1 Management Plan For Control of Blood-borne Pathogens, Infectious Wastes and Other Potentially Hazardous Biological Agents 1.0 Executive Summary 1.1 The Bloodborne Pathogen standard, initiated by OSHA, is designed to protect employees from blood and body fluid encountered in the workplace. The Standard went into effect in Northeast Metro 916 Blood-borne Pathogen Plan (BBP) was developed in 1992, with MN-OSHA verification in early This plan is updated regularly, however when OSHA guidance differs from this plan, the OSHA guidance is followed. 1.2 The performance of routine tasks will be the basis of at risk determination. Maintenance and Health Service employees are designated to handle blood and body fluid incidences. The Good Samaritan provision for accidental exposures is not part of any job description nor included as routine duties. 1.3 Personal protective equipment (personal barriers) such as gloves, CPR masks, eye protective wear, and aprons must be used when cleaning blood and body fluid spills. Housekeeping guidelines and clean-up procedures are in place directing the staff in proper procedures to minimize personal risk, and provide adequate decontamination of affected spaces. The Standard precaution (assumption that all body fluids are contaminated and treated as such) is used in all response actions. 1.4 Training for all staff is optional whereas the identified At Risk and maintenance employees receive their OSHA required training annually through District Health and Safety Services. 1.5 The District will rely on a HealthPartners Occupational Medicine physician to perform case determination and provide necessary follow-up care and treatment. The Employee Accident Investigation Report and First Report of Injury will initiate necessary record keeping procedures. Physicians will Reviewed and approved by School Board , , 2009, 2010, 2011,
2 provide the District with a Written Opinion outlining case findings and recommended treatment. 1.6 The District has developed a spill response procedure and a housekeeping guideline to be followed when performing spill cleanup. Staff involved in this activity will adhere to these procedures. 1.7 The person responsible for compliance of this program is the Health and Safety Coordinator, Background In 1992 the Occupational Safety and Health Administration issued new rulings on Bloodborne Pathogens (Bloodborne Pathogens Standard, 20 CFR ). The Minnesota Department of Labor (MN-OSHA) adopted these standards and all revisions and interpretations. The provisions in this standard were written to include any requirements already in place for Infectious Wastes and Infectious Agents. In 2000 additional requirements for antibody titers and sharps logs were adopted. Information about these requirements can be found in sections 6.4 and 7.0. This Management Plan has been developed by Northeast Metro for the protection of its staff against infectious agents, infectious wastes, and bloodborne pathogens that may be encountered in the workplace. 3.0 Coverage under the Standard 3.1 Determination of At Risk employees The standard does not specify which employee groups or which tasks are considered at risk. The District will establish Response Teams, consisting of Health Service staff and designated maintenance employees to handle blood and body fluid incidences. Maintenance employees and other at risk individuals will receive training as outlined in Sections 5.0 and 6.0, and post exposure treatment if needed in Section 7.0. Due to the nature of work involved in Special Education, all staff will be trained to recognize risks and take protective measures. 3.2 Exclusions for Good Samaritans Revised and Approved by School Board , , 2 June 2009, June 2010, June 2011, June
3 Employees may be involved in situations where there is an exposure to blood or body fluid, which has not been reasonably anticipated, nor is it part of the routine tasks performed by the employee (i.e.: Teacher breaks up fight in hallway where there has been a blood or other body fluid exposure.) The District will provide Good Samaritans with post exposure treatment and follow up as outlined in Section Implementation of the Management Plan 4.1 Implementation Dates District Plan reviewed and updated June Northeast Metro 916 Bloodborne Pathogens Management Plan 4.2 School Board Review and Approval RESOLVED, that the Northeast Metro 916 School Board approves and certifies the school district s Bloodborne Pathogen Management Plan and furthermore, designates Jill Stewart as program coordinator. Note: See Attachment 10 for School Board approval of Bloodborne Pathogen Management Plan 5.0 Best Practices Best work practices are used to effectively eliminate or minimize exposure to bloodborne pathogens. 5.1 Standard Precautions Standard Precautions dictate that all body fluids are considered potentially infectious and therefore treated as such. All detailed procedures will be followed during cleaning and sanitizing a body fluid release. Standard Precautions shall also be used during cleanup of miscellaneous Revised and Approved by School Board , , 3 June 2009, June 2010, June 2011, June
4 materials such as broken glass, personal sanitary items, or other personal items. Assume everyone is infected with HIV, hepatitis B or other bloodborne pathogens and avoid skin exposure to infected fluids. Fluids to be concerned about are: 1. Blood 2. Cerebrospinal fluid a clear fluid surrounding the brain and spinal cord that may leak out of the nose, ears or mouth as a result of severe head injuries 3. Amniotic fluid the fluid in the uterus present during labor and delivery 4. Semen, vaginal fluids and breast milk may also contain bloodborne pathogens, but are not common in first aid situations. 5. Any body fluid containing visible blood. 6. Pericardial, peritoneal, pleural and synovial body fluids. 5.2 Work Practice Controls A. Work Requirements Wear disposable vinyl or nitrile gloves Always wash hands well with soap and warm running water after removing gloves. If soap and water are not immediately at hand, alcohol gel hand sanitizer may be used to clean hands; wash as soon as possible with soap and running water. Wear safety goggles if there is potential for contaminates splashing in the eyes Wear a mask if there is potential for contaminants splashing in the mouth or nose If your skin is not covered by clothing, wear additional protective clothing such as a disposable apron or gown. Use an absorbent material (paper towel/cloth) as a barrier between you and the blood source. If you believe you have been exposed, notify your supervisor or school nurse. Revised and Approved by School Board , , 4 June 2009, June 2010, June 2011, June
5 B. Handling of Sharps Be careful with sharps and dispose of sharps such as needles or lancets or contaminated broken glass in a puncture resistant container. Use tongs or other equipment to pick up broken glass Disposable gloves should be used along with tongs or equipment when handling any contaminated sharps. Needles and other contaminated sharps should not be bent, recapped or removed. Shearing or breaking off contaminated needles is absolutely prohibited. C. Self-Management Whenever possible and appropriate, employees should practice self-management of injuries and should teach students the same. The principle of self-management is that the individual whose blood or other body fluids are exposed should themselves, if possible, manage, treat, clean and dispose of the contaminated materials, thereby avoiding contact by a second party. D. Eating & Drinking/Other 5.3 Engineering Controls Eating, drinking, applying cosmetics or lip balm and contact lens handling are prohibited in work areas where there is reasonable likelihood of occupational exposure. Food and drink should not be stored in close proximity to where blood or potentially infectious materials are present. The Spill Response Team (Health Service staff & maintenance staff) and other persons identified as At Risk shall have available to them the necessary means to isolate or remove hazards from the workplace. A. Personal protective equipment Revised and Approved by School Board , , 5 June 2009, June 2010, June 2011, June
6 Gloves, CPR masks, eye protective wear, and aprons shall be the primary engineering controls used by the district. B. Sharps Container 1. Sharps containers will be located in the health office. 2. Container will be puncture-resistant, labeled or color-coded and leak proof on sides and bottom, and be able to be closed after each use. 3. If outside contamination of container occurs, the primary container shall be placed within a secondary container, which is punctureresistant, leak proof and labeled or colorcoded. C. Spill Clean-up Kit 6.0 Hazard Communication 6.1 Labeling A spill kit shall be placed in the Health and Maintenance offices. It will consist of the following items: 1. Disposable aprons 2. Disposable gloves 3. Disposable face mask 4. Disposable goggles 5. Heavy duty plastic disposal bags & ties 6. Absorbent towels 7. District approved disinfectant and applicator Warning labels will be placed on sharps containers and biohazard waste bins. This labeling shall meet the requirements for Hazard Communication. 6.2 Bloodborne Pathogen and Information Revised and Approved by School Board , , 6 June 2009, June 2010, June 2011, June
7 The District provides Bloodborne Pathogen Awareness training to all identified At Risk and maintenance employees. The OSHA required safety training is offered annually by District Health and Safety Department and by Licensed School Nurses. 6.3 Recordkeeping A. Records of training will be maintained for a period of 3 years from the date of training and will include: a program summary which includes any written information presented, the trainers name, and qualifications, training dates and the name and job title of all persons attending training. B. Sharps Log 7.0 Exposure Control 7.1 Pre-Exposure Options Log of incidents pertaining to needle sticks or other sharps Must contain information about the type and brand of device involved in incident, the location of the incident, and a description of the incident May be unnecessary if this information is included on the First Report of Injury /OSHA 300 Log. Northeast Metro 916 and At Risk employees who desire the pre-exposure vaccination of three (3) intramuscular (arm) injections over a six (6) month period are asked to contact the Health & Safety Office ( ) for a referral to a provider. Employees shall be reminded that the vaccination offers a variable level of protection and only to Hepatitis B. 7.2 First Reports of Injury The Employee First Report of Injury completed and submitted to the Human Resources Department for each body fluid exposure incident. HR will notify the Health and Safety Office for an evaluation of each exposure incident. Informal communications may precede the Accident form based upon situation urgency. Revised and Approved by School Board , , 7 June 2009, June 2010, June 2011, June
8 7.3 Use of HealthPartners Occupational Health Physicians Northeast Metro 916 will rely on a Health Partners Occupational Health Physician to determine whether an exposure took place and provide the necessary follow-up care. The following care provider has been designated by the District to perform post-exposure services as deemed necessary and prudent: 7.4 Physicians Written Opinion The physician will provide the District with a written opinion when an employee is sent to them for a Hepatitis B vaccine or when an employee is seen following an exposure incident. The Physicians Written opinion will contain an evaluation of the exposure incident, whether or not the Hepatitis B vaccine is warranted, and discussion with the employee regarding any conditions resulting from the exposure incident. 7.5 Retention of Medical Records 8.0 Training Medical records will be kept for exposed employees for the length of employment plus 30 years. All records will be confidential. The records will contain: the employee name, social security number, vaccination status, exam status, a physician written opinion, and any test results pertinent to the case. These records are available to the employee. The training curriculum shall follow the Occupational Health and Safety Administration guidelines and the employees shall receive their training during their normal work hours or be compensated for overtime by the employer. The Health and Safety Coordinator offers large group, small group, and individualized instruction (by appointment) for employees identified as exposed to a safety hazard. 8.1 The training roster and attendance documentation is located at the Health of Office of each school, and in the Health & Safety Revised and Approved by School Board , , 8 June 2009, June 2010, June 2011, June
9 Office for Maintenance, Human Resources for new employees, and Career and Technical Center Employees. Online rosters may also be kept. Infectious Waste and Blood-borne Pathogens Plan This plan is intended to maintain safe working environments by preventing exposure to waste products that may be contaminated with infectious waste such as bloodborne pathogens or other potentially infectious materials, and to comply with applicable state and federal safety regulations (OSHA, EPA, health department). If these guidelines differ from OSHA directions, the OSHA guidance is to be followed. Hazardous waste includes chemicals such as pesticides, lead and mercury; pharmaceutical waste; objects contaminated by blood or other body fluids; and poisons. PPE should always be used when working with potentially infectious materials, and may include eye protection or face masks, gloves and gowns. Do not eat, drink, apply cosmetics, or handle contact lenses in areas where hazardous waste products may be located. After removing PPE, hands should be washed thoroughly for at least 20 seconds with soap and warm running water. Any splashes to the eyes, nose, mouth/mucous membranes or punctures must be reported immediately. Medical treatment may be needed if an exposure has occurred. Biological infectious waste should be placed in a red plastic bag or double-bagged and marked as a biohazard, then placed in a leak-proof red infectious waste bin. Sharps should be placed in a red Sharps container, and then into the red waste bin, for removal by an authorized waste removal contractor. Revised and Approved by School Board , , 9 June 2009, June 2010, June 2011, June
10 Expired medication will be disposed of according to DEA regulations. It should be left in original containers (personally identifying information removed) and rendered uningestible before placing it in the bin. Salt, kitty litter, old coffee grounds etc may be used to render items uningestible. Non-biological hazardous waste should be placed in a plastic bag or double-bagged and marked as a biohazard, then placed in a leak-proof brown hazardous waste bin. Contaminated sharps should be placed in a red Sharps container, and then into the brown waste bin, for removal by an authorized waste removal contractor. Training and information will be provided in compliance with Right-To-Understand requirements. Additional information can be found in the district Blood-borne pathogen exposure control plan. It is essential that all pertinent safety rules be followed when implementing this plan, particularly with regard to the use of PPE, cleaning and disinfection. Only approved products should be used, according to label directions, for cleaning and disinfection. This plan will be reviewed at least annually and will be updated as needed to maintain compliance. Please contact the Health and Safety Coordinator or your supervisor for questions. Revised and Approved by School Board , , June 2009, June 2010, June 2011, June
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