Effective January 1, 2001
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
An employee's risk of exposure to infected blood is determined by evaluating two variables:
- the employee's risk of contacting blood based on occupational duties, and
- the amount of contact with persons likely to be infected with HIV or Hepatitis B
The following questions are considered in evaluating risk:
- Does the employee provide care in which blood and body fluids containing blood are
- Is the employee responsible for providing first aid or responding to emergencies?
- Are contacts with blood part of the normal routine of the employee's job?
- Does the employee have frequent contact with students who are known to be infected, are
drug users, or are immigrants from countries with high incident of HIV or HBV?
- Does the employee provide custodial care to students on a daily basis?
- Does the employee have frequent contact with students that behave aggressively (biting or
scratching) or have special medical problems that increase the risk of exposure to their
blood or secretions.
Individual job duties must be considered when determining which employees are at risk.
The Waco I.S.D. Human Resources Department has identified the following:
- all school nurses and health aides, and
- all athletic trainers
The Waco I.S.D. Director of Special Education has identified the following:
- Special education teachers and aides who are highly exposed to bodily fluids when
providing physical care in classrooms for the mentally retarded and severely handicap
2. IMPLEMENTATION SCHEDULE AND METHODOLOGY
November 2000 Develop Control Plan and Identify Occupational Groups
December 14, 2000 Informative Report to the WISD Board of Trustees
December 2000 Begin Bloodborne Pathogen Training.
December 2000 Begin 1st shot of the Hepatitis B Vaccine series for all occupation groups identified.
January 2001 Follow-up with 2nd shot of the Hepatitis B Vaccine series for all occupation
July 2001 Follow-up with the 3rd and last shot of the Hepatitis B Vaccine series for all occupational groups identified.
Universal precautions are observed to prevent contact with blood or other potentially infectious materials. All blood or other potentially infectious material is considered infectious regardless of the perceived status of the source individual. Work practice controls are used to eliminate or minimize exposure to employees.
- All district employees must examine and maintain engineering and work practice controls within the work center on a regular scheduled basis.
- Use of appropriate personal protective equipment has been discussed with employees. In the school setting this includes gloves, gowns/aprons, face/eye shields and pocket masks. Employees have also been informed on how to reasonably anticipate exposure to blood and body fluids.
- Personal protective equipment is available to school employees and is provided by the employer free of charge. Goggles and protective face/eye shields are found in the custodial supply room at each campus.
- Disposable gloves are available in appropriate sizes to all employees at risk. Any employee who is allergic to regular gloves should report this to their supervisor. Disposable gloves are located in the nurse's office of each campus and in the office of the Director of Student Services for Waco ISD located in the Waco ISD Administration Building.
- 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.
- Hand washing facilities are available to the employees who incur exposure to blood or other potentially infectious materials.
- Contaminated needles and other contaminated sharps are not bent, recapped, removed, sheared, or purposely broken. The Texas Department of Health'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 is done by the use of a device or a one-hand technique. This is a method in which all LVNs and RNs have been taught.
- Contaminated sharps are discarded immediately or as soon as feasible in containers that are closable, puncture resistant, and leak proof on sides and bottom.
- 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 Where Exposure is Most Likely to Happen
- In work areas where there is a reasonable likelihood of exposure to blood or other potentially infectious materials, employees may not eat, drink, apply cosmetics or lip balm, smoke or handle contact lenses.
- Food and drinks are not allowed in refrigerators, freezers, shelves, or cabinets or counter tops or bench tops where blood or other infectious substance material is present.
- Employees shall wear gloves where it is reasonably anticipated that employees will have hand contact with blood or other infectious substance/materials.
- Contaminated needles and other contaminated sharps may not be bent, recapped, removed, sheared, or purposely broken.
- Place all contaminated sharps into a sharps container.
Personal Protective Equipment
- All personal protective equipment used is provided 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 protective equipment include gloves, eyewear, with side shields, gowns, lab coats, aprons, and face shields/mask.
- All personal protective equipment is cleaned, laundered, and disposed of by the employer at no cost to employees. The employer, at no cost to employees, makes all repairs and replacements.
- All garments, which are penetrated by blood, are removed immediately or as soon as feasible and placed in a red infections waste bag. 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 may request 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 the 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, or exhibit other signs of deterioration, or when their ability to function as a barrier is compromised.
- Mask in combination with eye protection devises, such as goggles, glasses with 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.
- Surgical caps or hoods and/or fluid resistant shoe covers or boots are worn in instances when gross contamination can reasonably be anticipated (this rarely applies since related situations normally don't occur).
- Each work site is maintained in a clean and sanitary condition. An appropriate written schedule and cleaning procedures are implemented. These procedures are strictly followed and a method of decontamination is based upon the location within the facility.
- Custodial staff utilizes all precaution measures and personal safety equipment when cleaning, sanitizing, and sterilizing.
- All bins, pails, trash 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 hands.
Regulated Waste Disposal
- All contaminated sharps are discarded as soon as feasible in each work area.
- Regulated waste other than sharps is placed in appropriate containers that are closable, and leak resistant.
- All regulated waste is properly disposed of in accordance with federal, state, county, and local requirements.
All items laundered in the district are done so with a special anti biohazardous detergent.
Hepatitis B Vaccine
Employees listed under the occupational groups section have been identified as having occupational exposure to blood or other potentially infections materials are offered the Hepatitis B Vaccine, at no cost to the employee, under the supervision of a licensed physician or licensed health care professional. The vaccine is offered after bloodborn pathogens training and within 10 working days of their initial assignment to work unless employee has previously received the complete Hepatitis B Vaccination series.
Employees who decline the Hepatitis B vaccine must sign a declination statement.
Employees who initially decline the vaccine but who later elect to receive it may have the vaccine at no cost.
Post Exposure Evaluation and Follow Up
An employee who has an exposure incident shall immediately report the incident to their supervisor, principal and the District's risk manager.
An employee who has been exposed to bloodborne pathogens will be immediately referred for post-exposure treatment testing and follow-up.
The following information will be provided to the health care physician:
- a written description of the exposed employee's job duties as related to the exposure incident;
- written documentation of the route of the exposure and the circumstances under which exposure occurred;
- result of the source individual's blood testing, if available;
- all medical records relevant to the appropriate treatment of the employee, including vaccination status.
Training for all employees is conducted prior to the initial assignment where occupation exposure may occur if reasonably possible. All employees will also receive annual refresher training. This training is to be conducted within one year of the employees's previous training.
Training for employees are conducted by a person knowledgeable to the subject matter and includes an instructional video and/or handouts which contain an explanation of the following:
- A general explanation of the epidemiology and symptoms of bloodborne pathogens;
- An explanation of the modes of transmission of bloodborne pathogens;
- An explanation of the exposure control plan and where to obtain a copy;
- Information on methods that will prevent or reduce exposure including appropriate engineering controls, work practices, and personal protective equipment;
- Information on HBV vaccine, including its efficacy, safety, and the benefits of being vaccinated; and
- An explanation of the signs, tags, and/or color coding used to denote biohazards, such as contaminated sharps containers;
The Waco I.S.D. Risk Management-Benefits Office is responsible for maintaining records for the duration of the employment plus thirty years. Training records will be kept the by Waco I. S. D. Coordinator for Staff Development and maintained for a least three years from the date on which the training occurred.
The District's Risk Manager performs a review of the Bloodborne Pathogen Control Plan annually.