post-exposure events. Infectious disease
practices deal with these issues on a day-to-day basis, so there would be quality of care
and consistency of care.
This begs the question: Why use the middle man? If this is the case for your department, look at the cost you’re paying on the
contract and determine if this is the best
routine to follow.
Another factor is availability of the service. When assessing the use of an occupational medicine group for post-exposure
issues, asking key questions before selection
and signing on the dotted line is very important. Is the occupational medicine practice
available for coverage for exposure events 24
hours a day, seven days a week? If constant
coverage isn’t available and you’re required
to use an emergency department (ED) during “off” hours, then the cost of care for your
employees increases, and the proper care and
counseling may not be delivered.
AGENCY AUDIT
If you’re currently using an occupational
medicine practice, then you might consider conducting an audit. This will assist
in protection for your department if an
OSHA inspection was to occur, and will
identify any areas in need of improvement.
The goal is to protect care providers and
ensure the department is meeting its needs
for compliance.
VACCINES/IMMUNIZATIONS
On Nov. 25, 2011, the Centers for Disease
Control & Prevention (CDC) published
new guidelines for vaccination and immunization of healthcare personnel. In this
document, the CDC states that these records
are to be secure and computerized for easy
access. This is to facilitate prompt/proper
post-exposure medical treatment.
In today’s world, old diseases are back
and many individuals are in need of revaccination or vaccination. For example, if
you received measles, mumps, rubella vaccine (MMR) between the years of 1963 and
1967, you need to be re-vaccinated with the
live measles vaccine.
Did your occupational medicine group
notify you about this? Was your department notified in 2006 that all healthcare
workers were to get boosters for protection
from pertussis (whooping cough)? These
types of alerts should be included in their
role and service. All new hire personnel
should be asked to bring copies of their
vaccine/immunization records as part of
the hiring process. This will assist in the
identification of personnel who are in need
of vaccines because they haven’t had the
diseases or are in need of a booster.
In 2006, the CDC published that all
healthcare personnel needed a booster for
protection from pertussis. This was not
well responded to and was published again
Your agency may not be getting the most it can from its occupational medicine program.
in 2011. Occupational medicine groups
should be tracking this type of information and sharing it with their clients.
Previous vaccine/immunization records
can be obtained by an individual from
their high school, college or past employers. Each individual must request their
records, and should be able to obtain them,
because those records legally belong to
each individual.
Current members of your department
also need to put forth their records for
review of their protective status and childhood disease history. This is all part of
health maintenance and prevention from
exposure to these diseases. Some of these
vaccinations don’t work if given post exposure. This would apply to MMR, for example. Obtaining this information is in your
best interest for your protection and also
works for the department’s benefit because
prevention up front is far less costly than
exposure follow-up.
Clearly, the need for expanding protection beyond hepatitis B vaccine and TB
testing has long passed. Your occupational
health practice should be tracking and
maintaining records on all administered
vaccine and immunizations.
SA TORI13, CAPIFRU T TA/IS TOCKPHO TO.COM
The CDC stated in May 2008 that these
records need to be “readily available at the
work location.” If they aren’t available to
the Designated Infection Control Officer
