1. Blood Borne Pathogens and Universal Precautions * This is an interactive presentation, anywhere you see underlined text you will find web links that will make your learning more interesting. Follow those links for more information.

2. Universal Precautions Are those everyday practices done to prevent or minimize exposure to bloodborne pathogens: Use of protective equipment- gloves and proper handling of potentially contaminated garbage or clothing. Handwashing protocols as outlined in WAC 388-295-3020. Use care where eating occurs. Pay attention to what you are touching, ie. drinking, applying lip balm, and handling contact lenses in areas where fluids may be present. No food or drink shall be placed in areas where body fluids may be present. (such as on countertops on or around the diaper changing table) All surfaces contaminated with blood or fluid will be isolated, cleaned and decontaminated according to procedure outlined in this plan. ( Check out the solution required) Most items used in cleaning blood/body fluids will be placed in a lined trash receptacle unless saturated with blood. Items saturated with blood will be placed in a puncture proof bag labeled as a biohazard. Documentation of follow up procedures Universal precautions should be applied to all body fluids when it is difficult to identify the specific body fluid or when body fluids are visibly contaminated with blood.

3. Why Does it Matter to You? As a person responsible for the care of children you have a potential for exposure When children get hurt or have blood or body fluid You may come in contact with blood or body fluids and could become infected with germs or a dangerous disease Universal Precautions training is required by law It’s a way to prevent the spread of germs and disease to: children • co-workers • families • YOU

4. Where Do Germs Live? Don’t forget that dirty little device in your pocket! Germs live in child care Objects Example:surfaces, first aid equipment, first aid- waste, and other objects may be contaminated People Example:hands, under fingernails, mouth, nose Example:blood

5. Just 1 bacteria reproducing every 20 minutes can reproduce into 5 thousand billion, billion bacteria in 1 day. How do Germs Spread? People Objects People OR Person Person

6. Germs Live, Spread and Move Personz Object zPerson Person has a bleeding, wound, or open sore oozing liquid People touch objects and transfer the germs Germs live on objects Another person touches the object Now the germs have transferred to the other person

7. Germs on Objects Germs can be found on objects in any room or outdoors Classrooms Closets, cupboards Kitchens, food prep or serving areas Playgrounds Vehicles Anywhere

8. Germs Spread Picture of HIV virus from Electron Microscope Wash your hands! Scrub them clean! Skin is actually a pretty good protection! Check out this little video on the layers of skin! Germs can cause disability, death or diseases that are carried by blood such as HIV, Hepatitis A, Hepatitis B and Hepatitis C. FACT: ☞ Some viruses can survive outside the body for a week on surfaces.☞ A person who carries the disease may not be aware they are infected. * All staff must practice Universal Precautions in every situation that places them in contact with blood or potentially hazardous body fluids. Hepatitis B

9. Person to Person A person comes into direct contact with the blood or body fluids of another person I forgot gloves Exposure Examples: Not using personal protective equipment -gloves Not using proper hygiene Not using proper work controls

10. Person to Person Cuts, scrapes and sunburns Loose or bleeding tooth

11. Child Care Activities Can Be SAFE Bathing Carrying Helping with –Hygiene –Toileting or diapering Holding Hugging Playing

12. Child Care Activities can be RISKY First aid care –cuts, scrapes, blisters, splinters Giving injection medications Helping with health procedures (blood sugar testing) Children who bite(open skin and bleeding)

13. More Examples of Objects First aid equipment Needles (diabetic) Any object can become covered with germs Germs spread

14. Bloodand Body Fluids Examples: Any body fluid that you do not know its source Any body fluid that visibly contains blood Blister fluid or blood Semen or vaginal secretions Wound fluid or blood

15. What are Universal Precautions? Procedures for infection controldeveloped to limit the spread of germs and blood-borne diseases such as Hepatitis B and HIV. Apply to blood, other body fluids containing blood, semen, and vaginal secretions. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, saliva and vomit. We will use caution in handling these fluids and follow procedures especially if they contain visible blood or are likely to contain blood How Can I Protect Myself and Others? 1. Use –Personal Protective Equipment (PPE) –Work practice controls 2. Keep worksite clean 3. Get vaccinated for Hepatitis

16. Personal Protective Equipment (PPE) • Gloves • Protective clothing • Face or resuscitation shield • Eye protection Personal Protective Equipment- creates a barrier between you and blood or body fluids and prevents blood and body fluids from reaching skin, mucous membranes, or personal clothing Wear single use gloves when administering first aidto a cut, scrape or wound, unless the amount is so small that cleaning can contain it. Skin is an effective barrier against diseases, skin that is broken by a cut, abrasion or chafing can provide an entry point. Dispose of gloves after use. Blood-contaminated gloves should be put in a plastic bag with a secure tie. If gloves are not available, do not delay emergency treatment. Use a thick layer of paper towels or cloth to apply pressure. Put on gloves as soon as available. When removing the glove, do not touch the outside. To remove gloves:1.Use the fingertips of gloved hand to grasp the other glove near the cuff.2.Slowly pull the glove down while removing your hand. Turn the glove inside out as you pull.3.Drop the contaminated glove into a plastic bag.Wash your hands after removing gloves

17. Use PPE Every time you –give first aid –clean a wound –have potential for contact with blood or body fluids

18. Standard Precautions Are every day practices that prevent potential exposure to hazardous germs- urine, feces, blood, saliva, nasal discharge, eye discharge, and injury or tissue discharges . Cleaned up immediately, as follows: Remove objects of bloodor blood-containing body fluids and injury or tissue discharges. Then clean and disinfect the area. Wear gloves in these situations. Avoid exposing open skin sores or mucous membranes to blood or blood-containing body fluids or to injury and tissue discharges. Clean floor/objects, and or mop/rinse them with sanitizing solution. Wring the mops as dry as possible and hang to dry. Place blood-contaminated material and diapers in a plastic bag secured with a knot. Wash your handsproperly even if you wore gloves. Wash your hands after drying tears or wiping discharge from the nose or mouth.

19. Watch this movie about gloves! Managing Fluids All staff are to wear gloves while cleaning fluids of potentially infectious materials. Body fluid such as urine, vomit, blood, and body fluids should be treated as potentially infectious and surfaces should be cleaned and disinfected immediately. Disinfection kills most disease-causing organisms such as streptococcus, staphylococcus, E. coli, salmonella and the agents that cause HIV and hepatitis. Small amounts of urine and stool on smooth surfaces, such as the changing table, should be wiped off and cleaned with a detergent solution. Rinse the surface with clean water and apply a fresh solution of diluted household bleach. Allow at least a 2-minute contact time.

20. Handwashing If you made it through all these links you deserve a game! Want to play? Hands shall be washed with soap and water: Upon arrival each day After diapering or toileting children After personal use of the bathroom After handling body fluids of any kind Before and after giving first aid (such as cleaning cuts, scratches or a bloody nose) Before and after feeding a child or personal meal time After outdoor activities After handling pets or playing in the sand After cleaning up spills or objects contaminated with body fluids (e.g. nose-kleenex) After taking off disposable gloves or other PPE After handling foods After giving medications http://www.globalhealthychildcare.org/Download/HealthyHandwashingPoster.jpg A germ doesn’t like warm water He is frightened of a bubble Soap and water to a germ Means trouble, trouble, trouble Cover your nose Cover your sneeze If you don’t You spread disease

21. Check out this little ditty! Disinfection Bleach Disinfection Solution- removes almost all germs. A solution of 1/4 cup household, liquid chlorine bleach in one gallon of cool tap water (or 1 tablespoon of bleach to 1 quart of water), prepared fresh daily, is an effective disinfectant for environmental surfaces. Sun, evaporation and heat weaken the solution, so keep the solution covered, out the sun and away from heat sources. Caution: Never mix bleach with any liquid other than water. Mixing bleach with a liquid such as vinegar or ammonia can cause a dangerous chemical reaction. Bleach must not be mixed with hot water. Heat-Prolonged, intense heat, which occurs when using a dishwasher or hot cycle of a washing machine, is an effective disinfectant. Tap water is not hot enough to be an effective disinfectant.

22. Clean and Sanitary Worksite Set a cleaning and laundry schedule (Identify what needs to be cleaned, sanitized, and disinfected) Select and use appropriate cleaning and disinfecting products Use appropriate equipment, supplies, and personal protective equipment

23. Clean and Sanitary Worksite Develop a cleaning chart for each room and space Include outdoor learning environment in your schedule

24. Work Practice Controls Work practice controls are actions that remove the hazard and determine how you will handle situations: Medication administration using needles Blood sugar testing equipment Waste from first aid Hygiene following blood or body fluid exposure Examples: • Wastebasket with foot controlled lid • Container for sharps • Proper hygiene

25. Work Practice Controls Stop Applying cosmetics and lip balm Eating or drinking Handling contact lenses Smoking Where blood, body fluids, and other disease germs may be present.

26. Hepatitis Disease Attacks the liver Causes long term illness May lead to disability May cause death Vaccine Is: 90+%effective for adults Allergic reactions rare Pain at site of injection -common Mild system reaction headache, fatigue, low fever Thought to give lifetime protection Healthy Liver Hepatitis Liver

27. How Can I Protect Myself? Vaccinate for Hepatitis

28. What to do if Exposed? If it is determined that contact with blood on broken skin (cuts, scratches, open rashes or chapped skin) or mucous membranes (in the eye, mouth or nose), has occurred, immediate medical evaluation and treatment will be provided, at no cost to the you (WAC 296-823-160) The center’s documentation records should include :Documentation of the exposure situation 1. Report exposure to director or supervisor 2. Wash exposed skin with soap and running water or rinse eyes or other mucous membranes with running water 3. Get medical help–at employer expense 4. Know your Center Exposure Control Plan Identification of the source individual (person who’s blood or body fluid was exposed)Required Center Documentation The request and any required follow-up Person’s consent to test for HIV, Hepatitis B antibody and HCV If person exposed does not give consent, document that consent could not be obtained.*If a person has a contact- appropriate medical services will be made available to employees during work hours.

29. Your Center Work Place Policies Do you have a written policy regarding your work practices including handling and disposal of contaminated waste and objects? Do you know how to handle and dispose of contaminated waste or objects? Do you have proper equipment for discarding of contaminated waste or objects?