[MCOH-EH] #ExtMail# Re: BBP exposures

[Kathy.Dayvault at dekalbmedical.org]

We draw stat Rapid HIV; Hep B and Hep C titers for exposures.

We have two separate  exposure panel order sets: 1 for source and one for 
the exposed employee (or other person) already set up in Allscripts which 
contains all three labs.

The provider orders exposure labs. Occ health follows up  and / or refers 
the employee to be evaluated and have repeat labs set up.

We draw titers on our employees when they come for their new hire 
assessment.

Thanks,


Kathy Dayvault, RN, BSN, MPH
 Manager, Occupational Health and Safety 
 WorksWell Onsite
 Dekalb Medical  2701 North Decatur Road
 Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault at dekalbmedical.org




From:   "Tim Crump" <crumpt at ohsu.edu>
To:     "MCOH/EH" <mcoh-eh at mylist.net>, 
Date:   11/13/2017 12:44 PM
Subject:        Re: [MCOH-EH] #ExtMail# Re:  BBP exposures
Sent by:        "MCOH-EH" <mcoh-eh-bounces at mylist.net>



I would be interested in knowing how people are testing workers who have 
not completed the Hepatitis B immunization series.  Our staff who sustain 
a needle stick or other BBFE afterhours are seen in the ED, where they do 
not necessarily know their immunization status.  They test everyone w/ 
HepB sAb.  My understanding of CDC recommendations is that workers who 
have not completed the series should be tested w/ HepB core Ab, and that 
surface antibody is uninterpretable if the immu series is not complete. So 
my question is, can the HepB surface antibody be used as a marker of 
immunity to Hep B at that moment, or is it misleading and should be put 
aside when the immu series is incomplete, potentially making a worker a 
candidate for HBIG?  Thanks for any insight, Tim
 
Tim Crump, MSN, FNP
Tim Crump, MSN, FNP
Family Nurse Practitioner
Multnomah Pavilion 1 SE, Suite 1110
Occupational Health
Healthcare Human Resources
 
Oregon Health & Science University
3181 SW Sam Jackson Park Rd
Mail code: UHN 89
Portland, OR 97239-3098
Department Phone: 503-494-5271
Office Phone: 503-346-1152
Fax: 503-494-4457
Email: crumpt at ohsu.edu
 
Tues, Thurs, Fri, 8-4:30
 

 
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From: MCOH-EH [mailto:mcoh-eh-bounces+crumpt=ohsu.edu at mylist.net] On 
Behalf Of Tara Dockery
Sent: Monday, November 13, 2017 8:24 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
 
My facility, through encouragement by our epidemiologist, has freed this 
response from Employee Health and more  turned it into an Emergency Room 
protocol, they follow the reccommendations and guidelines, whether its an 
employee or the public that has been exposed. Follow up and information 
would be coordinated through them.
 
 
 
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 Timothy 
Herrick
Sent: Monday, November 13, 2017 8:16 AM
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
 
A question for Kathy Dayvault;   for your pep for travelers;  how does 
this work?  Are you giving meds for travelers to take with them on their 
trips abroad?  Or does traveler mean something different in this context?
Tim Herrick
 
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Fair, Susan
Sent: Monday, November 13, 2017 6:20 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
 
Our in-house pharmacy makes us a packet for three days, however, when I 
then prescribed only #14 with one refill (if they are tolerating it), the 
chain pharmacies have all refused to fill rx unless it is for quantity 34.
 
Susan Fair, MPAS, PA-C
Yale New Haven Health
Occupational Medicine 
New Haven, CT
From: MCOH-EH [mailto:mcoh-eh-bounces+susan.fair=ynhh.org at mylist.net] On 
Behalf Of Grubbs, Scott
Sent: Friday, November 10, 2017 6:07 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures
 
Re Kathy Dayvault’s comments:
I am curious which meds you are using for HIV PEP.  We have been told that 
a three day supply of Truvada was not available, since once the 30 day 
bottle was opened the pills had to be used fairly quickly.    So, we have 
been writing for 30 day supplies even if just for a few days.  Have your 
local pharmacies figured a way around that?
Thanks!
Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC
 
From: MCOH-EH [mailto:mcoh-eh-bounces+scott_grubbs=bshsi.org at mylist.net] 
On Behalf Of Kathy.Dayvault at dekalbmedical.org
Sent: Thursday, October 12, 2017 10:45 AM
To: MCOH/EH
Cc: MCOH-EH
Subject: #ExtMail# Re: [MCOH-EH] BBP exposures
 
We provide initial care for BBF exposures for students and travelers - 
meaning we draw initial blood and would give three days of meds if 
indicated by a positive HIV source. 

Follow up care, including continued blood draws and medications is under 
the direction of their WC or school liability insurance. 

The involved person is directed to their WC provider/school for further 
direction. 

For students, this is outlined in our contract with their school/college. 

Thanks, 

Kathy Dayvault, RN, BSN, MPH 
 Manager, Occupational Health and Safety 
 WorksWell Onsite 
 Dekalb Medical  2701 North Decatur Road 
 Decatur, GA 30033 
ph: 404.501.4972 Fax:404-501-2045 
kathy.dayvault at dekalbmedical.org 




From:        "Morelli, Karen J" <kmorelli at emhs.org> 
To:        "'mcoh-eh at mylist.net'" <mcoh-eh at mylist.net>, 
Date:        10/12/2017 09:18 AM 
Subject:        [MCOH-EH] BBP exposures 
Sent by:        "MCOH-EH" <mcoh-eh-bounces at mylist.net> 




I am wondering how other clinics bill for blood borne pathogen exposures. 
Our company caters to member organization hospitals/practices as well as 
many outside our system clients.  Historically, we have billed the member 
organization for our services.  We would like to move to billing worker’s 
comp.  Getting the worker’s comp information on our members organizations 
is not an issue, however, we see many locums, travelers, etc. that would 
be covered by other worker’s comp carriers.  How do you go about gathering 
this information?  Do your facilities charge worker’s comp for BBP 
exposures? 
  
Thank you for any guidance you may offer! 
Karen 
  
Karen Morelli RN, BSN, Clinical Manager 
WorkHealth LLC 
973-7382 
kmorelli at emhs.org 

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