Re: Occupational Exposures

[Lindy Ryan]

Dear Leanne,

here in office hours our staff health unit staff are responsible for
occupational exposure management …they are contacted by a pager system
by staff who sustain an injury and establishment of Occ exposure risk
from the outset is treated as a priorty here (they use a BBV risk
asessement chart that is similar to most others around)

after hours the occ exposures are followed up by the afterhours
managers (AHMs) . They have training provided by our sexual health team
& staff health team on management aspects.

They have a pack that is made available & kept in the AHM office to
use for each injury with all the paper work and flow chart for
management for the HCW and source, information pamphlets, needle stick
hotline no etc etc these packs also have the epinet occ exposure data
form which we all use in NSW as part of state reporting of figures etc .
The Staff health nurse checks with the AHM office each day at the
beginning of shift for new injuries report AHs ( we do not have a
medical officer attached to our staff health unit )

As we know the AHMs are very busy their priorty is to undertake the
risk assessment and support in the first instance when they are
contacted /paged by the staff member. If it is a low risk injury paper
work may be commenced and discussions with the HCW & AHM is done
according to need & they are generally followed up by staff health the
next day re consent and further counseling and source and follow up (as
we know they baselines being collected and time is required for source
and privacy for staff member which ofton out AHM don’t have..this is all
done in agreement with the affected HCW

If identifed as high risk or the HCW is not satisfied with AHM process
/ information etc etc etc (as sometimes with very anxious groups they
want more information and something sorted then and there despite the
AHM input) then the AHM contact the Infectious disease physician on
call for advice and follow up re more information PEP, source and
recipient testing etc.

we try at all times not to utisilise our ED as it is often full, very
busy and they usually are running and have no time to priotise our staff
according to their triage category definitions which places BBV exposure
as a 4 or 5 (bit sad i know ) every time……….. (i know if they
could at times they would but its not always possible..as they are
lovely people its just the way it is for some shifts for ED…like most
of you I would envison). So we have kept them out to provide some hope
for consitency of management

Also there is no real ability to provide privacy for our staff if they
are sent to the ED and this can be upsetting for staff and we find they
are less likley to report if they
1. have to wait to go though ED (many cannot be away for that long
..especially our clinicans afterhours as they are few)
2.feel that everybody in the ED department will now know their business

Can I say Its not always a perfect system but it has been a workable
one here for the past 10 years & we are always looking at ways to
improve and strenghten it and keep our staff in the lop and a priority
for managment with Occ exposures.

hope this information is helpful insight & I look forward to hearing
what others out there are doing

regards

Lindy

Lindy Ryan
Infection Control Clinical Nurse Consultant (CNC)

Nepean Hospital,
Western Cluster
Sydney West Area Health Service

email: ryanl@wahs.nsw.gov.au

“Infection Control is Everybody’s Business”

>>> Leanne.Redl@MH.ORG.AU 19/02/2010 8:34 am >>>
*Looking to review out of hours occupational exposure management.
Which department and occupational group manage occupational exposures in
(a) office hours and (b) out of office hours. For out of hours
management whose responsibility is it to
*risk assess incident
*counsel and consent recipient and source (+ BBV risk assessment
of source)
*follow up recipient and source

Leanne Redl
Clinical Nurse Consultant
Infection Prevention Surveillance Service
Tuesday/ Wedesday/ Friday
Ext 28325
Clinical Nurse Specialist
Intensive Care Unit
Monday/ Wednesday/ Friday
Ext 27209
Royal Melbourne Hospital

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