[MCOH-EH] hospital contractors and tier/vaccination requirements
Cindy M. Hansen
Chansen at mhg.com
Tue Dec 12 14:40:44 PST 2017
We are trying to come up with a rational approach to screening contractors who come into the hospital ? plumbers, electricians, other trades. Most of them will only be working the hospital for relatively short periods of time.
Please see my comments behind each posed recommendation:
1: Hepatitis B surface antibody titer and offer the first vaccination if not immune:
Why vaccinate for Hep B and incur this expense? Obviously the vaccination protects them from BBP exposure and the contractors you listed would not be providing patient care? This should be their decision on their own dime.
And in response to doing Hep b antigen testing just in case they are injured - With standard precautions every patient should be treated like they are infected - gloves and other PPE depending upon the injury or treatment being sought. I do not see any merit in Hep B antigen testing.
2: Respirator fit test
I have fit tested contractor 'just in time' that had to go into an active isolation room for repairs. Actually made the bearded fellow shave in order to fit test him. But I do not typically provide this for contractors because they don't typically enter an infectious airborne isolation room.
3: Measles, mumps and rubella: Titers indicating immunity or proof of two MMR vaccinations
I do not require MMR proof for contractors not providing patient care.
4: Tuberculosis: Negative T-spot, or negative Two-step PPD (TST)
I could see requiring the contract company to provide proof of TB test negativity but what if they had INH d/t prior infection how does this help you - negative questionnaire screening???
5: Varicella: Titer indicating immunity or proof of two varicella vaccinations
Don't require : Same as MMR - not providing patient direct care.
6: 10-panel drug screen
Contract company has to provide prior drug screen results upon request.
Overall, the panel seems defensible. I am curious if your institution has a similar approach?
(The one question I have at the moment is the need for the Hepatitis B surface antibody testing/vaccination. Contractors should not be having direct patient contact, so the chance of transmitting/contracting Hepatitis B seems remote. However, I wonder if Hepatitis B surface antigen would make more sense, because if they get injured, they might bleed and be a source of transmission of Hepatitis B. )
Any thoughts would be welcome.
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Today's Topics:
1. Re: [External] Re: Employee requests for their own
records-yes! (Davis, Sue)
2. Laboratory screening and vaccinations appropriate for
hospital contractors (not HCP) (Grubbs, Scott)
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Message: 1
Date: Tue, 12 Dec 2017 20:04:05 +0000
From: "Davis, Sue" <Sue.Davis at nmhs.org>
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] [External] Re: Employee requests for their own
records-yes!
Message-ID:
<96F55B37A56B6447A385113061720B270151A8C69E at W2K8MBX003.nmhs.org>
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We have to use the same one they use on the patients.
Thank you,
Sue Davis MS, BSN, RN, CVRN ? BC, NE-BC, CCRN-K Service Leader, Learning Center & Employee Health Methodist Health System
8601 West Dodge Road, Suite 18, Omaha, NE 68114
Phone: (402) 354-5694
Learning Center Fax: (402) 354-5466
Employee Health Fax: (402) 354-8819
sue.davis at nmhs.org<mailto:sue.davis at nmhs.org>
Making life easier, one day at a time ?
From: MCOH-EH [mailto:mcoh-eh-bounces+sue.davis=nmhs.org at mylist.net] On Behalf Of Amy Olson
Sent: Monday, December 11, 2017 1:24 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [External] Re: Employee requests for their own records-yes!
Would anyone be willing to share an example of the release they are using?
Amy Olson, BSN, MS, COHN-S
Director, Employee Health and Wellness
Johns Hopkins All Children's Hospital
500 Seventh Avenue South, Suite 103
St. Petersburg, FL 33701
P 727-767-8211 | F 727-767-8399
aolson9 at jhmi.edu<mailto:aolson9 at jhmi.edu>
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Sent: Thursday, December 07, 2017 8:14 PM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] [External] Re: Employee requests for their own records-yes!
Yes!
Diane M. Shaw, BSN, RN, COHN-S
Employee Health Nurse/Employee Health Services Tuality Healthcare OHSU Partner
335 S.E. 8th Ave.
Hillsboro, OR 97123
diane.shaw at tuality.org<mailto:diane.shaw at tuality.org>
Tel: 503-681-1444 | fax: 503-681-4170
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Sent: Tuesday, November 21, 2017 10:24 AM
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Subject: Re: [MCOH-EH] [External] Re: Employee requests for their own records
Absolutely
Deborah A. Sampson, PhD, APRN, COHN-S, FAANP Employee Health provider/ Worker?s Compensation Case Manager Employee Health and Wellness Services
Southern New Hampshire Health P.O.Box 2014 8 Prospect Street Nashua, NH 03060
p(603) 281-8575 f (603) 577-5665
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Sent: Tuesday, November 21, 2017 12:48 PM
To: MCOH/EH
Subject: [External] Re: [MCOH-EH] Employee requests for their own records
CAUTION: This email originated from outside SNHH. Please ** THINK BEFORE YOU CLICK ** on any links or attachments included with this email.
Yes we do
Susan Higgins RN, BSN, COHN
Sturdy Memorial Occupational Health Manager P 508-236-7505 F 508-222-0796
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Angeli Mancuso
Sent: Tuesday, November 21, 2017 12:21 PM
To: MCOH/EH
Subject: [MCOH-EH] Employee requests for their own records
If an employee requests a copy of their own employee health records?like TB screening and flu vaccination?does your organization require an Authorization of Release of Information to be on file? This would be the process for requesting records from our medical records department and our compliance folks are thinking we in Employee Health should have the same requirements.
What do you all do?
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 a1mancus at sbch.org<mailto:a1mancus at sbch.org> | cottagehealth.org<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.cottagehealth.org_&d=DwMGaQ&c=kxdwc7HB3AJZ-oqYwvvR_w&r=ZWIacbfpzd_Lky_E1VB9dV9MNUM6AL2UUAw2IHT0RsM&m=PBcvZYcwYHnfsRG167ziRNjfCK60uuwnT4ycyDeYs-4&s=CBz4TU_v8kkc1vGFvNrNB7hMjHjHhYvbRctc1xeTejw&e=>
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Message: 2
Date: Tue, 12 Dec 2017 22:26:28 +0000
From: "Grubbs, Scott" <Scott_Grubbs at bshsi.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Laboratory screening and vaccinations appropriate
for hospital contractors (not HCP)
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We are considering the following:
1: Hepatitis B surface antibody titer and offer the first vaccination if not immune
2: Respirator fit test
3: Measles, mumps and rubella: Titers indicating immunity or proof of two MMR vaccinations
4: Tuberculosis: Negative T-spot, or negative Two-step PPD (TST)
5: Varicella: Titer indicating immunity or proof of two varicella vaccinations
6: 10-panel drug screen
Overall, the panel seems defensible. I am curious if your institution has a similar approach?
(The one question I have at the moment is the need for the Hepatitis B surface antibody testing/vaccination. Contractors should not be having direct patient contact, so the chance of transmitting/contracting Hepatitis B seems remote. However, I wonder if Hepatitis B surface antigen would make more sense, because if they get injured, they might bleed and be a source of transmission of Hepatitis B. )
Any thoughts would be welcome.
Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC
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