OSHA banner
Technical Links > Nursing Home > Nursing Home eCAT > BBP Module > Methods of Implementation

Exposure Control Plan-Methods of Implementation

II. METHODS OF IMPLEMENTATION AND CONTROL
  1. Universal Precautions
  2. All employees will utilize universal precautions. Universal precautions is an infection control method which requires employees to assume that all human blood and specified human body fluids (OPIM) are infectious for HIV, HBV, HCV, and other bloodborne pathogens, and must be handled accordingly. 

  3. Exposure Control Plan

    1. Employees covered by the bloodborne pathogens standard will receive an explanation of this ECP during their initial training session. It will also be reviewed in their annual refresher training. All employees will have an opportunity to review this plan at any time during their work shifts by contacting ___________________________ A copy of the plan will be made available free of charge and within 15 days of the request.

    2. ______________________ will be responsible for reviewing and updating the ECP annually or more frequently if necessary to reflect any new or modified tasks and procedures which affect occupational exposure and to reflect new or revised employee positions with occupational exposure.

  4. Engineering Controls and Work Practices
    1. Engineering controls and work practice controls will be used to prevent or minimize exposure to bloodborne pathogens. The specific engineering controls and work practice controls which we will use, and where they will be used, are listed below:
    2. *__________________________________________________

      *__________________________________________________

      *__________________________________________________

      *__________________________________________________

    3. Sharps disposal containers in the office will be inspected and maintained or replaced by _______________________ every _______________ or whenever necessary to prevent overfilling.
    1. This facility identifies the need for changes in engineering control and work practices through: __________________________________________

We evaluate need procedures or new products by:________________ __________________________________________________________

The following staff are involved in this process: __________________ __________________________________________________________

__________________________________ will ensure effective implementation of these recommendations.


 

  1. Personal Protective Equipment (PPE)

    1. PPE will be provided at no cost to employees. Training will be provided by _________________ in the use of the appropriate PPE for the tasks or procedures employees will perform.

    2. The types of PPE available to employees are as follows:

      __________________________________________________________

      __________________________________________________________

    3. PPE is located ________________________________ and may be obtained through _________________________________________. (Specify how employees are to obtain PPE, and who is responsible for ensuring that it is available.)

    4. All employees using PPE must observe the following precautions:

      * Wash hands immediately or as soon as feasible after removal of gloves or other PPE.

      * Remove PPE after it becomes contaminated, and before leaving the work area. 

      * Used PPE may be disposed of in the client's home or returned to the office in appropriate containers for storage, laundering, decontamination, or disposal.

      * Wear appropriate gloves when it can be reasonably anticipated that there may be hand contact with blood or OPIM, and when handling or touching contaminated items or surfaces; replace gloves 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; discard utility gloves if they show signs of cracking, peeling, tearing, puncturing, or deterioration.

      * Never wash or decontaminate disposable gloves for reuse.

      * Wear appropriate face and eye protection when splashes, sprays, or droplets of blood or OPIM pose a hazard to the eye, nose, or mouth.

      * Remove immediately or as soon as feasible any garment contaminated by blood or OPIM, in such a way as to avoid contact with the outer surface.

    5. The procedure for handling contaminated PPE is as follows: (may refer to specific agency procedure by title or number and last date of review)

      ___________________________________________________________

      ___________________________________________________________

      (For example, how and where to decontaminate face shields, eye protection, resuscitation equipment)


Notes to Employer:

It is imperative that employees be provided with appropriate protection when occupational exposure is anticipated. PPE is considered "appropriate" only if it does not permit blood or OPIM to pass through or reach the employee's clothes, skin, eyes, mouth, or other mucous membranes. The type and characteristics of PPE will depend upon the task and degree of exposure anticipated. For example:

    * Gloves are used when employees have contact with blood, OPIM, non-intact skin, and mucous membranes, e.g. dressing changes, bathing client with broken skin, or phlebotomy. Hypoallergenic gloves, glove liners, powderless gloves or other similar alternatives must be provided for employees who are allergic to the gloves that are normally provided.

    * Masks and eye protection are used when blood or OPIM may be splashed or sprayed, e.g. suctioning, oral care, tracheostomy care.

    * Protective clothing is worn to protect against contamination of the employee's personal clothing with blood or OPIM, e.g. central venous line insertion.

Employees covered by the standard who make visits to clients in their homes must be provided with appropriate PPE. For employees who have occupational exposure, gloves, gowns or aprons, and disinfectant towelettes or antiseptic hand cleanser for hand washing in the absence of running water must be provided. Employees who perform invasive procedures must additionally be provided with face masks and eye protection. Employees using disposable sharps will be provided with portable sharps disposal containers. Employees who are expected to perform CPR as a function on their job must be provided with resuscitation bags or mouthpieces.

Due to the court of appeals decision, home health employers will not be held responsible for violating those provisions of paragraph (d)(3) in the bloodborne pathogens standard which require that the employer ensure that the PPE is actually used, or that employees wear PPE.

  1. Housekeeping

Regulated Waste is placed in containers which are closable, constructed to contain all contents and prevent leakage, appropriately labeled or color-coded (see labels), and closed prior to removal to prevent spillage or protrusion of contents during handling.

    1. The procedure for handling sharps containers is: (may refer to specific agency procedure by title or number and last date of review)

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    2. The procedure for handling other regulated waste is: (may refer to specific agency procedure by title or number and last date of review)

      _________________________________________________________

      _________________________________________________________

      _________________________________________________________

    3. Contaminated sharps shall be discarded immediately or as soon as possible in containers that are closable, puncture-resistant, leak-proof on sides and bottoms, and labeled or color-coded appropriately. Sharps disposal containers are available at _______________________________________________________ (must be easily accessible and as close as feasible to the immediate area where sharps are used).
Bins and pails (e.g., wash or emesis basins) must be cleaned and decontaminated as soon as feasible after visible contamination.

Broken glassware which may be contaminated must be picked up using mechanical means, such as a brush and dust pan.

  1. Laundry

    1. The following contaminated articles will be laundered by this company:
      _____________________   _____________________  

       

    1. Laundering will be performed by _______________________ at (time and/or location) ________________________________________________
    2.  

    3. The following laundering requirements must be met:

      * handle contaminated laundry as little as possible, with minimal agitation

      * place wet contaminated laundry in leak-proof, labeled or color-coded containers before transporting

      * use   (red bags or bags marked with biohazard symbol)    if the facility where items are laundered does not use universal precautions

      * wear appropriate PPE when handling and/or sorting contaminated laundry: (List appropriate PPE)___________________________________________

  2. Labels

    1. The following method(s) is used in this facility:

      EQUIPMENT TO BE LABELED   LABEL TYPE (size, color, etc.)
      ___________________________ ___________________________
      ___________________________ ___________________________
      (e.g. specimens, contaminated laundry, etc.) (red bag, biohazard label, etc.)
    2.  

    1. ________________________ will ensure warning labels are affixed or red bags are used as required if regulated waste or contaminated equipment is brought into the office. Employees are to notify _________________________ if they discover regulated waste containers, refrigerators containing blood or OPIM, contaminated equipment, etc. without proper labels.


Notes to Employer:

Red bags or red containers may be substituted for warning labels. Labels or red bags must be used for contaminated laundry, containers of regulated waste, refrigerators containing blood or other potentially infectious material, and other containers used to store, transport, or ship blood or OPIM. Exemptions are listed under paragraph g(1)(i)(E, F, and G).

The BIOHAZARD symbol is the required legend for labels in this section. See the bloodborne pathogens standard, section g "Communication of Hazards to Employees" for specific language about labeling requirements.

 

 

 

US Department of LaborContact InformationDisclaimer

tracking image OSHA Home Page OSHA Index OSHA Search