Edgewood Independent School District
Department of Health Services
Bloodborne Pathogens Exposure Control Plan
Table of Contents
Exposure Determination
Compliance Method
Universal Precautions
Engineering and Work Practice Controls
Hand washing
Sharps – Discarding and Containment
Housekeeping
Regulated Waste Disposal
Work Area Restrictions
School Clinics
Personal Protective Equipment (PPE)
Gloves
Resuscitation Devices
Face Shields
Specialized Protective Clothing
Hepatitis B Vaccine
Post Exposure Medical Evaluation and Follow-Up
Record Keeping
Medical Records
Contaminated Sharps Injury Reporting Form
Hepatitis B Vaccine Employee Declination Statement
Training
Bloodborne Pathogen Training Outline
District Policy DBB (Legal)
Forms
BloodBorne Pathogen Exposure Plan Training
Hepatitis B – Employee Declination Statement
Contaminated Sharps Injury Reporting Form
EISD HS REV. 8/2013
Edgewood Independent School District
Health Services Department
Bloodborne Pathogens Exposure Control Plan
In accordance with the new Texas Department of Health rules from House Bill 2085 approved in the 1999 legislation, Health and Safety Code, Chapter 81, Subchapter H, and analogous to OSHA Bloodborne Pathogens Standard, the plan was reviewed and update by a team composed of the Human Resources and Support Services Lead Area Administrator, the Director of Health Services and Nursing Staff, the Risk Manager and the Maintenance Director.
For the purpose of this plan, occupational exposure means reasonably anticipated skin, eye, mucous membrane or parenteral contact with blood or other potentially infectious materials (saliva, semen, vaginal secretions, cerebral spinal fluid, etc.) that may result from the performance of employee duties.
Bloodborne pathogens are microorganisms present in human blood that can cause diseases, and include but not limited to the Hepatitis B virus, Hepatitis C virus and the Human immunodifiency (HIV) virus.
The plan outlines the schedule and methods of implementation for the various elements of the Exposure Control Plan. Health Services is responsible for developing the Plan and evaluating it annually. The Health Services Director and nursing staff, each principal and other Department heads will ensure that district employees receive training and appropriate Personnel Protective Equipment (PPE) prior to initial assignment to tasks.
Exposure Determination:
Job classification in which employees are “at risk” of encompass occupational exposure to “blood and other
other infection material containing bloodborne pathogens in connection to SHARPS.”
Category I Employees: Nursing Staff, Athletic Trainers
Task Personal Protective Equipment (PPE)
· Clinic Procedures and Specialized Care Gloves, mask
· Nursing Tasks/Special procedures Gloves and other PPE as needed
· First Aid Gloves and other PPE as needed-goggles
· Resuscitation Mask and other PPE as needed
· Injections Gloves and other PPE needed
Category II: Employees
All district personnel who have reasonable anticipated occupational exposure to blood and material potentially containing bloodborne pathogens including, but not limited to: Bus Drivers, Police Officers, Custodians, Coaches, and Staff designated to provide First Aid, selective special education staff, selective administrators and plumbers
Task Personal Protective Equipment (PPE)
· Diapering/Toileting assistance Gloves
· Feeding/Mouth care Gloves and other PPE as needed
· Handling Excretions Gloves and other PPE as needed
· Cleaning areas soiled with body fluids Gloves and other PPE as needed
· General physical contact Gloves and other PPE as needed
Compliance Methods:
PUniversal Precautions
· This practice has been adopted by the EISD as a safe practice for all employees. Universal Precautions is an approach to infection control. According to the concept of Universal Precautions, all human blood and body fluids are treated as if known to be infectious with bloodborne pathogens, micro-organisms that are present in human blood that can cause diseases such as, hepatitis B and C and human immunodeficiency virus (HIV).
· District employees will observe the practice of Universal Precautions at all times in the performance of tasks where occupational exposure to blood or other material potentially containing bloodborne pathogens.
Engineering and Work Practice Controls
Employees have received instruction regarding the following Engineering and Work Practice Controls. In order to minimize or eliminate employee exposure the following Engineering and Work Practice Controls are in place in the EISD.
PHandwashing
· Hand washing is the first line of defense in the prevention of disease.
· Hand washing is required at this district and employees have been instructed to wash their hands with soap and water immediately or as soon as possible every time you remove your gloves or other Personal Protective Equipment. In addition employees also have been instructed to flush mucous membranes with water immediately or as soon as possible following contact of these areas with blood or other potentially infectious materials and to report such exposures immediately to their immediate supervisor.
· Hand washing facilities with soap, water appropriate drying materials/equipment are available and accessible to all employees at the following locations:
School Nurses Clinics
Staff Restrooms
PWork Area Restrictions
School Clinics:
· Employees or students are not to eat, drink or apply cosmetics. 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.
· All nursing procedures shall be conducted in a manner to minimize splashing, spraying, splattering, and generation of droplets of blood or other potentially infectious materials. Protective eye wear and/or mask must be worn when performing these tasks.
PAntiseptic Towelettes
Where hand washing facilities are not available, such as a school bus or playground, employees have been instructed on the use of waterless cleansers, such as antiseptic towelettes. Towelettes can be obtained at the following location/s:
Health Services Dept. School Nurses
Bus Drivers Transportation Department
Special Ed Staff Special Education Department
Athletic Trainers Athletic Department
Custodians Campus/ Maintenance Department
Police Police Department
School Staff Principals
PSharps – Discarding and Containment
· Sharps is defined as an object used or encountered in a health care setting that can penetrate the skin resulting in an exposure incident and includes: needle devices, scalpels, lancets, broken glass, broken capillary tubes, an exposed and of a broken wire or a dental knife, drill or bar.
· Employees can become infected by cutting or pricking themselves with a sharp.
*CAREFUL HANDLING OF SHARPS CAN PREVENT INJURY AND REDUCE THE RISK OF INFECTION.
BY FOLLOWING THESE WORK PRACTICES, EMPLOYEES CAN PREVENT THEIR CHANCES OF
CONTRACTING BLOODBORNE PATHOGENS.
PProcedure for Handling Sharps in the District
In order to prevent and minimize needle sticks the nursing staff is the designated employees to administer injections in the district. To further prevent and minimize exposure to blood and bloodborne pathogens, employees are to avoid handling sharps directly with hands. Employees are not to break, recap, shear, or purposely break contaminated needles. If recapping should be necessary, a proper one- handed scoop technique using the needle itself to pick up the cap, pushing cap and sharp together against a hard surface to ensure a tight fit.
Sharps, such as needles, broken glass, lancets, etc. shall be picked up with mechanical means, such as forceps or a broom and dustpan. If a sharp is observed in a trash can, employees should not reach into the trash can with their hands; instead the trashcan should be taken to the nurse’s clinic where a sharps container is available and carefully and appropriately discarded by the school nurse or a designated and trained employee.
PDiscarding Sharps and Sharps Containers in the School Nurse’s Office:
· Contaminated sharps are to be discarded in the appropriate container immediately or as soon as possible.
· Sharps containers are available at the Health Services Department. The school nurse is responsible for ensuring that Sharp containers are available in the nurse's clinic or in immediate area of anticipated use at all times and that they are properly discarded.
· The containers provided by the district have a lid, are puncture resistant, leak proof on sides and bottom and are properly labeled in accordance with Texas Department of Health rules.
· Containers are to be kept in a visible and safe location in the nurse’s clinic, out of student's reach, not allowed to over fill and to be replaced routinely. When using containers employees must ensure that they are always kept upright, no one ever reaches by hand into containers.
· When school nurses are ready to discard containers and transport them to the Health Services Department office, they should first close the lid. If there is a chance of leakage from the primary container and outside contamination occurs, a second container that is closeable, labeled, or coded and leak resistant should be used. Containers provided by Health Services are disposable, should not be opened after lid is closed, emptied or cleansed manually, or in any other manner, which could expose employees to the risk of percutaneous (skin) injury.
PRegulated Waste Disposal
Sharps generated by the district are disposed of in accordance with federal state, and local regulations with services provided by:
Company: Stericycle Inc. Medical Waste Services
Address: 8950 Conroe Park North Drive
City, State: Conroe, Texas
Schools are not viewed by the Texas Department of Health and the TNRCC as being generators of medical waste and are therefore not required to use red waste containers, bags or biohazard labels. The waste generated in the school nurse's clinic wastebasket may be disposed of in the regular dumpster. *There have been no requirements to red bag sanitary napkins and tampons; therefore they can be discarded in the trashcans lined by plastic bags.
PHousekeeping (School Office)
The school nurse’s office must be kept in a clean and sanitary condition. A written cleaning schedule must be posted in the clinic.
The School Nurse is responsible for:
Cleaning and decontaminating work surfaces after completion of procedures, immediately or as soon as possible after any spill of blood or other potentially infectious materials, and daily at the end of the work shift. i.e., counters, cots.
The building Custodian is responsible for:
Clean and sanitize the sink/s and the toilet daily, and as needed
Floors must be swept and mopped daily and as needed.
Floors will be stripped and waxed annually and as needed.
Trash cans with trash bags and emptied daily and as needed throughout the day. See schedule.
Personal Protective Equipment (PPE)
Personal Protective Equipment (PPE) are provided by the appropriate department head, at no cost, and must be used in the performance of tasks where there is likelihood of exposure to blood, other body fluids or other potentially infectious materials. Examples of PPE include gloves, eyewear with shields, gowns, lab coats, aprons, resuscitative devices, etc..
PGloves
· Employees must wear gloves whenever an employee is performing a task which may result in hands coming in contact with blood, potentially infectious body fluid or material, such as some nursing procedures, and when assisting with activities of daily living, such as, diapering, feeding, oral hygiene, etc.
· Never wash or decontaminate single-use disposable gloves for reuse. Heavy-duty utility gloves should be used when cleaning blood or body fluids. These are available through custodial services and are provided to all custodians by the assigned campus administrator.
· Since gloves can be torn or punctured, cover any hand cuts with bandages before putting on gloves. Replace gloves as soon as you can if they are torn, punctured, contaminated, and defective in any way.
PGlove Removal Instructions
As important as wearing gloves is, you are not protected unless you remove them correctly. Gloves should be removed as follows:
· With both hands gloved, peels one glove off from top to bottom and hold it in the gloved hand
· With the exposed hand, peel the second glove from the inside, tucking the first glove inside the second.
· Dispose of the gloves promptly.
· Never touch the outside of the glove.
· Every time you remove your gloves wash your hands with soap and running water as soon as possible.
Vinyl powder free and latex gloves are available in the school nurse’s clinic for nursing staff to use in the performance of clinic duties.
· Provision of gloves for other staff in the campuses, i.e., custodians, special education staff and regular teachers is the responsibility of the building administrator.
PResuscitation Devices
Pocket masks and mechanical emergency respiratory devices are designed to isolate you from contact with a victim’s saliva. Avoid unprotected mouth-to-mouth resuscitation. Students or co-workers may expel saliva, blood or other fluids during resuscitation.
*CPR pocket masks are provided to nursing staff and are to be kept in the First Aid box. The First Aid box is to be kept in a safe and visible location and out of reach of students.
*The school nurse is responsible for ensuring that a pocket mask is available at all times in the First Aid kit and replaced immediately after use.
PFace Shields
Face shield mask with visors (goggles) are available in the Health Services Department and 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.
PSpecialized Protective Clothing
· Lab coats are to be used at all times in the performance of nursing tasks.
· Lab coats are provided for all nursing staff prior to initial assignment, at the start of each school year and replaced as needed throughout the school year.
· General work clothes (i.e., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard is not considered to be personal protective equipment.
PHepatitis B Vaccine:
Category I Employees
· Each Department Head will offer the hepatitis B vaccine, at no cost to employees. The vaccine is offered after bloodborne pathogens training and within 10 working days of their initial assignment to work unless the employee has previously received the complete hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or that the vaccine is contraindicated for medical reasons.
· Employees who decline the Hepatitis B vaccine sign a declination statement. (See Hepatitis B Employee Declination Statement under Forms section of this plan). Employees who initially decline the vaccine but whom later elect to receive it may then have the vaccine provided at no cost.