00 CS FOR HOUSE BILL NO. 440(L&C) 01 "An Act relating to needle stick and sharps injury protections and the use of 02 safe needles by health care facilities and health care professionals; relating to the 03 vaccination of health care workers against diseases transmitted by blood borne 04 pathogens; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 18.60 is amended by adding new sections to read: 07 Article 13. Health Care Protections. 08  Sec. 18.60.880. Needle stick and sharps injury protections for health care 09 workers. (a) An employer shall conduct product evaluations of needle less systems 10 and sharps with engineered sharps injury protections. The product evaluations shall 11 include the categories of devices that are used in the employer's facilities. For each 12 category of device, the product evaluations shall be performed by front-line health care 13 workers representing all wards and medical specialties where the devices are used. 14 The evaluation committee described in (g) of this section shall determine the amount 01 of time necessary for the front-line health care workers to perform product evaluations 02 under this subsection. The categories of devices to be evaluated under this subsection 03 include 04  (1) IV catheters; 05  (2) IV access devices and IV connectors; 06  (3) vacuum-tube blood collection devices; 07  (4) blood-drawing devices including phlebotomy needle and tube 08 holders, butterfly-type devices, and syringes and other similar devices; 09  (5) syringes used for purposes other than blood drawing; 10  (6) suture needles; 11  (7) scalpel devices; and 12  (8) any other category of device used at the employer's facility where 13 there is a sharps injury risk. 14  (b) The department shall, by regulation, adopt a standard concerning the use 15 of needleless systems and sharps with engineered sharps injury protections for devices 16 listed in (a) of this section. The regulations must provide that 17  (1) needleless systems and sharps with engineered sharps injury 18 protections must be included as engineering and work practice controls; however, the 19 needleless systems and sharps with engineered sharps injury protections are not 20 required if 21  (A) the devices are not available in the marketplace; 22  (B) the evaluation committee described in (g) of this section 23 determines by means of objective product evaluation criteria that use of the 24 devices may jeopardize patient safety if used for 25  (i) a class or type of procedure; or 26  (ii) a class or type of procedure when performed on a 27 certain type of patient; 28  (C) a certified or licensed health care worker directly involved 29 in the patient's care determines, in the reasonable exercise of clinical judgment, 30 that use of the devices will jeopardize the patient's safety or the success of the 31 particular medical procedure involving the patient; a health care worker who 01 makes this determination shall file a report with the employer, in writing, 02 including the date, time, patient, and procedure involved, and a statement of the 03 reasons why the employee failed to use an approved needleless system or sharp 04 with engineered sharps injury protections; 05  (D) the employer can demonstrate by means of objective 06 product evaluation criteria that use of the devices is not more effective in 07 preventing exposure incidents than the alternative used by the employer; or 08  (E) the employer can demonstrate, with respect to an 09 engineering control that has not been available in the marketplace for at least 10 12 months, that reasonably specific and reliable information is not available 11 regarding the safety performance of the engineering control for the employer's 12 procedures, and that the employer is actively determining by means of 13 objective product evaluation criteria whether the use of the engineering control 14 will reduce the risk of exposure incidents occurring in the employer's 15 workplace; 16  (2) a written exposure control plan include an effective procedure for 17 identifying and selecting existing needleless systems and sharps with engineered sharps 18 injury protections; the procedure must provide that an evaluation committee described 19 in (g) of this section has responsibility for identifying and selecting the devices; 20  (3) written exposure control plans shall be updated when necessary to 21 reflect progress in implementing needleless systems and sharps with engineered sharps 22 injury protections as determined by the evaluation committee described in (g) of this 23 section; updating must occur at least once every year; 24  (4) information concerning exposure incidents shall be recorded in a 25 sharps injury log as required by (c) of this section. 26  (c) A sharps injury log must include at least 27  (1) the date and time of the exposure incident; 28  (2) the type and brand of sharp involved in the exposure incident; and 29  (3) the description of the exposure incident that must include 30  (A) the job classification of the exposed employee; 31  (B) the department or work area where the exposure incident 01 occurred; 02  (C) the procedure that the exposed employee was performing 03 at the time of the incident; 04  (D) how the incident occurred; 05  (E) the body part involved in the exposure incident; 06  (F) if the sharp had engineered sharps injury protections, 07 whether the protective mechanism was activated, and whether the injury 08 occurred before the protective mechanism was activated, during activation of 09 the mechanism, or after activation of the mechanism; 10  (G) if the sharp had no engineered sharps injury protections, the 11 injured employee's opinion as to whether and how such a mechanism could 12 have prevented the injury, as well as the basis for the opinion; and 13  (H) whether an engineering, administrative, or work practice 14 control could have prevented the injury, as well as the recorder's basis for the 15 opinion. 16  (d) The department shall adopt regulations to implement AS 18.60.880 - 17 18.60.890 and to revise the bloodborne pathogen standard to prevent sharps injuries 18 or exposure incidents. The regulations may include 19  (1) training and education requirements; 20  (2) measures to encourage the vaccination of health care workers 21 against diseases transmitted by bloodborne pathogens; 22  (3) requirements for the strategic placement of sharps containers as 23 close to the work area as practical; and 24  (4) requirements for the increased use of personal protective equipment. 25  (e) The department shall compile and maintain a list of sources of information 26 on existing needleless systems and sharps with engineered sharps injury protections. 27 The department shall make the list available to assist employers in complying with the 28 requirements of the bloodborne pathogen standard adopted under this section. 29  (f) Standards adopted under (b) of this section do not apply to the use of a 30 drug or biologic prepackaged within an administration system or used in a prefilled 31 syringe that is approved for commercial distribution or investigational use by the 01 federal Food and Drug Administration. 02  (g) An employer who employs 10 or more front-line health care workers shall 03 establish an evaluation committee, at least half the members of which are front-line 04 health care workers. An employer who employs fewer than 10 front-line health care 05 workers shall establish an evaluation committee with at least one member who is a 06 front-line health care worker. An employer who has established a committee before 07 the effective date of this section that satisfies the requirements of this subsection is not 08 required to establish an additional committee under this subsection. 09  (h) Standards adopted under this section do not apply to an employer or 10 supervised employee who primarily uses needles and other sharps for intraoral 11 procedures. 12  Sec. 18.60.890. Definitions. In AS 18.60.880 - 18.60.890, 13  (1) "bloodborne pathogens" means pathogenic microorganisms that are 14 present in human blood and can cause disease in humans, including hepatitis B virus, 15 hepatitis C virus, and human immunodeficiency virus; 16  (2) "department" means the Department of Labor and Workforce 17 Development; 18  (3) "employer" 19  (A) means an employer having an employee with occupational 20 exposure to human blood or other material potentially containing bloodborne 21 pathogens; but 22  (B) does not include an employer who has fewer than 25 full- 23 time-equivalent employees; 24  (4) "engineered sharps injury protections" means a physical attribute 25 built into 26  (A) a needle device used for withdrawing body fluids, accessing 27 a vein or artery, or administering medications or other fluids that effectively 28 reduces the risk of an exposure incident by a mechanism such as barrier 29 creation, blunting, encapsulation, withdrawal, retraction, destruction, or other 30 effective mechanisms; or 31  (B) another type of needle device, or a nonneedle sharp, that 01 effectively reduces the risk of an exposure incident; 02  (5) "engineering controls" means controls, including needleless systems 03 and sharps with engineered sharps injury protections, that isolate or remove the 04 bloodborne pathogens hazard from the workplace; 05  (6) "front-line health care worker" means a nonmanagerial employee 06 responsible for direct patient care with potential occupational exposure to sharps- 07 related injuries; 08  (7) "needleless system" means a device that does not use needles for 09  (A) the withdrawal of body fluids after initial venous or arterial 10 access is established; 11  (B) the administration of medication or fluids; or 12  (C) another procedure involving the potential for an exposure 13 incident; 14  (8) "sharp" means an object used or encountered in a health care setting 15 that can be reasonably anticipated to penetrate the skin or any other part of the body 16 and to result in an exposure incident, including needle devices, scalpels, lancets, 17 broken glass, and broken capillary tubes; 18  (9) "sharps injury" means cuts, abrasions, needlesticks, or other injuries 19 caused by a sharp; 20  (10) "sharps injury log" means a written or electronic record satisfying 21 the requirements of AS 18.60.880(c). 22  (11) "work practice controls" are controls that reduce the likelihood of 23 exposure by altering the manner in which a task is performed. 24 * Sec. 2. AS 18.60.880(f) is repealed December 31, 2003. 25 * Sec. 3. This Act takes effect January 1, 2001.