestick, bite, cut or abrasion)

Post exposure
Wash or flush exposed area thoroughly

Employee reports incident to employer

The Exposure Control Officer at each school is the building principal
Records exposure incident information (paperwork)
Employer directs employee to HCP (Health Care Provider)
Employee evaluated by HCP
Confidential results, procedures and follow up given to employee by HCP
HCP provides written opinion to employer and employee
Documentation of incident
All portions of the post exposure follow up are provided to you without cost
Results of any testing are confidential and will not be shared with school
administration or with the school nurse

Post exposure continued:

All incidents with exposure to blood or
OPIM must be reported immediately to
the main office.
DO NOT GO HOME WITHOUT
REPORTING INCIDENT.
Must be reported ASAP.

Health Conditions and

Medications
Remember confidentiality!
Any questions from class list, please ask
secretaries and myself.
We may need help reminding kids to
come down to office for medications. We
will let you know.

Field Trips
Please plan ahead for field trips. If a
student has a medical need, I may need
to be involved in planning.
Always come to the office in the morning
to get a first aid kit and any medications
needed for the duration of the trip.

Completion
You have now completed BBP training for
the year.
Please contact the district nurse: Jill
Sheeley with any concerns or questions
sheeley@waterford.k12.wi.us
262-424-2868