Standard:
In order to provide for the safety of Employees and Students alike, Hilcrest provides these Infection Control Guidelines. ALL Employees will be responsible for having a working knowledge of the principles of infection control, modes of transmission of disease, and their role as Employee in the prevention of the spread of disease.

Introduction:
The concept of Universal Precautions focuses on the isolation of body substances such as Blood, Urine, Feces, Wound and Oral Secretions, Sputum, Semen, Vomitus, etc. In this way, the individual diagnosis of the student is not the determining factor in the handling of blood/body fluids.
CDC, OSHA, and the Massachusetts Department of Public Health state that we should consider all blood/body fluids as potentially infectious. By not relying on diagnosis for Universal Precautions we are better able to protect students and staff alike.
The most important parts of this concept are:
• INCREASED AND PROPER HAND WASHING BY STUDENTS AND STAFF
• THE USE OF GLOVES.

Certain Employees are at a higher risk of exposure to infectious materials than others. There are 3 categories of decreasing risk as shown below:

Category I: Tasks that involve exposure to blood/body fluids or tissue.
These are ALL procedures that involve an inherent potential for mucus membrane or skin contact with blood/body fluids or body substances. PROTECTIVE BARRIERS APPROPRIATE FOR THE TASK MUST BE WORN.

Category II: Tasks that involve no exposure to blood/body fluids or body substances, but may require performing unplanned Category I tasks.
These are procedures that during routine work, skin and mucus membrane contact with blood, body fluids or body substances doesn’t normally occur. However, the potential for exposure may occur. Appropriate barrier protection must be worn.

Category III: Tasks that involve no exposure to Blood, Body Fluids, or Body Substances.
These are tasks that during normal work routine, there is no exposure or potential for exposure to blood, body fluids, or body substances.

In order of decreasing intensity and/or potential for exposure, the following Employees are at risk:
Nurses
YDP’s
Teachers
Teachers Adies
Supervisors and Assistant Supervisors
Houskeeping
Maintenance
Food Service/Dietary
Administrative Personnel
Administrative/Campus Secretaries
Business Office

In-service training is provided at least yearly for ALL employees, and to ALL new employees, at time of hire. At least the following topics are covered:
Infection Control Policies and Procedures
Employee Health Practices
Risk of exposure to blood/body fluids or tissue(s)
Employee responsibility for reducing risk
Universal Precautions

Equipment is provided to safeguard Employee/Student contacts. Each Employee should know where to obtain supplies. These include:
Gloves – Vinyl or Latex of appropriate size.
Gowns – as necessary
Masks/Eye Protection – (Gobbles, or Glasses with Side Pieces)
Resuscitation Equipment
Plastic Bags – Plain or RED, as needed
Sharps Disposal Units – Appropriately placed
Cleaning Products – as needed.

Individual judgement is necessary in determining which type of barrier equipment will be needed. Some of the reasons for barrier use are listed below:
• Wear gloves when it is likely that hands will be in contact with: Body fluids such as Blood, Urine, Semen, Feces, Wound and Oral Secretions, Sputum, or Vomitus.
• Protect clothing ,a gown ,when: It is likely clothing will be soiled.
• Wear eye protection when: Eyes or mucous membranes may be splashed such as blood draws, irrigating wounds, etc.
• Follow Written Policy for handling of linens, trash, contaminated equipment.
• Used Needles, Syringes, Sharps are to be discharged in puncture proof containers which are provided. Do NOT recap needled after use.

• Wash hands often and carefully. ALWAYS wash hands after contact with: Blood, Body Fluids, Tissue(s), and after removing gloves.
• Mouth-to-Mouth resuscitation should be done with the use of a one-way mask which is provided.

In order to safely handle Blood, Body Fluids or Tissue(s) and ensure good care and treatment, the following Guidelines should be used:

Specimens:
All specimens of Blood/body fluids or Tissue are to be treated the same, and are to be considered potentially infectious. ALL persons handling specimens should take care in obtaining specimens or handling the container to prevent contamination of the container or self. If a container becomes soiled with Blood/body fluids or Tissue(s), while being obtained, cleanse the outside of the container with 70% alcohol (wear gloves), or place in a plastic bag for transport to the laboratory.

Wound Dressing:
ALL wound dressings are to be handled so as to confine and contain Blood/body fluids. The Inverted Glove technique may be used for small dressings. Gloves are to be worn when removing dressings. Care should be taken when removing large dressings, so as not to spill on self or patient. Place ALL dressings in an impervious bag, as soon as removed. Bags/gloves may be placed in regular trash for disposal.
EXCEPTION: Heavily soiled dressings are to be red-bagged, secured tightly, for removal and disposal.

Trash:
Trash is to be placed in appropriate plastic bags, secured tightly, for removal and disposal.

Sharps:
All sharps are to be placed in puncture-proof containers as provided. When containers are full, close securely, and arrange for pick-up as per Policy for Disposal. Keep container in Nurses Station until pick-up.

Linens:
Linens are to be handled in the following manner:
• Regular Linen – Placed into linen bag at site of use. Laundry is done by Students with Supervision or by Laundry personnel. Some laundry is done by direct care staff.
• Linen visibly soiled with Blood/body fluids – is to be placed into a plastic bag using gloves. Laundry will be done by Staff, Supervising the Student, or by a Laundry person.

PERSONAL CLOTHES:
Student’s personal clothing, soiled with blood/body fluids is placed into a plastic bag. Most clothing may be washed in a regular washing machine with detergent and bleach.

MOUTH-TO-MOUTH RESUSCITATION:
Disposable mouth-to-mouth resuscitation equipment is provided for use, when needed.

COMMUNICABLE DISEASE EXPOSURE:
Employees exposed within or outside the school, and susceptible to a communicable disease should notify the ICC, so approprate policy may be followed to prevent exposure to other Students and co-workers.

BLOOD/BODY FLUID SPILLS:
Large blood/body fluid Spills are to be treated carefully to avoid contamination of the Environment, Students, and Personnel. The blood or body fluids should be carefully wiped up with disposable paper towels, which should then be discarded into red plastic bags, and secured tightly. The contaminated area should then be wiped with a solution of 1:10 Bleach or other suitable sanitizer. Following this, Housekeeping will santize the area.

FOOD/DRINK:
Food or drink shall NOT be stored in Refrigerators, Freezers, Cabinets where Blood/body fluids are stored.

DISHES:
Dishes have not been found to transmit infections. Therefore, regular trays and dishes may be used for ALL staff and students.

BLOOD SPILLS AND CLEAN UP

Purpose:
To safely clean up and dispose of Blood/Body Fluid spills.

Equipment:
• Blood/Body Fluid Spill Kit ( Gloves, Goggles)
• Double Plastic Bags
• Disposable Paper Towels/Cloths for Clean-Up
• Dustpan and Brush
• Bleach Solution 1:10 Dilution or virex (Made Up as needed)
• Detergent/Germicide

Definition:
Blood/Body Fluid Spill – A spill will be defined as a large amount of blood spilled. If body fluids (as Gastric fluids, Fecal material, Urine) are obviously Blood tinged/contaminated, they will also be treated as a blood Spill. Drops of blood/body fluids may be wiped up with an alcohol wipe, or gauze, wearing gloves.

Procedures:
1. Mark/close off area of spill.
2. Obtain supplies needed and dress appropriately.
3. Prepare solution of detergent/germicide and a solution of bleach 1:10 or virex to decontaminate the area, after the spill is cleaned with the detergent.
4. Using care, clean up any broken glass using a dustpan and brush.
5. Using disposable paper towels/cloths, wipe up the Blood/Body spill. Place into red bag, secure tightly.
6. After Blood/body fluids have been wiped up, using a Clean paper towel/cloth, wipe area with bleach solution 1:10 or detergent/germicide.
7. Place used paper towels/cloths into red plastic bag, along with barrier gear, secure tightly, for disposal.
8. Arrange for transport and disposal.
9. Dustpan and brush are to be soaked in the 1:10 bleach solution or virex, rinsed and replaced.
10. Notify Housekeeping to sanitize the area.