HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Procedures
2016 – 2017
BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN The purpose of this plan is to reduce Head Start employees' risk of exposure to BLOODBORNE Pathogens such as Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) through appropriate prevention and control measures. The Nutrition/Health Coordinator, with assistance from members of the Health Advisory Committee, is responsible for assisting staff in the implementation of the plan and for reviewing and updating the plan annually. A copy of this plan will be available in every Head Start Site Supervisor’s office and Head Start Administrative office for employee use. EXPOSURE DETERMINATION Exposure to BLOODBORNE pathogens is defined as eye, mouth, other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious materials (OPIM) that results from the performance of an employee’s duties. Parenteral contact means piercing of mucous membranes or the skin through stick with a sharp object (such as a needle). There is also a slight risk of transmission of Hepatitis B through human bites, if blood is present. Any of the following must be reported and treated immediately: 1. All accidental sticks with any contaminated needles or other sharp objects. 2. Splashes of blood or OPIM on mucous membranes of the mouth, nose or eyes. 3. Any splash or spill of blood or OPIM on broken skin. Those employees at risk of such exposure are: Site Supervisors Teacher or Teacher Assistants The activities performed by these employees that could expose them to risk are: Rendering First Aid Cleaning up blood or blood-contaminated body fluids IMMEDIATE TREATMENT Regardless of the source of exposure, first aid is given initially to treat the wound or site of the exposure. Needle stick or broken skin exposure: Attempt to express blood from the wound. Using friction, wash the exposed area immediately with an antimicrobial skin cleanser, rinse well with running water. Apply a sterile dressing if necessary. Mucous Membrane Exposure: Flush the area with water for 15 minutes. Unbroken skin: Wash any spill on unbroken skin with soap and flush with water. Medical evaluation and Hepatitis B and HIV testing should not be necessary. PRECAUTIONS Universal precautions are observed by all employees of Community Action Inc. All human blood and other potentially infectious materials (OPIM) are treated as if known to be infectious for HIV and HBV. Universal precautions do not apply to feces, nasal secretions, sputum, sweat tears, urine or vomitus unless they contain visible blood. Personal protective equipment is required to be used to reduce the risk of exposure. Personal protective equipment will be provided at no cost to employees and include:
Community Action, Inc. of Central Texas All Rights Reserved @ 2016 – 2017 Revised: July 2016 Page 1 of 7
HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Procedures
2016 – 2017
1) Gloves – Medical Quality Disposal gloves( that are located in every classroom at all centers), will be worn during contact with body fluids, cleaning small blood spills and administering First Aid for cuts and scrapes. When removing gloves, turn inside out and place in plastic garbage can. Wash hands thoroughly. 2) Ultra Protection Pack - which contains gown, mask, gloves, protective glasses, shoe covers, surgical cap and biohazard waste bag are located in the Site Supervisor’s office. These will be worn during major bleeding episodes or when cleaning up large amounts of blood. After use, place personal protective equipment in Biohazard waste bag, then into plastic garbage bag, and then into plastic garbage can with a lid. These garbage cans will be kept out of children’s reach. Site Supervisor and/or Teachers will drop off the contaminated plastic bag at any Community Health Service Clinic for disposal. The following work practice controls are implemented to eliminate or minimize employee exposure: 1) Hand washing facilities are readily accessible. 2) Employees will wash their hands immediately or as soon as feasible after removal of gloves or other personal protective equipment. 3) Employees will wash their hands or other skin with soap and water, or flush mucous membranes with water immediately or as soon as feasible following an exposure incident. 4) Employees will wear Medical Quality Disposal gloves when it is reasonably anticipated that employees will have contact with blood or OPIM. 5) All garments that are penetrated by blood will be removed immediately. 6) All personal protective equipment will be removed prior to leaving the work area and placed in an appropriately designated area or container for storage, cleaning, decontamination, or disposal. HOUSEKEEPING: Immediately or as soon as feasible after any spill of blood or OPIM, clean and disinfect the surfaces with 1 volume of bleach to 10 volumes of water (2 tbsp. of bleach per 10 ounces of water or about 1/3 cup for a quart.). Handle children's clothes soiled with blood or OPIM as little as possible. Place clothes soiled with blood in a plastic bag and send home with child. Employees must use personal protective equipment to prevent contact with blood or OPIM when coming in contact with contaminated surfaces or clothing. HEPATITIS B VACCINE All Head Start staff including Site Supervisors, Teachers and Teacher Assistants have been identified as having the potential for exposure to blood or OPIM are encouraged to get the Hepatitis B vaccine. Employees who decline the vaccine shall sign a waiver form. Employees who initially decline the vaccine but who later wish to have it may do so at no cost. Employees who leave their employment with Head Start before completing the HBV vaccination series will be provided information on their status and how to complete their immunization series. POST-EXPOSURE EVALUATION AND FOLLOW-UP When an exposure incident occurs, after the wound has been treated, the employee reports the incident to the supervisor immediately. Following a report of an exposure incident, the employer shall immediately make available to the exposed employee a confidential medical evaluation. The employee completes the Employee Exposure Report Form and if needed is referred to St. David’s Occupational Health or other medical provider. Community Action encourages the employee to seek an evaluation from St. David’s Occupational Health Services within 2 hours. This confidential visit is for an evaluation to decide what treatment or preventative care is needed. The health care provider will make available to the employee and employer a written report within 15 days. It will include:
Community Action, Inc. of Central Texas All Rights Reserved 2016 – 2017 Revised: July 2016
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HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Procedures
2016 – 2017
1. Information about Hepatitis B vaccination. 2. Documentation that the employee has been informed of the results of the evaluation. 3. Documentation that the employee has been informed about any medical conditions resulting from exposure to blood or OPIM which require further evaluation or treatment. 4. All other findings are confidential. St. David's Occupational Health Services has agreed to provide timely occupational post exposure evaluation, serologic testing, treatment and follow-up for CA employees who may experience an exposure incident. It is recommended that the employee or supervisor call the facility to alert them that an employee is coming. If the employee cannot arrive before one of the Occupational Health clinics closes, they may be seen for immediate assessment at one of the St. David's Medical centers or one of the St. David's HealthCare Partnership's emergency departments. The employee tells the intake person that they are a Community Action employee and that an agreement is in the computer. The providers in these clinics have expertise in the evaluation of exposure incidents, are current in the latest OSHA requirements for testing and US Public Health Service treatment recommendations. They have immediate access to post exposure HIV prophylaxis drugs, should they be warranted. HIV drugs should be initiated within two (2) hours after exposure to be maximally effective. The medical provider and exposed employee decide what is to be done. Occupational Health Clinics:
Concentra Urgent Care 10001 South IH-35, Suite 3 Austin, TX 78747 512-440-0555 512-448-1113 (fax) 8am-8pm Mon-Fri 10am-6pm Sat & Sun The supervisor is responsible for notifying the Nutrition/Health Coordinator or Program Director by telephone before the end of the work day. (If neither is available, notify the Human Resource Director). The Nutrition/Health Coordinator will notify the Human Resource Director within 24 hours. If the employee refuses to complete either the Employee Exposure Report Form or the Employee’s Notice of Occupational Injury or illness, the supervisor will complete them. The employee must then sign the REFUSAL TO FILE INJURY REPORT stating that they have been made aware of the risk factors. FAX these forms to the Program Director within 24 hours and mail the originals at the same time. All medical evaluations and procedures including the Hepatitis B vaccine and vaccination series and post-exposure evaluation and follow-up, including prophylaxis, will be made available at no cost to the employee and at a reasonable time and place. The employee may not disclose any information about the source individual which he/she receives in the medical evaluation.
Community Action, Inc. of Central Texas All Rights Reserved 2016 – 2017 Revised: July 2016
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HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Procedures
2016 – 2017
TRAINING All new employees will receive training upon initial assignment and yearly thereafter. Head Start provides Annual training about HIV infections, AIDS, and other BLOOD BORNE pathogens to all staff during pre-service including at a minimum: mode of transmission, methods of prevention, and high risk behaviors. As of August 1994, Head Start staff are provided with training sessions which covers BLOODBORNE Pathogen Standard and information on the Exposure Control Plan, which include universal precautions, personal protective equipment, work practice controls and the offering of Hepatitis B vaccine to all employees. All Head Start classroom staff are taught Standard First Aid by a certified instructor which includes the use of universal precautions. RECORD KEEPING Records of exposure incidents will be kept for thirty years in the Human Resource Director=s office and records of BLOODBORNE Pathogens training will be kept for three years in the Head Start office.
Community Action, Inc. of Central Texas All Rights Reserved 2016 – 2017 Revised: July 2016
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HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Forms
2016-2017
Community Action, Inc. of Central Texas All Rights Reserved @ 2016 – 2017 Revised: July 2016 Page 5 of 7
HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Forms
2016 – 2017
COMMUNITY ACTION INC., OF CENTRAL TEXAS EMPLOYEE CONFIRMATION FOR EXPOSURE CONTROL PLAN Employee Name Job Title
SS #
Date of Employment By signing this statement, I am stating that I have read and understand the Exposure Control Plan of Community Action, Inc. of Hays, Caldwell, and Blanco Counties. I am further stating that I shall utilize my best efforts to abide by this Exposure Control Plan. Employee Signature
Date
Witness
Date
Community Action, Inc. of Central Texas. All Rights Reserved @ 2016 – 2017
revised: July 2016
HEAD START PROGRAM FORMS & PROCEDURES Binder: Health Services
Section: Forms
2016 – 2017
REFUSAL TO FILE INJURY REPORT and/or REFUSAL OF MEDICAL EVALUATION I the
have received an unintentional exposure to blood or OPIM while working at work site.
REFUSAL TO FILE INJURY REPORT I am aware of the procedures Community Action requires that I follow with such an occurrence. I am aware that this incident will not be put in my personnel file and that I am encouraged to report this occurrence for my own protection. At this time I decline to file a report regarding this occurrence. I understand that my supervisor will be filing an EMPLOYEE EXPOSURE REPORT and EMPLOYEE'S NOTICE OF OCCUPATIONAL INJURY OR ILLNESS. Employee Signature:
Date:
Witness Signature:
Date:
REFUSAL OF MEDICAL EVALUATION I am aware of the risks of infection and procedures Community Action requires that I follow with such an occurrence. I have been offered a confidential medical evaluation at St. David's Occupational Health Services or at another out of agency medical provider. I understand that this evaluation is recommended. At this time I am refusing to have a medical evaluation. Employee Signature:
Date:
Witness Signature:
Date:
Form faxed and mailed to Program Director. Signature and Date
Community Action, Inc. of Central Texas. All Rights Reserved @ 2016 – 2017
revised: July 2016
