INFECTION CONTROL

In this Chapter . . .

•  Hand Washing
•  Use of Disposable Gloves
•  Use of Utility Gloves
•  Disinfection/Disposal of Contaminated Materials and Surfaces
  • Health Room Cots
  • Floors, Carpets, Tile, etc.
  • Clothing
  • Countertops and Sinks
  • Non-Sharp Regulated Waste
  • Sharps Regulated Waste
  • Labeling Potentially Infectious Materials
•  Diaper Changing Recommendations
  • Diapering Procedure
  • Diapering Checklist
•  Standard (Universal) Precaution for School Setting

The following guidelines are intended to provide simple and effective precautions against disease transmission for all persons who may be exposed to blood or body fluids.

Hand Washing

There is no substitute for good hand washing!  Frequent and thorough hand washing is probably the most effective practice in preventing the spread of disease. 

Procedure for hand washing:

•    Wet your hands and wrists with running water.

•    Apply soap from a dispenser.

•    Work up a generous lather by rubbing your hands together vigorously for 15 seconds.  Pay special attention to the area under fingernails, around cuticles, to the thumbs, knuckles, and sides of the fingers and hands.  If you don't remove rings, move them up and down your fingers to clean beneath them.

•    Rinse hands and wrists thoroughly under running water with flow directed from wrist down to fingers.

•    Pat hands and wrists dry with a paper towel.

•    Turn off faucets with paper towel.

Perform careful hand washing:

•    Before and after physical contact with each student.

•    Before and after eating, feeding another person, or handling food.

•    Before and after giving first aid.

•    Before and after giving medications.

•    After assisting others to use the restroom.

•    Before or after performing any bodily functions, such as blowing your nose or using the restroom.

•    After cleaning surfaces soiled with body fluids.

•    Before and after taking off gloves.

•    After leaving playground and other out of doors areas.

•    After changing a diaper or coming in contact with body fluids.

•    Before and after handling pets (see school board "Guidelines for Visiting/Resident Animals in the Classroom").

Note:    Wash hands thoroughly with soap and water when possible.  Antiseptic towelettes or waterless hand wash may be used when personnel must care for students in areas that are not accessible to water (i.e. bus, field trips).  Towelettes are not adequate if a blood accident occurs.  All buses are to have "Body Fluid Kits" on board at all times.

Use of Disposable Gloves

Direct contact with blood or body fluids containing blood can be avoided by wearing disposable gloves when applying first aid or cleaning spills.  Carry gloves at all times when not in the health room.  A supply of disposable gloves should be available in the health room, in the lunchroom, in classrooms, on buses, with physical education supplies and in the custodian's supplies.  It is also recommended that gloves be accessible when accompanying students on the playground or school campus.

Disposable gloves should be worn in the following situations:

•    When giving first aid for a bleeding injury or a nose bleed.

•    When caring for draining sores or sores with pus.

•    When your hands are dry and chapped or have open areas.

•    When cleaning up spills.

•    When handling materials or surfaces soiled with bloody fluids.

•    When caring for children who vomit, and hand washing is not available (i.e. on a bus).

•    When using strong cleansers.

•    When pre-rinsing cloth diapers or clothing soiled with feces.

•    When handling non-intact skin, mucous membrane or any body fluids.

Precautions when using disposable gloves:

•    Use one pair of gloves one time for one child, then discard in a plastic bag.

•    Take care not to tear gloves when putting them on.

•    Dispose of materials or clean off surfaces contaminated with blood or bodily fluids before removing gloves.

•    If gloves become damaged, remove and discard them immediately and re-glove.

Procedure for removing gloves:

•    Grasp the edge of glove.

•    Unroll glove down over the hand and discard glove in plastic bag.

•    With the bare hand, grasp the opposite glove cuff on its inside surface.

•    Remove the glove by inverting it over the hand and discard glove in plastic waste bag.

•    WASH HANDS.

Use of Utility Gloves

•    Re-usable utility gloves may be used for housekeeping duties and should be washed and then decontaminated with 1% bleach solution or disinfectant cleaner (Dispatch) for reuse.  If their integrity has been compromised (i.e., cracked, peeling, torn or punctured) they must be discarded.

Disinfection/Disposal of Contaminated Materials and Surfaces

Care of health room cots:

•    Use paper or plastic protection for bed linens since it is not practical to change linen after each use by a child.  Change the protective covering after each use.  Blankets must be washed after each individual use.  Do not re-use a blanket for another student.   The bed should be carefully stripped and remade with clean linens at the end of the day if it has been used during the day.

For floors, carpet or tile contaminated with body fluids:

CALL SCHOOL CUSTODIAN.

Clothing soaked with blood or body fluids:

•     If a student's clothing is soiled with blood or body fluids, the clothing may be sent home in a sealed plastic bag to be washed.

•    Use disposable gloves to place items in a plastic bag.  Seal bag and send home with the student.

•    See OSHA manual for more information.

Countertops and sinks:

•    Health room counters and sinks should be cleaned at least once a day with school board approved disinfectant.

•    If soiled with body fluids, use gloves to clean the area with school board approved disinfectant.

Non-sharp regulated waste (gauze pads, cotton balls, diapers, and other disposable items):

•    All non-sharp potentially infectious waste materials shall be discarded in appropriate containers that are closeable and constructed to contain its contents and prevent leakage during handling, storage, and transport.  Containers must be closed prior to handling.  If outside contamination occurs or is likely to occur, the container must be placed in a secondary container with the same characteristics.

Sharps regulated waste (Lancets, needles, syringes or other types of equipment that may be contaminated with body fluids)

•    Sharps Regulated Waste must be placed in the proper red biohazard container.

•    OSHA regulations require two sharps containers (one for backup) in the health room.

Labeling potentially infectious materials:

The Sarasota County School Board utilizes a combination of orange/red color-coded signs and biohazardous labels to indicate all potentially infectious materials.  At a minimum the following areas/items must be labeled:

•    Containers used to transport, ship or store blood or other infectious materials.

•    Receptacles containing contaminated regulated waste in all health rooms.

•    See OSHA manual for further information.

Recommendations for changing diapers:

Changing diapers in a sanitary manner is an important way to prevent the spread of infectious organisms.  Germs found in stool can be spread by the hands of staff and contaminate food, water, objects or surfaces.  Many diseases can be spread by contact with stool.  These include infections caused by bacteria like Salmonella and Shigella, by parasites like Giardia and pinworms or by viruses like rotovirus and Hepatitis A.

•    Place a disposable cover (or waterproof material) on the changing table.  Remove the cover after each use and clean the changing table using a school board approved disinfectant.

•    Wash hands thoroughly and put on a clean pair of gloves.

•    Remove soiled diaper and use disposable wipes to clean the child.

•    Apply clean diaper.

•    Discard paper-products and soiled disposable diapers in a covered container that is lined with a plastic bag.  Empty and sanitize the container daily.

•    Discard gloves and wash hands after each diaper change.

•    Note: No over-the counter (non-prescription) topical creams/ointments may be used without a completed Medication/Treatment Authorization Form.   

Adapted from Infection Control in the Child Care Center and Preschool, Donowitz, Leigh G, 1999, Pennsylvania: Lippincott, Williams & Wilkins

DIAPERING PROCEDURE

Display/Print Procedure

PURPOSE:  To prevent spread of microorganisms during diaper changes.

ACTION TO BE PERFORMED BY:  All who change diapers.

Note: A Medication/Treatment Authorization Form must be on file if any prescribed or over-the-counter   topical creams/ointments are to be applied.

DIAPERING PROCEDURE CHECKLIST

 Display/Print Checklist

*Contact your school RN for your performance check and form completion. 

Name: ___________________________________  School: _______________________

Note: A Medication/Treatment Authorization Form must be on file if any prescribed or over-the-counter topical creams/ointments are to be applied.

Preceptor’s Signature _____________________________________ Initials _______ Date ___________

Preceptee's signature _____________________________________ Initials _______ Date ___________

*Initial and date in space beside each skill indicates procedure has been demonstrated in a competent manner.

Distribution: Original to preceptee, one copy in the Health Room, copy to Sherri Reynolds/PSS Landings

Standard (Universal) Precautions for School Settings

The School Board of Sarasota County, Florida and the Sarasota County Health Department observe standard precautions in the handling of blood and other potentially infectious body fluids.  Standard precautions refer to the usual and ordinary steps all school staff need to take in order to reduce their risk of infection with HIV, the virus that causes AIDS, as well as all other blood-borne organisms (such as the Hepatitis B virus).

They are standard because they refer to steps that need to be taken in all cases, not only when a staff member or student is known to be infected.

They are precautions because they require foresight and planning, and should be integrated into existing safety guidelines.

Appropriate equipment (mops, buckets, bleach, hot water, hand soap, disposable towels and latex gloves) must be readily available to staff members who are responsible for the clean up of body fluid spills, especially those contaminated with blood.

•    Treat blood spills and other body fluids as if they are infected.

•    Prior to performing any task connected to dealing with blood or body fluids, cover any and all open cuts or broken skin, especially on your hands, or ask another staff member to perform the task. 

•    Use personal protective equipment such as latex gloves.

•    Clean up blood spills promptly.  Initial cleanup of blood or other bodily fluids may include school board approved sanitary absorbent agents followed by one part household bleach to ten parts water, pouring the solution around the periphery of the spill.  Disinfect mops, buckets and other cleaning equipment with bleach or other disinfectant that is effective against HIV, HBV or TB.  Use school board approved disinfectant.

•    Always wash your hands after any contact with body fluids to avoid contaminating other surfaces or parts of the body such as the eyes.

•    Dispose of contaminated waste properly following OSHA guidelines.

Adapted from Sarasota County School Board OSHA Bloodborne Pathogens Compliance Manual

Last updated: 02/16/12