At AOHC 2017 in Denver there was a long session on this with several excellent speakers. And several of the UC OH Medical directors attended, me among them, and so with 5 of the UCs having medical centers we too are all interested in doing the right thing.  Mark Russi, MD Medical Director of Occupational Health at Yale Hospitals presented a fantastic segment of the Denver sessions on this and among other things reviewed the published data on what you find if you do lab tests (CBC, U/A, BUN/creat, AST/ALT) on 1000 healthy non exposed individuals, and you will have over 900 abnormal results to chase down.  So consensus among the medical directors all trained in USPSTF and first do not harm is that doing physicals and labs as part of this surveillance will generate so much chasing of incidental personal health findings like the lab tests just noted at significant time, expense and hazard to these individual with no evidence based medicine evidence of benefit, that we at UC are going on the minimalist end of this “surveillance” spectrum; education, review of use of PPE and exposure history and potentially more if exposure occurs depending on the exposure.  Warner

 

 

 

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

 

 

 

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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!

 

 

 

 

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.

 

 

 

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

 

 

 

 

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.

 

 

 

 

 

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

cesenior@phhealthcare.org

www.phhealthcare.org

 

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