Attachment_B_-_Sample_Exposure_Control_Plan_(ECP).pdf

foh.bbp.ecp.5-07 Appendix A - 7 Rev. 5-07

SECTION II:

SITE SPECIFIC INFORMATION

(Keep a current printed copy of pages A7, A8, A9 on site)

Location: (site)

Site coordinator(s) for Bloodborne Pathogens (BBP) Exposure Control Plan:

(usually OHC or W/F coordinator at site)

Job Titles/Tasks Covered by the BBP Standard:

(e.g. RN, Wellness/Fitness Coordinator, M.D.)

Location of BBP Exposure Control Plan (electronic copies are permissible):

Location of post-exposure Incident packet (having a printed copy available on-site is advised):

Location of training records for site staff:

Location of medical records related to hepatitis-B immunizations and exposure incidents:

IN CASE OF AN EXPOSURE TO BLOODBORNE PATHOGENS PLEASE:

• Wash the area thoroughly with soap and water or flush with water.

• Report the exposure immediately to your shift supervisor.

• Complete Post-exposure Incident Packet employee and supervisor portions and other appropriate forms (e.g. Federal employees include OWCP form).

• Seek immediate treatment advice from a health care provider or emergency room. Take along the Post-exposure Incident Packet and other necessary forms. Call the Health and Human Services National Toll-Free Hotline for Clinicians at 1-888-448-4911 if your access to a health care provider is limited or if you want advice regarding your need for follow up or treatment based on the most recent guidelines.

foh.bbp.ecp.5-07 Appendix A - 8 Rev. 5-07

Site Specific Information, Page 2

SUPPLIES

ITEMS

LOCATION

1. Gloves

2. Masks, eye protection, and face shields

3. Sharps containers

4. Biohazard labels

5. Red bags

6. Container for contaminated personal protective equipment (PPE) (if not disposable)

7. Container for contaminated laundry

8. Container for contaminated waste

9. Bleach/EPA registered tuberculocidal disinfectant

10. Antiseptic hand cleanser and paper towels or antiseptic towelettes

11. First Aid Kits

Company or contact for hazardous/contaminated waste removal

Name/Title: Phone:

Contact to reorder PPE and supplies

Name/Title: Phone:

Signature: Date: