We draw titers at hire and repeat series for negative titers as indicated.


From: "Long, Deryl" <Deryl.Long@wellstar.org>
To: 'MCOH/EH' <mcoh-eh@mylist.net>
Date: 01/20/2015 10:51 AM
Subject: Re: [MCOH-EH] Hep C positive HCW
Sent by: "MCOH-EH" <mcoh-eh-bounces+kmccracken=mcleodhealth.org@mylist.net>





All- We are following the recent guidelines and drawing titers on new hires at risk who are without Hep B titer results.  You are correct in that the guidelines are vague but we are erring on the side of caution to establish a baseline immunity for employees at risk of exposure.  
 
As far as the employee positive for Hep C we use the SHEA guidelines as a reference.
 
Deryl
 
Deryl Long, RN, COHN
Director of WellStar Employee Health Services
677 Church Street
Marietta, Georgia  30060
Office -770-793-7227
Fax-770-793-7952
 Deryl.Long@Wellstar.org
 
The Flu Ends with You! Get Vaccinated!
It¡¯s the right thing to do for our patients, our families, and our community.
 
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Barb K. Grabenbauer
Sent:
Friday, January 16, 2015 3:49 PM
To:
MCOH/EH
Subject:
[MCOH-EH] Hep C positive HCW

 
Do you allow Hep C positive HCW's start IV's?
Is that fall into: Digital palpation of a needle tip in a body cavity
 
Thank you!
Barb Grabenbauer, RN
Quality Director
Marshalltown Medical & Surgical Center
Marshalltown, IA 50158



From: MCOH-EH [mcoh-eh-bounces@mylist.net] on behalf of Brenda Kantner [bkantner@schuylkillhealth.com]
Sent:
Wednesday, September 24, 2014 8:44 AM
To:
MCOH/EH
Subject:
Re: [MCOH-EH] Hepatitis B and titers

It is unfortunate that even though there were new 2013 CDC recommendations, there are still so many individual decisions that need to be made with regard to Hep B for healthcare workers. Nothing is ever totally clear-cut, but there are still so many questions.
 
We still struggle with many new hires not having documentation of their Hep B vaccines given in the past. Previously, we would titer new hires
if the employee ¡°was sure¡± they completed the series in the past. In most cases now, based on the newest recommendations, we repeat the series or get a declination rather than titer if there is no documentation of the three vaccines.
 
 
Brenda Kantner RN COHN-S/CM
Employee Health Coordinator
Schuylkill Medical Center
700 East Norwegian St
Pottsville, PA 17901
Phone 570-621-4351
Fax   570-621-4257

bkantner@schuylkillhealth.com



From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Adamo, Philip
Sent:
Wednesday, September 24, 2014 8:40 AM
To:
'mcoh-eh@mylist.net'
Subject:
Re: [MCOH-EH] Hepatitis B and titers

 
Good morning all:
I am interested in how your institution handles Hep B titers at pre-placement
The 2013 CDC recommendations state:
¡°All HCP recently vaccinated or recently completing HepB vaccination who are at risk for occupational blood or body fluid exposure should undergo anti-HBs testing. Anti-HBs testing should be performed 1¨C2 months after administration of the last dose of the vaccine series when possible. HCP with documentation of a complete ¡İ3-dose HepB vaccine series but no documentation of anti-HBs ¡İ10 mIU/mL who are at risk for occupational blood or body fluid exposure might undergo anti-HBs testing upon hire or matriculation. Testing should use a quantitative method that allows detection of the protective concentration of anti-HBs (¡İ10 mIU/mL) (e.g., enzyme-linked immunosorbent assay [ELISA]).¡±
The word ¡°might¡± is not good especially when mid level providers work off protocols. This is also different then what figure 6 implies.We also know and the literature supports that the measurement of immunity wanes over time. My recall is that after 7 years it is difficult to measure the immunity greater than 10. There is also literature that those who receive the vaccine in infancy have undetected immunity in adulthood; however, they are immune to Hep b.
Based on this information, I have in previous hospitals set a standard of giving a booster for those with documented 3 doses and more than 7 years and then checking the immunity with a titer rather than checking a  titer, getting an non immune response, administering a booster and checking again. Any thoughts on this?
 
Thanks,
Phil
 
 
Philip Adamo, M.D., MPH, FACOEM
Associate Vice President and
Medical Director, Employee Health &
Occupational Injury Care and Wellness
UMass Memorial Medical Center
Hahnemann Campus Suite 201
291 Lincoln Street
Worcester, MA 01605
Phone: 508-334-6179
FAX: 508-334-6433
cell 508-713-3993
philip.adamo@umassmemorial.org
 
"THE GREAT USE OF LIFE is to spend it for something that will outlast it."
William James
 
 
 



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