Blood Borne Pathogen Plan Pg. 2

EVALUATION OF CIRCUMSTANCES SURROUNDING EXPOSURE INCIDENTS
1. Following an exposure incident Lenoir-Rhyne College will make or cause to be made an investigation of the circumstances surrounding the incident and provide the exposed employee a confidential medical evaluation and follow-up including the following information:
  1. Documentation of the route(s) of exposure and the circumstances under which the exposure incident occurred.
  2. Identification and documentation of the source individual, unless the employer can establish that identification is infeasible or prohibited by state or local law.
  3. The source individual’s blood shall be tested as soon as possible after consent is obtained. If consent cannot be obtained, the employer shall establish that legally required consent cannot be obtained. When the source individual’s consent is not required by law, the source individual’s blood, if available, shall be tested and the results documented. If the source individual is known to be infected with HBV or HIV, re-testing is not required.
  4. Results of the above testing shall be made available to the exposed employee and that employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.
  5. The exposed employee’s blood shall be collected and tested as soon as feasible after exposure if consent is given.
  6. The exposed employee will be offered post-exposure prophylaxis when medically indicated, counseling, and evaluation of reported illnesses.
2. Lenoir-Rhyne College shall ensure that healthcare professional evaluating an employee after an exposure incident is provided with the following information:
  1. A copy of 29 CFR 1910.1030.
  2. A description of the exposed employee’s duties as they relate to the exposure incident.
  3. Documentation of the routes of exposure and the circumstances under which exposure occurred.
  4. Results of the source individual’s blood testing if available.
  5. All medical records relevant to the appropriate treatment of the employee which are the employer’s responsibility to maintain.
3. Lenoir-Rhyne College shall obtain and provide to the employee a copy of the health care professional’s written opinion within fifteen (15) days of the completion of the evaluation.
METHODS OF COMPLIANCE
1. General: Universal precautions shall be implemented. All students and employees self-administering injections or otherwise generating potentially infectious waste shall be trained in proper methods of disposal and control. Guidelines issued by the centers for disease control, U.S. public health service will be followed.
2. Engineering and work practice controls
  1. Handwashing facilities are readily available throughout the campus and will be used immediately by all employees exposed to blood or other body fluid or as soon as feasible after removal of gloves or other protective equipment.
  2. Contaminated needles and other contaminated sharps shall not be recapped, bent, or removed except as noted in paragraphs 1 and 2 below. Shearing or breaking of contaminated needles is prohibited.
    1. Contaminated needles or other contaminated sharps shall not be recapped or removed unless no alternative is feasible or such action is required by a specific medical procedure.
    2. Such recapping or needle removal must be accomplished through the use of a mechanical device or a one-handed technique.
  3. Immediately or as soon as possible after use, contaminated reusable sharps shall be placed in appropriate containers until properly reprocessed. These containers shall be puncture resistant, labeled or color coded, leakproof on the sides and the bottom, and shall not require employees to reach by hand into the container.
  4. No person will keep food or drink in any freezer, refrigerator, shelf, cabinet, countertop, or benchtop where blood or any other potentially infectious material is present.
  5. No person will eat, drink, smoke, apply cosmetics or lip balm, or handle contact lenses in work areas where there is a reasonable likelihood of occupational exposure to blood or other potentially infectious material.
3. Personal Protective Equipment (PPE)
  1. Personnel having occupational exposure will be provided with appropriate PPE such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks, and eye protection. PPE will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employee’s work clothes, street clothes, under garments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the PPE will be used.
  2. All employees will use appropriate PPE when performing duties causing occupational exposure unless in the employee’s professional judgment in a specific instance the use of PPE would prevent the delivery of health care or public safety services or pose an increase hazard. These circumstances are presumed to be exceedingly rare. Each such circumstance will be investigated by the safety officer.
  3. PPE will be readily available to employees and will be repaired or replaced as necessary to maintain maximum effectiveness.
  4. Lenoir-Rhyne College will be responsible for all cleaning, laundering, and replacement of PPE.
  5. Gloves will be worn when it can be reasonably anticipated that the employee will have hand contact with blood. Single use gloves will not be washed or reused.
4. Housekeeping
  1. Work areas shall be maintained in a clean and sanitary condition.
  2. Examination and treatment tables will be cleaned and disinfected immediately after use and at the end of each day by the infirmary nurse or athletic trainer as appropriate. Decontamination will be accomplished by the use of “Sanimaster”. Only specially trained housekeeping personnel will be responsible for cleaning and decontamination of potentially infectious surfaces.
  3. Broken glassware, which may be contaminated, shall not be picked up directly with the hands. It shall be picked up using mechanical means such as brush and dustpan, tongs, or forceps.
  4. Laundry. Contaminated laundry will be handled as little as possible, will be bagged at the location where the contamination occurred, transported in leakproof bags, and washed according to the manufacturer’s instructions. Bagging, transport, and laundering of contaminated materials will be accomplished by persons described above as having occupational exposure. These persons will use appropriate protective equipment.
HEPATITIS B VACCINATION AND POST-EXPOSURE EVALUATION AND FOLLOW-UP
1. All employees with occupational exposure who desire the hepatitis B vaccine will get the shots at the Catawba County Health Service and will be reimbursed for the complete cost of the shots. Individuals getting their shots at other locations will be reimbursed only up to the amount charged by Catawba County Health Services. New employees having occupational exposure will receive the hepatitis B vaccine within ten (10) days of initial assignment unless they have already received the complete series, antibody testing has revealed that the employee is immune, vaccination is contraindicated for medical reasons, or they sign a statement declining the vaccination.
2. Employees and selected students (such as nursing students providing services on campus and athletic training students) having an exposure incident will receive post-exposure evaluation and follow-up at no cost, at a reasonable time and place, by a licensed physician, in accordance with the recommendations of the U.S. public health service. All tests will be conducted by an accredited laboratory. All exposures will be reported immediately to the Exposure Control Officer.
COMMUNICATION OF HAZARDS TO EMPLOYEES
1. Labels and signs—biohazard warning labels shall be affixed to all containers of potentially infectious waste and to the doors of any rooms in which such waste is stored. When removed from a labeled container, the waste will be placed in a red bag or properly labeled box.
2. Information and training—all employees identified above as having occupational exposure will receive initial training prior to working and annual training thereafter. Additional training will be provided when new tasks or procedures affect and employee’s occupational exposure. Records of training will be maintained in the employee’s personnel file and in the office of the Exposure Control Officer. Training records will be maintained for three years following the date of training.
RECORD KEEPING
1. Medical records—Lenoir-Rhyne College shall establish and maintain an accurate record for each employee with occupational exposure. These records are confidential and will be maintained in a file in the Human Resource Office. Medical records will include the following information:
  1. Name and social security number of the employee
  2. Copy of employee’s HBV vaccination status including dates of vaccinations, copies of medial records relative to employee’s ability to receive the vaccination, or declination statement.
  3. A copy of all results of examinations, medical testing, and follow-up procedures as required by paragraph (f)(3) of the standard.
  4. The employer’s copy of the healthcare professional’s written opinion as required by paragraphs (f)(5) of the standard.
  5. A copy of the information provided to the health-care professional as required by paragraphs (f)(5)(ii)(B)(C) and (D) of the standard.
2. Training records—employers shall ensure that employees with occupational exposure participate in a training program that must be provided at no cost to the employee during working hours. The Exposure Control Officer shall be responsible for training all employees with occupational exposure except for those departments that choose to complete their own training.
3. Availability of records—all required records will be made available as required by 29 CFR 1910.1030 h (3). Copies of records will be made available upon requests by employees.
4. Transfer of records—if Lenoir-Rhyne College ceases to do business and there is no successive employer to receive and retain records, then Lenoir-Rhyne College will contact the director of the national institute for occupational safety and health for disposal instructions.
CAMPUS PICK-UP AND STORAGE
Security shall be responsible for pick-up of containers of bio-hazardous materials on campus. Storage shall be in the athletic department until final off-campus disposal is accomplished.
REVIEW AND UPDATE
This exposure control plan will be reviewed and updated at least annually and whenever such updating is indicated by changes in requirements or job exposure.

Hepatitis B Vaccine Declination Statement

I understand that due to my occupational exposure to blood and other potentially infectious materials I may be at risk of acquiring a 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 blood and other potentially infectious materials and I want to be vaccinated with the hepatitis B vaccine, I understand that I can receive the vaccine series at no charge to myself.

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