Licking Valley Local School District

Administrative Guidelines

8453 - ROUTINE PROCEDURES FOR SANITATION AND HYGIENE WHEN HANDLING BODY FLUIDS

Purpose

To ensure that body fluids involving blood, vomitus, urine, feces, semen, saliva, and nasal discharges are handled properly.

Those Affected

All school staff should be alerted to dangers of infections from body fluids. School nurses, custodians, and teachers should be particularly alert to the proper techniques in handling and disposal of materials.

Equipment Needed


	Soap	Disposal Bags
	Water	Dust Pans
	Paper Towels	Buckets
	Disposable Gloves	Mops
	Disinfectants - should be one of the following classes:

	A.	phenolic germicidal detergent in a one percent (1%) aqueous solution (e.g. Lysol*)
	B.	sodium hypochlorite solution (household bleach), one (1) part bleach to ten (10) parts water (e.g. 1-1/2 cups bleach to one (1) gallon of water (needs to be prepared each time used)

	C.	quaternary ammonium germicidal detergent in two percent (2%) aqueous solution (e.g., Tri-quat, Mytar, or Sage*)
	D.	iodophor germicidal detergent with 500ppm available iodine (e.g., Wescodyne*)
	E.	sanitary absorbing agent (Chlora Sorb, X-O Oder Away)

Procedures

GENERAL

		1.	Wear disposable gloves before making contact with body fluids during care, treatment, and all cleaning procedures.
		2.	Dispose of gloves after each use.
		3.	Wash hands after handling fluids and contaminated articles, whether or not gloves are worn.
		4.	Discard disposable items including tampons, used bandages, and dressings in plastic-lined trash container with lid. Close bags and dispose of daily.
		5.	Do not reuse plastic bags.
		6.	Use disposable items to handle body fluids whenever possible.
		7.	Use paper towels to pick up and dispose of any solid waste materials such as vomitus or feces.

HANDWASHING

		1.	Use soap and warm running water. Soap suspends easily removable soil and micro-organisms allowing them to be washed off.
		2.	Rub hands together for approximately ten (10) seconds to work up a lather.
		3.	Scrub between fingers, knuckles, backs of hands, and nails.
		4.	Rinse hands under warm running water. Running water is necessary to carry away debris and dirt.
		5.	Use paper towels to thoroughly dry hands.
		6.	Dispose of paper towels.

FOR WASHABLE SURFACES

For tables, desks, etc.:

			a.	Use Lysol*, or household bleach solution of one (1) part bleach to ten (10) parts water, mixed fresh.
			b.	Rinse with water if so directed on disinfectant.
			c.	Allow to air dry.
			d.	When bleach solution is used, handle carefully.

				1)	Gloves should be worn since the solution is irritating to skin.
				2)	Avoid applying on metal since it will corrode most metals.

For floors:

			a.	One of the most readily available and effective disinfectants is the bleach solution (one and one-half (1-1/2) cups bleach to one (1) gallon water).
			b.	Use the two (2) bucket system--one bucket to wash the soiled surface and one (1) bucket to rinse as follows:

				1)	In bucket #1, dip, wring, mop up vomitus, blood.
				2)	Dip, wring, and mop once more.
				3)	Dip, wring out mop in bucket #1.
				4)	Put mop into bucket #2 (rinse bucket) that has clean disinfectant (such as Lysol*, bleach solution).
				5)	Mop or rinse area.
				6)	Return mop to bucket #1 to wring out. This keeps the rinse bucket clean for second spill in the area.
				7)	After all spills are cleaned up, proceed with "c.".

			c.	Soak mop in the disinfectant after use.
			d.	Disposable cleaning equipment and water should be placed in a toilet or plastic bag as appropriate.
			e.	Rinse nondisposable cleaning equipment (dustpans, buckets) in disinfectant.
			f.	Dispose disinfectant solution down a drain pipe.
			g.	Remove gloves, if worn, and discard in appropriate receptacle.
			h.	Wash hands as described above under HANDWASHING.

FOR NONWASHABLE SURFACES (rugs, upholstery)

		1.	Apply sanitary absorbing agent, let dry, vacuum.
		2.	If necessary, use broom and dustpan to remove solid materials.
		3.	Apply rug or upholstery shampoo as directed. Revacuum according to directions on shampoo.
		4.	If using a water extraction cleaner, follow the directions on the label.
		5.	Clean dustpan and broom, if used. Rinse in disinfectant solution.
		6.	Air dry.
		7.	Wash hands as described above under HANDWASHING.

FOR SOILED WASHABLE MATERIALS (clothing, towels, etc.)

		1.	Rinse item under running water using gloved hands if appropriate.
		2.	Place item in plastic bag and seal until item is washed. Plastic bags containing soiled, washable material must be clearly identified if outside laundry service is used.
		3.	Wash hands as described above under HANDWASHING.
		4.	Wipe sink with paper towels, dispose of towels.
		5.	Wash soiled items separately, washing and drying as usual.
		6.	If material is bleachable, add one-half (1/2) cup bleach to the wash cycle. Otherwise, add one-half (1/2) cup nonchlorine bleach (Clorox II, Borateem) to the wash cycle.
		7.	Dispose of plastic bag.
		8.	Wash hands as described above under HANDWASHING after handling soiled items.

TRANSMISSION CONCERNS IN THE SCHOOL SETTING

BODY FLUIDS SOURCE OF INFECTIOUS AGENTS

BODY FLUID			**ORGANISM OF	TRANSMISSION
SOURCE			CONCERN	CONCERN

Blood			Hepatitis B virus	Bloodstream inoculation
- cuts/abrasions			AIDS virus	through cuts and
- nosebleeds			Cytomegalovirus	abrasions on hands
- menses
- contaminated needle				Direct bloodstream
				inoculation

***Feces			Salmonella bacteria	Oral inoculation from
- incontinence			Shigella bacteria	contaminated hands
			Rotavirus
			Hepatitis A virus

***Urine			Cytomegalovirus	Bloodstream, oral and
- incontinence				mucus membrane
				inoculation from
				hands

***Respiratory Secretions			Mononucleosis virus	Oral inoculation from
- saliva			Common cold virus	contaminated hands
- nasal discharge			Influenza virus

***Vomitus			Gastrointestinal	Oral inoculation from
			viruses, e.g.	contaminated hands
			(Norwalk agent
			Rotavirus)

Semen			Hepatitis B	Sexual contact
			AIDS virus
			Gonorrhea

*		Brand names are used as examples and are not endorsements of products.
**		This is not an all inclusive list of organisms of concern for transmission in the school setting.
***	Possible transmission of AIDS is currently thought to be of little concern from these sources.