1. (a) A facility shall follow Standard Precautions for all patient care activities in accordance with Code of Federal Regulations, Title 29 §1910.1030(d)(1) - (3) (relating to Bloodborne Pathogens) and Texas Health and Safety Code Chapter 85, Subchapter I (relating to Prevention of Transmission of HIV and Hepatitis B Virus by Infected Health Care Workers).

   1. (1) The facility shall demonstrate that it follows standard infection control precautions by implementing the most current Recommended Infection Control Practices for Hemodialysis Units developed by the Centers for Disease Control and Prevention, to prevent and control cross-contamination and the spread of infectious agents.

   2. (2) The facility and facility staff shall take infection control precautions for all patients.

      1. (A) Facility staff shall wear disposable gloves when caring for a patient or touching the patient's equipment or bloodlines at the dialysis station.
      2. (B) Facility staff shall remove gloves and clean hands between each patient contact, and after touching blood, body fluids, secretions, excretions, and contaminated items or station.
      3. (C) Enough sinks, with water and soap shall be available to facilitate handwashing. Sink faucets shall have hands-free operable controls to activate the water flow, which may include a single-lever, wrist blade lever, electronic sensor faucet, or an elbow or wrist action faucet. Provisions for hand drying shall be included at each handwashing sink.
      4. (D) If hands are not visibly soiled, staff may substitute use of a waterless antiseptic hand rub for handwashing. Staff shall wash with soap and water when hands are visibly soiled.
      5. (E) Facility staff shall wear gowns, eye protection, and, where applicable, masks to protect themselves and prevent soiling clothing when performing procedures during which spurting or spattering of blood might occur (e.g., during initiation and termination of dialysis, cleaning dialyzers, and centrifuging blood). If visibly soiled, gowns shall be changed and discarded immediately.
      6. (F) Facility staff shall not eat, drink, or smoke in the dialysis treatment area or laboratory.

      7. (G) For an item taken to the dialysis station, facility staff shall:

         1. (i) dispose of the item;
         2. (ii) dedicate the item for use only on a single patient; or
         3. (iii) clean and disinfect the item before taking the item to a common clean area or using the item on another patient.
      8. (H) Facility staff shall dedicate non-disposable items that cannot be cleaned and disinfected (e.g., adhesive tape, cloth covered blood pressure cuffs) for use on only a single patient.
      9. (I) Facility staff shall use unused medications or supplies (syringes, alcohol swabs, etc.) taken to the patient's station for only that patient and not return the medications or supplies to a common clean area or use the medications or supplies on other patients.
      10. (J) A facility shall clearly designate clean areas for preparing, handling, and storing medications and unused supplies and equipment. Facility staff shall not handle or store medications or clean supplies in the same or an immediately adjacent area where facility staff handle used supplies, equipment, or blood samples.
      11. (K) A facility shall clearly designate contaminated areas where staff handle used supplies, equipment, or blood samples.
      12. (L) When facility staff use multiple dose medication vials (including vials containing diluents), staff shall prepare individual patient doses in a clean, centralized area away from dialysis stations and deliver the medication separately to each patient.
      13. (M) Facility staff shall not carry multiple dose medication vials from station to station.
      14. (N) Facility staff shall not use common medication carts to deliver medications to patients. If facility staff use trays to deliver medications to individual patients, staff shall clean and disinfect the trays after delivering medications to each patient.
      15. (O) If facility staff use a common supply cart to store clean supplies in the patient treatment area, this cart shall remain in a designated area at a sufficient distance from patient stations to avoid contamination with blood. Staff shall not move such carts between stations to distribute supplies.
      16. (P) Facility staff shall not carry medication vials, syringes, alcohol swabs, or supplies in their pockets.
   3. (3) The facility shall ensure the location and arrangement of handwashing sinks permit ease of access and proper use.
   4. (4) Facility staff shall explain the potential risks associated with blood and blood products to patients and family members and provide the indicated personal protective equipment to a patient or family member, if the patient or family member assists in procedures that could result in contact with blood or body fluids. Facility staff shall encourage patients to clean their access sites before each treatment and their hands following their treatment.
2. (b) A facility shall designate a staff member to monitor and coordinate infection control activities.
3. (c) A facility shall develop, maintain, and enforce a system to identify and track infections to allow identification of trends or patterns. This activity shall be reviewed as a part of the facility's quality assessment and performance improvement (QAPI) program described in §507.43 of this chapter (relating to Quality Assessment and Performance Improvement). The record shall include trends, corrective actions, and improvement actions taken.
4. (d) Facility staff shall replace a transducer protector when wetted during a dialysis treatment and use a transducer protector for only one treatment. If fluid or blood is visible on the side of the transducer protector that faces the machine, the machine must be opened by qualified personnel after the dialysis treatment to allow the internal transducer to be inspected for contamination, including inspection for possible blood contamination of the internal pressure tubing set and pressure sensing port.

Source Note:The provisions of this §507.36 adopted to be effective December 23, 2025, 50 TexReg 8289.