Download GUIDELINEFOREMPLOYEE EXPOSURE

GUIDELINE FOR REPORTING an EMPLOYEE EXPOSURE
To Transmissible Diseases
PURPOSE:
To ensure all staff and/or patients thought to have been exposed to a transmissible disease,
whether by a patient or employee, is assessed for the risk of the exposure by the Infection Prevention and Control
Staff and the Employee Health Nurses and applicable prophylaxis or treatment is initiated.
DEFINITIONS:
 Transmissible Disease: Also referred to as Communicable or Infectious are diseases due to a specific
infectious agent or its toxic products that arises through transmission of that agent or its products from an
infected person, animal, or reservoir to a susceptible host, either directly or indirectly through an
intermediate host, vector, or the inanimate environment.
 Communicable disease pathogens include bacteria, viruses, fungi, parasites and prions. Transmissible
diseases are sometimes called "contagious". (e.g., influenza, chicken pox, measles, TB).
RESPONIBILITIES:
Infection Prevention and Control (ICPO):
[Patient to Employee]
 In the event of an employee exposure to a patient diagnosed with a transmissible disease, the ICPO staff
will review the patient chart to identify all persons that provided care, including physicians, residents,
respiratory therapy, medical imaging, housekeeping, rehab service staff, nutritional services, students,
and affiliates during the identified contagious period of the disease.
 The manager(s) of the identified services will be contacted and instructed to provide a listing of all direct
and indirect staff that had or may have had contact with the “infected” patient during the identified
transmissible or contagious period of the disease.
 ICPO will notify the Employee Health Manager or Coordinator of the exposure; including the disease of
concern, the dates of identified concern, the name and MR# of the patient, and the cost centers involved
with the care of this patient.
[Employee to Employee]


In the event the ICPO is made aware of an employee illness through notification by the Department of
Health, or through review of laboratory culture results, the ICPO nurse will contact the Manager or
Coordinator of the Employee Health Office.
ICPO will contact the Manager of the “ill” employee to determine which patients he/she may have
exposed, notifying the responsible physician of care with instructions for any required follow-up or
prophylaxis.
Managers:



Managers will compile listings of the employees that provided care to the identified employee or patient.
The list is to be fax’d to the Employee Health Office [448-5742] by as soon as possible, but no later than
the end of the shift in which they were notified by the ICPO staff (patient related) or Employee Health
(employee related)
Managers will be contacted by Employee Health regarding any follow-up testing or interventions that will
be required for all persons listed as exposed.
Managers will ensure all concerned staff has been in contact with Employee Health as directed.
Employee Health Office (EHO):
[Patient to Employee]



Once the EHO receives the lists of exposed persons, designated nurses start an assessment of the risk of
the exposure by review of employee medical records.
Depending on the nature of the exposure, a plan of action is established and executed, including phone
calls and or notices to exposed staff and the managers with instructions for their immediate need of
testing, treatment or prophylaxis. Dates of exposures will determine the risk of exposure.
EHO will maintain communication with the Managers and ICPO staff if/when staff fails to report to the
EHO as instructed.
[Employee to Employee]



When the EHO becomes aware of an employee that has exposed his/her co-workers to a
transmissible disease while at work, The Manager or Coordinator of the EHO will notify ICPO.
EHO will notify the Manager of the “ill” employee instructing him/her to compile a listing of all
persons the “ill” employee was in contact with, according to dates of infectivity.
Under the direction of the Epidemiologist and/or Department of Health, a plan of action is
established and executed, including phone calls and or notices to exposed staff and the managers with
instructions for their immediate need of testing, treatment or prophylaxis.
Offer Tamiflu within 48-hours of exposure, or furloughed from work until 7th
day post-exposure
Meningitis, bacterial Prophylaxis must be administered with the first 48-hours of reported exposure
Check immunity status; if non-immune furlough from 10th – 21st day postMMRV
exposure
Prophylaxis within 72 hours; if employee declines, furlough from 7th – 10th day
Pertussis
post-exposure
Baseline TBST immediately, repeat TBST no sooner than 12-weeks postTuberculosis
exposure
MRSA
Positive Culture Results
Negative Culture
Results
1. Employee is notified by EHO
Notification letter
sent to employee.
No further
intervention.
2. Mupivocin ointment in both nares bid for 5 days, is prescribed.
3. Hibiclens shower daily for three days
4. Out of work for first 24 hours of treatment.
5. Reculture 14 days after therapy completed.
Influenza
. REPORTING:
EHO and ICPO are both responsible for reporting relevant data to the Department of Health and a
summary report will be presented at the Infection Control Meeting
Guidelines for Employee Exposure_9/25/2013
RECOMMENDATIONS AND WORK RESTRICTIONS
FOR PERSONNEL WITH INFECTIOUS DISEASES
Illness/Infection
Relief from Direct
Work Restrictions
Duration
Pt. Contact
Conjunctivitis
Yes
Until discharge ceases and on
antibiotic for 24 hours
Cytomegalovirus
No
Diarrhea, Acute state/self
Yes
Until symptoms resolve
limiting
Diagnosed
Yes
Evaluated case by
-Salmonellosis*
case
*See Policy re: Treatment Guideline
-Shigellosis*
-Campylobacteriosis*
of Infectious Diseases
-Gairdiasis*
-Hepatitis A
-Cholera
-Yersinia
Group A Strep Disease
Yes
Until completed 24-hours antibiotics
Hepatitis, Viral
Hepatitis A
Hepatitis B Acute
Yes
For 7 days after onset of jaundice or
clear by physician
For7 days after onset of jaundice or
clear by physician
Based on case by case evaluation/
physician evaluation
For 7 days after onset of jaundice or
clear by physician
Yes
Carrier - Hepatitis B
Possible
Hepatitis C
Yes
Herpes Simplex
Genital
Hands (Herpetic
Whitlow)
-Orofacial
Measles - Active
No
Yes
Possible
Yes
Post-Exposure
Yes
(susceptible personnel)
HIV
Possible
Mumps – Active
Yes
Mumps; Post-Exposure
Yes
Pertussis - Active
Post-Exposure
Yes
No
(asymptomatic
personnel)
Post-Exposure
Yes
(Note: it is not
known whether
gloves prevent
transmission)
Until lesions heal;
If early state or draining, evaluate
individual case.
For 7 days after the rash appears;
From the 5th through 21st day after
exposure and or 7 days after the
appearance of rash
Based on case by case evaluation/
physician evaluation
For 9 days after onset of parotitis;
From the 12th through 26th day after
exposure or until 9 days after onset of
parotitis
From the beginning of the catarrhal
stage through the 3rd week after onset
of paroxysms or until 7 days after start
of effective therapy
Until pertussis differentiated
(symptomatic
personnel)
Rubella - Active
Post-Exposure
Yes
Yes
For 5 days after the rash appears;
From the 7th through the 21st day
after exposure and/or 5 days after rash
appears
Scabies
Staphylococcus Aureus
(skin lesions)
Zoster (Shingles) Active
Zoster (Shingles)
-Post-Exposure
Employees NonImmune to Varicella
Varicella (Chicken Pox)
Active
Post-Exposure NonImmune to Varicella
Tuberculosis
*See T.B. policy for
exposure
surveillance
Immuno-suppressed
Employee
Yes
Until treated
Yes
Until lesions have resolved
Possible
Until lesions dry and crust/or based on
case by case evaluation/ability to
cover draining areas
From the 10th to the 21st day after
exposure or if Varicella occurs until all
lesions dry and crust
Yes
Yes
Until all lesions dry and crust;
Yes
From the 10th through 21st day after
exposure or if Varicella occurs until all
lesions dry and crust
Base on case by case
evaluation/physician evaluation
Possible
Employees immune-suppressed as a result
of disease or therapy should evaluate, with
their personal physicians, their own risks
of working in a hospital environment.
Employee should provide a letter from
his/her physician indicating abilities to
work and outlining any patient care areas
where they should not work.
Employee Health Office
Report of Communicable/Infectious Disease Exposure
Date of Exposure:___________________________
Date seen by Health Office:______________________
Nature of Exposure: _________________________________________________________________________
Patient Name/Medical Record No.: ___________________________________________________________
Employee:_______________________________________________________ ID#:____________________
Department: ______________________________________________________________________________
The Employee Health Office has been notified of an employee exposure to the above noted
communicable/infectious disease by the Infection Control staff nurse and/or Infectious Disease Physician.
Following the Employee Health post-exposure policy for this disease, the following treatment(s) and
recommendation(s) has been initiated:
Rx:
Allergies:_________________________________________________________________
Current Medications:_________________________________________________________
________________________________________________________________________
Pregnant or Breast Feeding?___________
Notes:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_________________________________________
Signature of Employee Health Nurse/Practitioner
____________________
Date