HomeMy WebLinkAbout6.a. Exposure Control PlanCITY OF ROSEMOUNT
EXECUTIVE SUMMARY FOR ACTION
CITY COUNCIL MEETING DATE: AUGUST 18, 1992
AGENDA ITEM: EXPOSURE CON'T'ROL PLAN
AGENDA SECTION:
NEW BUSINESS
PREPARED BY: SCOTT AKER, FIRE CHIEF
AGENDA NITEM # 6 A
ATTACHMENTS: POLICY
APP OVED /BY:
, u -
Attached for your consideration and adoption is City Policy 2, Exposure
Control Plan. This policy has been put together through the efforts of
Lieutenant Dwayne Kuhns, Administrative Assistant Susan Walsh and myself.
In December, 1991 OSHA issued the new bloodborne pathogens standards to
protect workers from infectious diseases including but not limited to
Hepatitis.B virus (HBV) and human immunodeficiency virus (HIV). The
purpose of the standard is to limit occupational exposure to blood and
other potentially infectious materials since any exposure could result in
transmission of bloodborne pathogens (pathogenic microorganisms that are
present in human blood and can cause disease in humans) which could lead to
disease or death.
The attached policy addresses the OSHA standards by including in the City's
policy an Exposure Control Plan, Methods of Compliance, Personal Protective
Equipment, Housekeeping, Hepatitis B Vaccination and Post Exposure
Evaluation, Training and Record Keeping.
Upon adoption of the policy by Council, training will be provided to our
employees who are identified to be at risk of exposure to infectious
diseases. Patrol Officer Grant Thorstad and Firefighter Joe Ger_rits have
been designated to train our employees. Healtheast Divine Redeemer
Hospital will train these two employees and will probably assist with the
first initial training to employees this fall. Thereafter, annual review
sessions will be given to the employees and all new employees will be
trained.
Fortunately, actual costs for implementing this policy are at a minimum.
For the most part, the departments had most of these procedures in place.
Divine Redeemer will provide the personal protective equipment, sharps
containers, and disposal of contaminated sharps at minimum costs. The
Hepatitis B
the ongoing
program.
vaccine policy was implemented by Council in April, 1991, and
cost is $200 for each new employee who consents to the vaccine
RECOMMENDED ACTION: MOTION TO ADOPT CITY POLICY P-2, EXPOSURE CONTROL
PLAN
COUNCIL ACTION:
CITY OF ROSEMOUNT
POLICY TITLE•
POLICY NUMBER•
PROPOSED BY•
DATE APPROVED
BY CITY COUNCIL•
EXPOSURE CONTROL PLAN
P-2
ADMINISTRATION
August 18, 1992
I. PURPOSE: To provide full and part-time City employees with
necessary information needed to prevent the spread of infectious
disease in the work place. Necessary information includes, but is
not limited to, principles of infection control, the infectious
disease process and the use of personal protective equipment and
supplies as they relate to the prevention of occupationally
acquired infectious disease.
II. EXPOSURE CONTROL PLAN
A) Exposure Determination
1. Employees. Employees determined to be at -risk of
exposure to infectious diseases transmitted through blood
and other body fluids are in the following job
classifications:
a) Sworn police personnel
b) Police reserve officers
C) Firefighters
d) Custodians
2. Groups. A high risk of the transmission of infectious
diseases exists when department personnel have contact
with the following groups:
a) Bleeding accident victims
b) Alcohol abusers
C) Illegal drug users
d) Homosexual, bisexual, and promiscuous persons
e) Hemophiliacs
f) Persons with open or infected wounds
g) Persons who state they have Hepatitis B or AIDS
3. Situations. Employees may encounter situations where
there is a high risk of the transmission of infectious
disease. They are:
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a) Assisting with IV Starts/Venipuncture
b) Intubation
1) endotracheal
2) esophageal
3) tracheostomy
C) Suctioning
d) Pt ventilation
1) mouth to mouth
2) mouth to mask
3) positive pressure device
4) bag/valve/mask
e) Wound Care
f) Obstetrics
g) Chest Decompression
h) Violent Patients
i) Trauma Management
j) Fracture Management
k) Any time body fluids are present
1) Homes with unsanitary conditions
M) Death scene, especially those situations where
body fluids may be oozing from the corpse
n) Combative situations, especially those situations
where bleeding occurs
o) Body cavity searches
P) Crime scenes, specific dangers include knives,
needles, and razor blades
q) Extrication at auto accidents
r) Cleaning and disposing of contaminated material
Methods of Compliance
1) Universal Precautions
Universal Precautions shall be followed by all employees
at all times to prevent contact with potentially
infectious materials. These shall include; blood and
human body fluids, semen, vaginal secretions,
cerebrospinal fluid, synovial fluid, pleural fluid,
saliva, vomitus, any body fluid that is visibly
contaminated with blood, and all body fluids in
situations where it is difficult or impossible to
differentiate between body fluids. Universal precautions
shall also be followed when handling, cleaning, or
disposing of equipment, linen or articles contaminated by
such fluids. Since any body fluid may transmit
infectious diseases if it contains traces of blood,
employees are directed to treat all blood and body fluids
as infectious substances.
2) Engineering and work practice controls
a) Engineering and work practice controls shall be
used to eliminate or minimize employee exposure.
Whenever an occupational exposure risk still exists
the employee must wear appropriate Personal
Protective Equipment.
b) Engineering controls shall be examined annually
for all employees and with any changes in
regulations, policy, or accepted practices, to
ensure the effectiveness of the current
controls.
C) Any changes or additions shall be communicated to
all employees within 60 days of the institution of
such policies through mandatory training and
inservice, at no cost to the employee.
3) Hand washing
Hands and other skin surfaces must be washed thoroughly
as soon as possible if contaminated with blood or other
potentially infectious materials to which universal
precautions apply. Hands should always be washed after
gloves are removed even if the gloves appear intact.
Hand washing should be completed using appropriate
facilities such as utility or restroom sinks. Hands must
not be washed in a sink where food preparation may occur.
Hand washing should be done with warm water and soap.
The application of hand creme after hands are dried
is advisable. Waterless antiseptic hand cleaner
shall be provided to employees when hand washing
facilities are not available. Employees are advised to
wash their hands at the earliest opportunity after using
the waterless antiseptic hand cleaner.
4) Needles and Sharp Objects
a) Employees shall take precautions to prevent
injuries caused by needles, knives, broken glass,
razor blades, or other sharp instruments, devices,
or debris which can puncture or lacerate the skin.
b) Police employees must use caution when searching
prisoners for weapons or contraband or when
searching small areas or crevices in containers,
vehicles and buildings.
C) Sharp objects that are located and are inventoried
by the police department must be placed in a
puncture resistant container or packaged in such a
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manner as to render the sharp object harmless to
those handling it. Evidence containers or
sheathing material must be labeled with the bio-
hazard warning label or color -coded or both.
5) Housekeeping
a) All equipment and work areas shall be
cleaned and decontaminated after contact
with blood or other potentially infectious
materials.
b) The work area shall be cleaned with an
appropriate disinfectant as soon as possible after
a spill of blood or any other potentially
infectious materials.
C) Wastebaskets and other receptacles which have a
likelihood of contamination shall be inspected and
cleaned on a regularly scheduled basis. The
wastebaskets must be color -coded and/or display the
bio -hazard warning label.
d) Wastebaskets and receptacles that are visibly
contaminated shall be cleaned immediately.
e) Eating, drinking, smoking, applying cosmetics or
lip balm and handling contact lenses are prohibited
in work areas where there is a reasonable
likelihood of occupational exposure.
f) Food and drink shall not be kept in refrigerators,
freezers, shelves, cabinets, or on counter tops
where blood or other potentially infectious
materials may be present.
III. PERSONAL PROTECTIVE EQUIPMENT
A) Personal Employee Protective Equipment Packets will be
available to all employees. These barrier garments must be
used when the possibility for contamination of the employee's
uniform, clothing, or person, from potentially infectious
materials, blood, or body fluids exists.
These packets shall include: 1) Barrier Gown
2) Head Cover
3) Shoe Covers
4) Mask
5) Eye Protection
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Gloves must be worn as a part of this protective packet and
will be available to all employees.
B) The employee must use personal protective equipment except in
rare and extraordinary circumstances. Such circumstances
occur when in the employee's professional judgement the use of
personal protective equipment would have prevented the
delivery of health care or public safety services or would
have posed an increased hazard to the safety of the employee
or other associates. When the employee makes this judgement,
the circumstances shall be reported in writing to their
supervisor within 24 hours and investigated and documented in
order to determine whether changes can be instituted to
prevent such occurrences in the future.
C) Personal Protective equipment as well as the laundering,
repair, disposal, and replacement of personal protective
equipment as outlined above shall be provided at no cost to
the employee.
D) When soiled or contaminated:
1) Personal protective equipment shall be removed prior to
leaving the work place and as soon as possible when the
risk of contamination has passed.
2) It shall be placed in a clear plastic linen bag and
sealed by tying shut.
3) It will then be disposed of in the appropriate manner.
E) If a garment has been penetrated by potentially infectious
materials:
1) It shall be removed as soon as possible and replaced if
the potential for continued exposure continues to exist.
2) If the skin beneath such a garment has been contaminated
it shall be immediately washed with a disinfectant wash
solution. Such incidents will then be documented in
writing to the supervisor as in IIIb above.
3) Disposal shall be handled as in IIId above.
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F) Gloves
1) Gloves will be worn by all employees when it can be
reasonably anticipated that they may have hand contact
with blood, other potentially infectious materials,
mucous membranes, and non -intact skin, and when handling
or touching contaminated articles or surfaces.
2) Disposable (single use) gloves such as surgical gloves or
exam gloves will be replaced as soon as possible when
they become contaminated, and as soon as feasible when
they become torn, punctured, or when their ability to act
as a barrier becomes compromised.
3) Disposable (single use) gloves will not be washed or
decontaminated for reuse.
4) Gloves will be available at -all times.
5) Heavy duty protective gloves will be available at all
times.
a) These gloves must be worn when there is a
significant risk of the normal weight glove not
being strong enough to provide adequate barrier
protection.
b) This may be due to the nature of the patient's
injuries or the environment the employee is in.
C) Heavy duty gloves will be single use only and
will not be washed or reused.
G) Masks and Eye Protection
Masks and eye protection shall be worn at all times when there
is reasonably anticipated eye, nose, or mouth contamination
from splashes, spray, splatter, or droplets of blood or other
potentially infectious materials.
H) Contaminated Uniforms or Clothing
If the employee's uniform or personal clothing becomes
contaminated with blood or other potentially infected
materials, it shall be removed as soon as possible. The area
underneath should be thoroughly washed with soap and water.
Sets of alternative temporary clothing will be available on
each vehicle in appropriate sizes for temporary use until such
time as clean clothing can be obtained. It is suggested that
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each uniformed employee bring one complete uniform to work
with them to facilitate replacement when necessary.
IV. HOUSEKEEPING
A) Cleaning
1) All reusable equipment shall be cleaned and then
decontaminated using a disinfecting solution as soon as
possible after becoming contaminated with blood or other
potentially infectious materials, and before reuse with
another patient.
2) Contaminated work surfaces will be disinfected using a
disinfecting solution as soon as possible after the
completion of the procedure.
3) Broken glassware or other broken or sharp objects which
have a potential for puncturing or cutting of the skin
which may be contaminated may not be picked up directly
with the hands. It must be cleaned up using mechanical
means, such as a dust pan and brush or other such
devices.
4) Single use patient care items shall not be cleaned or
reused and will be replaced as soon as possible if they
become contar-Anated.
5) Garbage receptacles in the vehicles will be cleaned with
a disinfecting solution whenever they become
contaminated. They shall also be inspected to insure
that they have not been visibly contaminated, and cleaned
with a disinfecting solution when contaminated.
B) Sharps
1) Contaminated sharps will be promptly disposed of after
use, in the supplied, leak resistant, labeled and
closable containers provided as soon as possible after
use without recapping. They Shall Not be bent, sheared,
replaced in the sheath or guard, or removed from the
syringe after use.
2 ) Sharps containers will be replaced before the door on the
top of the container contacts any of the contents of the
container. This will ensure that the containers do not
become overfull.
3) Sharps containers shall be placed in vehicles such that
they will remain upright throughout use and easily
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accessible to employees.
4) Sharps containers will be disposed of before full by:
a) Closing lid of container securely.
b) Placing in closed red marked bags. If the outside
of this bag should become contaminated it shall be
in a double red, marked bagged to insure that the
contents may not spill, leak or protrude during
storage, transport, or shipping.
C) Delivered to DRMH Hospital.
d) Not be emptied for reuse at any time.
5) Reusable sharps such as bandage scissors that have been
contaminated, shall be placed in the provided container
for cleaning and decontamination as soon as possible.
These sharps shall then be removed by dumping out into a
sink for cleaning. They may not be removed by reaching
into the container. They will then be cleaned and
disinfected using a disinfecting solution.
C) Laundry
1) Contaminated laundry, such as blankets and towels, shall
be handled as little as possible. Contaminated laundry
shall be placed in bags or containers bearing the bio-
hazard label or color coded to alert others of the
potential danger.
2) The laundry service receiving the laundry must be advised
of the contents.
V. HEPATITIS B VACCINATION AND POST EXPOSURE EVALUATION
A) Hepatitis B vaccination shall be made available to all
employees, who may have an occupational exposure, after
training and within 10 days of their initial assignment to
work.
1. This vaccination shall be provided at no cost to the
employee.
2. Shall be made available at a reasonable time and place.
3. Shall be provided by a licensed physician or under a
physician's direction according to U.S. Public Health
Guidelines.
4. Prescreening is not required for HBv.
5. Hepatitis B vaccination may be refused by the employee.
a) If an employee does not wish to be vaccinated they
must sign a refusal statement.
b) If they later decide at any time that they wish to
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be vaccinated, the vaccination will be provided
within 10 days, at no cost to them.
B) Post Exposure Procedures, Evaluation and Followup
1) If an employee receives a significant exposure:
a) They shall immediately or as soon as possible wash
the exposed area using soap and water.
b) They will then notify their supervisor as soon as
possible that they have had an exposure. The
supervisor shall be responsible for completion of
the supervisor's First Report of Injury form. The
employee will, as soon as possible, complete the
employee's First Report of Injury form.
C) They will go to the nearest or most appropriate
facility to be evaluated. If at a hospital, that
hospital should be notified to insure that the
patient will be tested as soon as possible.
d) Document the route of exposure and the incident in
which they were exposed so that it may be evaluated
to determine if work practices should be changed to
prevent exposures in the future. This report
should then be turned in to their supervisor prior
to the end of their shift, or within 24 hours.
e) The employee should be tested as soon as possible
to determine their initial status.
f) The exposed employee's blood shall be collected as
soon as feasible and tested after consent is
obtained. If the employee consents to base line
blood collection but does not give consent for HIV
testing, the sample shall be preserved for at least
90 days. If, within 90 days of the exposure
incident, the employee elects to have the base line
sample tested, such testing shall be done as soon
as feasible.
g) All employee health records pertaining to the
exposure and medical findings and diagnoses will be
kept confidential.
h) Records pertaining to the exposure will be kept for
the duration of the employees employment plus 30
years.
2) Request shall be made to the receiving facility of the
source individual to test for HBV/HIV.
a) The results of these tests shall be made available
to the employee as well as the laws concerning
disclosure identity.
b) If the Source refuses to be tested, the employee
should proceed to be evaluated as above in 1).
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3) Within 15 days the employee shall be provided with the
written professional opinion of the evaluating physician.
Recommendations for treatment and inoculation will be
followed at the employer's expense.
VI. INFORMATION AND TRAINING
A) Labels and Signs
1) All containers or sharps or contaminated articles shall
be identified with the Bio -hazard label.
2) All linen in clear plastic bags shall be considered as
contaminated and shall be handled with universal
precautions.
3) All red plastic bags shall be considered to contain
contaminated articles and shall be handled with universal
precautions and disposed of properly.
B) Training
The City of Rosemount shall provide training regarding the
spread of infectious disease to all personnel with the
potential for occupation exposure. Training will be provided
at the time of initial assignment to tasks where occupational
exposure may take place. Annual refresher courses must be
provided. Additional training shall be provided as technology
and medical research dictate.
VII. RECORD KEEPING
A) Accurate records shall be kept for each employee with
occupational exposure.
B) These records shall include:
1) Name and Social Security Number.
2) HIB vaccination status and medical record relating to
receiving vaccine.
3) Results of exams, medical testing, and follow-up
procedures, and record of event of exposure.
4) Employer's copy of professional written opinion.
5) A copy of information provided to the professional.
C) Confidentiality
1) All employee medical records will be kept confidential.
2) No records may be released without the employee's written
consent.
D) Records will be kept for a period of 30 years beyond the
employee's duration of employment.
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E) Training Records
1) Shall include:
a) Date of Training
b) Contents of training
C) Names and qualifications of trainers
d) Names and job titles of all persons attending
training
2) Training records shall be kept for 3 years from the date
of training.
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