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@dekalbmedical.org




From:        "Jordana L. Mcdonald" <Jordana.Mcdonald@salemhealth.org>
To:        "mcoh-eh@mylist.net" <mcoh-eh@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@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@salemhealth.org
503-814-7250
Fax: 503-814-7253
 


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