Policy Development Guidelines

HIV/AIDS

i SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES December 1995

Produced by: South Australian Independent Schools Board Inc 301 Unley Road Malvern SA 5061 Ph: (08) 373 0755 Fax: (08) 373 1116

ACKNOWLEDGMENTS

This policy has been adapted from the draft Independent Schools Board AIDS Policy produced by the Health Educators’ Network in 1993 and the South Australian Commission for Catholic Schools (SACCS) HIV/AIDS Policy.

Thanks go to the following staff and parents for their contribution to this revised Policy document.

Bethesda Christian College

Ian Hopper

Southern Montessori School

Debbie Anderson Heather Powell Fran Thulborn Kath Welsh

Woodcroft College

Marnie Watts

SA Independent Schools Board

ii SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES Barbara Keen Health HIV/AIDS Coordinator Paul Van Ruth Occupational Health Safety & Welfare Consultant Bevan Connor Industrial Officer

Consultant

Alison Morrissey Educator & Management Consultant

iii SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES CONTENTS

Page

1 INTRODUCTION1

1.1 Background to the Document 1 1.2 Aims of the Document 1 1.3 Purpose of the Document 1 1.4 Key Principles 2 1.5 Application to Individual Schools 2

2 BASIC MEDICAL-SCIENTIFIC DATA 3

2.1 What is HIV/AIDS? 3 2.2 Immune System 3 2.3 HIV Characteristics 3 2.4 Transmission of HIV 4 2.5 School, Social or Non-Sexual Contact 5 2.6 Reducing the Spread of AIDS 5

3 THE SCHOOL RESPONSE - EDUCATION 6

3.1 School Education Policy 6 3.2 Prevention Education 7 3.3 The Christian Response 7 3.4 The Humanistic Response 8

4 EMPLOYMENT RESPONSIBILITIES 9

4.1 Occupational Health & Safety 9 4.2 Conditions of Employment, Protection from Discrimination & Victimisation 10 4.3 The Right to Privacy 11

5 STUDENT ENROLMENT 12

5.1 Privacy/Notification Requirements 12 5.2 Protection from Victimisation/Discrimination 12 5.3 Continued Access to Schooling 12

6 HEALTH AND SAFETY ISSUES 13

6.1 General Precautions 13 6.2 First Aid 14 6.3 Procedures for Cleaning Utensils, Benches, Play Equipment & Blood Spills 15 iv SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 6.4 Safe Disposal of Needles/Syringes 16

7 SCHOOL-BASED POLICY - application to individual schools 18

v SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 1 INTRODUCTION

1.1 BACKGROUND TO THE DOCUMENT

This document is an update of previous guidelines which were developed by the Health Educators Network in response to requests from schools for assistance in developing their own HIV/AIDS policy guidelines.

1.2 AIMS OF THE DOCUMENT

This document is not in itself an HIV/AIDS education package. Rather, it provides guidelines for the implementation of standards and procedures by:

 presenting basic medical-scientific data relating to HIV/AIDS, its transmission and prevention  encouraging schools to ensure that they have in place a sound HIV/AIDS education program which emphasises personal and social responsibility in the context of a caring school community  providing guidelines for the employment and continuing employment of staff living with or affected by HIV/AIDS, having regard to their special needs and proper care  providing guidelines for the enrolment and admission to schools of students living with or affected by HIV/AIDS, having regard to their special needs and proper care  discussing the responsibilities of schools in relation to HIV/AIDS and  occupational health and safety  hygiene and first aid procedures  confidentiality of information.

1.3 PURPOSE OF THE DOCUMENT

The personal and social implications of the human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are significant and cannot be ignored. Prevention of the spread of HIV is a public health issue which affects all sections of the community.

It is acknowledged that HIV infection is only one of many communicable diseases (including blood borne Hepatitis B and Hepatitis C) which affect the health and well-being of the community. Infection control and occupational health and safety strategies are important tools in reducing the impact of all such infections. However, the nature of HIV/AIDS, together with the absence of an effective vaccination and lack of a medical cure, necessitate that special

1 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES attention be paid to its prevention and to the care of those whose lives it affects.

School communities have an important role in providing accurate information about the virus and in promoting responsible attitudes and behaviours relating to the prevention of HIV/AIDS. From time to time a school community may include a student, family, volunteer or staff member affected directly or indirectly by HIV/AIDS. Schools will wish to be sensitive to the needs of those affected and have access to guidelines concerning aspects of their management. Schools may consider that the development of a school- based HIV/AIDS Policy will be helpful when dealing with these issues.

This document has been prepared to address the implications of HIV/AIDS for schools. It is not an Independent Schools Board policy but is presented as a guide for those schools which may wish to develop their own policies or guidelines. Schools may choose to use sections of the document, either as presented or modified to meet individual needs.

1.4 KEY PRINCIPLES

The policy development guidelines are based upon the following principles:  the dignity and uniqueness of each person  the equality of all people  the acceptance of responsibility for self and others for the good of all  the right of each school to independence and free choice  the right of students to accurate information which promotes health and safety.

1.5 APPLICATION TO INDIVIDUAL SCHOOLS

It is recognised that school philosophies are based on a variety of traditions. While the document’s references to technical information, infection control procedures and legal obligations are applicable to all schools, separate sections addressing Christian and Humanistic responses have been included in Part 3.

2 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 2 BASIC MEDICAL-SCIENTIFIC DATA

HIV/AIDS Technical Information

This section of the guidelines presents basic medical-scientific data on HIV/AIDS. As with all other diseases, it is important to respond to HIV/AIDS in a manner consistent with the best medical and scientific information available.

2.1WHAT IS HIV/AIDS?

The human immunodeficiency virus (HIV) is a blood borne virus that can cause Acquired Immune Deficiency Syndrome (AIDS). It is expected that fifty percent of people living with HIV will develop AIDS within two to ten years of becoming infected and that ninety-nine percent will eventually develop AIDS.

While there are treatments which prolong the life of someone with HIV infection, there is no cure for AIDS.

2.2 IMMUNE SYSTEM

The body's general response to the invasion of any infecting virus is to mobilise its immune system. White blood cells (lymphocytes):  produce antibodies which neutralise the virus  activate killer cells to destroy virus infected cells and  secrete interferon to inhibit viral replication and spread.

Generally, white blood cells produce antibodies to infective agents, including HIV, within a period of two to eight weeks. The result is usually the termination of the infection, recovery to a normal state of health and a long term immunity to subsequent infections by the same form of infecting agent.

2.3 HIV CHARACTERISTICS

The human immunodeficiency virus (HIV) is a retrovirus identified in 1981 by French and American scientists. Like all viruses, HIV does not have the capacity to replicate itself. It must invade body cells and use the cell’s metabolic processes for replication. This leads to the death of the cell and the shedding of HIV progeny into the blood stream, resulting in the infection of other susceptible cells.

3 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES The specific characteristics of HIV, however, impede the normal immune responses. The ability of the virus to change its outer protein coat confuses and limits the ability of antibodies and killer cells to recognise and neutralise the invading viruses. This enables a continuous infection of healthy cells.

To reproduce itself HIV prefers the CD4 lymphocytes which are white blood cells whose primary role is regulation of the immune response. Infection of CD4 cells by HIV results in ineffective immune responses to other infectious agents and eventually the total breakdown of the immune system.

The natural history of HIV within the human body is not fully understood and the immune system is only one of several body organs attacked by the virus. Following the initial infection, the virus reproduces itself at a relatively low rate within the lymph glands. After several years of infection, for reasons which are not fully understood, the level of viral replication increases. Consequently, the effect of the virus on the immune system takes several years to become obvious, with people carrying the virus for ten years or more whilst remaining healthy. Once infected however, the person remains infected for life and faces the prospect of life threatening disease.

Children born carrying the virus may not show signs of an impaired immune system for eight to ten years.

The term AIDS (Acquired Immune Deficiency Syndrome) is used when people show clinical signs of those rare or unusual diseases which can occur only when the immune system is irretrievably compromised.

2.4 TRANSMISSION OF HIV

HIV is a blood borne virus which survives and reproduces itself in the blood cell system. Unlike airborne viral infections, such as influenza, which can be easily transmitted from one person to another through the air, the transmission of HIV requires that the virus must in all cases leave the body of an infected person and enter the blood stream of an uninfected person.

Infective concentrations of HIV are found in blood, semen, vaginal secretions, cerebrospinal fluid and breast milk. HIV is not in infective concentration in other body fluids such as tears, saliva and urine.

The primary means of transmitting HIV are:

4 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES  through unprotected sexual intercourse (anal and vaginal) with an infected person  through sharing needles and syringes with an infected person when injecting drugs  from an infected mother across the placenta to the foetus or during birth  via breast milk  through receptive oral sex with an HIV positive person  through receiving contaminated blood, blood products or artificial insemination with infected semen  as a result of accidental needle-stick injury, ie puncturing the skin with a blood contaminated syringe needle  through treating accidental injuries involving contaminated blood, if the carer has open sores or cuts on the hands.

NOTE: Hepatitis B and C are also caused by blood borne viruses and are transmitted in the same manner as HIV.

2.5 SCHOOL, SOCIAL OR NON-SEXUAL CONTACT

There is no evidence of spread of HIV from child to child in schools or child care centres through normal social contact.

A significant number of studies have been undertaken of households where one or more members were infected with HIV. The infected members have included intravenous drug users, people with haemophilia, homosexual and bisexual men, recipients of blood transfusions and heterosexual men and women. Not a single case of infection has been reported in other household members except where these members had been additionally exposed to the virus through blood, sexual activity or perinatal transmission.

2.6 REDUCING THE SPREAD OF HIV/AIDS

Currently, testing for an effective vaccine continues with the possibility of promising results. However, to date there is no cure or vaccine available and world wide the numbers of people carrying the virus continue to rise.

Knowing how to avoid the risk of being infected is central to developing responsible attitudes and making decisions about adopting healthy behaviours. In the absence of a vaccine or other method of prevention, avoidance of high risk behaviours is the only satisfactory means of reducing the spread of HIV/AIDS.

5 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 3 THE SCHOOL RESPONSE - EDUCATION

In light of the preceding basic technical information on HIV/AIDS, this section of the document addresses the education implications for schools.

3.1 SCHOOL EDUCATION POLICY

Appropriate education is the major strategy in dealing with the HIV epidemic. Education should include provision of factual information, exploration of attitudes and values and details of prevention methods.

Education should be directed towards all members of the community as HIV/AIDS is a community issue. The application to schools is particularly significant. Hence:

 All school staff need information that is accurate, appropriately extensive and current. Staff should know the definite ways HIV can be transmitted and should be able to dispel unfounded fear and prevent phobias about HIV and AIDS.  Schools have a duty to provide appropriate inservice for staff, including instruction in first aid procedures.  Students need accurate information that is appropriate to their stage of learning readiness and development. Each school is the best judge of its own students' requirements.  It is recommended that students receive appropriate instruction in basic hygiene and first aid procedures.  Each school is encouraged to establish an HIV reference group including, for example, the school principal, staff member(s) and parent(s), to promote HIV education.  School staffs should explore ways of reinforcing HIV education programs by using cross-curriculum strategies.  Resource material should not be used indiscriminately, but after careful review and taking into account the values of the school community. Cultural sensitivity also is counselled and materials should always be used within the context of the education curriculum guidelines of the school.  Parents need easy access to current, accurate information. They also need help to process and apply that information. Schools should seek to keep parents informed of government, community and relevant Church resources already operating. They should involve parents at all stages of HIV program development and implementation.

6 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 3.2 PREVENTION EDUCATION School teaching values each person and his or her sexuality.

Education programs to inform the community about the transmission of HIV must be factual, objective and updated as more information becomes available.

Prevention messages should be clear, consistent and simple, so that they can be personalised and incorporated into an individual's unique values and beliefs and adopted as personal behaviours.

HIV/AIDS prevention education is best taught within a school curriculum which develops students’ knowledge, attitudes and skills in sound decision making for safe and responsible behaviour. It should include education in interpersonal skills, sexuality and the responsible use of drugs.

3.3 THE CHRISTIAN RESPONSE The Christian response to HIV/AIDS is based on truth and love. When truth is embraced, courage and balance prevail. When love is embraced, the response is characterised by compassion and care for all.

These guidelines call upon schools to implement a caring, Christian response to HIV/AIDS and so promote justice and the dignity of each person.

Commitment to a Christian faith requires schools to respond to HIV/AIDS in a manner which is theologically and morally sound and to contribute not only through education, but also through Christian moral formation and renewal. The school’s personal development and Christian values education programs should emphasise moral responsibility in behaviour.

Key principles integral to this program are:  recognition of God's unconditional love for all people and the equality of all in God's sight  the Christian virtues of justice and respect  the dignity and uniqueness of each person created in the image and likeness of God  the sacredness of human life  reverence for the God-given beauty of human sexuality  a special awareness that indiscriminate sexual activity is not only in conflict with Church teaching, but is also a high-risk activity in terms of transmitting HIV  Christian acceptance of responsibility for self and others.

Curriculum guidelines should be designed to promote in students: 7 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES  a deep sense of God's love  a high sense of self worth  self acceptance and self confidence  ease in coping with relationships  good communication skills  self assertiveness  the ability to choose wisely and well.

Christian love is the basis of the response to HIV/AIDS. A love of self and a respect for others is the key to living morally.

3.4 THE HUMANISTIC RESPONSE

A commitment to social justice and concern for human dignity forms the basis for the school’s response to HIV. This concern for human dignity requires the school to respond to the HIV epidemic not only through education, but also with a commitment to individual moral responsibility and behaviour.

Key principles integral to this program are:

 acceptance of the responsibility for self and others  acknowledgment of the human virtues of justice and respect  recognition of the dignity and uniqueness of each person  respect for human life  a valuing of human sexuality  an understanding that irresponsible sexual behaviour is a high risk activity in terms of transmitting HIV.

Curriculum guidelines should be designed to promote in students:

 a high sense of self worth  self acceptance and self confidence  ease in coping with relationships  good communication skills  self assertiveness  the ability to choose wisely and well.

8 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 4 EMPLOYMENT RESPONSIBILITIES

This section addresses the responsibilities of principals and other members of the school community concerning:  occupational health and safety  conditions of employment, protection from discrimination and victimisation  the right to privacy.

4.1 OCCUPATIONAL HEALTH AND SAFETY

The Occupational Health, Safety and Welfare Act 1986 places strict legal obligations on employers with respect to the provision of safe working facilities, safe processes and appropriate inservice safety training for their employees.

 EMPLOYERS Principals and appropriate school personnel are responsible for the implementation of safe working practices. They should:  take steps to enhance their own knowledge and understanding of HIV/AIDS issues as they relate to the school environment  ensure that all employees and other members of school communities are provided with appropriate HIV/AIDS information, including modes of transmission and prevention  facilitate training and development in relation to health, safety, welfare and justice aspects of HIV/AIDS  inform school councils and the wider school community about the implications of HIV/AIDS for schools, and encourage their participation in the development of school-based policies  manage occupational health and safety issues arising from the presence of people with HIV/AIDS in the workplace  implement procedures which safeguard the health, safety, welfare and privacy of all employees, volunteers and students in relation to HIV/AIDS  provide support and counselling for school staff directly involved in HIV/AIDS issues.

 EMPLOYEES Employees should:

9 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES  ensure that they understand school-based HIV/AIDS policy guidelines concerning occupational health and safety and be familiar with their own responsibilities  participate in training and development programs which are designed to enhance their knowledge and understanding of HIV/AIDS issues  practise universal precautions in relation to first aid procedures  support and implement school education programs for HIV/AIDS prevention.

4.2 CONDITIONS OF EMPLOYMENT, PROTECTION FROM DISCRIMINATION AND VICTIMISATION

The Federal Disability Discrimination Act defines “disability” to include “the presence in the body of organisms causing disease or illness” and “the presence in the body of organisms capable of causing disease or illness”. Discrimination against a person with such a disability would certainly include HIV status discrimination and AIDS related discrimination. Under the South Australian Equal Opportunity Act, complaints of AIDS related discrimination are accepted by the Equal Opportunity Commission on the grounds of impairment.

Employment within the school should not be refused on the grounds that a person may be HIV infected. As far as is reasonably practicable, employees should not have restrictions placed on their conditions of employment.

Employees or applicants for employment should be treated fairly and protected from any form of victimisation or discrimination - direct or indirect - on the grounds that they have or are imputed to have AIDS or HIV. Examples of such discrimination are:  dismissal, refusal to recruit, re-engage or promote  unreasonable denial of access to employment benefits, professional development or work-related social activities  failure to protect an employee from harassment or victimisation by other people present in the workplace  unreasonable differential application of any regulation or benefit associated with employment  breach of confidentiality or failure to maintain confidentiality of personal information.

All members of the school community need to be aware of the importance of the use of sensitive, non-discriminatory language and the need to develop and maintain a supportive school environment.

10 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES Long-term sick leave, which may be necessary because of an HIV/AIDS- related condition, is determined by the rules which apply in the case of any illness, including the provisions relating to fitness to resume work.

11 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 4.3 THE RIGHT TO PRIVACY The HIV/AIDS status of an employee is a private matter between patient and doctor. This privacy is protected as follows:  No employee is required to disclose information about his/her condition in relation to HIV/AIDS.  No school employee may seek information relating to the HIV/AIDS status of another employee without the written approval of the individual concerned. A person who divulges information provided in confidence may be sued for breach of confidence and may be liable to pay monetary damages.  Medical certificates relating to sick leave do not require specification of the nature of the illness or condition. They need only state that the person is unfit for work, specify the expected duration of absence and provide the medical practitioner's signature. Employees should be alerted to the fact that medical certificates are processed by a range of people. If a certificate contains information about HIV/AIDS status it should be returned to the employee before processing, so that he/she may arrange for the medical practitioner to amend the information.

12 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 5 STUDENT ENROLMENT

The following guidelines regarding school admission of students who are classified as living with HIV/AIDS should be based on the principles of justice, compassion and respect for the rights and dignity of each person.

5.1 PRIVACY/NOTIFICATION REQUIREMENTS All members of the school community should respect each person’s right to privacy.

There is no legal requirement for students, parents or doctors to report a student’s HIV/AIDS status to a school. However, some parents may choose to make this information available. In such a case members of the school community should not disclose the identity of an HIV positive student without the parents’ written authority.

5.2 PROTECTION FROM VICTIMISATION/DISCRIMINATION Students should be protected from any form of victimisation and discrimination on the grounds that they have or are thought to have HIV infection or AIDS. Examples of victimisation and/or discrimination are:  refusing to enrol the student  excluding the student from attendance  unreasonably denying access to school programs or activities  unreasonable differential treatment  differential application of school rules. Students should also be protected from victimisation or discrimination on the grounds of association with people who have or are thought to have HIV infection or AIDS.

5.3CONTINUED ACCESS TO SCHOOLING Students should not be excluded from attendance at school solely on the grounds that they have or are thought to have HIV infection or AIDS. Principals should:

 as far as is reasonably practicable, provide support to allow students with HIV/AIDS related conditions to be supported so that they can remain at school and participate in the school program. Examples of such support could be the re-allocation of existing school resources, involvement of appropriate school personnel, adjusted hours of attendance for the student, provision of personal counselling, and provision of additional resources as far as is reasonably practicable

13 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES  as is the case of any student with a chronic illness, students who are absent because of HIV/AIDS should be provided with appropriate curriculum support as determined by the school, in consultation with parents.

14 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 6 HEALTH & SAFETY ISSUES

The following guidelines relating to blood and body substances are provided on the advice given by the South Australian Health Commission.

All cases of external bleeding should be dealt with in accordance with procedures outlined in this section. Procedures should be applied universally and be regarded as mandatory because of the Occupational Health Safety and Welfare Act 1986. The information is basic to developing and maintaining effective practices in treating students or staff who are bleeding.

6.1 GENERAL PRECAUTIONS In addition to the human immunodeficiency virus, there are other blood-borne infections, including Hepatitis B and Hepatitis C, which make it important to implement rigorous hygiene and first aid procedures in schools and workplaces. Such procedures are relevant to many diseases and are not solely designed to deal with HIV, which is, in fact, one of the least infectious of the communicable diseases that might be found in schools. The term “universal precautions” refers to the method of avoiding transmission of infection through the use of protective barriers and other safe work practices. It is based on the assumption that all blood and body substances are potential sources of infection, irrespective of whether HIV or other infection has been diagnosed or is suspected.

 It is important to emphasise basic universal hygiene in schools and review first aid procedures. These procedures are designed to deal with the HIV virus and all blood borne infections.  Direct contact with blood and body substances should, if possible, be avoided.  Intact skin is the most effective barrier against infection with contaminated blood and body substances.  Latex gloves provide additional protection from cross infection between the person requiring care and the carer. Accordingly, when treating cuts and abrasions, teachers and others should wear disposable latex gloves supplied by the school.  It may be necessary for students/staff/volunteers to go to the emergency assistance of a child or adult when latex gloves are not immediately available. In such cases they should wash their hands and lower arms and any other parts in contact with blood or body substances, using soap and water, as soon as practicable.  Staff involved in toileting a student should exercise strict hygiene, using gloves at all times to prevent contact with the student's body substances.

15 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 6.2 FIRST AID

6.2.1 Responsibilities  Generally one or more members of staff will be designated as having responsibility for attending to students requiring first aid treatment. However, all staff should be reminded of the particular need for care in handling blood and body substances.  There is no basis on medical grounds to refuse assistance of first aid to any person. The duty of care which a teacher owes to students requires the teacher to take positive action to preserve the health and safety of students.

6.2.2 Training  It is recommended that all teachers and school assistants receive Basic Casualty Care training every three years. Training in cardio- pulmonary resuscitation should include practice with the use of resuscitation masks which should be disinfected after use.  Since teachers, other school staff and voluntary workers are likely to come into contact with injured and bleeding students, the employer is legally obliged to ensure that these people are instructed in and required to observe safe processes in the handling of injured and bleeding students.

6.2.3 First aid kits and equipment  Principals should ensure that the school has adequate numbers of appropriately stocked first aid kits and clearly established first aid procedures. First aid kits must be made available for all school organised activities on and off the school grounds.  Principals should ensure that the school has an appropriately stocked first aid cupboard which contains a supply of 70 per cent alcoholic chlorhexidine, as well as a supply of household bleach for cleaning surfaces.  It is recommended that teachers on yard duty be issued with a pouch that can be attached to the waist with a belt, or a shoulder bag. Contents should be simple first aid materials such as disposable gloves, pressure pads, bandages, resuscitation mask.

6.2.4 Mouth-to-mouth resuscitation There are no documented cases of HIV infection from mouth-to- mouth resuscitation. As the risk of HIV infection through mouth-to- mouth resuscitation is negligible, it should not be withheld from a person in need of emergency assistance. However, as a precaution, a resuscitation mask should be used, if available.

16 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 6.2.5 First aid procedure - external bleeding

Precautions  Great care should be taken in all cases of wound care.  Staff with cuts and lesions on hands and arms should not administer first aid.  Avoid direct contact with blood.  Always use disposable latex gloves. After handling blood or blood contaminated material, always wash hands.

Equipment  antiseptic  disposable latex gloves  disposable towels  bin with lid and bin liner (plastic or heavy duty paper) for used items  dressings/bandages

Procedure 1 Use gloves. 2 Clean wound with antiseptic solution. 3 Dress wound. 4 Attend to instruments/equipment used as in 6.3. 5 Dispose of any used dressings etc into bin. 6 Remove gloves and place in bin. 7 Seal bin liner and arrange for appropriate disposal, eg garbage collection or incineration. 8. Wash hands with soap and water. 9 Document incident and procedure.

WASHING HANDS WITH SOAP AND WATER BEFORE AND AFTER ATTENDING TO INJURIES IS THE MOST IMPORTANT STRATEGY IN THE PREVENTION OF CROSS INFECTION.

6.3 PROCEDURES FOR CLEANING UTENSILS, BENCHES, PLAY EQUIPMENT & BLOOD SPILLS

Equipment

17 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES  household bleach (1:100 bleach to water on cleaned surfaces) or 70% chlorhexidine solution. [Bleach solution must be mixed daily to be reliable.]  latex gloves  bin with lid and bin liner (plastic or heavy duty paper) for used items  hot water and detergent

Procedure 1 Use latex gloves. 2 Mop up spills with paper towelling and dispose of directly into the lined bin. 3 Wash area with hot water and detergent. 4 Wipe area with bleach to disinfect. 5 Carpets - wash with detergent and water. 6 Utensils/Instruments/Linen - rinse with cold water then wash with hot water and detergent. Soak in bleach or 70% chlorhexidine solution for 20 minutes. Remove and rinse with water. 7 Remove gloves and place in bin. 8 Seal bin liner and arrange for appropriate disposal, eg garbage collection or incineration. 9 Wash hands with soap and water.

(Blood spills in yard areas may be hosed down before flushing with hot water and detergent.)

6.4 SAFE DISPOSAL OF NEEDLES/SYRINGES

Students should be instructed not to pick up syringes but to stand watch while another student gets a teacher.

Equipment  latex gloves  "sharps" disposal container or a secure sturdy container with a screw top lid (such as a wide necked drink bottle)  bin with lid and bin liner (plastic or heavy duty paper) for used items  tongs

Procedure 1 Use latex gloves. 2 DO NOT TRY TO RECAP THE NEEDLE. 3 Place the disposal container next to the syringe.

18 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 4 Pick up the syringe with tongs (or as far from the needle end as possible if tongs unavailable). 5 Place the syringe - needle point down - in the disposal container and screw on the lid. 6 Repeat the procedure to pick up all syringes. 7 Remove gloves and place in bin. 8 Seal bin liner and arrange for appropriate disposal, eg garbage collection or incineration.

9 Wash hands with soap and water.

Disposal  Syringe disposal containers or syringes must NOT be put in normal waste disposal bins.  Advice about disposal of syringe disposal containers may be provided by contacting the:  local Municipal Office  Drug and Alcohol Services Council for the location of the nearest Needle Exchange outlet or public disposal point.  (08) 274 3385 or after hours (08) 364 0055 or 008 18 2118  Local hospital/doctor  Clinic 275 (STD Clinic).  (08) 226 6025  SAVIVE at The AIDS Council of SA.  (08) 363 9299  KESAB - 395 Glen Osmond Road, Glen Osmond.  (08) 338 1855

19 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES 7 SCHOOL-BASED POLICY

Application of the guidelines to individual schools.

It is important that school-based policy, including practices, procedures and programs concerning HIV/AIDS, is developed within the framework of the school philosophy and in full consultation with the wider school community.

The whole school community should be actively involved in the development of any policy in relation to the management of health in schools.

The successful implementation of practices, procedures and programs requires open dialogue with families.

Ongoing evaluation of policy will include discussion and input from staff and parent groups.

A school-based policy for HIV/AIDS will:

 reflect the values of justice and respect for human dignity

 support and be supported by the school's policies on enrolment, employment, occupational health and safety, first aid, etc

 support HIV education as outlined in the implementation process of the school’s curriculum guidelines

 ensure any legal requirements are clearly documented

 explain the rights and responsibilities of all members of the school community

 make provision for ongoing implementation, review and evaluation of the policy.

20 SA INDEPENDENT SCHOOLS BOARD - HIV/AIDS POLICY GUIDELINES