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453.33 - Significant Exposure to Bloodborne Pathogens

453.33

SIGNIFICANT EXPOSURE TO BLOODBORNE PATHOGENS

An Appleton Area School District Exposure Control Plan has been written to establish procedures to protect the health and safety of students, employees and the community. This Plan is available on the district website and is reviewed annually and updated sooner if required. The Plan complies with regulations governed by the Wisconsin Department of Commerce.

Policy 453.33 authorizes and reflects the Exposure Control Plan, which applies to incidents that occur during the school day and school sanctioned activities. It also delineates the necessary controls for managing and reporting significant exposure to blood and body fluids.

 

Legal References:
Wisconsin State Statutes 146.82, 252.15, and 252.21

Adoption Date: March 14, 2005

Amended Date: June 10, 2013

 

 

453.33-Rule

EXPOSURE TO BLOODBORNE PATHOGEN GUIDELINES

Procedures

The following guidelines and procedures are provided for the management of exposure to blood and body fluids. The Appleton Area School District’s (AASD) goals are to prevent exposure and to assure timely and appropriate care following exposure to blood, body fluids or other potentially infectious materials that may possibly be harmful to students and employees.

GUIDELINES

  1. Although “significant exposure” usually refers to an exchange of blood, the term “body fluids” in this document also includes semen, drainage from scrapes, cuts, open lesions and any other body fluids visibly contaminated with blood. Significant exposure is defined under Wisconsin State Statute 252.15 as follows:
     
    1. Transmission into a body orifice or onto mucous membrane of blood; semen; vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial or amniotic fluid; or other body fluid that is visibly contaminated with blood.
       
    2. Exchange during the accidental or intentional infliction of a penetrating wound, including a needle puncture, of blood; semen; vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial or amniotic fluid; or other body fluid that is visibly contaminated with blood.
       
    3. Exchange, into an eye, an open wound, an oozing lesion, or where a significant breakdown in the epidermal barrier has occurred, of blood semen; vaginal secretions; cerebrospinal, synovial, pleural, peritoneal, pericardial or amniotic fluid; or other body fluid that is visibly contaminated with blood.

This definition refers to sustained contact that carries the potential for transmission of HIV (AIDS virus). Since other infectious diseases such as hepatitis B can also be transmitted by significant exposure to blood or other body fluids, the appropriate form(s) shall be completed to document a possible exposure.

  1. School personnel are not authorized to determine if a significant exposure has occurred. This authority, per state statute, falls within the purview of a physician.
     
  2. Blood and body fluids are considered potentially infectious. They may contain bacteria and viruses that can carry many diseases including but not limited to hepatitis B and HIV. Unrecognized carriers may pose a greater threat of transmission of diseases because they may not demonstrate outward signs or symptoms or may not be aware that they are infected.
     
  3. Student and employee exposure to blood or body fluids requires management by school personnel in accordance with first aid procedures, universal precautions, and specific guidelines provided in the AASD’s Exposure Control Plan. Significant exposure may include blood or body fluids visibly contaminated with blood that comes in contact with one’s mucous membranes such as the eyes, nose or mouth, exchange of blood into a body orifice, exposure through non-intact skin, or a penetrating wound.
     
  4. Exposure to saliva, such as spitting, does not constitute a significant exposure unless the saliva or other body fluid is visibly contaminated with blood and the conditions of exposure have occurred as defined previously.

PREVENTION PROCEDURES

The following procedures are provided in order to protect the health and safety of the students and employees exposed to blood and other body fluids.

  1. Employees will annually be advised of the risks of handling blood, body fluids and other potentially infectious materials.
     
  2. Employees responsible for illness and injury care will be properly trained in responding to situations that contain blood and body fluids. This includes the proper disposal of contaminated items.
     
  3. Employees are required to follow universal precautions whenever exposure to blood, body fluids and infectious materials is possible.
     
  4. Blood soaked clothing of students needs to be removed by the student whenever possible and placed in a transport bag. If a change of clothes is not available, the student should remain in the health room and the parent contacted to provide the necessary garments. Blood soaked clothing of employees is addressed under the “Protection” section of this policy.

PROTECTION

Besides the requirement that employees utilize universal precautions, which is the most critical set of procedures in preventing a significant exposure, the AASD will provide other protections to avoid and reduce student and employee exposure to blood and other body fluids. These include the following:

  1. Hepatitis B Vaccine
    All designated employees with occupational exposure to bloodborne pathogens will be offered the hepatitis B vaccine at no cost. The vaccine will be offered within 10 working days of initial assignment unless the designated employee previously had the vaccine, is already immune, or signs a declination waiver. Employees who decline to receive the hepatitis B vaccine will be requested to sign a declination waiver. Employees who initially decline the vaccine but later wish to have it administered may do so. The Personnel Office has the responsibility for informing employees of their right to receive the vaccine, or to sign the declination waiver if they choose not to be vaccinated.
     
  2. Personal Protective Equipment (PPE)
    All personal protective equipment (PPE) used in the AASD will be provided without cost to the employees. PPE will be chosen based on the anticipated exposure to blood or other potentially infectious materials. The PPE will be considered appropriate only if it does not permit blood or other potentially infectious materials to pass through or reach the employee’s clothing, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used.
    1. PPE will be provided to employees as follows: Goggles, aprons, gloves, masks, resuscitation devices, should be kept in a centralized location and should be worn. The Exposure Control Plan is available on the district website. Each container should be labeled “Personal Protective Equipment.” Each administrator will inform all employees of the locations of PPE. One container must be located in the health room or school office.
    2. Gloves are required for all personnel handling blood or body fluids. Furthermore, individuals with open lesions or non-intact skin on their hands must also apply a protective barrier such as a Band-Aid or other dressing. Following removal of gloves, hands are to be thoroughly washed. Gloves will be available in the school office for playground supervisors, classrooms, athletic events and all other school activities.
    3. Masks in combination with eye protection devices such as goggles or glasses with solid side shield, or chin length face shields, are required to be worn whenever splashes, spray, splatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can reasonably be anticipated.
    4. Employees expected to perform CPR must have safe resuscitation devices available. A soft seal mask is available in each AED cabinet.
    5. PPE which is penetrated by blood shall be removed immediately or as soon as feasible. All repairs and replacements of garments will be done at no cost to the employees. Contaminated garments and clothing are not to leave the premises except in properly labeled, leak proof red biohazard bags.
    6. Personal clothing contaminated by blood or other potentially infected materials of other people may be cleaned or replaced by the AASD. Cleaning or replacement will be at the discretion of the AASD. Please contact the Office of the Director of Facilities and Operations for further information.
       
  3. Disposable Sharps Container
    The sharps containers in the AASD are puncture resistant, labeled with a biohazard label, and are leak proof. Sharps containers are placed in school offices or designated health areas. Sharps containers are under the supervision of maintenance and disposed of through contracted waste management. When it is necessary to replace and remove the sharps container, the maintenance department should be contacted for timely replacement.
     
  4. Regulated Waste Disposal
    Regulated waste means liquid or semi-liquid blood or other potentially infectious materials, contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed, items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling, contaminated sharps, and pathological and microbiological wastes containing blood or other potentially infectious materials. All contaminated sharps shall be discarded as soon as feasible in sharps containers. These containers are located in school offices or designated health areas.

    Regulated waste containing drippable, pourable, or squeezable blood will be placed in a red biohazard bag. Such containers are located in the maintenance office. The Director of Facilities and Operations is responsible for removal and proper disposal.

REPORTING POSSIBLE EXPOSURE

  1. A student who is exposed to blood or body fluids will need to be immediately reported to the principal, nurse, or designated illness and injury provider. This reporting will generally occur by the first adult having information of the incident. Employees that may be exposed should self-report if able, or the first adult aware of the incident should report.
     
  2. In the event of an exposure incident of students, the principal, nurse, or illness and injury provider will notify the parent or guardian as soon as possible within the school day or within 24 hours of the incident. When reporting to the parent or guardian, employees will maintain confidentiality and refrain from making a determination regarding a significant exposure. Only appropriate medical personnel, not including school nurses, can make a determination of significant exposure. The decision to proceed with a medical evaluation or follow-up for a student is the responsibility of the parent.
    1. A Student Accident Form is to be forwarded to the Business Office (Supervisor of Purchasing and Grants) within twenty-four hours of the accident. A report is required for both the injured student and others having contact with blood or body fluids visibly contaminated with blood.
       
  3. If an employee is involved in an accident, the Employee Accident Report Form must be completed and filed with Employee Benefits within twenty-four hours.
    1. If the incident included contact with blood or body fluids that may represent an exposure, the principal, school nurse, or illness and injury provider will provide the employee with the School Exposure Incident Investigation Form that is available on the district’s website. If the employee believes a significant exposure has occurred, the Determination of Exposure to Blood/Body Fluids Form (WKC-8165), which can be obtained by contacting the district’s student services or personnel office, should be completed and provided to his/her personal physician or to an agency designated by the AASD. The agency, through a contractual agreement with the AASD, must be certified to perform the medical assessments necessary to reasonably conclude if a significant exposure occurred. The decision to proceed with a medical evaluation or follow-up is the responsibility of the employee. Depending upon the determination, the applicable state and federal laws and handbook language may apply including but not limited to sick leave, worker’s compensation, and individual rights contained within Wisconsin Statutes Chapter 252.
    2. If the source individual of the possible exposure is a student or another employee, the District does not have the authority to require the source to be tested. Procedures for voluntary as well as involuntary testing of the source individual are delineated in Wisconsin Statutes Chapter 252.
       
  4. A student incident will also be entered in the school’s Daily School Health Log.
     
  5. Exposure incidents occurring during co-curricular events will also be governed under WIAA guidelines.

 

Adoption Date: March 14, 2005

Amended Date: June 10, 2013

  • Series 400: Students
First page of the PDF file: 453-33

Click the image above to download this policy as a PDF.