[MCOH-EH] MCOH-EH Digest, Vol 252, Issue 191

Schwindt, Pamela K PSchwindt at IUHealth.org
Tue Jun 6 11:45:36 PDT 2017
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We use the Ishihara as a screening tool to meet the requirements for CLIA certification.  I couldn't agree more with Dr. Swift but have long ago decided to choose my brick walls with care.

Pam


Pamela Schwindt, RN BSN
Indiana University Health
Employee Occupational Health Services Manager
AHC | Arnett | Ball | North | West |
IU Health Physicians
1633 Capitol 
Indianapolis, IN  46202
Telephone          317-962-8244
Fax                         317-962-8349
eohs at iuhealth.org




-----Original Message-----
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Subject: MCOH-EH Digest, Vol 252, Issue 191

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Today's Topics:

   1. Re:  MCOH-EH Digest, Vol 252, Issue 190 (Kari Cline)


----------------------------------------------------------------------

Message: 1
Date: Tue, 6 Jun 2017 09:13:32 -0500
From: Kari Cline <kstein2011 at gmail.com>
To: mcoh-eh at mylist.net
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 252, Issue 190
Message-ID:
	<CAAkzZLj9_tNTa5kFvm7gN2SGiyhjW=-yTPUZaTJVk22iGr1e3A at mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

?Melanie, I wholeheartedly agree with your approach, but I have been advised by lab leadership at multiple healthcare organizations that they have a CLIA (clinical lab improvement) requirement that mandates color blindness screening for their lab personnel.  Of course, I can't find anything in writing now that I look. Maybe this is a myth! Anybody else know where I can find this in writing?
Thanks,
Kari

*Karilyn Cline, MPH RN COHN*

Team Member Health

Direct: 763-581-2187

Fax: 763-581-2181

Karilyn.Cline at NorthMemorial.com

*NorthMemorial.com*


On Tue, Jun 6, 2017 at 8:32 AM, <mcoh-eh-request at mylist.net> wrote:

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> Today's Topics:
>
>    1. Re:  Color blindness screening (Swift, Melanie, M.D.)
>    2. Re:  [EXTERNAL] MCOH-EH Digest, Vol 252, Issue 189
>       (Mitchell, Peter)
>    3. Re:  Color blindness screening (Linda Clark, MD)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Tue, 06 Jun 2017 13:22:53 +0000
> From: "Swift, Melanie, M.D." <Swift.Melanie at mayo.edu>
> To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
> Message-ID: <9153c6$6t9o8p at ironport10.mayo.edu>
> Content-Type: text/plain; charset="us-ascii"
>
> Darn, I loved "screening mythology" - I might use that. Particularly 
> apt for color vision screening.
>
> A couple of things to bear in mind:
>
> *         Color vision testing in a clinical setting is a medical test
> under the ADA.
>
> *         Competency demonstration in the workplace is not a medical test.
>
> Chew on that a minute. Now a few more background things to note:
>
> *         Color vision deficiency can occur in different spectra -
> red-green, blue-yellow are the main types. Ishihara and most 
> commercially available color vision screening tests are focused on 
> red-green which is most common congenital deficiency. Point of care 
> tests often use the yellow-blue spectrum more.
>
> *         Even if the colors you test do match those the person uses in
> their job (and the ADA expects you not to be doing a medical test 
> unless it relates directly to the job function) that does not mean 
> that they can correctly perform and interpret the test. For patient 
> safety you still have to do a competency test.
>
> *         People with color vision deficiency can often compensate. If the
> test includes a key or legend, they may still be able to accurately 
> match the key, even if what they are seeing looks olive to them instead of pink.
> Therefore someone who fails a color vision test still needs a 
> competency test to determine if they can do this job function safely.
>
> *         While some color vision deficiencies are genetic, others are
> acquired, most often through a chronic disease process like diabetes. 
> So if you are going to rely on color perception testing, you would 
> need to do it periodically, not just at hire.
>
> *         Lighting is a huge factor in color vision perception. Someone
> with a partial deficit could perform well in a well-lit exam room 
> where you are going screening, but be completely unable to 
> discriminate those same colors in a poorly lit area.
>
> In short, for color vision screening to make sense and be ADA 
> compliant, you'd need to perform the testing in a setting that mimics 
> their work environment, using the same colors that they would be using 
> in the tests they perform and not just what is in the Ishihara plates, 
> and you'd need to repeat testing periodically. And they would still 
> need to do competency testing periodically to demonstrate that they 
> can accurately perform and interpret the test.
>
> I'd urge you to resist the temptation to do standard color vision 
> screening test, and to consider doing good competency testing annually.
> That's another rock to look under - what does the competency testing 
> entail. There should be positive and negative controls, and everyone 
> should have adequate lighting to do the task, both in the competency 
> test area and in the clinical area where the test is performed, which 
> are ideally the same place.
>
> Melanie
>
> Melanie Swift, MD
> Senior Associate Consultant
> Division of Preventive, Occupational, and Aerospace Medicine Phone 
> 507.284.2560 _______________________________ Mayo Clinic
> 200 First Street SW
> Rochester, MN 55905
> www.mayoclinic.org<http://www.mayoclinic.org/>
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Holley, 
> Stephanie A
> Sent: Monday, June 05, 2017 6:24 PM
> To: mcoh-eh at mylist.net
> Subject: Re: [MCOH-EH] Color blindness screening
>
> Ok-screening is not a myth:)  How about sharing your methodology, please.
> Thanks!  Steph
>
> From: Holley, Stephanie A
> Sent: Monday, June 05, 2017 5:59 PM
> To: 'mcoh-eh at mylist.net'
> Subject: Color blindness screening
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
> ________________________________
> Notice: This UI Health Care e-mail (including attachments) is covered 
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> is intended only for the use of the individual or entity to which it 
> is addressed, and may contain information that is privileged, 
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> ------------------------------
>
> Message: 2
> Date: Tue, 6 Jun 2017 13:28:37 +0000
> From: "Mitchell, Peter" <Peter.Mitchell at va.gov>
> To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] [EXTERNAL] MCOH-EH Digest, Vol 252, Issue 189
> Message-ID:
>         <8C605126729C3B42B3AED025267ED9BF2847C268 at VAPNSMSGD53S01.
> vha.med.va.gov>
>
> Content-Type: text/plain; charset="us-ascii"
>
> We use Ishihara as loaded in a TiTmus machine.
>
> Peter T. Mitchell, APRN, CNP, COHN-S
> Employee Occupational Health (111H)
> Veterans Affairs Health Care System
> Minneapolis, MN
> 612-467-2986 (direct)
> peter.mitchell at va.gov
>
> -----Original Message-----
> From: MCOH-EH 
> [mailto:mcoh-eh-bounces+peter.mitchell=va.gov at mylist.net]
> On Behalf Of mcoh-eh-request at mylist.net
> Sent: Tuesday, June 06, 2017 7:29 AM
> To: mcoh-eh at mylist.net
> Subject: [EXTERNAL] MCOH-EH Digest, Vol 252, Issue 189
>
> Send MCOH-EH mailing list submissions to
>         mcoh-eh at mylist.net
>
> To subscribe or unsubscribe via the World Wide Web, visit
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>
>
> Today's Topics:
>
>    1.  Color blindness screening (Holley, Stephanie A)
>    2. Re:  Color blindness screening (Holley, Stephanie A)
>    3. Re:  Color blindness screening
>       (SherriLynn.Davidson at hcahealthcare.com)
>    4. Re:  Color blindness screening (Senior, Cathy (Employee Health))
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Mon, 5 Jun 2017 22:58:43 +0000
> From: "Holley, Stephanie A" <stephanie-holley at uiowa.edu>
> To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
> Subject: [MCOH-EH] Color blindness screening
> Message-ID:
>         <1968FE2C56092444865BCBE94FEA64CD7F4CF77F at hc-mailboxc1-n2.
> healthcare.uiowa.edu>
>
> Content-Type: text/plain; charset="us-ascii"
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
>
> ________________________________
> Notice: This UI Health Care e-mail (including attachments) is covered 
> by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521 and 
> is intended only for the use of the individual or entity to which it 
> is addressed, and may contain information that is privileged, 
> confidential, and exempt from disclosure under applicable law. If you 
> are not the intended recipient, any dissemination, distribution or 
> copying of this communication is strictly prohibited. If you have 
> received this communication in error, please notify the sender 
> immediately and delete or destroy all copies of the original message 
> and attachments thereto. Email sent to or from UI Health Care may be 
> retained as required by law or regulation. Thank you.
> ________________________________
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> ------------------------------
>
> Message: 2
> Date: Mon, 5 Jun 2017 23:23:39 +0000
> From: "Holley, Stephanie A" <stephanie-holley at uiowa.edu>
> To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
> Message-ID:
>         <1968FE2C56092444865BCBE94FEA64CD7F4CFB11 at hc-mailboxc1-n2.
> healthcare.uiowa.edu>
>
> Content-Type: text/plain; charset="us-ascii"
>
> Ok-screening is not a myth:)  How about sharing your methodology, please.
> Thanks!  Steph
>
> From: Holley, Stephanie A
> Sent: Monday, June 05, 2017 5:59 PM
> To: 'mcoh-eh at mylist.net'
> Subject: Color blindness screening
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
>
> ________________________________
> Notice: This UI Health Care e-mail (including attachments) is covered 
> by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521 and 
> is intended only for the use of the individual or entity to which it 
> is addressed, and may contain information that is privileged, 
> confidential, and exempt from disclosure under applicable law. If you 
> are not the intended recipient, any dissemination, distribution or 
> copying of this communication is strictly prohibited. If you have 
> received this communication in error, please notify the sender 
> immediately and delete or destroy all copies of the original message 
> and attachments thereto. Email sent to or from UI Health Care may be 
> retained as required by law or regulation. Thank you.
> ________________________________
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>
> ------------------------------
>
> Message: 3
> Date: Tue, 6 Jun 2017 11:57:09 +0000
> From: <SherriLynn.Davidson at hcahealthcare.com>
> To: <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
> Message-ID:
>         <3E6B29246184AD4290C8D65E6808AEDB22B2EC97 at XRDCWPMSGHCMD2C.
> hca.corpad.net>
>
> Content-Type: text/plain; charset="us-ascii"
>
> We use Ishihara in our facilities.
>
>
> 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 at mylist.net] On Behalf Of Holley, 
> Stephanie A
> Sent: Monday, June 05, 2017 7:24 PM
> To: mcoh-eh at mylist.net
> Subject: [EXTERNAL] Re: [MCOH-EH] Color blindness screening
>
> Ok-screening is not a myth:)  How about sharing your methodology, please.
> Thanks!  Steph
>
> From: Holley, Stephanie A
> Sent: Monday, June 05, 2017 5:59 PM
> To: 'mcoh-eh at mylist.net'
> Subject: Color blindness screening
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
> ________________________________
> Notice: This UI Health Care e-mail (including attachments) is covered 
> by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521 and 
> is intended only for the use of the individual or entity to which it 
> is addressed, and may contain information that is privileged, 
> confidential, and exempt from disclosure under applicable law. If you 
> are not the intended recipient, any dissemination, distribution or 
> copying of this communication is strictly prohibited. If you have 
> received this communication in error, please notify the sender 
> immediately and delete or destroy all copies of the original message 
> and attachments thereto. Email sent to or from UI Health Care may be 
> retained as required by law or regulation. Thank you.
> ________________________________
> -------------- next part -------------- An HTML attachment was 
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>
> ------------------------------
>
> Message: 4
> Date: Tue, 6 Jun 2017 12:28:54 +0000
> From: "Senior, Cathy (Employee Health)" <CESenior at phhealthcare.org>
> To: 'MCOH/EH' <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
> Message-ID:
>         <4d75c0442fd94e0498f4f71967c6ad40 at EX13DB01.phhealthcare.org>
> Content-Type: text/plain; charset="us-ascii"
>
> We use Quick Six Color Vision Test Pseudoisochromatic Plates.
>
>
> Cathy Senior RN BSN CDE
> Employee Health Director
> Penn Highlands DuBois
> 100 Hospital Avenue
> P.O. Box 447
> DuBois Pa 15801
> Phone 814-375-3392
> Fax 814-372-2610
> cesenior at phhealthcare.org
> www.phhealthcare.org
> [PHH ESig Logo 150dpi]
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of 
> SherriLynn.Davidson at hcahealthcare.com
> Sent: Tuesday, June 06, 2017 7:57 AM
> To: mcoh-eh at mylist.net
> Subject: Re: [MCOH-EH] Color blindness screening
>
> We use Ishihara in our facilities.
>
>
> 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 at mylist.net] On Behalf Of Holley, 
> Stephanie A
> Sent: Monday, June 05, 2017 7:24 PM
> To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
> Subject: [EXTERNAL] Re: [MCOH-EH] Color blindness screening
>
> Ok-screening is not a myth:)  How about sharing your methodology, please.
> Thanks!  Steph
>
> From: Holley, Stephanie A
> Sent: Monday, June 05, 2017 5:59 PM
> To: 'mcoh-eh at mylist.net'
> Subject: Color blindness screening
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
> ________________________________
> Notice: This UI Health Care e-mail (including attachments) is covered 
> by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521 and 
> is intended only for the use of the individual or entity to which it 
> is addressed, and may contain information that is privileged, 
> confidential, and exempt from disclosure under applicable law. If you 
> are not the intended recipient, any dissemination, distribution or 
> copying of this communication is strictly prohibited. If you have 
> received this communication in error, please notify the sender 
> immediately and delete or destroy all copies of the original message 
> and attachments thereto. Email sent to or from UI Health Care may be 
> retained as required by law or regulation. Thank you.
> ________________________________
>
> This email and any attached files are sensitive in nature and intended 
> solely for the intended recipient(s). If you are not the named 
> recipient you should not read, distribute, copy or alter this email. 
> Any views or opinions expressed in this email are those of the author 
> and do not represent those of Penn Highlands Healthcare or its affiliates.. Warning:
> Although precautions have been taken to make sure no viruses are 
> present in this email, the company cannot accept responsibility for 
> any loss or damage that arise from the use of this email or attachments.
>
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> ------------------------------
>
> Subject: Digest Footer
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>
> End of MCOH-EH Digest, Vol 252, Issue 189
> *****************************************
>
>
>
> ------------------------------
>
> Message: 3
> Date: Tue, 6 Jun 2017 13:32:09 +0000
> From: "Linda Clark, MD" <lclark at doctorclark.org>
> To: MCOH/EH <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
> Message-ID:
>         <DM5PR19MB1035C8B0A750E3B68E43C739C3CB0 at DM5PR19MB1035.
> namprd19.prod.outlook.com>
>
> Content-Type: text/plain; charset="us-ascii"
>
> I agree with you 100% Melanie, and made such an argument to a client 
> of mine, a multi-site FQHC.  However, they were "dinged" from the 
> Joint Commission for not conducting color vision screening 
> pre-employment. I argued the point, for many of the reasons you 
> mention below, and per the health center, they would not budge on this 
> opinion. So, we perform a 6-plate Ishihara through our Titmus for 
> their employees, with the caveat that they still must complete all 
> competency training requiring color interpretation - as you point out, 
> many can still perform the tests accurately.
> Linda
>
> Linda L. Clark, MD, MS
> Occupational and Preventive Medicine
> (585) 227-0072 P
> (585) 227-9585 F
> lclark at doctorclark.org<mailto:lclark at doctorclark.org>
>
> [065_clark_occ_logo_long_color]
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, 
> Melanie, M.D.
> Sent: Tuesday, June 6, 2017 9:23 AM
> To: mcoh-eh at mylist.net
> Subject: Re: [MCOH-EH] Color blindness screening
>
> Darn, I loved "screening mythology" - I might use that. Particularly 
> apt for color vision screening.
>
> A couple of things to bear in mind:
>
> *         Color vision testing in a clinical setting is a medical test
> under the ADA.
>
> *         Competency demonstration in the workplace is not a medical test.
>
> Chew on that a minute. Now a few more background things to note:
>
> *         Color vision deficiency can occur in different spectra -
> red-green, blue-yellow are the main types. Ishihara and most 
> commercially available color vision screening tests are focused on 
> red-green which is most common congenital deficiency. Point of care 
> tests often use the yellow-blue spectrum more.
>
> *         Even if the colors you test do match those the person uses in
> their job (and the ADA expects you not to be doing a medical test 
> unless it relates directly to the job function) that does not mean 
> that they can correctly perform and interpret the test. For patient 
> safety you still have to do a competency test.
>
> *         People with color vision deficiency can often compensate. If the
> test includes a key or legend, they may still be able to accurately 
> match the key, even if what they are seeing looks olive to them instead of pink.
> Therefore someone who fails a color vision test still needs a 
> competency test to determine if they can do this job function safely.
>
> *         While some color vision deficiencies are genetic, others are
> acquired, most often through a chronic disease process like diabetes. 
> So if you are going to rely on color perception testing, you would 
> need to do it periodically, not just at hire.
>
> *         Lighting is a huge factor in color vision perception. Someone
> with a partial deficit could perform well in a well-lit exam room 
> where you are going screening, but be completely unable to 
> discriminate those same colors in a poorly lit area.
>
> In short, for color vision screening to make sense and be ADA 
> compliant, you'd need to perform the testing in a setting that mimics 
> their work environment, using the same colors that they would be using 
> in the tests they perform and not just what is in the Ishihara plates, 
> and you'd need to repeat testing periodically. And they would still 
> need to do competency testing periodically to demonstrate that they 
> can accurately perform and interpret the test.
>
> I'd urge you to resist the temptation to do standard color vision 
> screening test, and to consider doing good competency testing annually.
> That's another rock to look under - what does the competency testing 
> entail. There should be positive and negative controls, and everyone 
> should have adequate lighting to do the task, both in the competency 
> test area and in the clinical area where the test is performed, which 
> are ideally the same place.
>
> Melanie
>
> Melanie Swift, MD
> Senior Associate Consultant
> Division of Preventive, Occupational, and Aerospace Medicine Phone 
> 507.284.2560 _______________________________ Mayo Clinic
> 200 First Street SW
> Rochester, MN 55905
> www.mayoclinic.org<http://www.mayoclinic.org/>
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Holley, 
> Stephanie A
> Sent: Monday, June 05, 2017 6:24 PM
> To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] Color blindness screening
>
> Ok-screening is not a myth:)  How about sharing your methodology, please.
> Thanks!  Steph
>
> From: Holley, Stephanie A
> Sent: Monday, June 05, 2017 5:59 PM
> To: 'mcoh-eh at mylist.net'
> Subject: Color blindness screening
>
> Good Evening,
>
> We are interested in knowing if your facility screens health care 
> providers for color deciphering (i.e. Ishihara or Farnsworth).  If so, 
> would you please share what screening mythology you use and if you 
> have a product that works well (vendor for purchases).
> Thanks much!
>
> Stephanie Holley MBA, BSN, RN, CIC, FAPIC Nurse Manager, University 
> Employee Health Clinic University of Iowa Hospitals and Clinics
> 319.384.9584
> stephanie-holley at uiowa.edu<mailto:stephanie-holley at uiowa.edu>
>
> [https://medcom.uiowa.edu/theloop/wp-content/uploads/2015/04/Forbes-em
> ail-
> signature-2016.jpg]
>
>
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