The prevalence of bloodborne pathogen exposure events in healthcare remains a huge concern as emphasized by the annual reports of sharps related injuries in health care from the Center for Disease Control and Prevention. The topic is reviewed in our trainings, officer webinars and inserted in the TMC OSHA manuals. An effective Exposure Control Plan begins with prevention before an bloodborne pathogen exposure event takes place; however, accidents do happen, so let’s take another opportunity to review.
Once a worker has an exposure to blood or other potentially infectious materials, the steps taken in the next few hours and days (and sometimes months) are crucial for employee health. Ensure that you have completed the Post Exposure Protocol in the Exposure Control Plan section of your TMC OSHA manual. An electronic version of the plan is available on the TMC website in the Client Portal. Log in and select the OSHA Exposure Tool Box. This plan will identify the healthcare facility where the source patient will be sent for blood tests and which physician or practice will care for the exposed worker.
When an Exposure Occurs
- Employee washes skin with soap and water or flushes mucous membranes with water.
- Report immediately to the Safety Officer or person appointed to manage exposure incidents.
- Test for infection.
If you have identified the source patient but their infection status is not known, the patient must sign a consent for testing if required by state law (form ECP 107), and be sent immediately to be tested for HBsAg, HCV Ab and HIV Ab. A Rapid HIV test is recommended if available.
If you do not know who the source patient is, assume the worker may have been exposed to HBV, HBC and HIV. Communicate this information to the healthcare provider caring for the exposed worker.
- Offer the exposed worker a confidential medical evaluation and counseling immediately.
The worker should sign OSHA form ECP 108 to consent or decline baseline testing and treatment. The healthcare provider treating the exposed worker will determine if baseline testing is needed based on guidance by the CDC. If a source patient is tested and results are negative for infection, no further testing of employee is indicated.
Documentation and Follow Up
The following information must be given to the treating provider at the time an exposed worker is sent for care. This is required by the bloodborne pathogen standard:
Name of healthcare professional providing source patient testing
Employee HepB vaccinations and titers and any medical records relevant to the treatment of the employee
Employee’s job duties that relate to the exposure incident
Documentation of the exposure incident (may use form ECP 105)
Copy of the OSHA 1910.1030 Bloodborne Pathogen Standard
The following documents are located in the Exposure Tool Box in the Client Portal and may also be helpful to have on hand.
A copy of the CDC article-Public Health Service Guidelines: HBV, HCV & HIV Exposure
A copy of the Physician Written Opinion form ECP 108
The physician caring for the exposed worker should send a written letter of opinion back to the employer within 15 days following the initial treatment. Workers should receive a copy of the letter and a copy is to be kept in the employee’s confidential medical file. Remember employee medical records are to be kept for the duration of employment plus 30 years.
Follow up testing of the exposed worker should occur following the treating provider’s medical evaluation and recommendation.
TMC is here to work with you to create a safer workplace and reduce the number of exposures in healthcare; and if the need arises, we can help you manage the post exposure process. Are you ready now?
[N1]TJ: The sedation is like a side note and needs to be in a box or something around this part of the article. you can make it look cool however you want