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MANUAL for Medical Facilities OSHA PROGRAM MANUAL for Medical Facilities About the Author Sheila Dunn, DA, MT (ASCP), holds a doctoral degree in clinical laboratory science from the Catholic University of America in Washington, DC. She has helped thousands of outpatient medical facilities comply with federal regulations such as CLIA and OSHA through her presentations at a nationwide seminar series. She has written more than 150 articles about regulatory issues and healthcare delivery systems and serves as an advisor to numerous companies. 11A HCPro, Inc. P.O. Box 1168 Marblehead, MA 01945 Tel: 800/650-6787 Fax: 800/639-8511 www.hcmarketplace.com ©2005–2011 HCPro, Inc. All rights reserved, including right of reproduction. The author(s) and their agent(s) have made every reasonable effort in the preparation of this publication to ensure the accuracy of the information. However, the information in this book is sold without warranty, either expressed or implied. The authors, the editors, their agents, and the publishers will not be liable for any damages caused or alleged to be caused directly, indirectly, incidentally, or consequentially by the information in this publication. This publication cannot and does not provide specific information for a user’s exact situation. Users of this publication should exercise their own judgment and, where appropriate, seek the assistance of legal counsel regarding their particular situation. OSHA Program Manual for Medical Facilities is published by HCPro, Inc. Copyright © 2011 HCPro, Inc. All rights reserved. Printed in the United States of America. 5 4 3 2 1 ISBN: 978-1-60146-743-0 No part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro, Inc., or the Copyright Clearance Center (978/750-8400). Please notify us immediately if you have received an unauthorized copy. HCPro, Inc., provides information resources for the healthcare industry. HCPro, Inc., is not affiliated in any way with The Joint Commission, which owns the JCAHO and Joint Commission trademarks. Sheila Dunn, DA, MT (ASCP), Author David A. LaHoda, Managing Editor Michael Briddon, Executive Editor Emily Sheahan, Group Publisher Mike Mirabello, Senior Graphic Artist Matt Sharpe, Production Supervisor Jean St. Pierre, Senior Director of Operations Advice given is general. Readers should consult professional counsel for specific legal, ethical, or clinical questions. Arrangements can be made for quantity discounts. For more information, contact: HCPro, Inc. 75 Sylvan Street, Suite A-101 Danvers, MA 01923 Telephone: 800/650-6787 or 781/639-1872 Fax: 800/639-8511 E-mail: [email protected] Visit HCPro online at: www.hcpro.com and www.hcmarketplace.com 01/2011 21825 TAB 5: BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN Contents Page Exposure Control Plan Introduction ............................................................... 5-1 Overview of Bloodborne Pathogens Standard Components ....................... 5-2 A Quick Look at Occupational Exposure ....................................................... 5-3 Industries Subject to the Bloodborne Pathogens Standard ........................ 5-3 Key Provisions and Effective Dates ............................................................... 5-4 Universal Precautions ...................................................................................... 5-4 Other Potentially Infectious Materials (OPIM) .........................................................................5-4 Implementing Universal Precautions ......................................................................................5-5 Bloodborne Pathogens .................................................................................... 5-6 Epidemiology of Bloodborne Pathogens.................................................................................5-6 Update on AIDS in the Workplace ..........................................................................................5-9 Transmission of Bloodborne Pathogens .................................................................................5-10 Exposure Determination .................................................................................. 5-10 Personnel Who Are Occupationally Exposed .........................................................................5-10 Exposure Prone Procedures ...........................................................................................5-11 Bloodborne Pathogens Exposure Determination List #1 (Form 8) .........................................5-12 Other Personnel Who Could Potentially Be Occupationally Exposed ....................................5-13 Bloodborne Pathogens Exposure Determination List #2 (Form 9) .........................................5-14 Employees Who Are Not Occupationally Exposed .................................................................5-15 Restricted Access Areas ................................................................................. 5-15 Engineering / Work Practice Controls ............................................................ 5-15 Biohazard Labels ....................................................................................................................5-16 Handwashing ..........................................................................................................................5-16 When to Wash Hands .....................................................................................................5-18 How to Wash Hands .......................................................................................................5-18 Artificial Nails ..................................................................................................................5-18 Sharps Safety .........................................................................................................................5-19 What to Look for in Safety Devices .................................................................................5-19 Contents Sharps Evaluation Procedure .........................................................................................5-20 Use of Non-Safe Sharps .................................................................................................5-21 Phlebotomy Needles .......................................................................................................5-22 Sharps Containers ..................................................................................................................5-22 Sharps Container Maintenance ......................................................................................5-23 Sharps Container Disposal Procedure ............................................................................5-23 Biohazardous Waste (See Tab 8) ................................................................................... Laundry ...........................................................................................................................5-24 Personal Protective Clothing & Equipment ................................................... 5-25 PPE Strategy ..........................................................................................................................5-25 Locations of PPE ....................................................................................................................5-26 Gloves .............................................................................................................................5-27 When to Wear Gloves .............................................................................................5-27 How to Wear Gloves ...............................................................................................5-27 Latex Allergy ............................................................................................................5-28 Preventing Allergic Reactions .................................................................................5-29 Face Protection ...............................................................................................................5-30 Body Protection ...............................................................................................................5-30 Emergency Resuscitation Equipment .............................................................................5-31 When to Wear PPE .................................................................................................................5-31 Hepatitis B Vaccine .......................................................................................... 5-32 Safety of the Hepatitis B Vaccine ............................................................................................5-33 Documenting Employee Hepatitis Vaccines ...........................................................................5-33 Titering Employees after the Hepatitis B Vaccination .............................................................5-34 How to Determine Employee Immunity ...........................................................................5-34 Testing Employees Vaccinated before the Titer Requirement ........................................5-35 Types of Hepatitis B Tests ............................................................................... 5-35 Interpreting Hepatitis B Test Results .......................................................................................5-36 New Employee Hepatitis B Virus Vaccination Flow Chart ............................ Supplement Post-exposure
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