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Indicates That Precautions Are to Be Taken at All Times and in All Situations

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Indicates That Precautions Are to Be Taken at All Times and in All Situations FRANCIS HOWELL SCHOOL DISTRICT UNIVERSAL PRECAUTIONS AND Severe Allergy Awareness Revised May, 2012 Universal Precautions The strategy of Universal Precautions was developed in the mid-1980’s as a means of preventing the transmission of blood borne pathogens such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Although Universal Precautions were initially designed for use in hospitals and clinics, they are applicable in any workplace setting, including schools, where exposure to blood or blood-contaminated materials could potentially occur. The term “universal” indicates that precautions are to be taken at all times and in all situations. Universal Precautions involve the following measures: 1. Appropriate barrier precautions should be used to avoid skin or mucous membrane contact with any of the body fluids. (blood, urine, feces, mucous, saliva). Such barrier precautions can, based on the given situation, include the use of standard medical vinyl or latex gloves along with protective eyewear or masks. If potential contact with a significant amount of blood is anticipated, latex gloves are preferred. These items should always be available and readily accessible. 2. Hands and other skin surfaces should be washed immediately and thoroughly if contaminated. Hands should be washed immediately after gloves are removed. 3. If any body fluids come in contact with the mucous membrane surfaces of the mouth or nose, the area should be vigorously flushed with water. If the mucous membrane surfaces of the eye are contaminated, they should be irrigated with clear water, or saline solution or sterile irrigants designed for the purpose. 4. Precautions should be taken to avoid injury with sharp instruments contaminated with blood. Sharp items such as x-acto knives should be placed in puncture resistant, leak proof containers for disposal. 5. Persons providing health care who have excessive oozing fluids from skin lesions or weeping dermatitis should refrain from all direct student care, and from handling student-care equipment, until the condition resolves. GUIDELINES FOR HANDLING BODY SUBSTANCES IN SCHOOLS The following guidelines are meant to provide simple effective precautions against transmission of disease for all persons, including pregnant women, potentially exposed to blood or body fluids of any student. No distinction is made between body substances from persons with a known disease or those from persons without symptoms or with an undiagnosed disease. DOES CONTACT WITH A BODY SUBSTANCE PRESENT A RISK? The body substances of all persons should be considered to contain potentially infectious agents (germs). The term “body substances” includes, but not limited to, blood, urine, semen, mucous, drainage from wounds, and saliva. Contact with body substances presents a risk of infection with a variety of germs. In general, however, the risk is very low and dependent on a variety of factors including the type of substance with which contact is made and the type of contact made with it. It must be emphasized that with the exception of blood, which is normally sterile, the body substances with which one may come in contact usually contain many organisms, some of which may cause disease. Furthermore, individuals who have no symptoms of illness can carry many germs. These individuals may be a various stages of infections: incubating disease, mildly infected without symptoms, or chronic carriers of certain infectious agents including the AIDS and hepatitis viruses. In fact, transmission of communicable disease is more likely to occur from contact with infected body substances of unrecognized carriers than from contact with substances from recognized individuals because simple precautions are not always followed. WHAT SHOULD BE DONE WHEN HUMAN-TO-HUMAN BITE/SCRATCH OCCURS? If the skin is unbroken, wash the area with soap and water and rinse the area with hydrogen peroxide. If the skin is broken, wash the area with soap and water, rinse with hydrogen peroxide and apply antibiotic ointment and a dressing. All human-to-human bites and scratches are to be reported immediately to the health office for documentation. For a bite or scratch that opens the skin, the employee may request follow-up care with Workman’s Compensation at district expense. WHAT SHOULD BE DONE IF SKIN CONTACT OCCURS? In many instances, unanticipated skin contacts with body substances may occur in situations where gloves may not be immediately available, such as when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, or helping a child in the bathroom. In these instances, hands and other affected skin areas of all exposed persons should be routinely washed with soap and water after direct contact has ceased. Clothing and other non-disposable items, such as towels, should be rinsed and placed in plastic bags prior to laundering them. If presoaking is required to remove stains, use gloves while rinsing or soaking items prior to bagging. Clothes should be sent home for washing with appropriate directions to parents. Contaminated disposable items such as tissues, paper towels, diapers, should be handled with disposable gloves and disposed of in a plastic bag. HOW SHOULD SPILLED BODY SUBSTANCES BE REMOVED FROM THE ENVIROMENT? Each school has standard procedures already in place for removing body substances. These procedures should be reviewed to determine if appropriate cleaning and disinfection steps have been included. All schools stock sanitary absorbent agents specifically intended for cleaning body substance spills. Disposable gloves should be worn when using these agents. The dry material is applied to the area, left for a few minutes to absorb the fluid, and then vacuumed or swept up. The vacuum bag or sweepings should be disposed of in a plastic bag. Broom and dustpan should be cleaned in a disinfectant. No special handling is required for vacuum equipment. Area should be scrubbed with a disinfectant. INFECTION CONTROL PROCEDURES FOR SCHOOLS Having direct contact with body fluids of another person can potentially provide the means that can transmit infection. Some of the diseases that can result are: Body Fluid Diseases Spread by Contact with this Body Fluid Eye Discharge Conjunctivitis (Pink Eye) Nose or Throat Drainage Colds and Influenza, Strep Blood Hepatitis B, HIV disease Feces Hepatitis A, Shigellosis, Giardiasis Urine CMV infection It is important to remember that any person could potentially have disease; having organisms in their body fluids, even if they have no signs or symptoms of illness. Consequently, the following recommendations should be followed in all situations and not just those involving an individual known to have an infectious disease. In the school setting, it is recommended that reasonable steps be taken to prevent individuals from having direct skin or mucous membrane contact with any body fluid from another person. Specifically, direct contact should be avoided with the following: 1. Blood 2. All other body fluids, secretions, and excretions regardless of whether or not they contain visible blood 3. Non-intact skin (moist skin sores, ulcers, open skin cuts) 4. Mucous membranes (eyes, inside of nose and mouth) If hands or other skin surfaces are contaminated with body fluids from another person, washing with soap and water should take place as soon as possible. In general, standard medical vinyl or latex gloves should be worn whenever the possibility of direct contact with any body substance from another person is anticipated. Gloves should be available and easily accessible in any setting where contact with body fluids could take place. Hands should be washed immediately after removal of gloves. Pocket masks or other devices for mouth-to-mouth resuscitation should be available. RECOMMENDATIONS FOR INFECTION CONTROL IN THE CLASSROOM 1. Hand washing technique taught to staff and students. 2. Adequate hand washing facilities: running water, liquid soap and paper towels. 3. Time provided for students and staff to wash hands after toileting. 4. Tissue available in all classrooms. 5. All waste baskets lined with plastic liners. Covered containers with plastic bags provided in Health Office and any other areas likely to have disposable items contaminated with body fluids. Never reuse plastic bags. 6. Students and staff should have all lesions and cuts covered with a bandage. 7. All potentially contaminated areas should be sanitized at least once daily. If surfaces are visibly soiled, wash with soap and water first, then sanitize. Liquid soap dispensers should be sanitized daily. 8. Mop water must be changed after a body substance clean up. Mops must be hung up after sanitizing. Mops and dirty water should not be left standing. 9. Cleaning sponges should not be used in the classroom. 10. Disposable dishes should be used in the classroom. 11. ANIMALS: Guidelines should be in place that recognize animals carry and transfer diseases to humans. a. Keep animals in closed cages that have floors. Do not allow them to roam freely in the classroom. b. If the animal has symptoms of illness, such as diarrhea, drainage or crusting of the eyes or ears, or hair loss, it should be examined by a veterinarian. c. All litter boxes should be placed within the animal’s cage so that fecal matter does not come in contact with the classroom floor. d. If a student is assigned to clean litter box, he/she must wear plastic gloves and be supervised. Stress the importance of this. e. Any bite or scratch by an animal must be washed thoroughly with soap and water. Soap kills the rabies virus. All bites must be reported to the Health Office. 12. SHARPS: broken glass, razor blades, etc. a. DO NOT use hands to pick up broken glass, use brush and dustpan. b. Always place broken glass and sharp objects in a hard sided sealed container before placing it in the trash. HEPATITIS A PREVENTION GUIDELINES Hepatitis A, or viral hepatitis, is a form of infectious hepatitis, a liver disease.
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