Appalachia Intermediate Unit 8
INFLUENZA GUIDELINESAppalachia Intermediate Unit 8 provides services in district and agency buildings as well in other locations, and has developed sets of guidelines based on guidance from the CDC and PA Dept. of Health that include similar content in some areas but reflect the differences relevant to the type of site. The guidelines include:
ü Influenza Guidelines for Programs Located in School District and Non-Public Buildings – To be used by staff whose program is located in a school district or non-public school building.
ü Influenza Guidelines for Programs Located in Agency Facilities – To be used by staff who work in Day Treatments, Partial Hospitalizations, HEAD STARTS, CSTU, Detention Home, or County Prisons. Guidelines have been added to the Emergency Plan for each site.
ü Influenza Guidelines for Early Intervention Programs NOT Located in HEAD STARTS – To be used by staff who work in sites that are neither an agency nor a district facility. Guidelines have been added to the Emergency Plan for each site.
ü Influenza Guidelines for the BRIDGE AND STAIRS Programs – To be used by staff who work in one of the “apartment programs.” Guidelines have been added to the Emergency Plan for each site.
ü Influenza Guidelines for Intermediate Unit 8 Offices - To be used by staff who work in one of the IU8 offices.In the event circumstances dictate the implementation of these guidelines, staff need to become familiar with the guidelines that are relevant for your site and that are reviewed with the staff with whom you work.Hand cleaners, cleaning agents, tissues, and surgical masks are available through our IU Interoffice Supply Requisition/Purchase Order process. Please note: surgical masks are only recommended for individual staff that remain with an ill child while waiting for their parent to come to take their ill child home.As noted in each of the Guidelines, an IU8 Supervisor is to be alerted should the absentee rate in any program doubles.
MRSA & INFECTION CONTROL PROCEDURES FOR CLASSROOMS
General Procedures for Preventing Transmission of Infectious Diseases in Classroom Settings
Having direct contact with the body fluids of another person can potentially provide the means by which many different infectious diseases can spread. Some examples of body fluids which transmit infection, and some of the diseases that can result, include the following:
Body Fluid Diseases Spread Through Contact With This Body Fluid Eye discharge Conjunctivitis (pink eye) Nose or throat discharge Colds, influenza, parvovirus B19 (Fifth's disease) Blood Hepatitis B, C, HIV Feces Hepatitis A, shigellosis, giardiasis Urine Cytomegalovirus
It is important to remember that any person could potentially have disease-causing 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, 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 moist body fluid from another person. Specifically, direct contact should be avoided with all the following:
- Blood (preventing exposure to blood or blood-contaminated body fluids is discussed in more detail in the following section on standard precautions);
- All other body fluids, secretions, and excretions regardless of whether or not they contain visible blood;
- Non-intact skin (any area where the skin surface is not intact, such as moist skin sores, ulcers or open cuts in the skin); and
- Mucous membranes.
If hands or other skin surfaces are contaminated with body fluids from another person, vigorous washing with soap and water should take place as soon as possible. Hand sanitizers are not believed to be as effective as washing with soap and water. Hand sanitizers are never appropriate when there is significant contamination.
In general, standard medical vinyl or latex gloves should be worn whenever the possibility of direct contact with any body fluid with another person is anticipated. Gloves should be available and easily accessible in any setting where contact with body fluids could take place. Hands should always be washed immediately after removal of gloves. Pocket masks or other devices for mouth-to-mouth resuscitation should be available.
Mucous membranes cover the eyes and the inside of the nose and mouth, along with certain other parts of the body. In a school setting, avoiding mucous membrane contact with body fluids means, for practical purposes, that one does not get these fluids in one’s eyes, nose or mouth. This can generally be accomplished by not rubbing the eyes with one’s hands, and not putting the hands or anything touched by unwashed hands (such as food) in one’s mouth. Good handwashing is vital to preventing mucous membrane exposure to disease-causing organisms.
Additional steps to reduce the risk of transmission of communicable diseases in the school setting include the following:
- Toilet tissue, liquid soap dispenser, and disposable towels should always be available in all restrooms. All children should be taught proper handwashing and encouraged to practice this after using the restroom.
- All children should wash their hands, with direct supervision as necessary, before eating.
- Children should be discouraged from sharing food, personal grooming items, and cosmetics.
- Younger children should be discouraged from placing others’ fingers in their mouths, or their own fingers in the mouths of others, and from mouthing objects that others might use.
- Proper sanitation procedures must be followed with regard to food handling and preparation, control of insects and rodents, and proper disposal of solid waste.
Standard Precautions (formerly universal precautions) is the term now used to acknowledge that any person’s body fluids, including blood, may be infectious, and includes the need to use personal protective devices such as gloves, masks or clothing to prevent exposure to body substances. These precautions include:
- Wearing disposable gloves for contact or anticipated contact with any person’s blood or body fluids;
- Wearing protective gown/apron if soiling of clothes is likely;
- Wearing goggles and/or mask as appropriate when splashing of blood/bloody fluids is likely; and
- Always washing hands after removing gloves or when hands have come in contact with blood or any body fluid/excretion.
- If any body fluids come into contact with the mucous membrane surfaces of the nose or mouth, the area should be immediately flushed with water. If the mucous membrane surfaces of the eye are contaminated, there should be irrigation with clean water, or with saline solution or sterile irrigants designed for this purpose.
- Precautions should be taken to avoid injuries with sharps (needle devices, lancet, broken glass, etc.) contaminated with blood. Needles should not be recapped, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand. Disposable syringes and needles, and other sharp items should be placed in puncture-resistant, leak-proof containers for disposal; the puncture-resistant containers should be located in the school nurses office or other secure location. There should be a clear procedure for sharps usage and disposal specified in the student’s health plan.
Procedures for Cleaning Spills of Blood or Other Body Fluids
- Absorbent floor-sweeping material should be used to cover larger body fluid spills.
- Wear sturdy, non-permeable gloves and other protective clothing as necessary.
- Use disposable absorbent towels or tissues, along with soap and water, to clean the area of the spill as thoroughly as possible.
- All surfaces that have been in contact with the body fluids should then be wiped with a disinfectant. Any EPA-approved disinfectant can be used. A 1:100 dilution of household bleach can also be used (this solution should not be mixed in advance because it loses its potency). After the disinfectant is applied, the surface should either be allowed to air dry, or else to remain wet for 10 minutes before being dried with a disposable towel or tissue.
- If the gloves worn to clean up the spill are reusable rubber gloves, they should be washed with soap and running water prior to removal. Disposable gloves should be placed in an impermeable plastic bag. Regardless of the type of gloves used, care should be taken during glove removal to avoid contamination of the hands. However, whether or not any known contamination occurs, the hands should be thoroughly washed with soap and water after the gloves are removed.
- If the person doing the clean up has any open skin lesions, preparations should be taken to avoid direct exposure of the lesions to the body fluids.
- If direct skin exposure to body fluid accidentally occurs, the exposed area should be thoroughly washed with soap and water for at least 15 seconds.
- It is necessary to keep one or more clean-up kits on hand for blood/body fluid spills. The clean up kit should consist of the following items:
- Absorbent floor-sweeping material
- Liquid soap
- Small buckets
- Rubber or plastic gloves
- Disposable towels or tissues
- Impermeable plastic bags
All of these materials should be kept together in one or more central locations so that they are readily accessible.
CAUTION: Diluted bleach solutions, if utilized, should not be used for any other purpose than the clean-up described above. Mixing this solution with certain other chemicals can produce a toxic gas. Also, any EPA-approved disinfectant that is used should be diluted according to manufacturer’s instructions. It is not appropriate or necessary to add more disinfectant than the directions indicate. Doing so will make the disinfectant more toxic, and could result in skin or lung damage to those individuals using it.
(Adapted from Missouri Department of Health and Senior Services, July 2005)