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Management of occupational exposureCALVARY PUBLIC HOSPITAL BRUCE

Function: Infection control21ca3266-8f59-43ac-9490-41410f1e1e13

Management of occupational exposures to blood and body fluids 1 Applies to

This policy applies to Calvary Public Hospital Bruce (CPHB): Employees, contractors, volunteers, visitors and students. Patients exposed to blood and body fluids from a Health Care Worker (HCW).

2 Purpose

An Occupational Exposure Incident (OEI) is an incident that occurs during the course of a Health Care Workers (HCW’s) employment and involves contact with blood and other body fluids. Such exposures may put the HCW at risk of acquiring a Blood Borne Virus (BBV).

Consistent with our values of hospitality, healing, stewardship and respect, CBPH is committed to managing all occupational exposures in line with current best practice recommendations; to providing support for staff during the potentially stressful situation; and to take steps to minimise future exposures where possible.

3 Responsibilities

Responsible group – Ward/Department managers1. Ensure the policy is communicated to their staff2. Monitor compliance to procedure in their area3. Provide staff with opportunities to attend education and training 4. Ensure resources available adhere to the procedure5. Investigate any incidents of non-compliance to the procedure in Riskman2.

Responsible group 2 - Nursing, Medical, Allied health staff1. Comply with the procedure2. Notify noncompliance to the procedure to the manager and in Riskman2.

4 Procedure

OEI’s are to be managed by trained staff only, never by the exposed person him/herself. CPHB staff trained in OEI risk assessment includes Infection Control and Staff Health (IC&SH) Department Registered Nurses, as well as the Emergency Department Medical Officers (MO) and Advanced Practice Nurses (APN).

The attending RN, APN or ED MO is responsible for: Appropriately documenting all information obtained during the risk assessment; and Working through the contents of the OEI Pack with the exposed HCW

Approved by: Approved Date: 22/08/2019

UNCONTROLLED WHEN PRINTED Review Date: 31/08/2022

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PROCEDUREVersion 7.0

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Ensuring that the source person paperwork (yellow sheets) are given to the medical team caring for the source patient, and that the team is aware it needs to be completed as soon as possible.

Knowledge regarding the treatment of exposure to Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) is evolving rapidly, therefore in addition to following the guidelines included in this Policy, the advice of an appropriate medical specialist should always be sought prior to the commencement of Post Exposure Prophylaxis (PEP). The Infectious Diseases Consultant on-call is available through Calvary switchboard, on (02) 6201 6111.

A. FIRST AID

Attend to immediate first aid to decrease contact time with pathogen.

Percutaneous(needlestick or other sharp)

Allow active bleeding, clean with soap and water only. Avoid irritants such as disinfectants and alcohol based hand cleaning products. Cover with a water proof dressing. Further management of wound depending on injury ie: suturing.

Mucous membrane (mouth/nose/eye)

Spit out or blow nose. Rinse gently and liberally with water. Do not swallow.Eye splash rinse eye liberally. Do no use an eye irrigator (ie Morgan Lens) as the tube can damage the mucosa.

Intact skin Clean with soap and water and rinse well.

Non-intact skin Clean gently and thoroughly with water or saline and cover with a waterproof dressing. Where soap and water is not available, use of alcohol based hand rub is an acceptable alternative for washing cuts or punctures of the skin.

Contaminated clothing Remove clothing and shower if necessary

B. INITIAL REPORTING AND REFERAL

1. After attending to immediate first aid the exposed individual is to report the incident immediately to their supervisor, and Infection Control staff or the After Hour’s Coordinator (AHC).

2. The notified supervisor is to ensure first aid has been attended and the exposed is relieved from duty to attend the Emergency Department for assessment as soon as possible. Theatre staff may be assessed by infection control during business hours for low risk exposures only.

C. RISK ASSESSMENT

Risk assessment of an OEI should begin as soon as possible after the exposure, to ensure timely administration of PEP if indicated. The attending RN, APN or ED MO is responsible to:





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1. Determine if a significant exposure has occurred and identifying the risk of transmission of BBV’s to the exposed by working through the contents of the OEI Risk Assessment Pack and the OEI Risk Assessment Guideline.

Table 2 - Contents of OEI Risk Assessment Pack.

ContentsBlue Forms- Exposed HCW Forms Yellow Forms- Source Person FormsE1 OEI Information Sheet- Exposed S1 OEI Information sheet- sourceE2 OEI Risk Assessment Form- Exposed S2 OEI Risk Assessment Form- sourceE3 ACT Pathology OEI test request Form S3 ACT Pathology OEI test request FormE4 Hepatitis B Virus (HBV) Information sheetE5 Hepatitis B Immunoglobulin Information

sheet

2. If a risk of BBV transmission is identified when working through the OEI pack, then the need for any post exposure prophylaxis must be decided and implemented, taking into account:

The significance of the mechanism of injury. The BBV status of the exposed. The BBV status of the source. The viral load of the source blood. Complicating factors such as immune compromised persons or pregnancy.

3. Baseline testing and risk factors for BBV of source person - Assessment of the source patient risk factors and BBV baseline status are helpful in determining the risk of transmission of BBVs.

Post Exposure Prophylaxis (PEP) should not be delayed while waiting for source pathology results.

The clinician caring for the exposed is responsible for: Contacting the source patient medical team, requesting BBV testing of the source patient and ensuring

the source person Forms (Yellow Forms) are forwarded to the source patient team. The Infection Control or the after hour’s coordinator may facilitate this process, however the clinician must discuss this option to ensure it will occur. Simply delivering paperwork to the AHHM office is not acceptable.

The medical team for the source patient is responsible for:





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Location of OEI Risk Assessment Pack and Guideline.

The OEI Packs are located in the emergency department triage and theatre recovery stations. Additional packs are located in the Infection Control Department, and available via the IC&SH webpage. Each Pack contains a full set of blue forms for the exposed HCW, a set of Yellow Forms for the source person and a OEI Risk Assessment Guideline. See table 2.

Notify the Infectious Diseases Physician on call at Calvary Hospital immediately if an exposure occurs from a HIV positive or high risk source patient.

http://connect.calvarycare.org.au/Services/PublicHospitals/Bruce/Departments/Pages/Infection-Control-and-Staff-Health.aspx



Working through the Source Patient Forms (Yellow Forms) and reporting results back to the clinical team for the exposed as quickly as possible. This includes attending to:

o Assessment of any risk factors of the source patient; o BBV testing, including obtaining valid consent; o Identifying who the patient decides may be informed of the test results.

Note: the yellow forms include the correct pathology request form. Using the correct form will ensure urgent testing and reporting.

If the source patient is not available (for example they have already been discharged), or declines testing, the relative risk of the source being positive for BBV must be inferred.

Consent for BBV serological testing SHALL NOT be obtained from the source person by the exposed person.

4. Exposed BBV testing- Baseline BBV testing of the exposed patient is to determine their current BBV status at the time of exposure and to determine any risk factors they may have. The HCW assessing the exposed person must work through the Blue Forms (Exposed Forms) which

contain information sheets for the exposed, written consent and the correct pathology form. Using the correct form will ensure urgent testing and reporting.

The exposed is to be advised about where and when they will be informed of the pathology results and by whom.

D. TREATMENT OF THE EXPOSED FOLLOWING A SIGNIFICANT EXPOSURE

1. If HIV PEP is indicated from the risk assessment, it must only be given in consultation with an Infectious Diseases Consultant who can be contacted 24 hours a day 7 days a week through the Calvary switchboard (02) 6201 6111.

2. HIV PEP stater packs are to be available in the ED in order for PEP to be started ideally within 2 hours of injury and no later than 72 hrs.

E. OTHER PROPHYLAXIS

1. Assess the Hepatitis B virus (HBV) immunity of the exposed person. The Infection Control Department are able to assist with accessing staff health records during business hours.

2. If the exposed person is not vaccinated, immunity is unknown or they are a non-responder, give vaccinations and/or Immunoglobulin (Ig) in accordance to the current Australian Immunisation Handbook. Hepatitis B immunoglobulin (HBIG) should preferably be given within 24hrs (up to 72 hours) and therefore; if indicated, should not be delayed while waiting for serology results.

3. Pertussis containing Tetanus vaccination should be considered for HCW who require tetanus vaccination for wounds that may be contaminated with dirt or dust in accordance with the Australian Immunisation Handbook.

4. Antibiotics should be considered for injuries that may contain bacteria such as a human bite.





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F. CRISIS COUNSELLING

Crisis counselling is not the same as the pre-test discussion. This is what exposed individuals need before they go home and continue with their lives.

1. Determine if crisis counselling is required by assessing anxiety and coping strategies. Crisis counselling may be conducted by trained HCW’s before discharge or a referral to another agency or mental health professional may be provided and should take into consideration partners and/or significant others.

2. If a significant exposure has occurred the exposed person could be infected and must be given information about how to prevent transmission to others.

G. DOCUMENTATION AND NOTIFICATION

Occupational exposures to employees/contractors/visitors/students and volunteers:

1. The HCW assessing the exposed person is to complete all documentation contained in the OEI Risk Assessment Pack as per instructions above and contact Infection Control (during business hours) or the after hour’s coordinator (outside of business hours) for collection of the exposure pack. Additionally, after hours an email should be sent to Infection Control advising an exposure has occurred, and indicating where the pack has been sent, to ensure the pack is followed up as soon as practicable.

2. The HCW assessing the exposed, as well as the Staff Health Nurse, are to ensure that the staff member is aware to complete a Riskman2 incident report.

Occupational exposures to non-CPHB employees:

3. Documentation for non-CPHB employees is to follow standard procedures for the Emergency Department as for any other presentation. Pre-printed Infection Control pathology forms are not to be used for non-CPHB employees.

H. FOLLOW-UP OF OCCUPATIONAL EXPOSURES

The Infection Control or Staff Health Nurse is to:

Check baseline serology (during business hours) of source and exposed staff members, determine the need for follow-up treatment or testing and provide feedback as outlined below.

Negative BBV test results: Provide feedback and counselling to the exposed staff member (only provide source results if consent to

do so has been given). This may be completed over the telephone and should be followed up with a written letter advising of results. Consent to send written information regarding BBV testing should be obtained from the exposed during follow-up discussion.

If requested by the source patient, advise the source patient medical team (if inpatient) or the patient directly (if outpatient) of results.

Positive BBV results or non-immunity





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Liaise with the on-call Infectious Diseases Physician (available through Calvary switch) for any positive BBV results from the exposed or source patient, or if the exposed shows non-immunity to HBV and has not received immunoglobulin or vaccination for Hepatitis B.

Liaise with the Sexual Health Clinic at Canberra Hospital for referral if required. Complete mandatory reporting if required.

The recommended schedule of follow-up testing after an OEI is outlined in Table 5 below (also available at Attachment 1). The ACT Health Sexual Health Clinic schedule is also available at Attachment 2, for further reference. Follow up will be managed by the Staff Health nurse, in consultation with the exposed person, and either infectious diseases physician or the Sexual Health Clinic if required.

Table 3: Recommended Schedule of Follow-Up Testing After an OEI.

HCW status Tests (see Note for Tests below) Immunisation

6 weeks * 3 months 6 months

HCW immune to HBV HIV HIVHCV

HCV Nil required.

HCW non-immune to HBV

HIV HBV + LFTsHIVHCV

HBV + LFTsHCV

HBV vaccine at4 weeks (dose 2) and

6 months (dose 3).* 6 week follow-up is optional if the source is HIV, HBV and HCV negative and no disclosed window period risks. Follow-up at 3 months is recommended.Note: HIV: HIV Ag/Ab; HBV: HBV sAg,sAb, cAb; HCV: HCV Ab

Additional follow-up:If HIV PEP has been commenced: add HIV PEP review at 5-10 days including repeat full blood count, renal & liver function tests.If exposure to HCV positive source: add HCV PCR and LFTs at 6 weeks and 3 months.If a HCW is HCV Ab positive, PCR negative at baseline: add HCV PCR and LFTs at 6 weeks and 3 months. HCV Ab testing is not required.

An exposed HCW may not consent to follow-up management by Staff Health. It is then the responsibility of the Staff Health Nurse to clarify follow-up arrangements with the exposed HCW, for example, his or her GP or Canberra Sexual Health Centre.

CPHB will not cover the costs of follow-up testing for agencies/locums or contractors. This will need to be determined between the HCW and agency/locum or contractor.

The After Hours Coordinator (AHC) (afterhours only) is to:

1. Check the baseline BBV serology 6 hours after testing for: Exposed person - Hepatitis B immunity (HBAb titre >10) and Source person - HCV, HIV or HBV status.

2. Based on the serology results the AHC is to take the following actions:





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Source results negative - Provide feedback of negative results to the exposed over the phone. Source results positive - Arrange for the exposed person to be consulted by the ED consultant medical

officer on duty as PEP may be required. Positive results are not to be provided over the phone. Exposed not immune to HBV and source patient negative for HBV - Advise the staff member of immune

status and that IC and SH will contact the staff member for any follow-up required. Exposed not immune to HBV and source positive for HBV - Arrange for the exposed person to be

consulted by the emergency medical team leader on duty, as PEP may be required. Positive results are not to be provided over the phone.

Exposed immune to HBV - Advise of immunity to Hep B when providing feedback.

3. Deliver the OEI Risk Assessment Pack to the Infection Control Manager the next business day and alert Infection control via email of the incident using infection [email protected]

The Emergency Department Medical Team Leader on duty is to:a. Arrange for PEP if indicated, within the required timeframe for effectiveness and in consultation

with the ID department, available via Calvary switchboard (02) 6201 6111.

b. Arrange for follow up with the Canberra Sexual Health Clinic to manage follow-up and continuous care of the exposed staff member.

c. Arrange for the patient to receive notification of the results from the medical team looking after the patient.

I. HEALTH CARE WORKER TO PATIENT EXPOSURE MANAGEMENT

1. Testing of HCW’s following consent and pre-test discussion for BBV’s should be attended if equipment contaminated with HCW’s blood was subsequently used on a patient or a patient was exposed directly to a HCW’s blood or a patient was both a source and a recipient of a HCW’s blood or body fluid.

2. Consent should be obtained from the staff member to make results and lifestyle practices known to the exposed patient (maintaining staff confidentiality).

3. The treating medical team of an exposed patient facilitated by the Infection Control Department shall inform the exposed patient of the incident in person (preferable) or by phone as soon as possible and arrange for assessment and appropriate action to be taken if indicated.

a. Follow-up BBV testing of the source HCW should continue at 3 and 6 months to ensure they were not in a window period at the time of the incident.

b. A Riskman2 report is to be completed by Infection Control.

J. INCIDENT REVIEW

1. The Calvary Riskman2 incident reporting form is to be appropriately completed and submitted by the exposed HCW. Incidents to patients and visitors, contractors and students who may not have access to Riskman2 are to be assisted by either Infection Control or the department manager where the incident occurred.





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mailto:infection%[email protected]



2. OEI’s should be reviewed by the Staff Health Nurse initially including an analysis of causative factors and any actions taken and report findings to the Work, Health and Safety committee and the Infection Control and Staff Health Management Committee for further review and discussion.

3. Further review of the OEI’s are to be conducted by Patient Safety and Quality staff in accordance with Risk Minimisation Policy.

K. FURTHER INFORMATION

Occupational Exposure Incident Risk Assessment Pack and Guidelines

1. Infection Control & Staff Health (IC & SH) are to provide sufficient quantities of OEI Packs and Guidelines within triage in the emergency department and theatre recovery. Staff in these areas are responsible for alerting IC & SH if supplies are low.

2. The OEI Pack is to be placed in a large envelope with a coversheet determining who the toolkit is to be used for and market confidential.

5 Related Calvary Documents

OEI Guide & Risk Assessment Pack- OEI Packs are located in the emergency department triage and theatre recovery stations. Additional packs are located in the Infection Control Department. Each Pack contains a full set of blue forms for the exposed HCW, a set of Yellow Forms for the source person and an OEI Risk Assessment Guideline.

6 Definitions

Blood Borne Virus - Means HIV, HBV and HCV

Exposure - Means contact between blood and other body fluids with the eyes, skin or mucous membranes of the exposed HCW.

Exposed HCW - Means the HCW exposed to blood or any other body fluid.

Post Exposure Prophylaxis - Means medication administered after an OEI that may reduce the risk of acquiring an infection.

Source - Means the blood or other body fluids to which the HCW is exposed.

Source person - Means the person whose blood or body fluids are involved in the exposure.

Risk assessment - Means the overall process of estimating the magnitude of risk following an OEI in order to determine appropriate management.

ABBREVIATIONS





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BBV - Blood borne VirusHBAb - Hepatitis B AntibodiesHBeAg - Hepatitis B e antigenHBV - Hepatitis B VirusHIV - Human Immunodeficiency VirusOEI - Occupational Exposure IncidentRiskman2 - Risk Management System

HBIG - Hepatitis B ImmunoglobulinHBsAg - Hepatitis B AntigensHCV - Hepatitis C VirusHCW - Health Care WorkerID - Infectious DiseasePEP - Post exposure Prophylaxis

7 References

Australian National Guidelines 2016, Post-exposure prophylaxis after non-occupational and occupational exposure to HIV, 2nd edn, available https://www.ashm.org.au/products/product/978-1-920773-47-2

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) 2017, National HIV testing policy, available http://testingportal.ashm.org.au/images/HIV_Testing_Policy_Feb_2017.pdf

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) 2015, National hepatitis B testing policy, available http://testingportal.ashm.org.au/images/HepB_TESTING_POLICY_REVIEW2015_v1.2.pdf

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) 2017, National hepatitis C testing policy, available http://testingportal.ashm.org.au/images/HCV/HCV_TESTING_POLICY_Mar_2017.pdf

Centres for Disease Control and Prevention 2018, Information for healthcare personnel potentially exposed to hepatitis C virus, available https://www.cdc.gov/hepatitis/pdfs/testing-followup-exposed-hc-personnel.pdf

Centres for Disease Control and Prevention 2013, CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management, available https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6210a1.htm

Kuhar, DT, Henderson, DK, Struble, KA, Heneine, W, Thomas, V, Cheever, LW, Gomaa, A, Panlilio, AL & US Public Health Service Working Group 2013, ‘Updated US public health service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis’, Infection Control and Hospital Epidemiology, vol. 34, no. 9 pp. 875-892, available https://www.jstor.org/stable/10.1086/672271

Centres for Disease Control and Prevention 2015, Occupational HIV transmission and prevention among health care workers, available https://www.cdc.gov/hiv/pdf/workplace/cdc-hiv-healthcareworkers.pdf

Healthcare Infection Control Management Resources (HICMR) 2015, Section 6:2P BBFEI management of occupational exposures, in HICMR (eds), Infection Prevention and Control Manual, Melbourne, VIC, pp. 7-18.

ATTACHMENT 1: Laboratory assessment and follow-up post OEBB





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https://www.cdc.gov/hiv/pdf/workplace/cdc-hiv-healthcareworkers.pdf

https://www.jstor.org/stable/10.1086/672271

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6210a1.htm

https://www.cdc.gov/hepatitis/pdfs/testing-followup-exposed-hc-personnel.pdf

https://www.cdc.gov/hepatitis/pdfs/testing-followup-exposed-hc-personnel.pdf

http://testingportal.ashm.org.au/images/HCV/HCV_TESTING_POLICY_Mar_2017.pdf

http://testingportal.ashm.org.au/images/HepB_TESTING_POLICY_REVIEW2015_v1.2.pdf

http://testingportal.ashm.org.au/images/HIV_Testing_Policy_Feb_2017.pdf

https://www.ashm.org.au/products/product/978-1-920773-47-2



For any high risk exposures, or if HIV PEP is indicated from the risk assessment, consult with an Infectious Diseases Consultant who can be contacted 24 hours a day 7 days a week through the Calvary switchboard (02) 6201 6111.

Source status HIV antibody Hepatitis B serologyd

Hepatitis C serology

FBE, LFT, EUC, CK

HIV/HBV/HCV positivea 6 weeks

3 months6 monthsb

HBAg at:6 weeks3 months6 monthsHBAb at:4 weeks post vaccination course

HCV Ag or RNA and anti-HCV at:6 weeks3 months6 months

3 weekse

Unknown status but high riska

Unknown sourcea

HIV/HBV/HCV negative-Low risk injury

No further follow up required

HIV/HBV/HCV negative-Moderate/High risk injuryc

3 months 3 months 3 months N/A

a) Persons who have been exposed to a HIV positive source person/high risk or unknown source, should be referred and managed through the Sexual Health Clinic at The Canberra Hospital. The Staff Health nurse is to liaise with the Sexual Health Clinic and the exposed staff member for the expected follow-up serology.

b) HIV testing at 6 months is only require if on HIV PEP.c) As source patients may not always provide accurate information about lifestyle practices, there may be a low but

possible chance that a source patient may have been in a window period when the exposure occurred. Therefore, testing for HIV should be repeated at 3 months for moderate to high risk exposures even if the source tests negative.

d) For at risk persons (i.e. no documented immune response to HBV vaccination) HBAg testing required and HBAb testing required post vaccination course.

e) Only for those individuals on HIV PEP. Only to be ordered by medical officer.

ATTACHMENT 2: ACT Health Occupational Risk Exposures Baseline Testing





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ATTACHMENT 3: Occupational Exposure Incident (OEI) Risk Assessment Guideline (also via IC&SH webpage)





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http://connect.calvarycare.org.au/Services/PublicHospitals/Bruce/Departments/Pages/Infection-Control-and-Staff-Health.aspx



Occupational Exposure Incident (OEI) Risk Assessment Guideline

The purpose of this guideline is to help estimate the level of risk of transmission of a BBV and determine if post exposure prophylaxis (PEP) is indicated. This is a guide only and each case should be assessed on a case basis, balancing potential harms and benefits of treatment.

After some exposure events, PEP treatment may be required until the infectious status of the source person is known. This is particularly the case in moderate to high risk exposures, when the exposed person is known not to be immune to Hepatitis B Virus (HBV) or where Human Immunodeficiency Virus (HIV) exposure is suspected.

In such cases, PEP is most successful if administered as close as possible to the exposure incident as possible.

Treatment for exposure to HBV and HIV should begin as soon as possible after the exposure preferably within 24 hrs.

HIV PEP treatments change as new information becomes available and HCW’s should ensure they consult with health professionals who can provide up-to-date information.

HBV PEP guidelines are available in the 2013 Australian Immunisation Handbook and summarised in this guideline.

There is no PEP available for Hepatitis C Virus (HCV) that will prevent infection, however treatment of acute HCV is now highly effective. Testing to ensure early identification is vital.

Reference documents:

Australian National Guidelines 2016 (2nd Edition) Post-Exposure Prophylaxis after Non-Occupational and Occupational Exposure to HIV; available https://www.ashm.org.au/products/product/978-1-920773-47-2

National HIV Testing Policy (2017) available http://testingportal.ashm.org.au/images/HIV_Testing_Policy_Feb_2017.pdf

National Hepatitis B Testing Policy (2015) available: http://testingportal.ashm.org.au/images/HepB_TESTING_POLICY_REVIEW2015_v1.2.pdf

National Hepatitis C Testing Policy (2017) available: http://testingportal.ashm.org.au/images/HCV/HCV_TESTING_POLICY_Mar_2017.pdf

Health Protection Surveillance Centre (2016) Emergency Management of Injuries and Post-exposure Prophylaxis (PEP) available: http://www.hpsc.ie/a-z/EMIToolkit/pep-and-pepse.html

Occupational Exposure Incident Packs Hard copy OEI packs in triage within the Emergency Department. Online via the IC&SH webpage

Management of Occupational Exposures to blood and body fluids procedure Hard copy with OEI packs in triage within the Emergency Department. Online via the CPHB Document Centre

Canberra Hospital and Health Services Clinical Procedure: Blood Borne Virus: Occupational Risk Exposure Management ID 4560, Approved 24/7/2018

ABBREVIATIONS





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http://connect.calvarycare.org.au/sites/documents/Pages/all-documents.aspx

http://connect.calvarycare.org.au/Services/PublicHospitals/Bruce/Departments/_layouts/15/WopiFrame.aspx?sourcedoc=/Services/PublicHospitals/Bruce/Departments/Infection%20Control%20and%20Staff%20Health/Occupational%20Exposure%20Pack.pdf&action=default

http://www.hpsc.ie/a-z/EMIToolkit/pep-and-pepse.html

http://testingportal.ashm.org.au/images/HCV/HCV_TESTING_POLICY_Mar_2017.pdf

http://testingportal.ashm.org.au/images/HepB_TESTING_POLICY_REVIEW2015_v1.2.pdf

http://testingportal.ashm.org.au/images/HIV_Testing_Policy_Feb_2017.pdf

https://www.ashm.org.au/products/product/978-1-920773-47-2



BBV Blood borne Virus

HBIG Hepatitis B Immunoglobulin

HBAb Hepatitis B Antibodies

HBsAg Hepatitis B Antigens

HBV Hepatitis B Virus

HCV Hepatitis C Virus

HCW Health Care Worker

HIV Human Immunodeficiency Virus

ID Infectious Disease

OEI Occupational Exposure Incident

PEP Post exposure Prophylaxis

RISKMAN2 Risk Management System

INTERPRETATION

Blood Borne Virus Includes HIV, HBV and HCV

Exposure Contact between blood and other body fluids with the exposed HCWs eyes, non-intact skin or mucous membranes.

Exposed HCW The HCW exposed to blood or any other body fluid.

Post Exposure Prophylaxis

Medication administered after an OEI that may reduce the risk of acquiring an infection.

Source The blood or other body fluids to which the HCW is exposed.

Source person The person whose blood or body fluids are involved in the exposure.

Risk assessment The overall process of estimating the magnitude of risk following an OEI in order to determine appropriate management





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