HEPATITIS B VACCINATION, POST EXPOSURE EVALUATION & FOLLOW UP

Everyone in our facility recognizes that even with good adherence to all of our exposure prevention practices, exposure incidents can occur.  As a result, we have implemented a Hepatitis B Vaccination Program, as well as set-up procedures for post-exposure evaluation and follow-up should exposure to bloodborne pathogens occur.

VACCINATION PROGRAM

To protect our employees as much as possible from the possibility of Hepatitis B infection, our facility has implemented a vaccination program.  This program is available at no cost, to all employees who have occupational exposure to bloodborne pathogens.

The vaccination program consists of three (3) inoculations over a six (6) month period.   As part of their bloodborne pathogens training, our employees have received information regarding Hepatitis vaccination, including its safety and effectiveness.

The University nurse is responsible for operating our vaccination program.

Vaccinations are performed under the supervision of a licensed physician or other health care professional.

To ensure that all employees are aware of our vaccination program, it is thoroughly discussed in our bloodborne pathogens training.

All exposed employees who want the vaccinations should complete the Consent to Vaccinate Form.  In addition, training should be completed before vaccinations are received.  Report to Health Services with signed (by Environmental Health and Safety Officer) form for vaccinations.

POST EXPOSURE EVALUATION AND FOLLOW-UP

If one of our employees is involved in an incident where exposure to bloodborne pathogens may have occurred, there are two (2) things that we immediately focus our efforts on:

• Making sure that our employees receive medical consultation and treatment (if required) as expeditiously as possible.
• Investigating the circumstances surrounding the exposure incident.

Immediate Treatment:

• Affected employee should wash area thoroughly with soap and water.   (for eye splashes, flush copiously with water)

Reporting and Treatment Procedure:  See Accident Reporting in the Safety Manual for more information.

The Safety Committee investigates every exposure incident that occurs in our facility.  This investigation involves gathering the following information:

• When the incident occurred
  • Date and time
• Where the incident occurred
  • Location within the facility
• What potentially infectious materials were involved in the incident
  • Type of fluid (blood, etc.)
• Source of the material
• HBV and HIV status of the source, if known
• Under what circumstances the incident occurred
  • Type of work being performed
• How the incident was caused
  • Accident
  • Unusual circumstances (equipment malfunction, etc.)
  • Engineering and work practice controls in use at the time
  • Description of the device being used
• Personal protective equipment being used at the time of the incident (i.e., gloves, eye protection)
• Actions as a result of the incident
  • Employee decontamination
  • Cleanup
  • Notifications made
  • Employee training evaluated
  • Necessary revisions to the Exposure Control Plan

After this information is gathered, it is evaluated, a then a written report of the incident and its causes is prepared.  Recommendations are made for avoiding similar incidents in the future. 

OSHA Recordkeeping - An exposure incident is evaluated to determine if the case meets OSHA's Recordkeeping requirements.  This determination and the recording activities are done by the Environmental Health and Safety Officer. 

In order to make sure that our employees receive the best and most timely treatment if an exposure to bloodborne pathogens should occur, our facility has set up a comprehensive post-exposure evaluation and follow-up process.  This process is overseen by the following people:

1. Director of Human Resources
2. Environmental Health and Safety Officer

We recognize that much of the information involved in this process must remain confidential, and we will do everything possible to protect the privacy of the people involved.

Employees are transported to a nearby medical facility for post-exposure evaluation and follow-up.

As the first step in this process, the consulting health care professional will provide an exposed employee with the following confidential information:

Identification of the source individual, if applicable. (unless infeasible or prohibited by law)

Next, if possible, the source individual's blood is tested to determine HBV or HIV infectivity.  This information will also be made available to the exposed employee, if it is obtained.  At that time, the employee will be made aware of any applicable laws and regulations concerning the disclosure of the identity and infectious status of the source individual.

Finally, the blood of the exposed employee is collected and tested for HBV and HIV status within seventy-two (72) hours of the incident (an employee may decline this step).

Once these procedures have been completed, the healthcare professional will discuss the exposed employee's medical status with him/her.  This includes an evaluation of any reported illnesses, as well as any recommended treatment.

INFORMATION PROVIDED TO THE HEALTHCARE PROFESSIONAL

To assist the healthcare professional we will forward any documents that are requested, including the following:

• A copy of the Bloodborne Pathogens Standard
• A description of the exposure incident
• Other pertinent information

HEALTHCARE PROFESSIONALS WRITTEN OPINION

After the consultation, the Physician provides our facility with a written opinion evaluating the exposed employee's situation.  In keeping with this process, emphasis on confidentiality, the written opinion will contain only the following information:

• Whether Hepatitis B vaccination is indicated for the employee.
• Whether the employee has received the Hepatitis B vaccination.
• Confirmation that the employee has been informed of the results of the evaluation.
• Confirmation that the employee has been told about any medical condition resulting from the exposure incident which require further evaluation or treatment.

All other findings or diagnosis will remain confidential and will not be included in the written report.

MEDICAL RECORDKEEPING

The Consulting Health Care Professional, the Director of Human Resources, along with the University Nurse (for Hepatitis B immunication records) are responsible for maintaining medical records on our employees.  This information will include the following:

• Name of the employee
• Social security number of the employee
• A copy of the employee's Hepatitis B Vaccination status
  • Dates of any vaccination
  • Medical records relative to the employee's ability to receive vaccination
• Copies of the results of the examinations, medical testing and follow-up procedures which took place as a result of an employee's exposure to a bloodborne pathogen.

As with all information in these areas, we recognize that it is important to keep the information in these medical records confidential.  We will not disclose or report this information to anyone without our employee's written consent (except as required by law).