5713. Methods of Implementation

  1. General-All employees will use Universal Precautions (see Appendix A) whenever there is reasonably anticipated contact with blood or other potentially infectious fluids.
  2. Safe First-Aid Practices
    1. The Regional Administrator or appropriate Director shall ensure that each office provides and maintains first aid kits and equipment which minimally include several sets of gloves, CPR protective shields, germicidal hand wipes, and plastic disposal bags.
    2. First line supervisors in each office shall inform their employees of the location of, and ensure that they have immediate access to, first aid equipment and will encourage them to use it while rendering first aid.
    3. Staff designated by the Regional Administrator or the applicable Director shall determine the location of first aid kits, to include placement in state cars and in office reception areas, bathrooms, and kitchens. Designated staff shall develop local procedures which include local office information and methods for documenting notification to staff.
    4. The office procedures shall designate and identify staff responsible for stocking of the kit and include posting names of responsible staff.
    5. Whenever blood or other potentially infectious materials may be present, the employee rendering first-aid shall use appropriate personal protective equipment, such as gloves. The employee shall immediately wash his/her hands after gloves are removed.
    6. The person giving CPR shall use a one-way valve micro-shield and then appropriately discard it.
    7. If there is more than one victim, the person giving assistance shall use new protective equipment, such as gloves and CPR micro-shields, for each victim.
  3. Disposal of Contaminated Items
    1. Staff shall handle all material exposed to and contaminated with blood or other potentially infectious materials with gloves. Staff shall place and transport contaminated material in a plastic bag that prevents soak-through and/or leakage to the exterior.
    2. The employee shall label the bag as to contents with label prominently displayed and dispose of contents in trash bins unless contents meet the definition of regulated waste (See Appendix A). In that case, the employee shall dispose of contents in accordance with state and local regulations; e.g., by taking the bag to a local hospital or medical clinic for disposal, by depositing with the fire department's emergency response team on the scene, or by calling the local solid waste utility for further information.
  4. Laundry
    1. To prevent the spread of contamination, staff shall remove all clothing that has been contaminated with gloves and place it in a plastic bag that prevents soak-through and/or leakage. The bag shall be labeled as to contents with label prominently displayed.
    2. The employee shall change out of contaminated clothing. CA shall provide temporary clothing, such as surgical scrubs, for the person to wear.
    3. If the employee is in the field and not intending to return to the work site, he/she should remove contaminated clothing, place it in a plastic bag immediately on arriving home, and return it to the work site as soon as possible.
    4. Employees shall not take contaminated personal clothing home for home-laundering.
    5. The CA office, in accordance with local or regional procedures, shall arrange for professional cleaning, laundering, repair and/or disposal and replacement of the garment at no cost to the employee. Payment for the cleaning will be handled according to regional policy. Local procedures shall state to whom the contaminated laundry shall be given.
  5. Cleaning
    1. All CA property that may have been contaminated with blood or other potentially infectious materials shall be cleaned immediately or as soon as possible after the incident, in accordance with local procedures.
    2. Employees shall wear gloves during all cleaning procedures.
    3. Employees shall dispose of gloves used for cleaning procedures into a plastic bag. The employees shall wash their hands immediately after gloves are removed.
    4. Each CA office shall provide and make available appropriate cleaning supplies, such as bleach, Lysol, AseptiCare, or MegaSol.
    5. Employees shall use a household bleach solution in a mixture of one part bleach to 10 parts water made fresh for immediate use or an appropriate germicide, which may include Lysol Spray, AseptiCare, or MegaSol.
    6. Staff shall handle all broken glass or other "sharps" with broom, dust pan, tongs, or forceps in order to reduce the risk of exposure. If items are contaminated, staff shall pour bleach solution or germicide over the area, prior to removal.
    7. Staff shall dispose of broken glass and/or "sharps" into containers that are leak-, spill- and cut-proof.
  6. Training
    1. The Regional Administrator or Director, as applicable, shall arrange for all employees to be trained in order to become knowledgeable on the plan.
    2. Training shall be provided during work hours and free of charge to all employees.
    3. All new employees shall be trained during employee orientation.
    4. The training shall address, at a minimum, the following subjects:
      1. Blood borne pathogens.
      2. Universal precautions.
      3. Safe first-aid practices.
      4. Blood borne Pathogens Protection Plan.
    5. All employees who have received training shall sign a S. F. 141, Developmental Training Report.
  7. Post-Exposure Prophylaxis, Evaluation, and Follow-up-Each Regional Administrator, Regional Manager, or Director, as appropriate, shall arrange for provision of post-exposure follow-up and prophylaxis to all employees who have an exposure to blood and/or other potentially infectious body fluids while on the job.
    1. Employee Self-Care-Every employee shall be informed during training of the following necessary self-care process:
      1. Exposure to the eyes - Flush eyes with water and/or appropriate solution.
      2. Exposure to the nose - Blow nose and wipe inside of nostril.
      3. Exposure to the mouth - Spit and rinse mouth.
      4. Exposure to skin - If a hand washing facility is not available, wipe immediately with germicidal towelette and then, as soon as possible, wash in hand washing facility.
    2. Incident Reporting-After every incident involving blood or other potentially infectious material, the employee shall report the incident to a supervisor. If exposure has occurred, the supervisor shall assist the employee in filling out a Report of Employee Personal Injury, DSHS 3-133.
    3. Medical Follow-up
      1. The supervisor shall ask the employee to go to a licensed health care professional immediately or at least within 24 hours of the incident for a post-exposure evaluation and follow-up.
      2. The employee will take the following to the health provider:
        1. A copy of the Report of Employee Personal Injury, DSHS 3-133.
        2. A post-exposure evaluation form for the health care professional's written opinion.
        3. A copy of the portion of WAC 296-62-08001(6) noting requirements for evaluation & follow-up.
      3. The supervisor shall complete the Report of Employee Personal Injury, DSHS 3-133, and route copies following the instructions on the form, including forwarding a copy of the Department of Labor and Industries (L&I) report to the Office of Safety & Risk Management, once the completed copy is received from the health care provider.
      4. Post-exposure evaluation and follow-up may consist of HIV counseling and testing, Hepatitis B immunoglobulin, and the offer of the full series of the Hepatitis B vaccine.
        1. CA shall make available all post-exposure evaluation and follow-up, including hepatitis B vaccination, at no cost to the employee.
        2. Employees who decline to receive recommended HBV vaccination must sign a declination form.
      5. The designee of the Regional Administrator or Director, as applicable, shall request that the source individual have his/her blood tested as soon as possible, with the test results disclosed to the exposed employee. The source individual is not required by law to have the tests or to disclose test results.
      6. The designee shall remind the exposed employee that the test results are not to be disclosed to anyone, except for the health care provider providing the employee's medical evaluation. When the source individual is already known to be infected with hepatitis B virus or human immunodeficiency virus (HIV), blood testing for these viruses need not be requested.
    4. Record-Keeping
      1. The health care provider will report back to CA that appropriate post-exposure evaluation, prophylaxis, and follow-up has been offered.
      2. All medical records of this exposure follow-up will be kept confidential by CA for the duration of the person's employment plus thirty years. Records will be maintained by the DSHS Office of Risk Management, Safety and Health Section, and will not be included in the employee's personnel file.
    5. Payment
      1. The regional office, for field staff, and state office, for headquarters staff, shall make payment for supplies, laundering, shots, and other expenses related to first aid practices, BBP exposures, and exposure preparations.
      2. The Regional Administrator or Director, Division of Management Services, as appropriate, shall determine the method of payment and include funding in the appropriate budget.
      3. The Regional Administrator, the Regional Manager, and the applicable Director shall ensure the development of local procedures, including identification of person to whom payment questions and requests shall be directed.