[MCOH-EH] Revisiting Policies regarding Immune-Suppressed Employees and Duty Exemptions

[Kathy.Dayvault at dekalbmedical.org]

Our process:

Wearing PPE protects the employee from exposures. We do not exempt 
employees unless there is a reason they can't be fit tested.

We only exempt for a medical or religious reason from fit testing and do 
not use any type of PAPRs at our hospital except disaster and then it is 
our Decon team only.

We do not use PAPRs at our hospital at all for any other reasons.

A medical reason would be due to the inability to fit test someone such as 
facial deformity, severe folliculitis resulting in an employees inability 
to shave.

When we have an employee that we are unsuccessful in fitting, the employee 
is sent to an occupational med clinic for eval which includes 
claustrophobia.

For the folliculitis, we will accept a letter from a physician. The 
employee is then exempted via Employee Relations of HR.

Out of 6000 employees and contractors (across three campus locations), we 
have only about 7 that are exempted.

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:   "Jordana L. Mcdonald" <Jordana.Mcdonald at salemhealth.org>
To:     "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>, 
Date:   03/06/2018 12:17 PM
Subject:        [MCOH-EH] Revisiting Policies regarding Immune-Suppressed 
Employees and Duty Exemptions
Sent by:        "MCOH-EH" 
<mcoh-eh-bounces+kathy.dayvault=dekalbmedical.org at mylist.net>



Hello Everyone:
 
This was a topic a couple of weeks ago and did not get much response.  I 
wish to revisit it because I now have an employee with RA on Xeljanz 
requesting that she be exempted from N95 mask fit testing because she does 
not believe that she should be caring for patients with TB.  My facility 
does not appear to have any policies around this and in checking it with 
Infection Prevention they are concerned that creating such exemptions 
would create further issues with staffing isolation rooms.  Additionally, 
we have no idea how many other employees are on similar medications or 
chemotherapy, though with the aging workforce, I would guess we would 
expect the incidence of such cases to increase over time.  Should they be 
exempted only from TB, should they be exempted from all isolation cases? 
Does this become another issue like claustrophobia which requires that the 
various units determine if ability to care for isolation patients is a 
core job function (so far we are working on the ability to wear an N95 or 
CAPR related to the claustrophobia).
 
I would appreciate any input.
 
Thank you all for this lively group.  Jordana
 
Jordana McDonald FNP-c
Salem Health Employee Health/Occupational Medicine
Salem Health Medical Group
 
SALEM HEALTH
Hospitals & Clinics
1002 Bellevue Street SE
Salem, OR 97301
Jordana.mcdonald at salemhealth.org
503-814-7250
Fax: 503-814-7253
 
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