[MCOH-EH] [EXTERNAL] hazardous drug administration

Allen-Hardy, Blythe Blythe.Allen-Hardy at memorialhermann.org
Fri Sep 8 17:09:46 PDT 2017


Once an employee is exposed and labs are drawn, at what frequency does the employee return for follow up labs? There isn't a lot of guidance on f/u testing for medical surveillance.

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Blythe Allen-Hardy, MD, FACOEM
Medical Director, Employee Health
Texas Medical Center
6411 Fannin, JB500
Houston, Texas, 77030
W: 713-704-2792
C: 720-840-9593
F: 713-704-6350
Blythe.allen-hardy at memorialhermann.org

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Seeburger, Sara
Sent: Friday, September 01, 2017 9:13 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

CBC, UA, CMP, reproductive health questionnaire

Sara Seeburger RN, BSN
Assistant Administrator
Centura Occupational Health
9100 E. Mineral Circle
Centennial, CO 80112

303-765-6498 Phone
720-874-5955 Fax


From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Morelli, Karen J
Sent: Friday, September 01, 2017 8:09 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

What components are you monitoring?
Thank you,
Karen Morelli RN, BSN, Clinical Manager
WorkHealth LLC
Eastern Maine Healthcare Systems

From: MCOH-EH [mailto:mcoh-eh-bounces+kmorelli=emhs.org at mylist.net] On Behalf Of Seeburger, Sara
Sent: Friday, September 01, 2017 10:06 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration





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We have a program in our hospitals.  The program is voluntary at this time, so there is no compliance tracking.  We extend invitations to all Pharmacy staff and to nurses who routinely administer hazardous drugs each year and upon hire.  We are considering their first visit a baseline (regardless of if they have worked for us for many years, we had to start somewhere).  For those with abnormal results, our Occ Health Physicians handle those case by case, so I suppose they may do follow up testing or in some cases refer them to their own providers.  As for the USP800, we are looking into that and will update our policies but have not done so yet.
Hope that helps!

Sara Seeburger RN, BSN
Assistant Administrator
Centura Occupational Health
9100 E. Mineral Circle
Centennial, CO 80112

303-765-6498 Phone
720-874-5955 Fax


From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Morelli, Karen J
Sent: Friday, September 01, 2017 6:39 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

I, too, would love to see if anyone has a hazardous drug surveillance program in place as our system is looking at this as well.

Karen Morelli RN, BSN
Clinical Manager
WorkHealth LLC
Eastern Maine Healthcare Systems

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Angeli Mancuso
Sent: Thursday, August 31, 2017 4:59 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration





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Hi all,

I sincerely appreciate the input and perspectives from this group. I have some follow up questions that I'm curious how others are handling:

  1.  For current employees, how are you getting folks into compliance with this regulation? Are you asking them to complete the questionnaire and lab work (CBC, metabolic panel, UA) now and considering this a baseline?
  2.  What are you doing with abnormal lab results for these current employees? Referring to their own physician? Doing follow up and more extensive testing through Occupational Medicine to determine other underlying health conditions and then referring to PCPs?
I've really appreciated the shared policies and forms from everyone! Thanks for being such a great community!


Angeli Mancuso, RN, COHN-S/CM
Manager, Employee Health & Safety | Cottage Health
P.O Box 689 | 400 W. Pueblo St | Santa Barbara, CA 93102-0689
Office: (805) 569-7866 |  Fax: (805) 569-8271
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Allen-Hardy, Blythe
Sent: Tuesday, August 01, 2017 3:39 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

I'm fairly new to the organization so still learning how it is determined who's in the program. I'm assuming that a list is giving to occur health by the director of oncology nursing. I can respond back once I get further clarification.

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Blythe Allen-Hardy, MD, FACOEM
Medical Director, Employee Health
Texas Medical Center
6411 Fannin, JB500
Houston, Texas, 77030
W: 713-704-2792
C: 720-840-9593
F: 713-704-6350
Blythe.allen-hardy at memorialhermann.org<mailto:Blythe.allen-hardy at memorialhermann.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thrasher, Terri
Sent: Tuesday, August 01, 2017 1:34 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

How do you determine who to place in surveillance and how many employees are you running through the surveillance labs?
Terri

Kindest regards,

Terri

Terri L. Thrasher RN MSN
Sr. Director HR
Employee Health, Occupational Safety, Environmental Health, Employee Relations, Leave Management  HR Compliance/Policy, Workers Compensation, 803-SAFE, Injury Management, Non CCHMC Badging, Early Education and Childcare Center
3333 Burnet Ave
Cincinnati Ohio 45229  MLC 9006
513-636-6240



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Allen-Hardy, Blythe
Sent: Tuesday, August 01, 2017 2:22 PM
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration

Cathy,

At Memorial Hermann we have a surveillance program that I am in the process of updating due to the USP 800 requirements. We have a policy in place in our hospitals on how the drugs are handled etc and it is fairly comprehensive. The medical surveillance I believe as involved checking a CBC, UA and completing an annual questionnaire. I am developing a medical surveillance guideline that will addl laboratory tests such as LFT's, BUN/Cr to the CBC w/diff and UA. Will also add a focused exam component for post exposures.

That may be overkill but I want to make sure we have a comprehensive program. Feel free to contact me for further questions.

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Blythe Allen-Hardy, MD, FACOEM
Medical Director, Employee Health
Texas Medical Center
6411 Fannin, JB500
Houston, Texas, 77030
W: 713-704-2792
C: 720-840-9593
F: 713-704-6350
Blythe.allen-hardy at memorialhermann.org<mailto:Blythe.allen-hardy at memorialhermann.org>

From: MCOH-EH [mailto:mcoh-eh-bounces+blythe.allen-hardy=memorialhermann.org at mylist.net] On Behalf Of Senior, Cathy (Employee Health)
Sent: Tuesday, August 01, 2017 11:42 AM
To: 'MCOH/EH'
Subject: [EXTERNAL] [MCOH-EH] hazardous drug administration



Does anyone have a medical surveillance plan for employees who handle hazardous drugs. We are seeing more administration of these hazardous drugs between starting the intravesical therapy and the biologics that are administered. We follow the ONS guidelines for safe handling of hazardous drugs as outlined in our policy. We already have the appropriate work practice in place including proper use of PPE and education for the staff that handle these drugs. There has been a concern voiced by one of our educators that institutions such as NIOSH have recommendations for medical surveillance to make it a comprehensive prevention program that we do not have in place.  Some of the drugs we administer is  Carboplatin, VP-16, Taxol, Cisplatin, Cytoxan, Erbitux, 5-FU, Abraxane, Gemzar, Herceptin, Parieto and Rituxan to name a few. We also give biologics to out-patients in our short stay unit. Any help would be much appreciated.  Thanks


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
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