HomeMy WebLinkAboutN-355 - Bloodborne Pathogen Policy CITY OF PASCO
ADMINISTRATIVE ORDERS
Administrative Order No. 355
Risk Management
Subject: Bloodborne Pathogen Policy Initial Effective Date:April 26, 1993
Revised 9/7/12
Approved
9
This Administrative Order is effective September 7, 2012 and supersedes Administrative Order
No. 70 dated April 26, 1993 .
I. PURPOSE:
The purpose of this Administrative Order is to protect employees from exposure to blood
or other potentially infectious materials and to comply with the Bloodborne Pathogens
standard, WAC 296-823 .
II. DEPARTMENTS AFFECTED:
All.
1II. DEFINITIONS:
1 . Bloodborne Pathogen: Pathogenic microorganisms present in human blood which can
cause disease in humans.
2. Contaminated: The presence, or the reasonably anticipated presence, of blood or other
potentially infectious materials on an item or surface.
3 . Decontamination: The use of chemical means to remove the bloodbome pathogen
from a surface or item to the point where they are no longer capable of transmitting
bloodborne pathogens and the item or surface is safe for handling, use or disposal.
4. Exposure Incident: A specific eye, mouth, other mucous membrane, cut to skin, or
contact with blood or other potentially infectious materials that result from the
employee's duties.
5. HBV: Hepatitis B Virus.
6. HIV: Human Immunodeficiency Virus.
7. Licensed Healthcare Professional: A person who is legally permitted to practice and
perform the Hepatitis B vaccination and post-exposure evaluation and follow-up.
8 . Parenteral: Piercing the skin barrier with needlesticks, human bites, cuts or abrasions.
9. Personal Protective Equipment (PPE): Always wear PPE (i.e., gloves, eye protection)
when there is a potential for exposure to blood or body fluids. This is proven to be
the single-most effective precaution to avoid exposure. PPE should be readily
accessible.
10. Universal Precautions: Universal Precautions is an approach to infection control .
According to the concept of Universal Precautions, all human body fluids (blood,
saliva, and bodily fluids) should be treated as if they contaminated with HIV/HBV.
IV, POLICY:
It shall be the responsibility of each department to implement this policy and to ensure all
training, personal protective equipment, reporting and follow-up after exposure incident
are compliant with the Exposure Control Plan, listed below:
1 . Exposure Determination:
The employees in departments/divisions listed below may be occupationally exposed
to blood and other potentially infectious materials. These departments include, but are
not limited to :
a. Fire
b. Facilities
c. Police
d. Public Works
e. Recreation
The City will evaluate other positions for exposure as applicable.
2. Hepatitis B Vaccination:
The Hepatitis B vaccination series will be available, without cost to employees who
have occupational exposure and who wish to receive the vaccination series. The
three-shot series is given one month and six months after the first shot. Employees at
risk of Hepatitis B should be tested (tittered) for antibodies to the Hepatitis B virus no
sooner than 30 days after completion of the three-shot vaccination series. If the titer
is negative, an additional shot ("booster") is given. The employee is then tittered 30
days following the booster. If titers are positive no further action is needed unless
there is an exposure. Employees who decline to accept the Hepatitis B vaccination
series shall sign the attached declination form. This declination may be rescinded at
any time during employment if the employee is still in an at risk assignment.
Hepatitis B series will not be offered to an employee who:
a. Has previously received the series.
b. Antibody testing reveals that the employee is immune.
c. Medical reasons prevent taking the vaccination.
The Hepatitis B vaccination and medical evaluation or follow up will be performed
by the City' s designated health care provider, Lourdes Occupational Health.
3 . Universal Precautions/Control Measures:
Supervisors of at-risk employees are to ensure their staff is trained in proper work
practices for Universal Precautions, PPE, and proper disposal techniques.
a. Provide disposable gloves, usually latex or vinyl. They must be used in the
following situations:
i. When an employee has cuts, chapped hands, or dermatitis.
AO No. 355 "Bloodbome Pathogen Policy"
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ii. When performing any first aid procedures.
iii. When cleaning up after an injury involving blood or other body fluids.
iv. Employees who have risk of exposure should follow universal
precautions, and treat all blood and other potentially infectious materials
as if they are infected.
b. Employees must wash their hands immediately, or as soon as possible, after
removal of gloves or other personal protective equipment and after hand
contact with blood or other potentially infectious materials.
c. Employees shall utilize the required personal protective equipment (i.e.
gloves, glasses and/or goggles, face shield, filtering facemask, and apron).
d. Employees shall treat all human body fluids and items soiled with human
body fluids as if contaminated with HBV/HIV.
e. All personal protective equipment and clothing contaminated with human
body fluids will be properly discarded.
4. Employee Training:
All employees who have potential exposure to bloodborne pathogens will receive
training at the time of initial assignment, and at least annually thereafter. Training
will include:
a. Information on the symptoms, and transmission ofbloodbome diseases.
b. Information on the Hepatitis B vaccine, including information on its safety,
and benefits of being vaccinated.
c. An explanation of the types, uses, location, removal, handling,
decontamination, and disposal of PPE.
d. Information on post-exposure evaluation and follow-up for exposure
incidents.
Training records will be kept on each applicable employee. Each department is
responsible for training. The training records shall be forwarded to Human Resources
and be kept in the employee's personnel file. Information to be kept includes:
a. Dates of the training sessions.
b. Contents of training.
c. Names and job titles of all persons attending the training.
d. Training records will be kept for three (3 ) years from the date of training.
5 . Post Exposure Evaluation and Follow-up:
All exposure incidents shall be reported, investigated, and documented. When the
employee incurs an exposure incident, it shall be reported immediately to his/her
supervisor. Following a report of an exposure incident, the exposed employee shall
go to Lourdes Occupational Health for a confidential medical evaluation and follow-
up, including the following elements:
a. Documentation of the route(s) of exposure.
b. A description of the circumstances under which the exposure occurred.
c. Identification and documentation of the source individual. (Identification is
not required if the employer can establish that identification is impossible or
prohibited by state or local law.)
AO No. 355 "Bloodborne Pathogen Policy"
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d. Collection and testing of the source individual 's blood for HBV and HIV
serological status (if available).
e. Post-exposure treatment for the employee, when medically indicated, in
accordance with the U. S. Public Health Service.
f. Counseling.
g. Evaluation of any reported illness.
6. Exposure Evaluation:
The healthcare professional evaluating an employee will be provided with the
following information:
a. A copy of this plan.
b. A copy of the Bloodborne Pathogen WAC 296-823- 100.
c. Documentation of the route(s) of exposure.
d. A description of the circumstances under which the exposure occurred.
e. Results of the source individual's blood testing, if available.
f All medical records applicable to treatment of the employee, including
vaccination status.
The Infection Control Officer (ICO) should receive a copy of the evaluating
healthcare professional' s written opinion with 15 days of the completion of the
evaluation. (The healthcare evaluator should send the opinion to Pasco Fire
Department, Infection Control Officer/EMS Officer, P.O. Box 293, Pasco, WA
99301 .) The ICO shall provide a copy of the written opinion to the employee.
The healthcare professional's written opinion for Hepatitis B vaccination is limited to
the following: (1 ) whether the employee needs Hepatitis B vaccination; (2) whether
the employee has received such a vaccination. The healthcare professional's written
opinion for post-exposure evaluation and follow-up is limited to the following
information:
a. That the employee was informed of the results of the evaluation.
b. That the employee was informed about any medical conditions resulting from
exposure to blood or other infectious materials that require further evaluation
or treatment.
AO No. 355 `Bloodborne Pathogen Policy"
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Exposure Evaluation Form
This form to be used when an employee reports an on-the-job exposure to blood and or
other potentially infectious materials.
Employee's Name:
Date of Incident:
Date of Evaluation:
Health Professional' s Address:
Health Professional Telephone:
❑ The employee named above has been informed of the results of the evaluation for
exposure to blood and other potentially infectious materials.
❑ The employee named above has been told about any health conditions resulting from
exposure to blood or other potentially infectious materials which require further
evaluation or treatment.
❑ Hepatitis B vaccination is _ is not indicated
Health Care Professional ' s Name
Health Care Professional' s Signature Date
Use with 296-823-160 WAC, Exposure to Bloodborne Pathogens
Return this form to the Employer
AO No. 355 'Bloodborne Pathogen Policy"
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Hepatitis B Vaccine Declination
1 understand that due to my potential for occupational exposure to blood or other infectious
materials I may be at risk of acquiring Hepatitis B virus infection. I have been given the
opportunity to be vaccinated with the Hepatitis B vaccine at no charge to myself. However, I
decline the 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 if I continue to
have the potential of an occupational exposure to blood or other potentially infectious materials
and I want the Hepatitis B vaccine, I may receive the vaccination series at no charge to me.
Print name:
Title:
Signature:
Date:
AO No. 355 `Bloodborne Pathogen Policy"
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