Bloodborne Pathogens Exposure Control Plan

CHAPTER 81, HEALTH AND SAFETY CODE

SUBCHAPTER H

MINIMUM STANDARD

This exposure control plan is proposed to be adopted as the minimum standard to implement the Bloodborne Pathogens Exposure Control Plan required in Health and Safety Code, 81.304.

APPLICABILITY

These minimum standards apply to a governmental unit that employs employees who: provide services in a public or private facility providing health care related services, including a home health care organization; or otherwise have a risk of exposure to blood or other material potentially containing bloodborne pathogens in connection with exposure to sharps. The Texas Department of Health may, in accordance with rules adopted by the Texas Board of Health, waive the application of Health and Safety Code, Chapter 81, Subchapter H, to a rural county if the department finds that the application of the subchapter to the county would be burdensome. A waiver granted under this 96.501 expires December 31, 2001. “Rural County” is a county that: (1) has a population of 50,000 or less; or (2) has a population of more than 50,000 but: (A) does not have located within the county a general or special hospital licensed under Health and Safety Code, Chapter 241, with more than 100 beds; and (B) was not, based on the 1990 federal census, completely included within an area designated as urbanized by the Bureau of the Census of the united States Department of Commerce.

GUIDANCE

This plan is provided by the department to be analogous with Title 29 Code of Federal Regulation 1910.1030, Occupational Safety and Health Administration (OSHA), Bloodborne Pathogens Standard as specified in Health and Safety Code, 81.304. Employers should review the plan for particular requirements as applicable to their specific situation. Governmental units may modify the plan appropriately to their respective practice settings. Employers will need to include provisions relevant to their particular facility or organization in order to develop an effective, comprehensive exposure control plan.

REVIEW

Employers review annually the exposure control plan, update when necessary, and document when accomplished.

FORT STOCKTON INDEPENDENT SCHOOL DISTRICT

BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN

Facility Name: Fort Stockton Independent School District

Date of Preparation: 11/15/00

In accordance with Health and Safety Code, Chapter 81, Subchapter H, and analogous to OSHA Bloodborne Pathogens Standard, the following exposure control plan exists:

1. EXPOSURE DETERMINATION

The Texas Department of Health Bloodborne Pathogens Exposure Control Plan requires employers to perform an exposure determination for employees who have occupational exposure to blood or other potentially infectious materials. The exposure determination is made without regard to the use of personal protective equipment. This exposure determination is required to list all job classifications in which employees have occupational exposure, regardless of frequency. The following job classifications apply:

a. Nurses

b. School Secretaries/ Office Aides

c. Shop Teachers

d. Athletic Trainer

e. Special Education Teachers/Aides

f. Custodians

g. Bus Drivers

h. Coaches

i. Cafeteria Workers

j. Teachers/Teacher’s Aides (including Nursery Workers)

k. Administrators

l. Other

The job descriptions for the above employees encompass the potential occupational exposure risks to bloodborne pathogens.

2. IMPLEMENTATION SCHEDULE AND METHODOLOGY

The department’s plan outlines a schedule and method of implementation for the various elements of the exposure control plan.

Compliance Methods

Universal precautions are observed to prevent contact with blood or other potentially infectious materials. All blood or other potentially infectious materials are considered infectious regardless of the perceived status of the source individual.

Engineering and work practice controls are used to eliminate or minimize exposure to

employees. Where occupational exposure remains after institution of these controls, personal protective equipment is used. Examples include safety design devices, sharps containers, needleless systems, sharps with engineered sharps injury protection for employees, passing instruments in a neutral zone, etc.

Supervisors and workers examine and maintain engineering and work practice controls within the work center on a regular schedule.

Handwashing facilities are also available to the employees who incur exposure to blood or other potentially infectious materials. The department’s plan requires that these facilities be readily accessible after incurring exposure.

If handwashing facilities are not feasible, the employer is required to provide either an antiseptic cleanser in conjunction with a clean cloth/paper towels, antiseptic towelettes or waterless disinfectant. If these alternatives are used, then the hands are to be washed with soap and running water as soon as feasible.

After removal of personal protective gloves, employees wash hands and any other potentially contaminated skin area immediately or as soon as feasible with soap and water. If employees incur exposure to their skin or mucous membranes, then those areas are washed with soap and water or flushed with water as appropriate as soon as feasible following contact.

Needles

Contaminated needles and other contaminated sharps are not bent, recapped, removed, sheared, or purposely broken. The department’s plan allows an exception to this if no alternative is feasible and the action is required by a specific medical procedure. If such action is required, then the recapping or removal of the needle must be done by the use of a device or a one-handed technique.

Contaminated Sharps Discarding and Containment

Contaminated sharps are discarded immediately or as soon as feasible in containers that are closable, puncture resistant, leak-proof on sides and bottom, and biohazard labeled

or color-coded.

During use, containers for contaminated sharps are easily accessible to personnel; located as close as is feasible to the immediate area where sharps are being used or can be reasonably anticipated to be found; maintained upright throughout use; are not allowed to overfill; and replaced routinely.

Work Area Restrictions

In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees are not to eat or drink. Food and beverages are not to be kept in refrigerators, freezers, shelves, cabinets, or on counter/bench tops where blood or other potentially infectious materials are present.

Mouth pipetting/suctioning of blood or other potentially infectious materials is prohibited.

All procedures are conducted in a manner to minimize splashing, spraying, splattering, and generation of droplets of blood or other potentially infectious materials.

Personal Protective Equipment

All personal protective equipment used will be made available without cost to employees. Personal protective equipment is chosen based on the anticipated exposure to blood or other potentially infectious materials. The protective equipment is considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employee’s clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of the time which the protective equipment is used. Examples of personal protective equipment may include gloves, eyewear, lab coats, or aprons. All personal protective equipment is fluid resistant.

All personal protective equipment is cleaned, laundered, and disposed of by the employer at no cost to employees. All repairs and replacements are made by the employer at no cost to employees.

All garments which are penetrated by blood are removed immediately or as soon as feasible and placed in the appropriate container. All personal protective equipment is removed prior to leaving the work area and placed in the designated receptacle.

Gloves are worn where it is reasonably anticipated that employees will have hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes. Latex sensitive employees are provided with suitable alternative personal protective equipment.

Disposable gloves are not to be washed or decontaminated for re-use and are to be replaced as soon as practical when they become contaminated or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised.

Utility gloves may be decontaminated for re-use provided that the integrity of the glove is not compromised. Utility gloves are discarded if they are cracked, peeling, torn, punctured, exhibit other signs of deterioration, or when their ability to function as a barrier is compromised.

Eye protection devices, such as goggles, are required to be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can reasonably be anticipated.

Housekeeping

This facility is cleaned and decontaminated with an Environmental Protection Agency (EPA) registered germicide to maintain an antiseptic clean environment at all times.

All contaminated work surfaces are decontaminated after completion of procedures, immediately or as soon as feasible after any spill of blood or other potentially infectious materials, and at the end of the work shift.

Protective covering (e.g., plastic wrap, aluminum foil, etc.) used to cover equipment and environmental surfaces are removed and replaced as soon as feasible when they become contaminated or at the end of the work shift.

All pails, cans, and similar receptacles are inspected and decontaminated on a regularly scheduled basis.

Any broken glassware which may be contaminated is not picked up directly with the hands.

Regulated Waste Disposal

All contaminated sharps are discarded as soon as feasible in sharps containers located as close to the point of use as feasible in each work area.

Laundry Procedures

All used laundry (i.e. athletic uniforms) is considered contaminated. Contaminated laundry is handled as little as possible and placed in an appropriate container/hamper. Any wet laundry is placed in leak resistant bag, closed, and transported in the leak proof bag to the laundry facility.

All employees who handle contaminated laundry use personal protective equipment to prevent contact with blood or other potentially infectious materials.

The laundry is cleaned at: The laundry room at the FSHS field house and the athletic department at Ft. Stockton Middle School. This laundry is done by the athletic trainer, coach, and/or field house custodian.

Hepatitis B Vaccine

All employees who have been identified as having occupational exposure to blood or other potentially infectious materials and have never received or completed the hepatitis B series, are offered the hepatitis B vaccine, at no cost to the employee. Employees will receive the vaccine (under the supervision of a licensed physician or licensed healthcare worker) at the Pecos County Community Health Center (PCCHC) of Ft. Stockton.

(* Please note: Vaccination of every school employee will be conducted over a 5 year period, beginning with the highest risk employees first. The highest risk employee will be identified by job description as outlined by this plan and central administration.)

Any Ft. Stockton I.S.D. employee may decline the Hepatitis B vaccine. Anyone who declines receiving this vaccine must sign a declination statement (See appendix A of this exposure control plan).

Employees, who initially decline the vaccine but who later elect to receive it, m ay then have the vaccine provided, at no cost to the employee. However, this vaccination will be offered by the school only once per year at a regularly scheduled clinic.

Post Exposure Evaluation and Follow Up

When the employee incurs an exposure incident, the employee reports to the facility school nurse. All employees who incur an exposure incident are offered a confidential medical evaluation and follow up as follows:

· Documentation of the route of exposure and the circumstances related to the incident.

· If possible, identify the source individual.

· The employee is offered the option of having his/her blood collected for testing of the employee’s HIV/HBV serological status. This testing will be done at the Pecos County Community Health Center at the school district’s expense. (If the employee chooses to go to his/her own physician for this testing, it would be at the employee’s own expense.)

· The employee is encouraged to follow post exposure prophylaxis in accordance with the current recommendations of the U.S. Public Health Service. The employee will be financially responsible for his/her own medical treatment.

· The employee is encouraged to seek appropriate health counseling concerning infection status, results and interpretations of tests, and precautions to take during the period after the exposure incident. The employee is informed about what potential illnesses can develop and to seek early medical evaluation and subsequent treatment.

· The Ft. Stockton I.S.D. personnel office is designated to assure that the plan outlined here is effectively carried out and maintains records related to this plan.

Interaction with Healthcare Professionals

A written opinion is obtained from the healthcare professional who evaluates employees of this facility after an exposure incident. In order for the healthcare professional to adequately evaluate the employee, the healthcare professional is provided with:

1) A copy of the Ft. Stockton I.S.D. exposure control plan;

2) A description of the exposed employee’s duties as they relate to the exposure incident;

3) Documentation of the route of exposure and circumstances under which the exposure occurred;

4) Medical records relevant to the appropriate treatment of the employee

Written opinions are obtained from the healthcare professional in the following instances:

1) When the employee is sent to obtain the Hepatitis B vaccine, or

2) Whenever the employee is sent to a healthcare professional following an exposure incident.

Healthcare professionals are instructed to limit their written opinions to:

1) Whether the Hepatitis B vaccine is indicated;

2) Whether the employee has received the vaccine;

3) The evaluation following an exposure incident;

4) Whether the employee has been informed of the results of the evaluation;

5) Whether the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials (the written opinion to the employer is not to reference any personal medical information); and,

6) Whether the healthcare professional’s written opinion is provided to the employee within 15 days of completion of the evaluation.

Training

Training for all employees is conducted prior to initial assignment to tasks where occupational exposure may occur. All employees also receive annual refresher training. This training is to be conducted within one year of the employee’s previous training.

Training for employees is conducted by a person knowledgeable in the subject matter and includes an explanation of the following:

1) OSHA Bloodborne Pathogen Final Rule;

2) Epidemiology and symptomatology of bloodborne diseases;

3) Modes of transmission of bloodborne pathogen;

4) Fort Stockton I.S.D. Exposure Control Plan (i.e., points of the plan, lines of responsibility, how the plan will be implemented, where to access plan, etc.);

5) Procedures which might cause exposure to blood or other potentially infectious materials at this facility;

6) Control methods which are used at the facility to control exposure to blood or other potentially infectious materials;

7) Personal protective equipment available at this facility (types, use, location, etc.);

8) Hepatitis B vaccine program at the facility;

9) Procedures to follow in an emergency involving blood or other potentially infectious materials;

10) Procedures to follow if an exposure incident occurs, to include U.S. Public Health Service Post Exposure Prophylaxis Guidelines;

11) Post exposure evaluation and follow up;

12) An opportunity to ask questions with the individual conducting the training.

Record Keeping

According to OSHA’s Bloodborne Pathogens Standard, medical records are maintained by the FSISD Administration Office.

According to OSHA’s Bloodborne Pathogens Standard, training records are maintained by FSISD Administration Office.

Annual Review

Signature ___________________________________ Date _______________________

APPENDIX A

Hepatitis B Vaccine Declination Statement #1

I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity by Ft. Stockton I.S.D. to be vaccinated with hepatitis B vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If, in the future, I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to myself at the next regularly scheduled administration of hepatitis B vaccine.

Signature of Employee __________________________________Date _____________