[MCOH-EH] MCOH-EH Digest, Vol 252, Issue 84

Guthrie, Caren cguthrie at ccgh.org
Wed Feb 22 14:02:00 PST 2017
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Subject: MCOH-EH Digest, Vol 252, Issue 84

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Today's Topics:

   1. Re:  MMR vaccine requirements (Leslie Thompson)
   2. Re:  Masking at Work for Respiratory Illnesses (Tara Dockery)
   3. Re:  Vanish Point needle/syringe sets (Lisa Dyrdahl)


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Message: 1
Date: Wed, 22 Feb 2017 21:37:51 +0000
From: Leslie Thompson <Leslie.Thompson at sharp.com>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] MMR vaccine requirements
Message-ID:
        <CF38DCDD47C59941BA521A50F0CDA57E0F6FF3FA at socexmb03.shcsd.sharp.com>
Content-Type: text/plain; charset="us-ascii"

Right, depends on the organization.  The CDC guidance suggests you can decide based on cost benefit.  We did a cost benefit analysis before switching from vaccine to titer on those without documentation.  In our experience, we see a high percentage of positive titers and the cost is significantly lower than 2 doses of MMR.  Depends on your pricing for titers and vaccine.

Leslie

Leslie Thompson, RN, MSN, COHN-S
Manager, Employee Occupational Health Department
Sharp HealthCare
8695 Spectrum Center Blvd
San Diego, CA  92123
leslie.thompson at sharp.com<mailto:leslie.thompson at sharp.com>



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Tara Dockery
Sent: Wednesday, February 22, 2017 13:28 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] MMR vaccine requirements

That's weird. Usually people don't have documentation and don't remember, so its been our practice to run a titer to see if they have immunity.  But I can imagine every program is different.

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Wednesday, February 22, 2017 9:45 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MMR vaccine requirements

Hi Cathy,

The CDC does not recommend that you run titers for these diseases in the absence of vaccination records. If someone does not have a record of vaccination, the appropriate thing to do is vaccinate them. Antibody testing is not very informative or helpful for MMR. No, you should not check titers after vaccinating. One in 5 appropriately vaccinated individuals will have a negative IgG for mumps!

We do accept a positive antibody test if someone presents us with one, and we have checked IgG on someone who has a contraindication to vaccination, just to guide an accommodation decision.

Guidance may be found at Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR 2011;60(RR07);1-45.<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm>

Attached is a statement we provide to people whose school, or next employer, is asking them to have labs drawn despite appropriate vaccination.

Melanie

Melanie Swift, MD
Associate Professor of Clinical Medicine
Director, Vanderbilt Occupational Health Clinic
Vanderbilt University Medical Center

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Reichen, Catherine
Sent: Wednesday, February 22, 2017 11:36 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] MMR vaccine requirements

Can anyone help me out?  If a new hire does not have vaccine records to prove MMR vaccination - we run titers.  If the titer for rubeola shows no immunity but rubella shows immunity - should the employee receive one or two MMR's?  Do you run repeat titers after a period of time?  Do you allow them to start working with only one vaccine? Can you also provide a resource of how to determine this requirement?  Thank you in advance!

Cathy

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Message: 2
Date: Wed, 22 Feb 2017 21:40:13 +0000
From: Tara Dockery <tdockery at oceanbeachhospital.com>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Masking at Work for Respiratory Illnesses
Message-ID:
        <BLUPR11MB07390AD1A2374FF0E90E462EB3500 at BLUPR11MB0739.namprd11.prod.outlook.com>

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We have the employees stay at home while they are sick and don't come back until the symptoms are under control.
If an employee is better, but still has a residual cough, those are the ones who come back to work and should have a mask on, however if they are still sick they should not come to work, or will be asked to go home.

Tara Dockery


Tara Lee Dockery, IP, MT(ASCP), BS
Infection Prevention and Employee Health

Ocean Beach Hospital and Clinics
174 First Avenue North
Ilwaco, Washington 98624

tdockery at oceanbeachhospital.com
Office Phone  360 - 642 - 6307
Cell Phone 509-760-7397
Fax  360-642-6309



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Monday, February 13, 2017 2:44 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Masking at Work for Respiratory Illnesses

We ask employees with flu and other respiratory infections not to be at work.

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Weaver Meredith
Sent: Monday, February 13, 2017 1:35 PM
To: 'mcoh-eh at mylist.net' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] Masking at Work for Respiratory Illnesses

Our influenza immunization policy requires exempted employees to wear masks at work when flu is prevalent in our area.  We've received some push back from a few employees asking why others who have other respiratory illnesses are not required to mask.  We do not have a policy that requires this, but we do ask that employees practice cough etiquette and good hand hygiene, etc.

Separate from any influenza immunization policies/procedures that you have, do you require employees who have other respiratory illnesses to mask while they are at work?  If so, would you be willing to share your policy with me?  Also, how do you "enforce" the masking policy, especially in your non-clinical areas?

Thank you,
Meredith

 / Meredith R. Weaver, SHRM-CP
Manager, Employee Health
WVU Medicine
PO Box 8120
Morgantown, WV 26506-8120
Phone: 304-598-4000 ext. 77719
Clinic: 304-598-4160
Fax: 304-598-4957
weaverm at wvumedicine.org<mailto:weaverm at wvumedicine.org>
WVUMedicine.com



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Message: 3
Date: Wed, 22 Feb 2017 22:00:37 +0000
From: Lisa Dyrdahl <Lisa_Dyrdahl at Valleymed.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Vanish Point needle/syringe sets
Message-ID:
        <DM5PR02MB24100200196EE5E4499A74ECEF500 at DM5PR02MB2410.namprd02.prod.outlook.com>

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We have used these since 2004 and they do eliminate needlesticks when used appropriately.  The problem is the Vanishpoint cannot be used for all procedures, it is only for 1 time use, IM, SQ or ID injection.  We do have the IV team use them for SQ Lidocaine but they have not gained any acceptance by the OR where they give lido block injections.

You have to have another safety needle system in place for prefilled syringes, for filter needle use and repeated block injections.

It is by far the best retractable system available.  When we had problems getting our staff to accept the Vanishpoint because of needle sharpness, concern about retracting in the skin and hurting the patient, etc.  I brought in another retractable product to trial.  At first staff loved it, then I was told I needed to remove it because it had so many problems with leaking at the hub, slower retraction and inability to retract in the skin.

I evaluate every needle stick to be sure the Vanishpoint is always used when it can be, this is the only way I know of to get to Zero.

Lisa Dyrdahl, RN, BSN
Employee Health Nurse
Lisa_Dyrdahl at Valleymed.org<mailto:Lisa_Dyrdahl at Valleymed.org>
Ph: 425-228-3440 X5720
Fax: 425-656-5066

From: MCOH-EH [mailto:mcoh-eh-bounces+lisa_dyrdahl=valleymed.org at mylist.net] On Behalf Of Galaid Edward I
Sent: Thursday, February 02, 2017 8:49 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Vanish Point needle/syringe sets

We took a look at the Vanish Point needle/syringe sets yesterday.  Seems to be a promising way to reduce needlesticks.  Nurse mgrs who looked at them liked them, except for their IV setup.
Most of their products involve a springloaded retractor or other mechanism that pulls the needle back into the barrel of the syringe.  They have many sizes, including insulin and tuberculin.
Sales rep said that hospitals that have used their products have had substantial reductions in their BBFEs.
He dropped a bunch of names of health systems currently using the Vanish Point products but wondering if anyone who is on the List has had any experience with them.

Thanks

Ed Galaid

Edward I. Galaid, MD, MPH
ABIM, ABPM (Occ Med, PH&GPM)
Medical Director, Occupational Health Partners
Roper St. Francis Healthcare   Charleston, SC
Member, ACOEM Task Group on Medical Guidance for Law Enforcement Officers
843-906-0519


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End of MCOH-EH Digest, Vol 252, Issue 84
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Previous message (by thread): [MCOH-EH] Masking at Work for Respiratory Illness MCOH-EH Digest, Vol 252, Issue 82
Next message (by thread): [MCOH-EH] Using BCG Live Bladder Irrigations
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