[MCOH-EH] [External] Re: Baseline Testing on Exposed Employee with Negative Source Results

[Sampson, Deborah]

We all know the tropes about higher risk of HIV and Hep infection (IVDA and MSM) but our facility has been working to eliminate the concept of 'high risk for HIV' in source patients since we are finding, and I think literature supports, that Hep C is prevalent in non IVDAs who are part of the boomer generation and the prevalence of HIV in older adults (> 50) is a concern for many reasons.

A quick summary, for those interested, is on https://www.cdc.gov/hiv/group/age/olderamericans/index.html.
So we have really tried to change perception of providers and staff about who is at 'high risk' and just assume that everyone is at risk to some degree.

Deb
Deborah A. Sampson, PhD, APRN, COHN-S, FAANP
Director
Employee Health and Wellness Services
Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street   Nashua, NH 03060
p(603) 281-8583  f (603) 577-5665
deborah.sampson at snhhealth.org<mailto:deborah.sampson at snhhealth.org>

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Schweitzer, Kit
Sent: Tuesday, January 17, 2017 5:01 PM
To: MCOH/EH
Subject: [External] Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results

We do if the source is negative, but is high risk, ie IV drug user. We test at BL and 6 months, per our ID MD recommendation and standing orders.



Kit Schweitzer, RN, BSN, COHN  |  Employee Health Nurse |  Employee Health Oregon Community
PeaceHealth<http://www.peacehealth.org/>  |  3333 Riverbend Way |  Springfield, OR 97477
[peace-logo-lockup copy_480px]office 541-222-2544  |  fax 541-222-2548





From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of April Tainter
Sent: Monday, January 16, 2017 6:15 AM
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results


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Do any of you continue to test beyond baseline if the source is negative?

April Tainter RN
Employee Health Nurse

[Description: Description: cid:image001.png at 01D0D11B.A449DA50]

ThedaCare Medical Centers-Shawano/New London/Waupaca
P 715-701-0168
F 715-524-9983

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Monday, January 16, 2017 7:55 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results

Ashley, there are several reasons to draw baseline labs on the employee:

*         Source patient testing may be negative in the early stages of infection so a negative source test is not absolute assurance they are not infectious.

*         The employee may have an unrecognized infection; when it later comes to light they are likely to associate it with the exposure. A positive baseline test establishes it as a preexisting infection.

*         The OSHA Bloodborne Pathogen Standard requires the employer offer baseline testing for HIV and hepatitis B regardless of the source's status:

1910.1030(f)(3)(iii)(A) The exposed employee's blood shall be collected as soon as feasible and tested after consent is obtained.

1910.1030(f)(3)(iii)(B)<https://mail1.peacehealth.org/enduser/classify_url.html?url=VbSFvk02yR8Lh4sqLhQtJNMPP28xoMXC+QRiPsBtdXVr5YGaaH5EQYsQ93a4MaKfgYmMasV7SYQIUVUbM5K9IdFc1wvDMWS8CFcqUBtD1gsRQhu0qyEojfSe0TtGufoZBQy19IRIjS5tOQxNKcwtBxjbniq4OtRrXB2tZ5WiQD8Ck/HQCTVHYxRxyRuu82k/EeGJ+YDfmAWMJtJCAInRuw==> If the employee consents to baseline blood collection, but does not give consent at that time for HIV serologic testing, the sample shall be preserved for at least 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing shall be done as soon as feasible.



Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu<https://mail1.peacehealth.org/enduser/classify_url.html?url=U+SdSP5+1vhsWNzrXXJEib37xWHsndSMwn+A2h3KjyAcv59tS5QGrxwAgj+ap5li>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Hinman, Ashley
Sent: Sunday, January 15, 2017 3:00 PM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results

I was wondering what other facilities are doing when an exposed employee follows up with their designated area (Employee Health) following a blood borne pathogen exposure and the source patient has negative test results.  Do you typically draw baseline testing (Hepatitis C and HIV) on the exposed employee even when the source is negative?  If so, what is your reasoning for doing so?


Thanks,

Ashley Hinman, RN MSN
Nurse Clinician, Employee Health Clinic
University of Iowa Hospitals and Clinics
200 Hawkins Drive, 1097-1 Boyd Tower
Iowa City, IA 52242

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