blood and body fluid exposures

OH and SSS 2005OH and SSS 2005

Blood and body fluid Blood and body fluid exposuresexposures

Order Tests on “Source” patient via Wiz Order Tests on “Source” patient via Wiz so results are available in StarPanel so results are available in StarPanel when exposed employee receives when exposed employee receives

treatmenttreatment


When a healthcare When a healthcare worker is exposed to a worker is exposed to a

patient’s blood or patient’s blood or infectious body fluids, the infectious body fluids, the

stakes are high.stakes are high.


Risk of Infection After Needlestick Risk of Infection After Needlestick From an Infected PatientFrom an Infected Patient

Hepatitis B - Hepatitis B - 1 in 3 needlesticks1 in 3 needlesticksHepatitis C –Hepatitis C –1 in 100 needlesticks1 in 100 needlesticksHIV -HIV -1 in 333 needlesticks & 1 in 1000 1 in 333 needlesticks & 1 in 1000

splashessplashesRisk is Higher if:Risk is Higher if:

the wound is deep the wound is deep the needle was hollow-bore the needle was hollow-bore the patient has a high viral loadthe patient has a high viral load

CDC - MMWR 1998CDC - MMWR 1998


Time is of the essence

Antiviral therapy givenwithin the first 2 hours reduces the risk by 80%.


Order Tests from Wiz on “Source Order Tests from Wiz on “Source Patient”. Patient”.

Tests conducted on Source of Exposure Tests conducted on Source of Exposure Rapid HIVRapid HIVHepatitis PanelHepatitis Panel

Who Should Order Tests On Source?Who Should Order Tests On Source?Any MD/NP on Unit Any MD/NP on Unit the exposure occurredthe exposure occurredCharge Nurse may enter the orders, Charge Nurse may enter the orders,

conferring with any provider to include as conferring with any provider to include as ordering physician ordering physician


Timely ResultsTimely Results on “Source Patient’s” on “Source Patient’s” Labs Make a Difference Labs Make a Difference

OHC and the ED can more accurately determine OHC and the ED can more accurately determine treatment needed for exposed employee treatment needed for exposed employee if they if they have lab results on the “source” within 2 hours.have lab results on the “source” within 2 hours.

““Source” Lab results can be viewed in StarPanel Source” Lab results can be viewed in StarPanel by OHC or ED and will direct treatment of the by OHC or ED and will direct treatment of the employee.employee.

If Wiz is down or location doesn’t use Wiz, order If Wiz is down or location doesn’t use Wiz, order Hepatic Panel and Rapid HIV manuallyHepatic Panel and Rapid HIV manually. .


Insert screenshot of Insert screenshot of WizWiz

Step 1: Type “source” (or

“needlestick” or “exposure”)

Step 2: Select “evaluate

source patient”


The necessary lab tests are

bundled together


Accept all orders in the set. The patient

will not be billed.


****Important********Important****

Make sure the exposed employee Make sure the exposed employee goes to Occupational Health or the goes to Occupational Health or the

ED,ED,

regardless of the HIV results.regardless of the HIV results.


When should I go…ED or OH?When should I go…ED or OH?

Go to Occupational Health during office Go to Occupational Health during office hourshours

7:30am – 5:30pm, Monday – Friday7:30am – 5:30pm, Monday – Friday

When Occupational Health is closed, go to When Occupational Health is closed, go to Emergency Department and identify Emergency Department and identify yourself as an employee who has had an yourself as an employee who has had an exposureexposure


Take Home Points…. Take Home Points…. If Employee is Exposed, If Employee is Exposed, Test “Source” ImmediatelyTest “Source” Immediately so so

Source Labs are available in StarPanel to help guide OH or Source Labs are available in StarPanel to help guide OH or ED staff in treating exposed employee.ED staff in treating exposed employee.

Order “Source” patient labs in Wiz from this order set: Order “Source” patient labs in Wiz from this order set: “Evaluate source patient whose blood/body fluids caused “Evaluate source patient whose blood/body fluids caused exposure.“exposure.“ Orders can be entered by any MD or Charge Orders can be entered by any MD or Charge Nurse conferring with an MD. Nurse conferring with an MD.

Send exposed employees to Occupational Health, or to the Send exposed employees to Occupational Health, or to the ED after hours, for evaluation. ED after hours, for evaluation. DO NOT TREAT EXPOSED DO NOT TREAT EXPOSED EMPLOYEES YOURSELF!!EMPLOYEES YOURSELF!!

Always notify supervisor and complete “TN First Report of Always notify supervisor and complete “TN First Report of Work Injury”Work Injury”

blood and body fluid exposures

Documents

source labs

order source patient

type source

test source

source lab results

source patients labs

exposed employees

occupational health