| (a) A center must establish and maintain an infection
prevention and control program (IPCP) designed to provide a safe,
sanitary, and comfortable environment by preventing the development
and transmission of disease and infection. Under the IPCP, the center
must:
(1) investigate, prevent, and control infections at
the center;
(2) decide what procedures, such as isolation, should
be applied to an individual minor;
(3) address vaccine preventable diseases in accordance
with THSC, Chapter 224;
(4) address hepatitis B vaccinations in accordance
with Occupational Safety and Health Administration;
(5) address tuberculosis requirements; and
(6) maintain a record of incidents and corrective actions
relating to infections.
(b) A center must provide IPCP information to employees,
contractors, volunteers, parents, health care providers, other service
providers, and visitors.
(c) A center's IPCP must include written policies and
procedures for admissions and attendance of minors who are at risk
for infections or present a significant risk to other minors. The
policy must include that a minor is accepted only:
(1) as authorized by a minor's prescribing physician:
(2) as determined by the center's medical director's
assessment of the risk;
(3) as determined by the medical and nursing director
review, on a case-by-case basis, to determine appropriateness of admission
to or attendance at the center; and
(4) in accordance with Centers for Disease Control
(CDC) guidelines.
(d) The center's IPCP must include written policies
and procedures for preventing the spread of infection.
(1) If the center determines, in accordance with its
IPCP, that a minor must be isolated to prevent the spread of infection,
the center must isolate a minor.
(A) The center must maintain an isolation room with
a glass window for observation of a minor. The isolation room must
be equipped with emergency outlets and equipment as necessary to provide
care to a minor. The isolation room must have a dedicated bathroom
not accessible to the center's other rooms if appropriate to control
the spread of infectious disease.
(B) The center must ensure that all equipment is thoroughly
cleaned and disinfected before being placed in the isolation room
and before being removed from the room.
(C) The center's procedures must address:
(i) notification to a minor's parent of the minor's
condition and the center's recommendation of isolation or removal
based on the minor's risk assessment;
(ii) the arrangement of transportation if the minor
must be removed from the center; and
(iii) the return of a minor to the center, as determined
by a reassessment conducted by a nurse that the minor no longer poses
a risk to other minors.
(2) The center must prohibit employees, volunteers,
and contractors with an infectious disease or infected skin lesions
from direct contact with minors or food, if direct contact will transmit
the disease.
(3) The center's infection control policy must provide
that staff, volunteers, and contractors wash their hands between each
treatment and care interaction with a minor.
(4) The center must immediately report the name of
any minor with a reportable disease as specified in 25 TAC Chapter
97, Subchapter A (relating to Control of Communicable Diseases) to
the city health officer, county health officer, or health unit director
having jurisdiction, and implement appropriate infection control procedures
as directed by the local health authority or the Department of State
Health Services.
(e) The center must assign a crib, bed, or sleep mat
for a minor's exclusive use each day. A center must label cribs, beds,
and sleep mats with the minor's name.
(f) A center must place liquid soap, disposable paper
towels, and trash containers at each sink.
(g) The center must adopt and enforce written policies
and procedures for the control of communicable diseases for employees,
contractors, volunteers, parents, health care providers, other service
providers, and visitors and must maintain evidence of compliance.
(h) The center must adopt and enforce written policies
and procedures for the control of an identified public health disaster.
(1) If a center determines or suspects that an employee,
volunteer, or contractor providing services has been exposed to, or
has a positive screening for, a communicable disease, the center must
respond according to current CDC guidelines and keep documentation
of the action taken.
(2) If the center determines that an employee, volunteer
or contractor providing services has been exposed to a communicable
disease, the center must conduct and document a reassessment of the
risk classification. The center must conduct and document subsequent
screenings based upon the reassessed risk classification.
(3) If the center determines that an employee, volunteer,
or a contractor providing services at the center is suspected of having
a communicable disease, the individual must not return to the center
until the individual no longer poses a risk of transmission as documented
by a written physician's statement.
(i) The center must conduct and document an annual
review that assesses the center's current risk classification according
to the current CDC Guidelines for Preventing the Transmission of Mycobacterium
Tuberculosis in Health Care Settings and 25 TAC Chapter 97, Subchapter
A.
(1) The center must have a system in place to screen
all individuals providing services at the center.
(2) The center must require employees, volunteers,
and contractors providing services to provide evidence of current
tuberculosis screening before providing services at the center. The
center must maintain evidence of compliance.
(3) Any employee, volunteer, or contractor providing
services at a center with positive results must be referred to the
person's personal physician, and if active tuberculosis is suspected
or diagnosed, the person must be excluded from work until the physician
provides written approval to return to work.
(j) A center must adopt and enforce written policies
and procedures to protect a minor from vaccine preventable diseases,
in accordance with THSC, Chapter 224.
(1) The policy must:
(A) require an employee, volunteer, or contractor providing
direct care to receive vaccines for the vaccine preventable diseases
specified by the center based on the level of risk the employee, volunteer,
or contractor, presents to minors by the employee's, volunteer's,
or contractor's routine and direct exposure to minors;
(B) specify the vaccines an employee, volunteer, or
contractor who provides direct care is required to receive in accordance
with subsection (i) of this section;
(C) include procedures for the center to verify that
an employee, volunteer, or contractor who provides direct care has
complied with the policy;
(D) include procedures for the center to exempt an
employee, volunteer, or contractor who provides direct care from the
required vaccines for the medical conditions identified as contraindications
or precautions by the CDC;
(E) include procedures, including using protective
equipment such as gloves and masks, to protect minors from exposure
to vaccine preventable diseases, based on the level of risk the employee,
volunteer, or contractor presents to minors by the employee's, volunteer's,
or contractor's routine and direct exposure to minors;
(F) prohibit discrimination or retaliatory action against
an employee, volunteer, or contractor who provides direct care and
who is exempt from the required vaccines for the medical conditions
identified as contraindications or precautions by the CDC, except
that required use of protective medical equipment, such as gloves
and masks, will not be considered retaliatory action;
(G) require the center to maintain a written or electronic
record of each employee's, volunteer's or contractor's compliance
with or exemption from the policy; and
(H) include disciplinary actions the center may take
against an employee, volunteer, or contractor providing direct care
who fails to comply with the policy.
(2) The center must have a written policy describing
whether it will exempt an employee, volunteer, or contractor providing
direct care:
(A) from the required vaccines based on reasons of
conscience, including a religious belief; and
Cont'd... |
