Blood-borne Pathogens Program
TITLE: HEALTHCARE WORKER OR LAB WORKER OCCUPATIONAL BLOODBORNE EXPOSURE POLICY
PURPOSE:
For all healthcare workers and laboratory workers to have available guidelines for confidential medical evaluation following an occupational exposure. Occupational exposure is skin, eye, mucous membrane, or parenteral contact with blood/body fluid that results from the performance of a worker's duties. In accordance with OSHA and Louisiana Workers Compensation requirements, all occupational exposures will be investigated and followed promptly and accurately. These guidelines are applicable to all students and employees of Tulane University.
PROCEDURE:
Upon exposure, the injured healthcare worker or lab worker (HCW) must scrub the wound for 5 minutes with betadine, hibiclens or soap. The injured HCW must notify his/her supervisor and complete immediately an injury report for the institution where the exposure occurred.
The HCW should proceed immediately for medical evaluation (within less than 2 hours) to the Occupational Medicine Clinic at Tulane Hospital (Monday - Friday, 7:30 a.m. - 4:30 p.m.), or to the Tulane Hospital Emergency Room or the site of care listed below outside of those hours, and follow up in Occupational Medicine on the next working day. He/she should bring a copy of the injury report from the institution where the injury occurred. In general it is preferred that the exposed person be seen in the Occupational Medicine Clinic at Tulane Hospital or the Tulane Hospital Emergency Room rather than an outside institution, except in the unusual circumstance where immediate trauma care is required.
Site of exposure ER
Tulane Hospital Tulane Hospital
Medical Center of Louisiana (UH, CHNO) Tulane Hospital
Veteran's Administration Hospital of NO Tulane Hospital
School of Public Health and Tropical Medicine Tulane Hospital
Primate Center Lakeview Hospital
Uptown Campus Tulane Hospital
Depaul's Tulane Hospital
Touro Tulane Hospital
Ocshner Tulane Hospital
Homeless Shelter or non-clinical site Tulane Hospital
Out Of Town Out Of Town Site
Contact the Occupational Medicine Clinic (586-3986), the Tulane Emergency Room, or the Tulane Infectious Diseases Consultant on-call for any questions.
The exposed HCW should receive baseline lab work if warranted, after written consent has been obtained. The HCW will receive a medical evaluation by a physician at no cost to the HCW to evaluate the need for additional testing.
The Occupational Medicine Clinic will retrieve all injury report forms from the Emergency Room or Occupational Medicine Clinic records pertaining to the incident and send copies to Bloodborne Pathogens Coordinator.
The HCW will be notified by Occupational Medicine in writing of follow-up lab results after initial testing and at 6 weeks, 3 months, 6 months, and one year post-exposure.
Source patient blood work should be collected according to the protocols outlined in either "HIV Testing Without Consent of the Patient" or "HIV Testing Informed Consent Protocol."
The source patient's physician should be notified that blood work is being requested.
The health care provider at the Occupational Medicine Clinic is responsible for obtaining the results of the source patient's blood testing from the source institution.
The HCW should receive counseling with regard to the occupational injury, risk of bloodborne infections, and available medical treatments. Counseling information is located in the Exposure Packet with names and telephone numbers of the Bloodborne Pathogens Coordinator and the Occupational Medicine Clinic.
If the source patient is known to be HIV+, follow the Anti-retroviral therapy Post-Exposure Prophylaxis Protocol as soon as possible.
The HCW will be medically assessed for tetanus and hepatitis vaccination.
* Tetanus is warranted if the HCW has not been immunized OR if ten or more years have passed since immunization.
* Healthcare worker is exposed o a patient known to have Hepatitis-C (non-A and non-B).
* Accelerated Hepatitis-B vaccination series is warranted if the source patient's HBsAg status is either unknown or positive and if the HCW has not been previously vaccinated and remains HBsAg negative.
Documentation of route(s) of exposure and circumstances under which the exposure occurred must be noted on the "Blood & Body Fluid Exposure Report" form in the Exposure Packet.
Management of the occupational exposure must follow the approved established guidelines outlines in the "Algorithm for Treatment of Needlestick or Permucosal Exposures to Infectious Materials."
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