Blood Borne Pathogen Exposure Control and Treatment Plan

 

Introduction:

This plan is designed to eliminate or minimize exposure to blood borne pathogens, as well as define reporting and follow-up procedures in case of an exposure incident. This plan refers to OSHA’s (Occupational Safety and Health Administration) blood borne pathogens standard.

Definitions

Blood borne pathogens: Refers to infectious materials in blood that can cause disease in humans. This includes hepatitis B (HBV) and C and human immunodeficiency virus (HIV). Staff and students who are in the health care industry are subject to the exposure to a variety of infectious and communicable diseases as a result of their daily personal contact with patients.

Exposure: The most obvious exposure incident is a needle stick, however any specific eye, mouth, other mucous membrane, non-intact skin, or contact with blood or other potentially infectious material is considered an exposure incident.

Universal Precautions: Universal precautions is an infection control method which requires employees to assume that all human blood and other body fluids (listed below) are infectious for HIV,HBV, and other bloodborne pathogens and must be treated accordingly.

Potentially infectious body fluids:

• Semen
• Vaginal secretions
• Cerebrospinal fluid
• Synovial fluid
• Pleural fluid
• Pericardial fluid
• Peritoneal fluid
• Amniotic fluid
• Saliva in dental procedure
• Any body fluid visibly contaminated with blood
• All body fluids in situations where it is difficult or impossible to differentiate between body fluids

Personal Protective Equipment (PPE): PPE is provided to our employees/students at no cost to them. Training is provided by the athletic training education program in the use of the appropriate PPE for tasks or procedures that employees/students will perform.

The types of PPE available to employees/students are as follows:

• Gloves
• Gowns
• Face shields
• Masks
• Eye protection
• Resuscitation bags
• Mouthpieces
• Biohazard bags

Individuals in need of such items should request them from their supervisor or other designee.

PPE is located at the following area: Gaither Sports Medicine Center (located last top cabinet in the lower taping area).

Universal Precaution Procedures:

Employees/students will perform their duties with the understanding that body fluids and medical waste may be infectious. When performing tasks that involve these materials, employees and students will adhere to the following universal precautions procedures:

1. Treat all situations involving potential contact with blood. Body fluids or medical waste with caution.
2. Wash hands after each contact with any bodily substance or articles contaminated with bodily substance. Use liquid soap from a dispenser, not bar soap. Employees/students must have immediate access to cleaning supplies and must not wait for appropriate washing. (i.e. If an exposure occurs during athletic event, the employee/student must be allowed to leave the event to engage in proper washing rather than waiting until half-time or the end of the game or event)
3. Wear protective gloves on both hands for anticipated direct contact hand contact blood, body fluids, medical waste or contaminated objects or surfaces. The gloves must be replaced if torn, punctured, contaminated, or if their ability to function as a barrier is compromised. Utility gloves may be decontaminated for reuse if their integrity is not compromised for reuse if there is not compromised; discard utility gloves if they show signs of cracking, peeling, tearing, puncturing, or deterioration. Disposable gloves should not be washed or decontaminated for reuse. Wash hands immediately after removing protective gloves.
4. Wear an impervious apron if body fluids are in large quantity and likely to get the clothing wet.
5. Wear a mask if splashing of blood or other body is anticipated, to protect the mucous membranes of the nose and mouth.
6. When unanticipated exposure occurs, remove contaminated substances by avoiding contact with the outer surface and washing hands and other skin surfaces immediately and thoroughly. If splashed in the eyes, nose or mouth, flush with water immediately, notify supervisor of all exposures.
7. All employees/students must take precaution to prevent injuries caused by needles or other sharp instruments. Mechanical means, such as a brush and dustpan should be used to handle such material. Report any needle punctures to supervisor immediately.
8. Soiled linens should handled as little as possible and with minimum agitation. All linen should be bagged at the location where it is used; it should be placed in impervious bags that prevent leakage.
9. Trashed must be placed in covered containers bagged in impervious bags; tops should be secured when full, double bag if break through is anticipated.
10. Areas, surfaces, or articles like wash or emesis basins that are grossly soiled with blood or other body fluids must be cleaned with detergent/disinfectant.

Prevention of Exposure Incident:

(The following is taken from the 2005-2006 NCAA Sports Medicine Handbook, 18th edition, August 2005, page 54.)

The following recommendations are designed to further minimize risk of blood borne pathogen transmission in the context of athletic events and to provide treatment guidelines for caregivers. These are sometimes referred to as “universal precautions”, but some additions and modifications have been made as relevant to the athletics arena.

1. Pre-event preparation includes proper care for wounds, abrasions, cuts or weeping wounds that may serve as a source of bleeding or as a port of entry for blood borne pathogens. These wounds should be covered with an occlusive dressing that will withstand the demands of competition. Likewise, care providers with healing wounds or dermatitis should have these adequately covered to prevent transmission to or from a participant.
2. Student-athletes may be advised to wear more protective equipment high-risk areas, such as elbows and knee’s
3. The necessary equipment and/or supplies important for compliance with universal precautions should be available to caregivers. These supplies include appropriate gloves, disinfectant bleach, antiseptics, designated receptacles for soiled equipment and uniforms, bandages and/or dressings and a container for appropriate disposal of needles, syringes, scalpels, and other sharps materials.
1. Preventative practice includes, use of gloves and other protective equipment such as one-way valve masks.
2. Appropriate procedures for hand washing, sharps disposal, glove and biohazard disposal, contaminated laundry handling and material cleaning should also be practiced to reduce the likelihood of exposure.
4. When a student-athlete is bleeding, the bleeding must be stopped and the open wound covered with a dressing sturdy enough to withstand the demands of activity before the student-athlete may continue participation in practice or competition. Current NCAA policy mandates the immediate, aggressive treatment of open wounds or be removed from the event as soon as is practical. Return to play is determined by appropriate medical staff personnel. Any participant whose uniform is saturated with blood, regardless of the source, must have that uniform evaluated by appropriate medical personnel for potential infectivity and changed if necessary before return to participation.
5. During an event, early recognition of uncontrolled bleeding is the responsibility of officials, student athletes, coaches and medical personnel.
6. Personnel managing an acute blood exposure must follow the guidelines for universal precautions. Sterile latex gloves should be worn for direct contact with blood or body fluids containing blood. Gloves should be changed after treating each individual participant and, after glove removal hands should be washed.
7. Any surface contaminated with spilled blood should be cleaned in accordance with the following procedures: With gloves on, the spill should be contained in as small an area as possible. After the blood is removed, the surface area of concern should be cleaned with an appropriate decontaminant.
8. Proper disposal procedures should be practices to prevent injuries caused by needles, scalpels and other sharp instruments or devices.
9. After each practice or game, any equipment or uniforms soiled with blood should be handled and laundered in accordance with hygienic methods normally used for treatment of any soiled equipment or clothing before subsequent use. This includes provisions for bagging the soiled items in a manner to prevent secondary contamination of other items or personnel.
10. Finally, all personnel involved with sports should be trained in basic first aid and infection control.

OSHA protocol and standards shall be reviewed yearly with athletic training students. This training will occur prior to ATS performing clinical assignments.

Reporting an Exposure Incident:

Employees of the University: In the event of an exposure incident, please inform the Director of Sports Medicine. Follow appropriate workers compensation guidelines including:Complete the employee injury report immediately.

1. If medical treatment is required, contact Human Resources to seek authorized medical care. Treatment not authorized will be at your own expense. (All exposure incidents should be medically treated).
2. Complete the Authorization to Release Medical Records form granting access to medical records. These records must be received before payment of medical charges may be considered.
3. Return all forms to Anderson University promptly. Failure to complete these forms may delay consideration of workers’ compensation benefits.
4. Questions or concerns may be directed to the Human Resources Department (Denise Kriebel) at (765) 641-4133

Athletic Training Students: In the event of an exposure incident, students should report the incident to the supervising certified athletic trainer (ATC) immediately. The following procedures should be followed:

1. Upon exposure, the ATC will contact the team physician for appropriate action. Treatment will be based on recommendations of the team physician.
2. Any questions or concerns may be addressed to Anderson University Human Resource Department (765) 641-4200
3. Written documentation of the incident should be completed as soon as feasible following the exposure.
4. Students: An exposure incident report should be used and properly filled out and returned to your supervising ATC.
5. If the student is an employee of the university: Fill out an Employee Injury Report-Workers Compensation Form.

Students who are not employees of the university and require testing treatment, care and counseling related to a blood borne pathogen exposure will be at the student’s expense. It is recommended that that all athletic training students carry health insurance. The university will assist in obtaining these services when necessary.

The Infected Athletic Trainer:

An athletic trainer infected with a blood borne pathogen should practice the profession of athletic training taking into account all professionally, medically, and legally relevant issues raised by the infection. Depending on individual circumstances, the infected athletic trainer will or may wish to:

1. Seek medical care and on-going evaluation
2. Take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her patients.
3. Inform, as or when appropriate, relevant patients, administrators, or medical personnel

Post-Exposure Follow-Up:

Follow up care will be based upon recommendation by medical personnel treating exposure. Follow up care includes:

1. Laboratory tests, confidential medical evaluation, identifying and testing the source of the individual (if feasible), testing the exposed employee’s blood, performing post-exposure prophylaxis, future screenings, preventative medicines, offering counseling, and evaluating reported illnesses.
2. ALL DIAGNOSIS AND MEDICAL RECORDS SHALL REMAIN CONFIDENTIAL

Proper Disposal of Contaminated Material: Material that has been contaminated should be disposed in properly marked Biohazard containers as soon as possible after use. Sharps materials, i.e. needles, scalpels, lancets, etc., should be disposed of in a container explicitly designed for that purpose.

Removal and Disposal of Contaminated Waster Material: A designated person(s) will supervise marked Biohazard and Sharps containers. When full, the biohazard bag will need to be properly closed and Sharps containers properly sealed, and then taken to the Director of Sports Medicine for proper disposal.

HBV Vaccinations:

As part of OSHA’s blood borne pathogens regulations, Anderson University employees are eligible to receive the Hepatitis B vaccine and vaccination series.

OSHA regulations however, do not cover students who are not employees of the University. This includes students who are accepted into or who are applying to the Athletic Training Education Program. HBV Vaccinations are strongly recommended and encouraged for all individuals who risk exposure to blood born pathogens. Please note that the cost of this inoculation is NOT covered by the Department of Intercollegiate Athletics or the Athletic Training Education Program. Anderson University Student Health Services is available to administer this vaccination series, or it may be obtained from your family physician. If the athletic training student does not obtain this vaccination, a declination form must be signed.

Contact Numbers:

Student Health Services	(765) 641-4222
OSHA	(800) 321-OSHA (6742)
Workman’s Compensation
Anderson University Human Resources	(765) 641-4200
Med Check	(765) 644-5025
Director of Sports Medicine	(765) 641-4491

Anderson University Athletic Training Student Exposure Incident Report This form should be filled out as soon as possible after incident. In case of exposure incident the Athletic Training Student should inform their supervising Certified Athletic Trainer, and proper action should be taken, including contacting the Team Physician for appropriate medical referral and testing. Please print clearly. Athletic Training Student Name:___________________________________________________ Date of Exposure:___________________ Time of Exposure:___________________ Describe clearly and in detail how the incident occurred: Certified Athletic Trainer incident was reported to:___________________________________ Were there any witnesses to incident, if so, list names: Did you contact the Team Physician for appropriate medical treatment and referral?? In your opinion, how might the injury be prevented or avoided in the future? _______________________________________________ Athletic Training Student ________________________ Date _______________________________________________ Certified Athletic Trainer ________________________ Date

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