GO 2-4.0 Infectious Diseases.pdf

OVIEDO POLICE DEPARTMENT GENERAL ORDER EFFECTIVE DATE: 07-12-2021 SUBJECT: Infectious Diseases AMENDS: None I. II. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. PURPOSE POLICY DEFINITIONS GENERAL PROCEDURES SUPPLIES CUSTODY PROCEDURES VEHICLE DISINFECTION EVIDENCE HANDLING HOUSEKEEPING HEPATITIS...

OVIEDO POLICE DEPARTMENT GENERAL ORDER EFFECTIVE DATE: 07-12-2021 SUBJECT: Infectious Diseases AMENDS: None I. II. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. PURPOSE POLICY DEFINITIONS GENERAL PROCEDURES SUPPLIES CUSTODY PROCEDURES VEHICLE DISINFECTION EVIDENCE HANDLING HOUSEKEEPING HEPATITIS B VACCINATIONS EXPOSURE PROCEDURES TRAINING I. PURPOSE APPROVAL: NUMBER: Dale Coleman Chief of Police GO 2-4.0 REFERENCE: City Exposure Control Plan & CFA Chapter 29 RESCINDS: None The purpose of this order is to provide a comprehensive infectious control system that maximizes protection against communicable diseases for all members of the Oviedo Police Department and for the public that they serve. II. POLICY It is the policy of the Oviedo Police Department to provide law enforcement services to the public without prejudice due to known or suspected diagnoses of individuals with communicable diseases. However, all individuals contacted shall be regarded as potentially infectious and appropriate safety measures shall be taken. Oviedo Police Department GO 2-4.0 Infectious Diseases III. Page 2 of 12 DEFINITIONS A. Airborne Pathogens: An agent that can cause infectious disease from person to person by aerosol transmission, such as infectious tuberculosis. B. Bloodborne Pathogens: Pathogenic microorganisms that are present in human blood or body fluids and can cause disease in humans. There pathogens include, but are not limited to, Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) that leads to AIDS. C. Contaminated: The presence, or the reasonably anticipated presence, of blood or other potentially infectious materials on an item or surface. D. Decontamination: The use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point that the pathogens are no longer capable of transmitting infectious particles, and the item or surface is rendered safe for handling, use, or disposal. E. Contaminated Sharps: Any contaminated object that has a likelihood to penetrate the skin including, needles, scalpels, broken glass, etc. F. Ryan White Officer: Designated officer that performs infection control and exposure notification duties; the Ryan White Officer is assigned to the EMS/Training Division of the Oviedo Fire Department and can be notified through the Police and Fire Communication Center. G. Occupational Exposure: Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of a member’s duties. H. Parenteral: Piercing mucous membranes or the skin barrier through such events as needle sticks, human bites, cuts, and abrasions. I. Exposure Incident: Circumstances in which there is a significant risk of being infected through airborne pathogens, or a specific eye, mouth, other mucous membranes, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of a member’s duties. J. Personal Protective Equipment: For the purpose of this policy, personal protective equipment (PPE) is that equipment designed for use to prevent the spread of contagion. Such equipment may be gloves, gown, mask, CPR shield, etc. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases IV. Page 3 of 12 K. Exposure Determination: The process of evaluating an individual’s job description in order to determine the risk of exposure to contagious diseases. Sworn members and property and evidence personnel are considered to be at-risk in reference to contagious diseases and are expected to conform to standard disease control practices as outlined in this general order. L. Universal Precautions: An approach to infection control that treats all human blood, and certain bodily fluids, as if known to be infectious for HIV, HBV, and other bloodborne pathogens. Caution is always used to avoid direct, physical contact with these substances. The use of personal protective equipment is utilized to assist in avoiding exposure to these substances. GENERAL A. Risk and Responsibility: The Oviedo Police Department recognizes that communicable disease exposure is an occupational health hazard. Communicable disease transmission is possible during any aspect of emergency response, including in-station operations. The health and welfare of each member is a joint concern of the member and the Oviedo Police Department as a whole. While each member is ultimately responsible for his or her own health, the department recognizes a responsibility to provide as safe a working environment as possible. B. Department Goals: The goals of the Oviedo Police Department relative to disease control are as follows: 1. Provide members with the best available protection from occupationally acquired communicable diseases. 2. Observe Universal Precautions at all times and expand those precautions to include all body fluids and other potentially infectious material (body substance isolation) as needed. 3. Provide all members with the necessary training, immunizations, and personal protective equipment (PPE) needed for a reasonable level of protection from communicable diseases. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases C. Page 4 of 12 4. Recognize the need for work restrictions based on infection concerns. 5. Prohibit discrimination against any member for health reasons including infection, and/or seroconversion, with HIV or HBV virus. Exposure Control Plan: A copy of the City’s Exposure Control Plan is available on the City SharePoint. The plan is adopted in its entirety and this general order is an overview of that plan. A documented annual review of the City Exposure Control Plan shall be completed by the Ryan White Officer. V. PROCEDURES A. Contaminated Sharps: Puncture resistant containers will be provided for contaminated sharps. The containers will be labeled as biohazard and will be red in color and will have leak proof sides and bottom. Contaminated needles and other sharps shall not be bent, broken, or sheared and will be placed in the appropriate containers as soon as possible. B. Refrigeration: Refrigeration supplies and biohazard labels for blood and other potentially infectious materials are located with the evidence packaging supplies. No food or drink intended for consumption shall be kept in any location where hazardous materials are stored. C. Leak-Proof Containers: Specimens of blood and other potentially infectious materials will be placed in a container that prevents leakage during collection, handling, processing, storage, or transport. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases D. Page 5 of 12 Washing After Contamination: Members shall wash their hands (and any other skin area) with germicidal cleaner as soon as possible following contact with blood or other potentially infectious material. Members shall wash their hands as soon as possible upon removing gloves or other personal protective equipment. E. Personal Protective Equipment: The department will provide appropriate personal protective equipment for instances in dealing with exposure situations. These can be gloves, masks, CPR shields, etc. Members are required to use personal protective equipment when handling materials, items, or persons reasonably expected to be infectious. There may be isolated situations where the guidelines for personal protective equipment are not followed due to officer safety issues or operational restrictions. When this occurs, the member not using the appropriate personal protective equipment shall send a memorandum through the chain of command identifying the situation that made it necessary not to follow PPE guidelines. The reason for the memorandum is to identify and evaluate the operational problems, and to recommend procedural modifications to prevent further incidents. F. Contaminated Equipment: When disinfecting department equipment, the process shall be completed in a well-ventilated area. Prior to disinfection procedures, the contaminated materials shall be stored away from any regularly inhabited areas. Disinfectants shall be utilized. Metal or electronic equipment shall be cleaned and then disinfected. Only disinfectants that are chemically compatible with the equipment shall be used. Any reusable equipment that came in contact with mucous membranes shall require cleaning and disinfection. G. Contaminated Laundry: Contaminated laundry shall be removed as soon as possible and laundered or disposed of depending on the level of contamination. H. Disciplinary Action: Members may be subject to disciplinary action for failing to use the provided personal protective equipment unless the situation was of such an emergency nature that it was not possible to utilize it and the proper documentation was submitted as outlined in V. E. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases VI. VII. Page 6 of 12 SUPPLIES A. Supervisors shall ensure that adequate supplies are available for infectious disease control within their respective members; Supervisors shall verify the presence of personal protective equipment during vehicle inspections. B. Each member is responsible to ensure that their police vehicle is adequately supplied with the mandated personal protective equipment. CUSTODY PROCEDURES A. High-Risk Groups: All individuals are to be treated courteously, however, persons of high-risk groups, including intravenous drug users and prostitutes, should be treated with extreme caution. When dealing with high-risk subjects known to be violent, or an altercation is likely, personal protective equipment should be worn. B. Searches of Suspects: Extreme caution should be used during the search of anyone contacted. Whenever practical, appropriate hand protection should be used when searching individuals to minimize exposure. C. Area Searches: Extreme caution must be used when reaching into areas, such as under car seats that are not readily visible. If at all possible, a visual inspection of the area should be completed prior to a manual search. After the completion of the task or search where protective disposable gloves were utilized, the gloves should be removed cautiously, placed in a biohazardous bag, and securely sealed. The member shall place the biohazardous bag into a designated biohazard box at the Oviedo Fire Department. D. Transporting of Subjects with Potential Bio-Hazards: 1. Whenever it is necessary to transport a subject who has blood or bodily fluids present on his/her person or clothing, the appropriate shift supervisor shall be notified. 2. Rescue shall be summoned through SCSO Communications when transport is necessary to a health care facility. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases VIII. Page 7 of 12 3. Subjects with blood or bodily fluids on their person shall be transported separately when possible. 4. Members have an obligation to inform other assisting support personnel (firefighters, paramedics, other law enforcement personnel, etc.) whenever the subject has blood or bodily fluid present on his/her person; if the subject has made a voluntary statement that he/she has a contagious disease, or if the subject is known to have a contagious disease. 5. Members shall indicate on the appropriate arrest documentation when a subject taken into custody makes a voluntary statement about having an infectious disease. A detailed narrative of the subject’s statements will be included when preparing offense reports. Additionally, a notation shall be made when a subject has blood or bodily fluids present on his/her person or clothing. (i.e. bodily fluids present). 6. Incidents involving an alleged, intentional attempt to transmit an infectious disease shall be documented with all appropriate reports according to Florida Statute. VEHICLE DISINFECTION Vehicle disinfecting procedures shall be performed whenever blood or bodily fluid is found in the vehicle or if the vehicle has been used to transport a suspect with blood or bodily fluids present on their person. Disinfecting procedures shall be completed as soon as possible, and always before the end of the member’s shift. A supervisor shall be notified and the following procedures shall apply and be adhered to concerning the disinfecting of vehicles. A. Department members who come in contact with potentially infectious individuals and are required to transport them must become familiar with vehicle and work place decontamination procedures as outlined in the City Exposure Control Plan. B. Members should ensure that they wear personal protective equipment prior to decontamination of the vehicle. When grossly contaminated, remove the vehicle from service and contact the City’s Ryan White Officer for direction. Significantly contaminated vehicles will be the responsibility of trained Fire Department personnel. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases IX. Page 8 of 12 EVIDENCE HANDLING All evidence shall be packaged and labeled according to GO 10-1.0 Property and Evidence Collection and Submission and the FDLE Evidence Submission Manual. A. Property and Evidence Procedures: Property and Evidence personnel will adhere to a precise regimen when handling, processing, and storing potentially infectious diseasecontaminated property and/or evidence. B. Required Labeling: Any clothing or evidence known to be contaminated with suspected AIDS, Hepatitis B or other contagious diseases will be placed in a specified area and clearly labeled as bio-hazard. All wet bloody clothing not placed in the drying rack area will be treated as contaminated and placed in a biohazardous bag. C. Property Intended for Disposal: All property intended for disposal that is suspected to be infectious, shall be kept in sealed plastic bags and placed in the infectious disease receptacle at the Oviedo Fire Department. A medical waste container for used rubber gloves, and any other material that is contaminated, will also be placed in a bio-hazard bag for disposal. No regular waste will be placed in any bio-hazard waste cans/bags. X. HOUSEKEEPING Extreme care must be taken to properly clean contaminated areas and dispose of contaminated laundry to prevent the spread of disease. A. Contaminated work surfaces must be decontaminated with appropriate disinfectant as soon as possible, after the completion of any necessary procedures. Decontamination procedures shall always be finished before the end of the member’s shift. B. All equipment and working areas are to be cleaned and decontaminated after contact with blood or other infectious materials prior to the end of the member’s shift. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases XI. Page 9 of 12 C. Any contaminated laundry that is wet and likely to soak through a bag or container, must be placed in a leak-proof container for transport and cleaning. The container must be labeled with a bio-hazardous label or colorcoded. Any member who may have contact with contaminated laundry must wear protective equipment while handling contaminated laundry. D. Member uniforms that become contaminated and pose an unacceptable risk for personal laundering may be cleaned at a commercial cleaner upon the authorization of the Lieutenant. Members choosing to clean contaminated uniforms at home shall take appropriate measures to ensure the safety of the member and his/her family. HEPATITIS B VACCINATIONS The City of Oviedo shall maintain a Hepatitis B Vaccination Program that is available to all department members. A. The City shall offer Hepatitis B Vaccinations to all members with potential occupational exposure unless the member has previously received the vaccination series or testing reveals the member is immune. The vaccinations shall be available after receipt of infectious disease training and within ten (10) working days of initial assignment. B. Vaccinations shall be at no expense to members and shall be provided at a reasonable time and place. C. If a member declines the Hepatitis B Vaccination after receipt of training, he/she must sign a City Hepatitis B Vaccination Declination Form. Should the member change his/her mind and wish to receive the vaccination, the City shall make it available at that time, at no cost. D. Vaccinations shall be provided by, or under the supervision of, a licensed physician or a licensed healthcare professional. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases XII. Page 10 of 12 EXPOSURE PROCEDURES A. B. Post-Exposure Evaluation: 1. Any time members of the department suffer an exposure incident or suspect that they have been exposed to HBV, HIV, or any infectious disease, they shall immediately wash any parts of the body that have had contact with blood or any other infectious material. 2. After washing, the member shall immediately notify their supervisor, who in turn will notify the Ryan White Officer. The supervisor shall direct the member to the Fire Department or City Clinic for evaluation. Fire Department personnel or City Clinic personnel will determine if the exposure warrants a call to the Florida Hospital Post Exposure Nurse (PEN) 24-hour hotline. The member may be sent to the nearest emergency room if necessary. 3. Should there be difficulty in securing the source individual’s blood, the City Attorney should be notified as soon as feasible. The City Attorney shall assist in preparing a court-ordered bloodborne pathogen test on all defendants who have been involved in an exposure incident involving department personnel. 4. When a positive finding of HIV, HBV, or any other infectious disease is confirmed, all evidence in the case will be marked as “Biohazardous” per department guidelines to warn other members of the risk. Any evidentiary items that are blood-soaked or covered in body fluids should be treated as potentially infectious and housed with the appropriate biohazard protections. Post-Exposure Follow-Up: 1. Members determined to have suffered an exposure incident are required to have a confidential medical evaluation and follow-up. Members will be required to provide documentation to the Ryan White Officer in the following forms: a. b. c. 2. Routes of exposure; Circumstances of exposure; and Identification and documentation of the source individual unless identification is not feasible or is prohibited by law. Appropriate Worker’s Compensation reports shall be completed as directed by the City of Oviedo Exposure Control Plan. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases Page 11 of 12 3. The source individual’s blood shall be tested to determine HIV and HBV infectivity as soon as feasible. When the source individual consents to the test, a written consent form shall be signed by the source individual. The form shall specify agreement to the test and the source individual’s permission for test results to be provided to the Chief’s Office and the exposed member. In the event that consent cannot be obtained, the City Attorney shall be contacted as detailed above. 4. In accordance with FSS 384.287, the department or its authorized representatives may examine or cause to be examined any person or inmate who injures an officer as defined in 943.10, a firefighter, paramedic, or emergency medical technician acting within the scope of their employment. Evidence of injury and a statement by a licensed physician that the nature of the injury is such as to result in the transmission of a disease covered by this act shall constitute probable cause for issuance of a warrant duly authorized by a court of competent jurisdiction. 5. As part of the evaluation of a source individual’s infection of a person with whom there has been a significant exposure, the exposed member must also be tested for HIV and HBV or must provide the results of HIV or HBV tests taken within six (6) months prior to the significant exposure, when such results are negative. 6. In the event it is possible to conclusively determine that the source individual is already infected with HIV or HBV, testing for the source individual’s known HIV or HBV status does not need to be repeated. 7. Information obtained for this purpose is exempt from the public records law. However, the records will be maintained by the Human Resources Department for the period of employment, plus thirty (30) years. The member will receive pretest counseling and periodic tests for a period of one (1) year following the incident. The test schedule will be set as specified by a physician authorized by the City of Oviedo. GO 2-4.0 Infectious Diseases Oviedo Police Department GO 2-4.0 Infectious Diseases XIII. Page 12 of 12 TRAINING Training on bloodborne virus infections must be provided to all members with potential occupational exposure. The member shall receive initial training as soon as they are assigned to potential exposure risk tasks and shall receive annual refresher training thereafter. A. The training program will include the following components: 1. 2. 3. 4. 5. 6. 7. 8. 9. B. The agency’s Exposure Control Plan; The basic description, symptoms, and the modes of transmissions of infectious diseases; The use and limitations of methods that will prevent or reduce exposure, including personal protective equipment; Information about the agency’s Hepatitis B Vaccination Program; The Universal Precautions philosophy; Procedures to follow if an exposure occurs, including reporting requirements and medical follow-up; The signs, labels, and color-coding identifying biohazardous waste; The agency’s biohazardous waste disposal procedures; and Point of contact for questions. Training records shall be maintained by the department for a minimum of three (3) years. The record shall include the following information: 1. 2. 3. 4. 5. The dates of training; A summary of the training; Names of members who receive training; Names and qualifications of instructors; and The instructor’s lesson plan. /s/ DHC ____________________________________ DALE COLEMAN CHIEF OF POLICE 04-01-2021 __________________ DATE GO 2-4.0 Infectious Diseases