While the person does need to complete the series for long term immunity assurance, for the exposure of the moment, it would seem reasonable to think that they have the right antibodies to deal with it.  However, I am not an ID doc, so that is just my opinion.

Scott Grubbs, MD

WorkWell Occupational Health

Greenville, SC

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@ohsu.edu

Tues, Thurs, Fri, 8-4:30

The information contained in this EMAIL message is confidential and protected by law. The information is intended only for the person or business identified in the document. If you are not the intended recipient, by sharing or copying the information you are breaking the law. If you have received this EMAIL by mistake, please notify the sender of this EMAIL and do not return, copy or keep the information in the EMAIL.

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@oceanbeachhospital.com

Office Phone  360 – 642 - 6307

Cell Phone 509-760-7397

Fax  360-642-6309

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

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

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@mylist.net]On Behalf Of Kathy.Dayvault@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@dekalbmedical.org




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

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