Texas Register, Volume 15, Number 42, (Volume II)Pages 3121-3269, June 5, 1990 Page: 3,210
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Subchapter O. Infection Con-
trol
40 TAC 19.1401-19.1402
The new sections are proposed under the
Human Resources Code, Title 2, Chapters 22
and 32, which provides the department with
the authority to administer public and medical
assistance programs.
919.1401. Infection Control. The facility
must establish and maintain an infection
control program designed to provide a safe,
sanitary, and comfortable environment in
which residents reside and to help prevent
the development and transmission of
disease and infection.
(1) Infection control program.
The facility must establish an infection con-
trol program under which it:
(A) investigates, controls,
and prevents infections in the facility;
(B) decides what procedures,
such as isolation, should be applied to an
individual resident; and
(C) maintains a record of
incidents and corrective actions related to
infections.
(2) Preventing spread of
infection.
(A) When the infection con-
trol program determines that a resident
needs isolation to prevent the spread of
infection, the facility must isolate the
resident in a well-ventilated, single bed-
room with a separate toilet and bathing unit.
(B) The facility must pro-
hibit employees with a communicable
disease or infected skin lesions from direct
contact with residents and their food, if
direct contact will transmit the disease.
(C) The facility must require
staff to wash their hands after each direct
resident contact for which handwashing is
indicated by accepted professional practice.
(D) The name of any
resident of a facility with a reportable
disease as specified in 25 Texas
Administrative Code, 97.1-97.11
concerning control of communicable
diseases shall be reported immediately to
the city health officer, county health officer,
or health unit director having jurisdiction,
and appropriate infection control procedures
shall be implemented as directed by the
local health authority. For further
information on reportable diseases, seeTexas Department of Health Publication
6-101 "Rules and Regulations for Control
of Communicable Diseases."(E) The facility must:
(i) ensure that aseptic
procedures and isolation techniques are
followed;
(ii) monitor the health
status of employees which includes
requiring periodic health examinations
which include those tests or procedures
determined by the employee's personal
physician, a physician representing the
facility, or by the facility's policy:
(I) a physician must perform
the examination or authorize the examina-
tion procedure(s) be performed by qualified
professionals. An example of the latter
requirement would be authorization by the
medical director for tuberculin skin tests to
be administered by a nurse;
(II) the facility's
program must involve all employees and be
based on periodic examinations. Periodic
means an initial examination, as well as, at
least annual examinations. Two weeks from
the date of employment is considered a
reasonable period for the initial examina-
tion. Facilities with a policy that exceeds
two weeks for the initial examination will
be required to justify their policy in writing,
and submit that justification to the Texas
Department of Health for approval;
(iii) monitor staff
performance to ensure that infection control
policies and procedures are followed; and
(iv) develop procedures
for handling food, laundry, disposal of
environmental and resident wastes, pest
control, traffic control, visiting rules, and
resident care to avoid possible sources of
infection, and
(3) Linens. Personnel must han-
dle, store, process, gnd transport linens so
as to prevent the spread of infection.
(4) The Quality Assessment and
Assurance Committee as described in
19.1917 of this title (relating to Quality
Assessment and Assurance) will monitor
the infection control program.
19.1402. Universal Precautions. Univer-
sal precautions shall be used in the care of
all residents because a reliable source can-
not identify all those persons infected with
blood-born pathogens.
(1) Universal precautions apply
to blood and other body fluids containing
visible blood.
(A) Universal precautions do
not apply to feces, nasal secretions, sputum,
tears, urine, and vomitus unless they con-
tain visible blood.(B) Universal precautions do
not apply to saliva. Gloves need not be
worn when feeding residents and when wip-
ing saliva from skin.
(2) General principles of univer-
sal precautions.
(A) All health-care workers
shall routinely use appropriate barrier
precautions to prevent skin and mucous-
membrane exposure when contact with
blood or other body fluids of any resident is
anticipated.
(i) Gloves shall be worn
for touching blood and blood contaminated
body fluids, mucous membranes, or non-
intact skin of all residents for handling
items or surfaces soiled with blood or body
fluids, and for performing venipuncture and
other vascular access procedures.
(ii) Gloves shall be
changed after contact with each resident.
(iii) Masks and protective
eyewear or face shields shall be worn
during procedures that are likely to generate
droplets of blood or other body fluids to
prevent exposure of mucous membranes of
the mouth, nose, and eyes.
(iv) Gowns or aprons
shall be worn during procedures that are
likely to generate splashes of blood or other
body fluids.
(B) Hands and other skin
surfaces shall be washed immediately and
thoroughly if contaminated with blood or
other body fluids. Hands shall be washed
immediately after gloves are removed.
(C) All health-care workers
shall take precautions to prevent injuries
caused by needles, scalpels, and other sharp
instruments after procedures.
(D) Although saliva has not
been implicated in HIV transmission, to
minimize the need for emergency mouth-to-
mouth resuscitation, mouthpieces,
resuscitation bags, or other ventilation de-
vices shall be available for use in areas in
which the need for resuscitation is predict-
able.
(E) Pregnant health-care
workers are not known to be at greater risk
of contracting HIV infection than health-
care workers who are not pregnant;
however, if a health-care worker develops
HIV infection during pregnancy, the infant
is at risk of infection resulting from perina-
tal transmission. Because of this risk, preg-
nant health-care workers should be
especially familiar with and strictly adhereto precautions to minimize the risk of HIV
transmission.15 TexReg 3210 June 5, 1990 Texas Register *
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Texas. Secretary of State. Texas Register, Volume 15, Number 42, (Volume II)Pages 3121-3269, June 5, 1990, periodical, June 5, 1990; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth201736/m1/92/?q=%22%5B1990..%5D%22&rotate=180: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.