Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety AV0900 - PREVENTION AND MANAGEMENT OF OCCUPATIONAL EXPOSURE TO COMMUNICABLE DISEASES 1.0 PURPOSE To provide a safe and healthy work environment as far as practicable through implementation of communicable disease prevention, education, surveillance, monitoring, and post exposure management for all Interior Health employees. 2.0 DEFINITIONS Education Includes informing employees of their obligations under this policy and educating them about risks, preventive measures and appropriate procedures following work-related exposure. Employee Includes individuals employed with Interior Health while engaged in an IH work activity Exposure Exposures may occur when an employee is in direct or indirect contact with a patient/resident/client or co-worker who has a, unknown, suspected or known infection with a communicable disease. Contact refers to needle-stick injuries, splashes, airborne droplets, contact with nasal or throat secretions or close contact during examinations/treatment. Personal Protective Equipment (PPE) PPE is equipment worn by a worker to minimize exposure to specific occupational hazards. Examples of PPE include masks, gloves, gowns, as well as, eye and foot protection. Proof of Immunity Day/month/year of a vaccination or a laboratory serological result or, in the case of Varicella, a statutory declaration of history of disease. Screening Includes verbal and documented health history taking, examination of documented evidence and/or laboratory serological tests to determine current or previous infection and/or vaccination status regarding a communicable disease. Vaccination The safe and appropriate administration of vaccines by licensed professionals. Workplace Health and Safety (WHS) A health authority department which provides preventative services to employees of Interior Health. This includes Immunity Screening and immunization recommendations for employees based on their risk of exposure to communicable diseases. Provides immunization clinics and Tuberculosis (TB) screening in many Interior Health sites, and referral to other services when needed. Provides education to employees and employers on policy and preventative measures. Policy Sponsor: VP, Human Resources and Organizational Development 1 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety Workplace Health Call Centre (WHCC) 3.0 A Provincial Call Centre that offers occupational health services to assist employees and employers in the management of exposures, including blood or body fluid and communicable disease, collection of health history information, reporting of potential and actual exposures, and preventative immunity screening and recommendations. Phone 1.866.922.9464 and follow the teleprompts. POLICY 1. Interior Health is committed to providing a safe and healthy work environment for all employees of the health authority. This commitment includes a protocol for screening, surveillance, education, vaccination and outbreak management that will minimize the risk to patients/residents/clients and employees from communicable diseases. Screening, education and vaccination are incorporated into the recruitment and orientation process for new employees. 2. In the event of an exposure/outbreak of a vaccine-preventable communicable disease, employees may be excluded from work for the period of communicability. An employee may be excluded with pay if there are medically documented contraindications to receiving the vaccine (i.e. pregnancy is a contraindication for a live vaccine) and/or known severe reaction to the vaccine or any of its components. See Appendix B for disease specific exclusions for ill employees. 3. The BC Centre of Disease Control (BCCDC) recommends vaccination of non-immune employees in order to protect themselves as well as susceptible patients, residents, clients and co-workers. In the event of an exposure/outbreak of a vaccine-preventable communicable disease, employees may be excluded from work for the period of communicability. 4. All employees must report their immunization and communicable disease history to Workplace Health. New employees must report by calling the WHCC (1.866.922.9464) within two weeks of hire. 5. Employees who have worked for the health authority for at least 3 months should report their vaccinations except influenza (on-line self-report) to Occupational Health Nurse call line 1866-899-7999. 6. In accordance with IH Policy AU1100 Student Placement and Volunteer VD0700 – Communicable Disease Outbreak, Interior Health will ensure that all agreements with contracted employers and academic institutions will contain the provision that their workers and students will have documented evidence of screening and vaccination histories consistent with the provisions of this document. 7. All employees are to receive orientation to communicable disease policy and procedures through reviewing this policy, site specific education, and by reviewing the disease specific information found in Appendix B of this policy. 8. Roles and Responsibilities of Interior Health employees in the management of Communicable Disease are described in Appendix A. 4.0 PROCEDURES 1. Post Exposure Follow-up Procedure a) Infection Control Practitioner will notify the Workplace Health Call Center, Communicable Disease Unit and Public Health of the potential exposure to a communicable disease. Policy Sponsor: VP, Human Resources and Organizational Development 2 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety b) Communicable Disease Unit may call a case conference to review the exposure with Public health, Infection control, Medical Health Officer (MHO) and others as appropriate. c) The Workplace Health Call Center will telephone and send an email to the managers using their Interior Health email address to review the exposure criteria. d) Managers or their designate will make a list and contact all employees who potentially meet the exposure criteria for a communicable disease exposure. The manager will ensure employees are notified as soon as reasonably possible and advised to call the WHCC at 1-866-922-9464. e) Employees call the Workplace Health Call Center as soon practicable within normal business hours at 1-866-922-9464 to review their contact with the case and receive recommendations for post exposure follow up or treatment. f) For Tuberculosis (TB) exposures the WHS Occupational Health Nurse will organize follow-up testing for all exposed employees. See Appendix C for Post Exposure TB Procedures. g) The WHS Occupational Health Nurse will follow-up as guided by the MHO for extraordinary exposures. h) Managers will complete an investigation as per WorkSafeBC Regulation. 2. Exceptions: 1. Gastrointestinal(GI) Outbreak: Refer to IH GI Outbreak Guidelines for Health Care Facilities a) Infection Control Practitioner will contact the Workplace Health Call Center (WHCC) when there is a GI exposure. b) WHCC will send the unit manager a poster to put up in their work area advising employees to WHCC if they develop a GI illness related to the exposure. c) Employees will call the WHCC and Early Absence Reporting Line (EARL) to report their illness and must remain off work until 48 hours after the symptoms resolve. 2. Respiratory Outbreak: a) Refer to Prevention and Control of Respiratory Outbreaks in Residential Care Settings (Oct 2014). 5.0 REFERENCES BCCDC Communicable Disease Manual - Communicable Disease Control Chapter (dates vary per disease).http://www.bccdc.ca/dis-cond/comm-manual/CDManualChap1.htm Interior Health Infection Prevention & Control Manual (September 2013). http://inet.interiorhealth.ca/QPS/IPC/Pages/default.aspx Controlling Exposure: Protecting Workers from Infectious Disease http://www.worksafebc.com/publications/health_and_safety/by_topic/assets/pdf/bk129.pdf Retrieved Jan 19, 2015 BC Public Health Act Part 3- Preventing Disease and Other Health Hazards http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_08028_01#part3/ Retrieved Oct 24, 2014 Policy Sponsor: VP, Human Resources and Organizational Development 3 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety Interior Health Authority (October 2014) Respiratory Infection (RI) Outbreak Guidelines http://insidenet.interiorhealth.ca/QPS/IPC/Documents/Respiratory%20Infection%20(RI)%20Outbr eak%20Guidelines.pdf Retrieved Nov 6, 2014 WorkSafeBC Occupational Health and Safety Regulation Retrieved Jan 27, 2015 http://www2.worksafebc.com/publications/OHSRegulation/Part3.asp#SectionNumber:3.4 Retrieved Jan 21, 2015 Policy Sponsor: VP, Human Resources and Organizational Development 4 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety APPENDIX A – Roles and Responsibilities in the Management of Communicable Diseases Senior Executive Team are responsible for: ensuring that employees are advised of the required standards of conduct and understand the consequences of non-compliance; ensuring that all possible breaches of the Policy directive are thoroughly investigated; based on the results of an investigation, ensuring that appropriate action is taken; ensuring that confidential information is handled with caution and discretion; and delegating authority and responsibility, where applicable, to apply this Policy within IH. Supervisors and managers are responsible for: applying this Policy within their area(s) of responsibility; notifying all employees by phone or via their Interior Health email that have had unprotected contact with a patient who has a communicable disease; advising exposed employee to call the WHCC to report their exposure incident; ensuring that all employees adhere to the control of communicable disease requirements as outlined in the policy; ensuring that employees are provided with the information, instruction, training, supervision and PPE necessary to enable them to comply with Interior Health’s policies and procedures for preventing the spread of communicable diseases; participating as required in facility risk assessment(s) for occupational exposure to communicable diseases; and ensuring that confidential information is handled with caution and discretion. Medical Health Officer or Physician Designate for Infectious Disease is responsible for: reviewing and confirming the communicable disease exposure; and providing consulting and supportive services in the management of the communicable disease exposure. Infection Control is responsible for: being familiar with this policy and procedures; informing employees of infection prevention and control policy/procedure and the use of appropriate PPE through employee orientation and education; collaborating with WHCC regarding confirmation of diagnosis, lab results and possible work restrictions or reassignments for exposed/infected employees; working with manager to identify internal and external contacts (i.e. BC Ambulance); and completing the Communicable Disease Notification Tool and forward to the WHCC and the Communicable Disease Unit (CDU). Policy Sponsor: VP, Human Resources and Organizational Development 5 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety Communicable Disease Unit is responsible for: being familiar with this policy and procedures; collaborating with the WHCC and WHS on confirmation of diagnosis, laboratory results, treatment/prophylaxis recommendations, and possible work restrictions for exposure/outbreaks and outbreak status of communicable disease as required. Workplace Health Call Centre (WHCC) is responsible for: receiving employee immunity status information through WHCC and document in WHITE database; providing new employee assessment of immune status, recommendations for immunization and screening based on BCCDC guidelines for Healthcare Worker Immunization; providing counselling and referral to employees in regard to occupational exposures; and collaborating with the CDU and MHOs. Workplace Health and Safety (WHS) are responsible for: being familiar with this policy and procedures; coordinating the facility risk assessments for occupational exposure to communicable diseases; ensuring that employees are given adequate information, education, and where appropriate, pre and post-test counseling to make informed decisions in regard to screening and vaccinations; providing accessible immunization and TB screening in accordance with BCCDC and Interior Health policy and guidelines; documenting and maintaining the confidentiality of all communicable disease screening and serological testing of employees; maintaining the WHITE data base and providing reports of non confidential information to managers as required; consulting with employees and managers as requested; collaborating with the WHCC, CDU, Public Health and Infection Control under the direction of the MHO; and providing immunization records to employees when requested. Employees are responsible for: being familiar with this policy and procedures; contacting the WHCC to report their immunization and communicable disease history within two weeks of hire; being aware of their own communicable disease and vaccination status to minimize the risk of transmitting infectious diseases to patients/residents/clients and co-workers; and reporting immunization history when new vaccinations are received. Policy Sponsor: VP, Human Resources and Organizational Development 6 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety Appendix B: Disease specific information Conjunctivitis (pink eye) Gastrointestinal Illness - Norovirus Influenza Measles (Rubeola) Methicillin-Resistant Staphylococcus Aureus (MRSA) Mononucleosis (mono) Mumps Pertussis Rubella (German measles) Scabies Shingles (Herpes Zoster) Tuberculosis Varicella Policy Sponsor: VP, Human Resources and Organizational Development 7 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R) This is an Interior Health CONTROLLED document. A copy of this document in paper form is not controlled and should be checked against the electronic file version to ensure accuracy Administrative Code: AV Workplace Health and Safety Appendix C: Post Exposure TB Screening Employees who have been exposed to someone with infectious TB are advised to call the Workplace Health Call Center 1-866-922-9464 to determine if they meet the screening criteria and get a referral for TB skin testing. TB skin tests are given to determine if an employee has been infected with TB germs. It takes between 2 and 8 weeks after the exposure before the TB skin test reacts as positive (5 mm induration after a contact). It is important to know if the TB skin test is from the current exposure as medication used to give preventative treatment will depend if the drug is effective against the strain. Whenever possible a baseline TB skin test should be done to determine if there is a conversion from negative to positive skin test with the exposure. A baseline can be considered established if given within a year of the current exposure Employees who have been exposed to someone with infectious TB are advised to call the Workplace Health Call Center 1-866-922-9464 to determine if they meet the screening criteria and get a referral for TB skin testing. For employees who have no history of a TB skin test, have a negative TB skin test, or have a nonreactive IGRA (TB blood test): A baseline TB skin test is recommended as soon as possible after exposure if the employee has not had a baseline skin test within the past year. A repeat skin test should be given 8-12 weeks after the last date of exposure. For employees who have had previous TB disease, have a positive TB skin test, or a positive IGRA (TB blood test): Occupational Health Nurse will review history and symptoms and send employee for a TB chest x-ray 4 months post exposure or sooner if symptoms develop. Employees who require ongoing post exposure follow-up such as repeat chest x-rays or medication will be referred to their family doctor and the local Public Health nurse for follow up. Policy Sponsor: VP, Human Resources and Organizational Development 8 of 8 Policy Steward: Manager Health & Wellness Date Approved: April 2003 Date(s) Reviewed-r/Revised-R: August 2004 (R) December 2009 (R) February 2015 (R)