4311(a)
PERSONNEL
Professional and Support Staff
Blood Borne Pathogens - Exposure Control
The district recognizes its responsibility to furnish a safe and healthful workplace for its employees.
This includes the possible exposure to blood borne pathogens.
The United States Department of
Labor, Division of Occupational Safety and Health Administration (OSHA), has enacted a standard to protect workers from occupational exposure to blood borne pathogens.
There is no population that is risk-free from transmission of human immunodeficiency virus (HIV) or
Hepatitis virus (HBV) infection, therefore, any employee who has occupational exposure to bodily fluids or other potentially infectious materials will be included within the scope of the standard, 29
CFR 1910, 1030. The standard has been used as a guideline in developing this policy in order to reduce exposure of designated personnel to blood borne pathogens.
It shall be the responsibility of all district employees to follow the established program and to conduct themselves accordingly. Further, it shall be the responsibility of the superintendent and administrative staff to provide leadership and continuous evaluation of the program.
Purpose
The purpose of this administrative regulation is to develop an exposure control program for all employees of the North Penn School District who reasonably anticipate coming into contact with bodily fluids and/or potentially infectious materials and to protect employees from possible infection due to contact with blood borne viruses, including human immunodeficiency virus (HIV) and
Hepatitis B virus (HBV). The plan will include exposure determination, methods of compliance, implementation of universal precautions, a Hepatitis B vaccination program, employee training, and procedures for record keeping. In accordance with the district’s Exposure Control Plan, employee’s having occupational exposure shall be offered the Hepatitis B Vaccination.
Exposure Control Plan
In accordance with the OSHA Blood Borne Pathogens Standard. 29 CFR 1910.1030, the following
Exposure Control Plan has been developed:
The provisions of the control plan apply to the following individuals and entities:
• employees of the district who provide health care / first aid services as a primary function within the scope of their work;
• employees of the district who might be exposed to bodily fluids as a function within the scope of their work;
• employees of the district who as a "collateral function" related to their primary job are exposed to blood borne pathogens.
An exposure determination will be performed concerning which employees may incur occupational exposure to blood or other potentially infectious materials. The exposure determination is made
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4311(b)
without regard to the use of personal protective equipment (i.e. employees are considered to be exposed even if they wear personal protective equipment.) This exposure determination is required to list all job classifications in which all district employees may be expected to incur such occupational exposure, regardless of frequency. In the North Penn School District, the following job classifications are in this category: nursing staff, custodial staff, athletic trainers, coaches, certain special education teachers.
In addition, a listing of job classifications in which some employees may have occupational exposure due to a collateral function of their primary job follows. Not all the employees in these categories would be expected to incur exposure to bodily fluids or other potentially infectious materials. Therefore , tasks or procedures that would cause these employees to have occupational exposure are also required to be listed in order to clearly understand which employees in these categories are considered to have occupational exposure. The job classifications and associated tasks for these categories are as follows:
Job Classification Tasks/Procedures
Maintenance personnel
Teachers
Administrators
Secretaries/Clerks
Transportation
Building and grounds maintenance
Teaching
Supervision
Clerical
An exposure control plan shall be reviewed and updated at least annually and whenever necessary to:
•
reflect new or modified tasks and procedures affecting occupational exposure;
•
reflect new or revised employee positions with occupational exposure;
•
review the exposure incidents which occurred since the previous update.
The district’s exposure control plan shall be accessible to employees in accordance with law. It also shall be made available to the chief or director of the National Institute for Occupational Safety and Health, U.S. Department of Health and Human Services, and or his/her designee, upon request for examination and copying.
IMPLEMENTATION SCHEDULE AND METHODOLOGY
The following complies with the requirement that this plan include a schedule and various requirements of the OSHA standard.
Universal precautions will be observed at all facilities in order to prevent contact with bodily fluids or other potentially infectious materials. All bodily fluids or other potentially infectious material will be considered infectious regardless of the perceived status of the source individual.
The district’s Exposure Control Plan provides that:
•
employees report all first-aid incidents involving the presence of blood or other potentially infectious materials before the end of the work shift during which the incident occurred;
•
designated personnel shall participate in the bloodborne pathogens training program.
Engineering and work practice controls will be utilized to eliminate or minimize exposure to employees of the district. Where occupational exposure remains after institution of these controls,
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personal protective equipment shall also be utilized. The following engineering controls will be utilized, examined and maintained on a regular schedule: (1) Sharps containers; (2) Red bags;
(3) Protective gloves ; (4) Body fluid clean-up kits; (5) Bleach solution and germicidal cleaners for cleaning of counters in health suit areas.
The schedule for reviewing the effectiveness of the controls is as follows:
Health Services Department Chair - monthly
Coordinator of Facilities - monthly
Athletic Director - monthly
Director of Secondary Education - as needed
Manager of Human Resources - as needed
Coordinator of Nutrition Services - as needed
Coordinator of Transportation - as needed
Hand washing facilities are also available to the employees who incur exposure to bodily fluid or other potentially infectious materials. These facilities should be readily accessible after incurring exposure. Hand washing facilities are located at: Health suites, custodial areas, lavatories, athletic training areas.
If hand washing facilities are not immediately available, an antiseptic cleanser in conjunction with a clean cloth/paper towels or antiseptic towelettes will be provided. 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 shall 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 shall be washed or flushed with water as appropriate as soon as feasible following contact.
B. Needles
Contaminated needles and other contaminated sharps will not be bent, recapped, removed, sheared or purposely broken. There are no procedures where recapping or removal of sharps is permitted. Reusable sharps will not be utilized.
C. Work Area Restrictions
In work areas where there is a reasonable likelihood of exposure to bodily fluids or other potentially infectious materials, employees are not to eat, drink, apply cosmetics or lip balm or handle contact lenses. Food and beverages are not to be kept in refrigerators, freezers, shelves, cabinets, or on counter tops or bench tops where bodily fluids or other potentially infectious materials are present.
Mouth pipetting/suctioning of blood or other potentially infectious materials is prohibited.
All procedures will be conducted in a manner which will minimize splashing, spraying, splattering, and generation of droplets of bodily fluids or other potentially infectious materials. Methods which will be employed at this facility to accomplish this goal are located at designated first aid stations in each health suite.
D. Specimens
Specimens of bodily fluids or other potentially infectious materials will be placed in a container which prevents leakage during the collection, handling, processing, storage and transport of the specimens. The container used for this purpose will be labeled or color coded in accordance with the requirements of the OSHA standard. Any specimens which could puncture a primary container will be placed within a secondary container which is puncture resistant.
If outside contamination of the primary container occurs, the primary container shall be placed within a secondary container which prevents leakage during the handling, processing, storage, transport, or shipping of the specimen, if applicable.
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4311(d)
Equipment which has become contaminated with bodily fluids or other potentially infectious materials shall be examined prior to servicing or shipping and shall be decontaminated as necessary unless the decontamination of the equipment is not feasible.
F. Personal Protective Equipment
All personal protective equipment used will be provided without cost to employees. Personal protective equipment will be chosen based on the anticipated exposure to blood or other potentially infectious materials. The protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employees' clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. Protective clothing will be provided to employees as described below:
•
Gloves: First aid procedures involving body fluids – Cleaning of body fluids
•
Other protective equipment such as the following: Face shield, shoe covers, utility gloves, and gowns or jackets.
All personal protective equipment will be cleaned, laundered, and disposed of at no cost to employees. All repairs and replacements will be made by the district at no cost to employees.
All garments which are penetrated by blood shall be removed immediately or as soon as feasible.
All personal protective equipment will be removed prior to leaving the work area.
Employees are expected to place the contaminated personal protective equipment in a designated container in the health suite, upon leaving the work area.
Gloves shall be worn where it is reasonably anticipated that employees will have hand contact with blood, other potentially infectious materials, non-intact skin, and mucous membranes. Gloves will be available from department heads.
Gloves will be used for any procedure involving bodily fluids.
Disposable gloves used 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 will be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration or when their ability to function as a barrier is compromised.
Masks in combination with eye protection devices, such as goggles or glasses with solid side shield, or chin length face shields, 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. Situations in the district which would require such protection are mainly confined to accidents that would involve the severing of an artery.
District facilities will be cleaned and decontaminated according to the following schedule: Health suites - daily and as needed; Athletic training areas - daily and as needed; All other areas - as needed.
Decontamination will be accomplished by utilizing the following materials: Health suites - bleach solution; All areas in contact with bodily fluids - beach solution or germicidal cleaner.
All contaminated work surfaces will be decontaminated after completion of procedures and immediately or as soon as feasible after any spill of blood or other potentially infectious materials, as well as the end of the work shift if the surface may have become contaminated since the last cleaning.
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All bins, pails, cans and similar receptacles shall be inspected and decontaminated on a daily basis by the custodial staff. The nursing staff may request additional cleaning as necessary.
Any broken glassware which may be contaminated will not be picked up directly with the hands.
Any broken glassware which may be contaminated will be placed in designated sharps containers and personnel will employ the use of personal protective equipment when handling the material.
G. Regulated Waste Disposal
All contaminated sharps shall be discarded as soon as feasible in sharps containers which are located in health suites throughout the district. Regulated waste, other than sharps, shall also be placed in appropriate containers located in each health suite.
H. Hepatitis B Vaccine
All employees who have been identified as having exposure to bodily fluids or other potentially infectious materials will be offered the Hepatitis B Vaccine, at no cost to the employee. The vaccine will be offered once a year of their initial assignment to work involving the potential for occupational exposure to blood or other potentially infectious materials unless the employee has previously had the vaccine or who wishes to submit to antibody testing which shows the employee to have sufficient immunity.
Employees who decline the Hepatitis B Vaccine must sign the waiver "Hepatitis B Vaccine
Declination" (See appendix A). The human resources department has the responsibility for insuring that the vaccine is offered and the appropriate forms are signed when a person is employed by the school district. The health services department chair , or designee, will administer the HBV vaccine.
Employees who initially decline the vaccine, but who later wish to have it may then have the vaccine provided at no cost.
I. Post Exposure Evaluation and Follow-Up
When the employee incurs an exposure incident. it should be reported to the immediate supervisor, the school nurse and the school nurse coordinator.
Following a report of an exposure incident, the district shall provide the exposed employee with a confidential medical evaluation and follow-up, as required by law. The district shall maintain the confidentiality of the affected employee and exposure source during all phases of the post-exposure evaluation.
All employees who incur an exposure incident will be offered post-exposure evaluation and follow-up in accordance with this regulation. This follow-up will include:
•
Documentation of the route of exposure and the circumstances related to the incident.
•
If possible, the identification of the source individual and, if possible, the status of the source individual, the blood of the source individual will be tested (after consent is obtained) for
HIV/HBV infectivity (See appendix B).
•
Results of testing of the source individual will be made available to the exposed employee with the exposed employee informed about the applicable laws and regulations concerning disclosure of the identity and infectivity of the source individual (See appendix C).
•
The employee will be offered the option of having their blood collected for testing of the employees HIV/HBV serological status. The blood sample will be preserved for up to 90 days to allow the employee to decide if the blood should be tested for HIV serological status. However, if the employee decides prior to that time that testing will or will not be conducted, then the appropriate action can be taken and the blood sample discarded.
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•
The employee will be offered post exposure prophylaxis in accordance with the recommendations of the United States Public Health Service.
•
The employee will be given appropriate counseling concerning precautions to take during the period after the exposure incident. The employee will also be given information on what potential illness to be alert for and to report any related experiences to appropriate personnel.
The health services department chair has been designated to assure that the policy outlined here is effectively carried out as well as to maintain records related to this policy.
J. Interaction with Health Care Professionals
A written opinion shall be obtained from the health care professional who evaluates employees of the school district. Written opinions will be obtained in the following instances:
•
when the employee is sent to obtain the Hepatitis B Vaccine; or
•
whenever the employee is sent to a health care professional following an exposure incident.
(These records will be maintained in the employee personnel file.)
Health care professionals shall be instructed to limit their opinions to:
• whether the Hepatitis B Vaccine is indicated and if the employee has received the vaccine, or for evaluation following an incident;
•
that the employee has been informed of the results of the evaluation; and
• that the employee has been told about any medical conditions resulting from exposure to blood or other potentially infectious materials. (Note that the written opinion to the district is not to reference any personal medical information.)
K. Training
Training for all employees will be conducted prior to initial assignment to tasks where occupational exposure may occur. Training will be conducted in the following manner:
Training for employees will include the following explanations:
•
epidemiology and symptomatology of blood borne diseases;
•
modes of transmission of blood borne pathogens;
•
this exposure control plan (i.e. points of the plan, lines of responsibility how the plan will be implemented, etc.);
• procedures which might cause exposure to bodily fluids or other potentially infectious materials at this facility;
• control methods which will be used at the facility to control exposure to blood or other potentially infectious materials;
•
personal protective equipment available at district facilities and who should be contacted;
•
post exposure evaluation and follow-up;
•
signs and labels used at the facility; and
•
hepatitis B Vaccine Program at the facility.
The district shall provide a training program as specified by law ot all employees in job classifications that have been determined to have some degree of occupational exposure. This program shall be offered at the time of initial assignment and annually thereafter, and whenever a change of tasks or procedures affects the employee’s exposure.
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Medical and training records shall be kept in accordance with law. Medical records shall be maintained for the duration of employment plus 30 years. Training records shall be maintained for three years from the date of training.
Medical records for each employee with occupational exposure will be kept confidential as appropriate and transferred or made available in accordance with law.
Records required by this standard (Appendices A, B and C) will be maintained by the school nurse coordinator and kept in the employee personnel file.
M. Dates
All provisions required by this standard will be implemented after approval by the board of school directors.
The health services department chair , the coordinators of facilities, food services and transportation and the athletic director are responsible for conducting the annual refresher training for all employees in the district according to each individual's responsibility. (Note that the training is to be conducted within one year of the employee's previous training.
O. Review and Update
ATTACHMENT
Reviewed: March 1997
December 11, 2008
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4311(h)
NORTH PENN SCHOOL DISTRICT
I understand that due to my potential occupational exposure to bodily fluids or other potentially infectious materials, I may be at risk of acquiring Hepatitis B virus (HBV) infection. I have been given the opportunity 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 Bodily fluids 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 me.
______________________________________ __________________________________
Employee Name Position
______________________________________ __________________________________
Signature Date
Please return completed form to school nurse.
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4311(i)
NORTH PENN SCHOOL DISTRICT
After due consideration, I, ____________________________________, hereby knowingly and voluntarily consent to have testiBLOOD BORNErmine HBV and HIV infectivity, post a blood borne pathogens exposure.
I further understand that the purpose of this request is so that appropriate testing might be done to determine the HBV and HIV infectivity of myself.
I further understand that my consent may be revoked at anytime.
I further understand that my consent will automatically expire six (6) months after the date I signed below, if not revoked by me before the expiration of the six (6) month period.
______________________________________ __________________________________
Student/Employee Name Building
______________________________________ __________________________________
Student/Employee Signature Date
_____________________________________ __________________________________
Parent/Guardian Signature Date
Please return completed form to school nurse.
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4311(j)
NORTH PENN SCHOOL DISTRICT
After due consideration, I, ____________________________________, hereby knowingly and voluntarily consent to have _______________________ release all records and/or information relating to my HBV-HIV status to the following individuals and entities:
_____ Manager of Human Resources
_____ Health Services Department Chair
_____ School Medical Director
___________________________________________________________________________ name of contact/exposed person(s)
I understand that the above individuals are strictly prohibited from further disclosures without my express written permission.
I further understand that the purpose of this disclosure is so that the appropriate school officials may properly evaluate my condition and make an informed decision as to my HBV-HIV infectivity and appropriately make an informed decision regarding BLOOD BORNEts of blood borne pathogens and the recommended course of vaccination if needed.
I further understand that my consent may be revoked at anytime except to the extent that the person named above who is to make the disclosure has already acted in the reliance on my consent.
I further understand that my consent will automatically expire six (6) months after the date I signed below, if not revoked by me before the expiration of the six (6) month period.
_____________________________________ __________________________________
Student/Employee Name Building
_____________________________________ __________________________________
Student/Employee Signature
Parent/Guardian Signature
(If subject is a Student)
Date
______________________________________ __________________________________
Date
Please return completed form to school nurse.
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