Rules and Regulations of the State of Georgia
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Rule 511-5-9-.01 Purpose

The purpose of these rules is to address the problem of needlesticks and other sharps injuries resulting in bloodborne pathogen exposure incidents. Changes in bloodborne disease trends have been reported, and engineering controls have been developed and made available, all of which impact the health and safety of employees. The requirements in these rules for procedures and engineering and work practice controls provide a clear assignment to employers to address the use of sharps injury prevention technology.

Rule 511-5-9-.02 Scope and Application

These rules apply to public employers and employees in Georgia as defined by O.C.G.A. Section 31-12-13(a)(6) and (7).

Rule 511-5-9-.03 Definitions

(1) "Bloodborne pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV).
(2) "Engineered sharps injury protection" means either:
(a) A physical attribute built into or used with a needle device used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids, which effectively reduces the risk of an exposure incident by a mechanism such as barrier creation, blunting, encapsulation, withdrawal, retraction, destruction, or other effective mechanisms; or
(b) a physical attribute built into or used with any other type of needle device or into a nonneedle sharp, which effectively reduces the risk of an exposure incident.
(3) "Exposure incident" means any sharps injury which may reasonably have exposed the person so injured to another person's blood or other material potentially containing bloodborne pathogens.
(4) "Front-line health care workers" means workers from a variety of occupational classifications and departments, including, but not limited to, registered professional nurses, nurse aids, medical technicians, phlebotomists, and physicians.
(5) "Needleless system" means a device that does not utilize needles for:
(a) The withdrawal of body fluids after initial venous or arterial access is established;
(b) The administration of medication or fluids; or
(c) Any other procedure involving the potential for an exposure incident.
(6) "Public employee" means an employee of a county board of health established in accordance with Chapter 3 of Title 31 or an employee of the state or an agency or authority of the state employed in a public health care facility or other facility providing health care related services, currently not subject to the jurisdiction of the federal Occupational Safety and Health Administration.
(7) "Public employer" means each employer having any public employee with occupational exposure to blood or other material potentially containing bloodborne pathogens.
(8) "Sharp" means any object used or encountered in a health care setting that can be reasonably anticipated to penetrate the skin or any other part of the body and to result in an exposure incident, including, but not limited to, needle devices, scalpels, lancets, broken glass, and broken capillary tubes, but does not include prefilled syringes or other drugs or biologics prepackaged with an administration system requiring federal Food and Drug Administration approval for changes to packaging, labeling or product.
(9) "Sharps injury" means any injury caused by a sharp, including, but not limited to, cuts, abrasions, or needlesticks.
(10) "Sharps injury log" means a written or electronic record satisfying the requirements of Rule 511-5-9-.07.

Rule 511-5-9-.04 Evaluation Committee

Each Public Health District shall establish and maintain an evaluation committee (at least 50% of which are front-line health care workers) to advise the employer on the implementation of the requirements in these standards. Committee members shall be trained in the proper method of utilizing product evaluation criteria, prior to the commencement of any product evaluation. Each employer will have the option of using the Public Health District evaluation committee or establishing and maintaining an evaluation committee of their own that meets these standards.

Rule 511-5-9-.05 Exposure Control Plan

Each Public Health District shall develop and implement an effective written exposure control plan that includes, but is not limited to, procedures for a) identifying and selecting needleless systems and sharps with ESIP through an appropriate evaluation committee and b) updating the written exposure control plan when necessary to reflect progress in implementing needleless systems and sharps with ESIP as determined by the evaluation committee but no less than once a year. Each employer will have the option of using the Public Health District plan or a plan of their own that meets these standards.

Rule 511-5-9-.06 Engineering and Work Practice Controls

The most effective available needleless systems and sharps with engineered sharps injury protection (ESIP) shall be included as engineering and work practice controls in each facility. Two exceptions are when no such devices or systems are available in the marketplace and when the appropriate evaluation committee (consisting of =50% front-line health care workers) determines by objective product evaluation criteria that use of such devices will jeopardize patient or employee safety with regard to a specific medical procedure. Employers shall ensure that all front-line health care workers are trained on the use of all engineering controls before they are introduced into the clinical setting.

Rule 511-5-9-.07 Sharps Injury Log

Information concerning exposure incidents shall be recorded in a sharps injury log including but not limited to:

(a) date and time of exposure incident;
(b) type and brand of sharp involved in the exposure incident;
(c) description of the exposure incident;
(d) job classification of the exposed employee;
(e) department or work area where the incident occurred;
(f) procedure that the exposed employee was performing at the time of the incident;
(g) how the incident occurred;
(h) body part involved in the incident;
(i) if the sharp had ESIP, whether the protective mechanism was activated, and whether the injury occurred before the protective mechanism was activated, during activation of the mechanism, or after activation of the mechanism, if applicable;
(j) if the sharp had no ESIP, the injured employee's opinion as to whether and how such a mechanism could have prevented the injury, as well as the basis for the opinion;
(k) the employee's opinion about whether any other engineering, administrative, or work practice control could have prevented the injury, as well as the basis for the opinion.

Rule 511-5-9-.08 Availability of List

The Department shall compile and maintain a list of existing needleless systems and sharps with ESIP, which shall be available to assist employers in complying with the requirements of these standards. The list will provide initial information so that potential users can conduct their own evaluations and make their own determinations as to the suitability of any particular device for use in their work environments.

Rule 511-5-9-.09 Additional Considerations

The Department shall consider additional enactments as part of the bloodborne pathogen standard to prevent sharps injuries or bloodborne pathogen exposure incidents including, but not limited to, training and educational requirements, measures to increase vaccinations, strategic placement of sharps containers as close to the work area as practical, and increased use of personal protective equipment.