What is the window for a source who is initially negative for the hepatitis testing? How long do you follow up on the employee?
Thanks!
Sherri Davidson, MSN, ARNP-BC, COHN-S
Nationally Certified DOT Medical Examiner
Clinic Mannager
Company Care at Blake Medical Center
2010 59th Street West
Suite 3600
Bradenton, Fl 34209
CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
From: MCOH-EH [mailto:mcoh-eh-bounces+sherrilynn.davidson=hcahealthcare.com@mylist.net]
On Behalf Of Nancy Rodway
Sent: Monday, January 16, 2017 10:02 PM
To: 'MCOH/EH' <mcoh-eh@mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results
I aggressively use the HCV RNA by PCR on the employee if the source is HCV Ab positive. Some studies have suggested the use of the newer HCV protease inhib antivirals should
the employee show early signs of HCV viral exposure. I have yet to use it on the source blood but thank you for the thought. I'll add that to my source labs in the future
Nancy
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From: MCOH-EH <mcoh-eh-bounces@mylist.net>
on behalf of Swift, Melanie <melanie.swift@Vanderbilt.Edu>
Sent: Monday, January 16, 2017 4:50 PM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results
Nancy, are you testing source patients for HCV with a DNA test? There are some new recommendations coming down the pike about that. Currently we’re testing
the source with HCV Ab, and of course there is a long infectious window with that method.
For anyone attending this spring’s AOHC, this is a topic that will be covered in the Medical Center Occupational Health preconference course. (Pardon the
shameless promo!)
Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Nancy Rodway
Sent: Monday, January 16, 2017 2:09 PM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results
I do not test further if source is negative as long as the lab is testing also for the p24 antigen.
I am a pathologist as well .... so i see both sides of this issue
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From: MCOH-EH <mcoh-eh-bounces+nrodway=hotmail.com@mylist.net>
on behalf of Swift, Melanie <melanie.swift@Vanderbilt.Edu>
Sent: Monday, January 16, 2017 3:04 PM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results
We do.
Source patients can test negative in early stages of infection so we offer f/u testing for everyone. It also can forestall against future WC claims if
you show they were negative after the exposure.
Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of April Tainter
Sent: Monday, January 16, 2017 8:15 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Baseline Testing on Exposed Employee with Negative Source Results
Do any of you continue to test beyond baseline if the source is negative?
April Tainter RN
Employee Health Nurse
ThedaCare Medical Centers-Shawano/New London/Waupaca
P 715-701-0168
F 715-524-9983
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This e-mail message, including attachments, is for the sole use of the intended recipient and may contain confidential and privileged information. Any unauthorized
review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply and destroy all copies of the original message.
From: MCOH-EH [mailto:mcoh-eh-bounces@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)
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
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Hinman, Ashley
Sent: Sunday, January 15, 2017 3:00 PM
To: mcoh-eh@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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