N.J. Admin. Code § 8:43F-16.2

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:43F-16.2 - Infection control policies and procedures

(a) The facility shall develop, implement, and review, at least annually, written policies and procedures regarding infection prevention and control. Written policies and procedures shall be consistent with the following Centers for Disease Control publications, incorporated herein by reference:

1. Guideline for Hand Hygiene in Health-Care Settings, PB85-923404, as amended or supplemented;

2. OSHA Standards 29 CFR--1910.1030, Bloodborne pathogens, as amended and supplemented;

3. Prevention and Control of Tuberculosis in Facilities Providing Long-Term Care to the Elderly, and contained in MMWR 39(RR-10), as amended or supplemented; and

4. Prevention of Nosocomial Pneumonia, PB95-176970, January 3, 1997, 46(RR-1), as amended or supplemented.

(b) Centers for Disease Control publications can be obtained from: National Technical Information Service

U.S. Department of Commerce

5285 Port Royal Road

Springfield, VA 22161

(703) 605-6000 or (800) 553-6847

or

Superintendent of Documents

U.S. Government Printing Office

Washington, D.C. 20402

(c) The facility shall document evidence of annual vaccination against influenza for each participant, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control most recent to the time of vaccination, incorporated herein by reference, unless such vaccination is medically contraindicated or the participant has refused the vaccine, in accordance with 8:43F-4.2(a)3. Influenza vaccination for all participants accepting the vaccine shall be completed by November 30 of each year. Participants admitted after this date, during the flu season and up to February 1, shall, as medically appropriate, receive influenza vaccination prior to or on admission unless refused by the participant.

(d) The facility shall document evidence of vaccination against pneumococcal disease for all participants who are 65 years of age or older, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control most recent to the time of vaccination, incorporated herein by reference, unless such vaccination is medically contraindicated or the participant has refused offer of the vaccine in accordance with 8:43F-4.2(a)4. The facility shall provide or arrange for pneumococcal vaccination of participants who have not received this immunization, prior to or on admission unless the participant refuses offer of the vaccine.

(e) Each new employee upon employment shall receive a two-step Mantoux tuberculin skin test with five tuberculin units of purified protein derivative. The only exceptions shall be employees with documented negative two-step Mantoux skin test results (zero to nine millimeters of induration) within the last year, employees with a documented positive Mantoux skin test result (10 or more millimeters of induration), employees who have received appropriate medical treatment for tuberculosis, or when medically contraindicated. Results of the Mantoux tuberculin skin tests administered to new employees shall be acted upon as follows:

1. If the first step of the Mantoux tuberculin skin test result is less than 10 millimeters of induration, the second step of the two-step Mantoux test shall be administered one to three weeks later;

2. If the Mantoux test is significant (10 millimeters or more of induration), a chest x-ray shall be performed and, if necessary, followed by chemoprophylaxis or therapy; and

3. Any employee with positive results shall be referred to the employee's personal physician and if active tuberculosis is suspected or diagnosed shall be excluded from work until the physician provides written approval to return.

(f) The facility shall have written policies and procedures establishing timeframes, requiring annual Mantoux tuberculin skin tests for all employees except those exempted under (f) above.

(g) The facility shall assure that all employees have received the Mantoux test upon employment, except those exempted by (f) above.

(h) The facility shall retain copies of the results of all tuberculin testing of personnel in each employee's personnel file.

(i) Written infection control policies and procedures shall include, but not be limited to, policies and procedures for the following:

1. In accordance with N.J.A.C. 8:57, a system for investigating, reporting, and evaluating the occurrence of all infections or diseases, which are reportable or conditions, which may be related to activities and procedures of the facility and maintaining records for all participants or personnel having these infections, diseases or conditions;

2. Infection control in accordance with 29 CFR 1910.1030 Bloodborne pathogens, as amended and supplemented, incorporated herein by reference;

3. Exclusion from work, and authorization to return to work, for personnel with communicable diseases;

4. Surveillance techniques to minimize sources and transmission of infection;

5. Techniques to be used during each participant contact, including handwashing before and after caring for a participant;

6. Protocols for identification of participants with communicable diseases and education of participants regarding prevention and spread of communicable diseases;

7. The prevention of decubitus ulcers; and

8. Where applicable, cleaning, sterilization and disinfection practices and techniques used in the facility, including but not limited to, the following:

i. Care of utensils, instruments, solutions, dressings, articles, and surfaces;

ii. Selection, storage, use, and disposition of disposable and nondisposable participant care items. Disposable items shall not be reused;

iii. Methods to ensure that sterilized materials are packaged, labeled, processed, transported, and stored to maintain sterility and to permit identification of expiration dates; and

iv. Care of urinary catheters, intravenous catheters, respiratory therapy equipment, and other devices and equipment that provide a portal of entry for pathogenic microorganisms.

(j) High-level disinfection techniques approved by the New Jersey State Department of Health and Senior Services shall be used for all reusable respiratory therapy equipment and instruments that touch mucous membranes.

(k) Disinfection procedures for items that come in contact with bed pans, sinks, and toilets shall conform with established protocols for cleaning and disinfection.

(l) Personnel who have had contact with participant excretions, secretions, or blood, whether directly or indirectly, in activities such as performing a physical examination and providing catheter care, shall wash their hands with soap and warm water for between 10 and 30 seconds or use other effective hand sanitation techniques immediately after such contact.

(m) Equipment and supplies used for sterilization, disinfection, and decontamination purposes shall be maintained according to manufacturers' specifications.

(n) Needles and syringes used by participants as part of home self-care shall be placed in a puncture-resistive container prior to disposal.

N.J. Admin. Code § 8:43F-16.2

Amended by R.2009 d.345, effective 11/16/2009 (operative April 1, 2010).
See: 40 N.J.R. 6266(a), 41 N.J.R. 4212(a).
In (c), deleted "adult" preceding "participant"; deleted former (e); recodified former (f) through ( o) as (e) through (n); rewrote (h); in (i)1, deleted "Chapter II, New Jersey State Sanitary Code," preceding "N.J.A.C.", updated the N.J.A.C. reference, inserted a comma following the first occurrence of "diseases" and of "conditions", and deleted a comma following "facility" and following the second occurrence of "diseases"; and in (i)2, substituted "29 CRF 1910.1030" for "OSHA Standards 29 CFR--1910.1030", and inserted a comma following "pathogens".